Studies on the etiology of the experimental neuropathy from industrial adhesive (glues)

Clinical, socio-demographic, neurophysiological and neuropsychiatric evaluation of children with volatile substance addiction

BACKGROUND

Abuse of organic volatile substances in children has become a social health problem that is increasing in the recent years. Among these substances, toluene is highly preferred by abusers because of its euphoric effect, cheapness and easy availability. There is no published research on the clinical and neurophysiological evaluation of children with short-term volatile substance addiction.

METHODS

In this study, socio-demographic characteristics were questioned in 12 children with a mean age of 15 years and a duration of toluene abuse for a mean of 2.3 years, and the clinical characteristics of central and peripheral nervous system damage caused by volatile substances, particularly by toluene were analysed, and probable neurological disorders were investigated by means of neurophysiological and neuropsychological tests. All tests were compared with a control group.

RESULTS

Fifty-eight percent of the children included in the study had pathological findings in the neurological examination. There was pyramidal involvement in 25% and peripheral nerve involvement in 33.3% of the cases. Evaluation of the cognitive functions revealed 33.3% pathology in the 'Short Test of Mental Status' which assesses functions of orientation, attention, learning, arithmetic calculation, abstraction, information, construction and recall. Sensorial polyneuropathy was found in 33.3% of the cases in nerve conduction studies. Somatosensory-evoked potentials revealed pathology in 16.7% of the cases and brainstem-evoked potentials in 50% of the cases. No pathology was observed in electroencephalography and visual-evoked potentials.

CONCLUSION

In our study, neurophysiological and neuropsychiatric tests revealed that toluene causes slow progressive, clinical and subclinical central and peripheral nerve damage. In Turkey, because of cheapness, easy availability and legal use of volatile substances, the clinical extent of systemic and neurological toxicity of volatile substance abuse is increasing. Abuse of volatile substances, a currently increasing social issue, may create important physical problems which can be permanent.

Investigation on neurotoxicity of occupational exposure to cyclohexane: a neurophysiological study

OBJECTIVES

To examine the effect of occupational exposure to cyclohexane on the peripheral nervous system.

METHODS

A nerve conduction study was performed on 18 workers exposed to cyclohexane in a luggage factory and on age and sex matched occupationally unexposed controls. 12 workers had been exposed to n-hexane (median 2.8 years) before the start of exposure to cyclohexane. To confirm the effect of exposure, a follow up study was performed on nine workers one year after the first study. The mean exposure to cyclohexane was 1.2 years in the first study. A symptom survey was performed. The exposure was measured by air sampling of the breathing zone of each worker. The urinary metabolite cyclohexanol was also monitored.

RESULTS

The concentration of airborne cyclohexane ranged from 5 to 211 ppm. The urinary concentration of cyclohexanol ranged from 0.12 to 1.51 mg/l. There was a strong correlation between the cyclohexane exposure in personal air and urinary cyclohexanol. No differences were found in nerve conduction velocities (NCV) between workers exposed to cyclohexane and age and sex matched controls. The results of the follow up study showed significant improvements in peroneal motor NCV (P < 0.01) and sural sensory NCV (P < 0.05) and in ulnar motor distal latency (MDL, P < 0.05) and peroneal MDL (P < 0.05) compared with the first study. Although the past n-hexane exposure affected the first neurophysiological study, the effect had disappeared in the second study, one year later.

CONCLUSION

Occupational exposure to the concentrations of cyclohexane experienced in this study had no adverse effects on the peripheral nervous system.

n-Hexane-induced changes in nerve conduction velocities and somatosensory evoked potentials

Fifteen women from a shoe factory were examined clinically and their cerebral evoked responses to 256 electrical stimulations of the median nerve were averaged. Neurophysiological investigations included maximal motor (MCV) and distal sensory (dSCV) nerve conduction velocity measurement on ulnar, median, and peroneal nerves. A referent group was composed of 15 age-matched women without exposure to neurotoxic chemicals. MCVs and dSCVs of the exposed workers were significantly reduced vs referents, while P15 and N20 components of the somatosensory evoked potentials (SEP) showed an increased latency. A negative linear relationship was found between dSCV and P15 latency. However, two subjects with an abnormally low dSCV showed normal SEP latency, and two other subjects displayed abnormal SEP latency, while their dSCV was in the normal range. Therefore, SEP investigation may give additional information on nervous system function, even in subjects with peripheral neuropathy. The later SEP components were much flatter in the exposed than in the referent group, suggesting some neurotoxic effects of n-hexane on the central nervous system too.

