Annals of Occupational and Environmental Medicine

Case Report

Dermal and neural toxicity caused by acrylamide exposure in two Korean grouting workers: a case report: Heeyun Kim, Sang Gil Lee, Jeongbae Rhie; Ann Occup Environ Med 2017;29:50. Published online October 9, 2017; DOI: https://doi.org/10.1186/s40557-017-0207-7

Background

Peripheral neuritis caused by acrylamide is well-known, and many Korean grouting workers are frequently exposed to acrylamide in grouting agents that are injected into cracked concrete. We recently encountered two cases of dermal and neural toxicity in Korean grouting workers with exposure to grouting agents that contained a high concentration of acrylamide.

Case presentation

The first case involved a 44-year-old man with 8 years of waterproofing experience. The patient developed peeling skin on both hands while grouting, which progressed to systemic neurological symptoms, such as reduced sensory function and strength. The patient was diagnosed with peripheral neuropathy caused by acrylamide exposure, and fully recovered after conservative treatment and withdrawal of exposure to the grouting agent. The second case involved a 34-year-old man with 10 years of grouting experience. The patient initially experienced weakness in both legs, which progressed to weakness in his arms and uncontrolled phonation. After being hospitalized, he was diagnosed with cerebellar ataxia and peripheral neuropathy caused by acrylamide exposure, and was discharged after conservative treatment. Our follow-up investigation revealed that both workers were recently exposed to grouting agents that contained higher concentrations of acrylamide, compared to the agents that they had previously been using.

Conclusions

Both workers had workplace acrylamide exposure through dermal contact plus inhalation of dust and vapor, which led to the neural toxicity and dermatitis. Therefore, government studies are needed to investigate the current status of workplace acrylamide use, and to protect workers from the hazardous effects of using acrylamide-containing grouting agents.

Citations

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Internal exposure to heat-induced food contaminants in omnivores, vegans and strict raw food eaters: biomarkers of exposure to acrylamide (hemoglobin adducts, urinary mercapturic acids) and new insights on its endogenous formation
Bernhard H. Monien, Nick Bergau, Fabian Gauch, Cornelia Weikert, Klaus Abraham
Archives of Toxicology.2024; 98(9): 2889. CrossRef
The role of microRNAs in acrylamide toxicity
Mina Homayoonfal, Danial Molavizadeh, Sara Sadeghi, Reza Sharafati Chaleshtori
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Effects of acrylamide on indoor air based on the reactions with O3 and •OH: Mechanism, kinetics, and toxicity evaluation
Xueyu Wang, Sisi Cheng, Guangcai Ma, Xiaoxuan Wei, Jichao Fang, Haiying Yu
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Acrylamide induces neurotoxicity in zebrafish (Danio rerio) via NLRP3-mediated pyroptosis
Boya Zhang, Mengyao Zhao, Xiaoguo Ji, Quanming Xia, Lihua Jiang, Liming Zhao
Science of The Total Environment.2023; 896: 165208. CrossRef
Seepage behavior and mechanical properties of two kinds of polyurethane/water glass in combined grouting experiment
Pengcheng Wang, Shuchen Li, Jinglong Li, Huiying Zhou, Pengfei Ma, Ye Tian, Chao Yuan, Xianda Feng
Tunnelling and Underground Space Technology.2023; 136: 105092. CrossRef
Effect of long-term exposure to acrylamide on endoplasmic reticulum stress and autophagy in rat cerebellum
Yiqi Wang, Lian Duan, Xing Zhang, Yang Jiao, Ying Liu, Lingling Dai, Hong Yan
Ecotoxicology and Environmental Safety.2021; 224: 112691. CrossRef
A Review on Acrylamide in Food: Occurrence, Toxicity, and Mitigation Strategies
Lubna Rifai, Fatima A. Saleh
International Journal of Toxicology.2020; 39(2): 93. CrossRef
Risk of exposure to acrylamide
Milena Bušová, Vladimír Bencko, Katarína Veszelits Laktičová, Ivana Holcátová, Mária Vargová
Central European Journal of Public Health.2020; 28(Supplement): S43. CrossRef
A new formulation of polymer gel dosimeter with reduced toxicity: Dosimetric characteristics and radiological properties
Abdulrahman Rashidi, Seyed Mohammad Mahdi Abtahi, Elham Saeedzadeh, Mohammad Esmaeil Akbari
Zeitschrift für Medizinische Physik.2020; 30(3): 185. CrossRef
Learning, memory deficits, and impaired neuronal maturation attributed to acrylamide
Seulah Lee, Hee Ra Park, Joo Yeon Lee, Jung-Hyun Cho, Hye Min Song, Ah Hyun Kim, Wonjong Lee, Yujeong Lee, Seung-Cheol Chang, Hyung Sik Kim, Jaewon Lee
Journal of Toxicology and Environmental Health, Part A.2018; 81(9): 254. CrossRef

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Case Report

A case of generalized argyria presenting with muscle weakness: Inha Jung, Eun-Jeong Joo, Byung seong Suh, Cheol-Bae Ham, Ji-Min Han, You-Gyung Kim, Joon-Sup Yeom, Ju-Yeon Choi, Ji-Hye Park; Ann Occup Environ Med 2017;29:45. Published online October 2, 2017; DOI: https://doi.org/10.1186/s40557-017-0201-0

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Background

Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness.

Case presentation

A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids.

Conclusions

Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.

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Biomédica.2021; 41(2): 234. CrossRef
Clinical and Forensic Aspects of the Different Subtypes of Argyria
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Journal of Clinical Medicine.2021; 10(10): 2086. CrossRef
The Food Matrix and the Gastrointestinal Fluids Alter the Features of Silver Nanoparticles
Laurie Laloux, Donika Kastrati, Sébastien Cambier, Arno C. Gutleb, Yves‐Jacques Schneider
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Peripheral neuropathy associated with silver toxicity
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Research Article

Vibration upshot of operating mechanical sewing machine: an insight into common peroneal nerve conduction study: Prakash Kumar Yadav, Ram Lochan Yadav, Deepak Sharma, Dev Kumar Shah, Niraj Khatri Sapkota, Dilip Thakur, Nirmala Limbu, Md Nazrul Islam; Ann Occup Environ Med 2017;29:8. Published online March 24, 2017; DOI: https://doi.org/10.1186/s40557-017-0164-1

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Background

Most of the people associated with tailoring occupation in Nepal are still using mechanical sewing machine as an alternative of new technology for tailoring. Common peroneal nerves of both right and left legs are exposed to strenuous and chronic stress exerted by vibration and paddling of mechanical sewing machine.

Methods

The study included 30 healthy male tailors and 30 healthy male individuals. Anthropometric variables as well as cardio respiratory variables were determined for each subject. