title: Neurologic syndrome in 25 workers from an aluminum smelting plant.
abstract: BACKGROUND
  This article expands on an earlier series of three patients with a neurologic syndrome, who had all worked in an aluminum smelting plant.
  
  
  METHODS
  Twenty-five symptomatic workers from the same plant were referred for a standardized evaluation, including completion of a health questionnaire, neurologic examination, and neuropsychologic evaluation. An exposure index was calculated for each worker based on level and duration of exposure in the potroom, where exposures were the greatest. This index was correlated with symptoms, signs, and neuropsychologic test scores.
  
  
  RESULTS
  Twenty-two (88%) of the patients reported frequent loss of balance, and 21 (84%) reported memory loss. Neurologic examination revealed signs of incoordination in 21 (84%) of the patients. Neuropsychologic test results showed preservation in certain spheres of functioning, such as verbal IQ, with substantial impairment in others, particularly memory functioning. On memory tests, 70% to 75% showed mild or greater impairment. The majority (17 of 19 tested, or 89%) showed depression on the Minnesota Multiphasic Personality Inventory. The exposure index was significantly correlated with signs and symptoms of incoordination.
  
  
  CONCLUSIONS
  This study and others in humans and animals support the existence of a syndrome characterized by incoordination, poor memory, impairment in abstract reasoning, and depression. Aluminum exposure in the potroom seems the most likely cause.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle 98195.
authors.forename: D M
authors.initials: DM
authors.lastname: White
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.forename: L
authors.initials: L
authors.lastname: Rosenstock
authors.forename: K H
authors.initials: KH
authors.lastname: Claypoole
authors.forename: C A
authors.initials: CA
authors.lastname: Brodkin
authors.forename: B D
authors.initials: BD
authors.lastname: Townes
mesh_terms: D000328:Adult; D000535:Aluminum / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology*; D016273:Occupational Exposure
chemical_list: D000535:Aluminum