Neurotoxicity of petroleum benzine compared with n-hexane

Petroleum benzine is one of the mixtures of organic solvents containing n-hexane. The occurrence of polyneuropathy in the workers using petroleum benzines is attributed mainly to n-hexane, though other hydrocarbons present are also suspected of having some neurotoxicity or some potential which could modify the neurotoxicity of n-hexane. The present experiment was performed in order to clarify the toxicity of petroleum benzine to the peripheral nerve and compare it with that of n-hexane. Forty rats were randomly divided into five groups. The groups were exposed to 200 ppm n-hexane, 500 ppm n-hexane, and petroleum benzine vapor containing 200 ppm n-hexane or 500 ppm n-hexane, together with aliphatic and aromatic hydrocarbons for 12 h a day for 24 weeks. The body weight, motor nerve conduction velocity, motor distal latency, and mixed nerve conduction velocities were measured before exposure and every 4 weeks of exposure. A rat from each exposed group was histopathologically examined after 24 weeks' exposure. The function of the peripheral nerve was conspicuously impaired by 500 ppm n-hexane, slightly impaired by 200 ppm n-hexane and petroleum benzine containing 500 ppm n-hexane, and even less impaired by petroleum benzine containing 200 ppm n-hexane. Degenerations of the myelin sheaths and axons were demonstrated in all exposed groups upon examination of the revealed tail nerves. Thus, the experiment revealed that petroleum benzine could impair the peripheral nerves, while some components of petroleum benzine were considered to inhibit the neurotoxicity of n-hexane.

Absorption and alveolar excretion of cyclohexane in workers in a shoe factory

The lung uptake and excretion of cyclohexane were studied in five workers and three volunteers in a shoe factory. Air samples were collected from the breathing zones with personal samplers, and simultaneous samples of inhaled and alveolar air were collected with the aid of a Rhan-Otis valve. Cyclohexane was absorbed on activated NIOSH approved charcoal tubes. The uptake was calculated from the pulmonary ventilation, the retention coefficient and environmental concentration. Alveolar excretion was monitored during a 6 h post-exposure period. The amount of exhaled cyclohexane was calculated from the decay curve. According to experimental data, the alveolar retention of cyclohexane is about 34% of the inhaled dose. This corresponds to a lung uptake of 23%. The post-exposure alveolar excretion does not exceed 10% of the total uptake. The difference between respiratory uptake and excretion indicates that the amount metabolized may be very large. Nevertheless, the urinary excretion of the main metabolites, cyclohexanol and cyclohexanone, was only about 1% of the absorbed dose.

A comparative study on the toxicity of n-hexane and its isomers on the peripheral nerve

Commercial hexane which caused polyneuropathy in many workers contained 10-40% of 2-methylpentane, 3-methylpentane and methylcyclopentane in addition to n-hexane. The hexacarbon compounds methyl n-butyl ketone, 2,5-hexanedione and etc. were shown to be neurotoxic like n-hexane. Therefore, 2-methylpentane, 3-methylpentane and methylcyclopentane which are also hexacarbon compounds were suspected to be neurotoxic, but their neurotoxicity had not been sufficiently investigated. The present experiment was performed to clarify their neurotoxicity by measuring the nerve conduction velocity in the rat's tail. Thirty rats were divided into five groups of 5-7 rats. n-Hexane, 2-methylpentane, 3-methylpentane and methylcyclopentane were diluted with olive oil and orally administered daily for eight weeks. The body weight, motor nerve conduction velocity, motor distal latency and mixed nerve conduction velocity were measured before administration, after two, four, six and eight weeks' administration. The n-hexane group showed a distinct impairment of the functional states of the peripheral nerve. Methylcyclopentane, 2-methylpentane and 3-methylpentane group had some significant differences in comparison with the control in the experiment, although these differences were not so distinct as those in n-hexane group. The results revealed that the neurotoxicity of the three chemicals was not so severe as that of n-hexane and were in the order of n-hexane greater than methylcyclopentane greater than or equal to 2-methylpentane divided by 3-methylpentane.