Neuropathy, toxic

Chronic Poisoning

Chronic

Toxic polyneuropathy; Peripheral neuropathy

Most symmetrical, sensorimotor neuropathies caused by exposure to chemicals are indistinguishable from similar effects caused by systemic diseases such as alcoholism, diabetes mellitus, uremia, or B12 deficiency. The diagnosis of toxic polyneuropathy is usually made on the basis of symptoms following exposure to the chemical and the resolution of symptoms months to years after cessation of exposure. [LaDou, p. 375-6] Chemicals that Can Cause Toxic Polyneuropathy: C: Carbon disulfide; L: Lead; A: Arsenic, Acrylamide; M: Mercury; N: N-hexane; O: Organophosphates (OPs); T: Thallium; E: Ethylene oxide; Some OPs can Induce Delayed Neuropathy (OPIDN). OPIDN usually occurs after ingestion, and is usually nonoccupational. [Levy, p. 431] Lead, n-hexane, and Ops tend to cause predominantly motor neuropathy, while the other agents produce sensorimotor neuropathy. [Rom, p. 640-55]

Weeks to months

History; Neurological examination; EMG and nerve conduction test

357.7

Symptoms/Findings associated with this disease:

• neuropathy
• paresthesia
• weakness

High risk job tasks associated with this disease:

• Apply arsenic preservatives to wood
• Cut and dry rayon filaments
• Extract mercury ore (cinnabar)
• Fabricate measuring devices containing mercury
• Heat, machine, or spray lead products
• Manufacture arsenical pesticides
• Manufacture lead products
• Manufacture or use mercury dental amalgams
• Mix or apply organophosphates or work in fields after an application
• Reclaim scrap metal containing lead, cadmium, beryllium, or mercury
• Remove lead coatings
• Saw or sand arsenic-treated wood
• Smelt or cast lead
• Smelt or refine zinc or copper
• Sterilize equipment with ethylene oxide
• Use acrylamide for grouting (sewers, mining, and tunnel construction)
• Use carbon disulfide as fumigant
• Use mercury to extract gold
• Use n-hexane as a solvent in glues, inks, coatings, or degreasers
• Work in the mercury cell room in a chloralkali plant
• Work with toxic chemicals that could be spilled or released

Hazardous agents that cause the occupational disease:

• 1-Bromopropane
• 2-Hexanone
• Acrylamide
• Arsenic and inorganic compounds
• Carbon disulfide
• Ethylene oxide
• Lead
• Mercury, aryl compounds
• Mercury, elemental
• Mercury, inorganic compounds
• n-Hexane
• ORGANOPHOSPHATES
• Thallium and soluble compounds
• All causes of motor neuropathy
• All causes of sensorimotor neuropathy