title: Absence of sensory neuropathy among workers with occupational exposure to chlorpyrifos.
abstract: Several studies have reported the occurrence of sensory neuropathy with exposure to chlorpyrifos and other organophosphorus insecticides, at levels not associated with overt toxicity. We evaluated 113 chemical workers, including 53 of 66 (80%) eligible chlorpyrifos workers and 60 of 74 (81%) randomly selected referent workers, to identify evidence of sensory neuropathy or subclinical neuropathy. Compared to referents, chlorpyrifos subjects had significantly longer duration of work in chlorpyrifos-exposed areas (9.72 vs. 0.01 years; P < 0.0001), greater cumulative chlorpyrifos exposure (64.16 vs. 0.69 mg/m(3). day; P < 0.0001), higher urine 3,5,6-trichloro-2-pyridinol (TCP) excretion (108.6 vs. 4.3 microg/g creatinine; P < 0.0001), and lower plasma butyrylcholinesterase (BuChE) activity (7281 vs. 8176 mU/ml; P = 0.003). Despite exposures among chlorpyrifos subjects to levels at which well-described physiological effects on B-esterases exist, the frequency of symptoms or signs of neuropathy did not differ significantly between groups, and the only 2 subjects fulfilling criteria for confirmed neuropathy were both in the referent group. Mean nerve conduction study results were comparable to established control values and did not differ significantly between groups. We found no evidence of sensory neuropathy or isolated peripheral abnormalities among subjects with long-term chlorpyrifos exposure at levels known to be associated with the manufacturing process.
authors.affiliation: Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. jwalbers@umich.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Albers
authors.forename: David H
authors.initials: DH
authors.lastname: Garabrant
authors.forename: Sarah
authors.initials: S
authors.lastname: Schweitzer
authors.forename: Richard P
authors.initials: RP
authors.lastname: Garrison
authors.forename: Rudy J
authors.initials: RJ
authors.lastname: Richardson
authors.forename: Stanley
authors.initials: S
authors.lastname: Berent
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002617:Chemical Industry; D016009:Chi-Square Distribution; D004390:Chlorpyrifos / Q000633:toxicity*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects; D009460:Neurologic Examination; D009784:Occupational Diseases / Q000139:chemically induced* / Q000503:physiopathology; D011129:Polyradiculoneuropathy / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D004390:Chlorpyrifos