title: Convulsions and hypoglycemia due to tetramethyl succinonitrile intoxication in the polyvinyl chloride (PVC) industry: A 4-year follow-up.
abstract: OBJECTIVE
  Exposure and clinical data concerning cases of toxic convulsions and hypoglycemia due to tetramethyl succinonitrile (TMSN) exposure are reported.
  
  
  METHODS
  Forty-four workers exposed to TMSN in the PVC production plant participated in occupational health medical check-ups including medical history, clinical examination and clinical chemistry. A 4-year follow-up was performed. To evaluate occupational exposure, measurements of TMSN in the ambient air as well as personal air sampling were conducted.
  
  
  RESULTS
  Four workers suffered from convulsions with reversible pathologic EEG and 16 other persons were hypoglycemic. Other frequent symptoms included headaches, dizziness and unpleasant taste sensations. TMSN levels had been clearly above the Swiss occupational exposure limit value (MAK). Occupational hygiene interventions resulted in a reduction of the TMSN concentration below the MAK value. TMSN related symptoms have not been observed anymore in the 4-year follow-up.
  
  
  CONCLUSIONS
  TMSN is a convulsive substance which in humans has also a hypoglycemic effect.
authors.affiliation: Swiss Int. Air Lines Ltd., Zurich, Switzerland, angela.ensslin@swiss.com.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Ensslin
authors.forename: Michael F
authors.initials: MF
authors.lastname: Koller
mesh_terms: D000328:Adult; D000368:Aged; D000395:Air Pollutants, Occupational / Q000032:analysis / Q000506:poisoning / Q000592:standards; D002617:Chemical Industry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000032:analysis / Q000506:poisoning*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis / Q000592:standards; D011143:Polyvinyl Chloride; D012640:Seizures / Q000139:chemically induced*; D013548:Sweden
chemical_list: D000395:Air Pollutants, Occupational; D009570:Nitriles; C036591:tetramethylsuccinonitrile; D011143:Polyvinyl Chloride