Increased risk of sensory neuropathy in workers with chloracne after exposure to 2,3,7,8-polychlorinated dioxins and furans.
OBJECTIVE
The existence of a peripheral neuropathy after exposure to polychlorinated dioxins (PCDD) is still discussed, as studies concerning dioxin effects on the peripheral nervous system are rare and contradictory.


METHODS
Clinical and neurophysiological examinations (motor conduction velocity of the peroneal nerve, sensory conduction velocities of the sural and ulnar nerves) were made in 156 dioxin exposed workers (42 with, 114 without cloracne) from one pesticide producing plant. Because of known risk factors for peripheral neuropathy, 7 workers with and 28 without cloracne were excluded from further analysis.


RESULTS
Workers with chloracne had a significantly higher exposure against PCDD as documented by back calculated lipid levels. They complained significantly more often of sexual impotence (28.6% compared to 5.8% of workers without chloracne, P<0.001), had significantly more frequent clinical signs of a sensory neuropathy (= abnormal sensory findings plus deep tendon reflex abnormalities) restricted to the legs (17.1% compared to 1.2%, P<0.001), had significantly more frequent > or =2 neurophysiologic abnormalities (34.3% compared to 14.0%, P<0.025), and had significantly lower mean amplitudes of the motor compound muscle potential of the peroneal nerve.


CONCLUSIONS
PCDD has a mild toxic effect on the peripheral nervous system manifesting as mild sensory neuropathy of the legs in a minority of the most severely exposed persons.
Department of Neurology, University of Mainz, Germany.
F
F
Thömke
D
D
Jung
R
R
Besser
R
R
Röder
J
J
Konietzko
H C
HC
Hopf
D000152:Acne Vulgaris / Q000139:chemically induced* / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D004147:Dioxins / Q000009:adverse effects*; D005663:Furans / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D011078:Polychlorinated Biphenyls / Q000009:adverse effects*; D018570:Risk Assessment; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D013497:Sural Nerve / Q000187:drug effects / Q000503:physiopathology; D013997:Time Factors; D014459:Ulnar Nerve / Q000187:drug effects / Q000503:physiopathology; D014937:Work
D000395:Air Pollutants, Occupational; D004147:Dioxins; D005663:Furans; D011078:Polychlorinated Biphenyls