title: Synergistic neurotoxicity of carbon tetrachloride/carbon disulfide (80/20 fumigants) and other pesticides in grain storage workers.
abstract: Neurophysiologic, neurobehavioral, and neuropsychologic profiles in 17 grain storage workers, 1 grain inspector, and 4 malting laboratory workers are described. The effects of CS2 toxicity as seen in viscose rayon workers as well as in experimental animals is remarkably similar to the clinical profile of our grain storage workers. CS2 use explains the dysfunction of peripheral axons, auditory nerve, the optic nerve, and the extrapyramidal system, as well as altered behavior and cognition changes. The signs and symptoms in these workers seem to be dose-related and we note that workers separated out from the areas where fumigation took place reported improvement not seen by fellow workers who continued the fumigant treatment routine. Likewise, malting laboratory workers exposed only to the grain dust from 3 to 7 years showed only minimal symptoms. Though a number of mechanism have been suggested for the alteration of neuropsychological function, the chelating ability of DDC derived from CS2 and its ability to markedly increase copper and zinc within the central nervous system suggests a mechanism of toxicity analogous to copper intoxication as in Wilson's Disease and may explain the production of extrapyramidal symptoms in these patients. Chelation of copper might prove therapeutic in CS2 poisoning. It is obvious that both basic and clinical research will be necessary to sort out the questions raised. We applaud the EPA's decision to ban the use of 80/20 fumigants and also methyl bromide, and trust that similar toxic substances be carefully studied before their selection for replacing these previous toxic agents. We further decry the technique of re-introducing grain dust into the food chain rather than destroying it, since the dust contains very high residues of fumigant material. We speculate on the possible role of CS2 and other pesticides in the food chain and the incidence of Parkinsonian symptoms in these patients and the general public.
mesh_terms: D000328:Adult; D001519:Behavior; D002246:Carbon Disulfide / Q000633:toxicity*; D002251:Carbon Tetrachloride / Q000633:toxicity*; D004357:Drug Synergism; D002523:Edible Grain; D015946:Ethylene Dibromide / Q000633:toxicity; D006311:Hearing Disorders / Q000209:etiology; D006801:Humans; D006842:Hydrocarbons, Brominated / Q000633:toxicity; D009069:Movement Disorders / Q000139:chemically induced; D009422:Nervous System Diseases / Q000139:chemically induced*; D009784:Occupational Diseases / Q000139:chemically induced*; D010575:Pesticides / Q000009:adverse effects*
chemical_list: D006842:Hydrocarbons, Brominated; D010575:Pesticides; D015946:Ethylene Dibromide; C005218:methyl bromide; D002251:Carbon Tetrachloride; D002246:Carbon Disulfide