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Koszewicz M, Markowska K, Waliszewska-Prosol M, Poreba R, Gac P, Szymanska-Chabowska A, Mazur G, Wieczorek M, Ejma M, Slotwinski K, Budrewicz S. The impact of chronic co-exposure to different heavy metals on small fibers of peripheral nerves. A study of metal industry workers. J Occup Med Toxicol 2021; 16:12. [PMID: 33858451 PMCID: PMC8048227 DOI: 10.1186/s12995-021-00302-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 04/03/2021] [Indexed: 12/14/2022] Open
Abstract
Background Chronic exposure to heavy metals affects various organs, among them the brain and peripheral nerves. Polyneuropathy is mainly length-dependent with predominantly sensory symptoms. There have been few studies on small fiber neuropathy due to heavy metal intoxication. Methods We investigated 41 metal industry workers, mean age 51.3 ± 10.5 years, with at least 5 years’ professional exposure to heavy metals, and 36 age- and sex-matched healthy controls. We performed neurological examinations, and assessed blood levels of cadmium, lead, and zinc protoporphyrin, urine levels of arsenic, standard, sensory and motor electrophysiological tests in the ulnar and peroneal nerves, sympathetic skin responses from the palm and foot, and quantitative sensation testing from dermatomes C8 and S1. Discussion The results of standard conduction tests of all nerves significantly differed between groups. The latency of sympathetic skin responses achieved from the foot was also statistically significantly prolonged in the study group. Significant differences were seen in both C8 and S1 regions for temperature and pain thresholds, and for vibratory threshold only in the S1 region, while the dispersions of low and high temperatures were important exclusively in the C8 region. Conclusions We can conclude that co-exposure to many heavy metals results in explicit impairment of peripheral nerves. The lesion is more pronounced within small fibers and is predominantly connected with greater impairment of temperature-dependent pain thresholds. The evaluation of small fiber function should be considered in the early diagnosis of toxic polyneuropathy or in low-dose exposure to heavy metals.
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Affiliation(s)
- Magdalena Koszewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
| | - Katarzyna Markowska
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | | | - Rafał Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-550, Wroclaw, Poland
| | - Paweł Gac
- Department of Hygiene, Wroclaw Medical University, J. Mikulicza-Radeckiego 7, 50-345, Wroclaw, Poland
| | - Anna Szymanska-Chabowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-550, Wroclaw, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-550, Wroclaw, Poland
| | - Malgorzata Wieczorek
- Faculty of Earth Sciences and Environmental Management, University of Wroclaw, Plac Uniwersytecki 1, 50-137, Wroclaw, Poland
| | - Maria Ejma
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Krzysztof Slotwinski
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Slawomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
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The Relationship between Occupationally Exposed Arsenic, Cadmium and Lead and Brain Bioelectrical Activity-A Visual and Brainstem Auditory Evoked Potentials Study. Brain Sci 2021; 11:brainsci11030350. [PMID: 33801787 PMCID: PMC7998874 DOI: 10.3390/brainsci11030350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the parameters of visual and brainstem auditory evoked potentials in patients occupationally exposed to arsenic, cadmium and lead. The study group comprised 41 copper smelter and refinery workers (average age: 51.27) with occupational exposure to arsenic, cadmium and lead. The control group consisted of 36 healthy volunteers (35 men and 1 woman, aged 27-66, average age: 51.08). Neurological examination, brain imaging, and visual and brainstem auditory evoked potentials were performed, and the relationship between blood Cd, Pb concentration (Cd-B, Pb-B), blood zinc protoporphyrin (ZnPP), and urine As concentration (As-U) were assessed. In the workers, exceedances of allowable biological concentrations were observed, with the urinary concentration of arsenic being 5.2%, the cadmium and lead in blood being 1.3%, while the case of ZnPP was 2.6%. The mean P100, relative P100, and N145 visual evoked potential (VEP) latencies were significantly longer in exposed workers than in the controls. The mean wave III and V brainstem auditory evoked potential (BAEP) latency and the mean wave III-V and I-V interpeak latencies were longer, and the I and V amplitude was lower in the workers than the controls. In summary, occupational exposure to As, Cd, and Pb is associated with prolonged latency and reduced evoked potential amplitude, but As-U, Pb-B, Cd-B, and ZnPP concentrations are not linearly related to potential components. The analysis of evoked potentials may be a useful method of assessment of the central nervous system in patients with occupational exposure to heavy metals.
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Papp A, Oszlánczi G, Horváth E, Paulik E, Kozma G, Sápi A, Kónya Z, Szabó A. Consequences of subacute intratracheal exposure of rats to cadmium oxide nanoparticles: Electrophysiological and toxicological effects. Toxicol Ind Health 2012; 28:933-941. [PMID: 22246446 DOI: 10.1177/0748233711430973] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cadmium (Cd) is a metal used in various industrial applications, thereby causing exposure to Cd-containing fumes. The submicron-sized particles in the fumes represent an extra risk due to their high mobility within the organism and high surface area. Toxicity of Cd on the liver, kidney and bones is well known, but there are less data on its neurotoxicity. Here, male Wistar rats were treated for 3 and 6 weeks by intratracheal instillation of cadmium oxide nanosuspension. The body weight gain in treated rats was significantly decreased, and in the rats treated with high dose (0.4 mg/kg Cd daily), there was a significant increase in the weight of lungs and thymus. In this group, the spectrum of spontaneous cortical electrical activity was shifted to higher frequencies, the latency of sensory-evoked potentials was lengthened, and the frequency following ability of the somatosensory evoked potential was impaired--even without detectable Cd deposition in the brain. The data support the role of the nano-sized Cd in the causation of nervous system damage and show the possibility of modeling human neurotoxic damage in rats.
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Affiliation(s)
- András Papp
- Department of Public Health, Faculty of Medicine, University of Szeged, Szeged, Hungary.
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