Modifications of the sympathetic skin response in workers chronically exposed to lead

Abstract

The long-term effects of low-level lead intoxication are not known. The sympathetic skin response (SSR) was evaluated in a group of 60 former workers of a primary lead smelter, located in Santo Amaro, BA, Brazil. The individuals participating in the study were submitted to a clinical-epidemiological evaluation including questions related to potential risk factors for intoxication, complaints related to peripheral nervous system (PNS) involvement, neurological clinical examination, and also to electromyography and nerve conduction studies and SSR evaluation. The sample consisted of 57 men and 3 women aged 34 to 69 years (mean ± SD: 46.8 ± 6.9). The neurophysiologic evaluation showed the presence of lumbosacral radiculopathy in one of the individuals (1.7%), axonal sensorimotor polyneuropathy in 2 (3.3%), and carpal tunnel syndrome in 6 (10%). SSR was abnormal or absent in 12 cases, representing 20% of the sample. More than half of the subjects (53.3%) reported a history of acute abdominal pain requiring hospitalization during the period of work at the plant. A history of acute palsy of radial and peroneal nerves was reported by about 16.7 and 8.3% of the individuals, respectively. Mean SSR amplitude did not differ significantly between patients presenting or not the various characteristics in the current neurological situation, except for diaphoresis. The results suggest that chronic lead intoxication induces PNS damage, particularly affecting unmyelinated small fibers. Further systematic study is needed to more precisely define the role of lead in inducing PNS injury.

Carpal tunnel syndrome and exposure to work-related biomechanical stressors and chemicals: Findings from the Constances cohort

“…Little epidemiological data is available on the impact of chemical exposure on the risk of CTS despite their potential neurotoxicity [20][21][22][26][27][28][29]31,36,37,49]. Chemical exposure was taken into account in a case-control study of CTS conducted in the general population of Wisconsin, but no significant association was found with CTS after adjustment for the main personal, medical and biomechanical risks [50].…”

“…The oldest one was by Bleecker in 1986, the author proposed to examine the vibration perception of workers co-exposed to neurotoxic agents and to biomechanical overload of hand and forearm, with the aim to consider the possible co-presence of damages due to chemical substances and to nerve compression [26]. Among the others papers, two were regarding co-exposure to pesticides [27,28], one was concerning the low-level chronic exposure to lead [29], one was on Toxic Oil Syndrome [30], and the last-one regarded particulate matter [31].…”

Σύνδρομο καρπιαίου σωλήνα & επάγγελμα/ φυσική δραστηριότητα

“…Οι επιδηµιολογικές µελέτες που έχουν χρησιµοποιήσει ηλεκτροφυσιολογικές εξετάσεις έχουν µεταχειριστεί µια πλειάδα µεθόδων αξιολόγησης και τεχνικών (Atroshi et al, 2003;Dunne et al, 1996;Isolani et al, 2002;Nora et al, 2007;Osorio et al, 1994;Werner, 2006 (Armstrong et al, 2008;Atroshi et al, 2007;Cherniack et al, 2008b;Hou et al, 2007). Βρέθηκε, δε, ισχυρή σχέση µεταξύ των συµπτωµάτων και της παρατεταµένης αγωγής του µέσου νεύρου (Nathan et al, 1992).…”

“…TCL=εγκαρσιος καρπιαίος σύνδεσµος, MC1= πρώτο µετακάρπιο, TM=τραπέζιο, TZ= τραπεζοειδές, C=κεφαλοειδής, H= άγκιστρο, MN=µέσο νεύρο, 1=µακρός καµπτήρας, 2-5= επιπολής καµπτήρας των δαχτύλων, 6-9=εν τω βάθει καµπτήρας των δαχτύλων. Τροποποιηµένο από(Bower et al, 2006b) Καθώς η χρήση του MRI για την διάγνωση διάφορων διαταραχών του άνω άκρου κερδίζει συνεχώς έδαφος οι Pasternack, Malmivaara et al(2001) προσπάθησαν να εντοπίσουν µέσω µιας βιβλιογραφικής ανασκόπησης την ακρίβεια του MRI στην αναγνώριση του ΣΚΣ. Συνολικά κατέληξαν σε 20 µελέτες που πληρούσαν τα κριτήρια που είχαν θέσει.…”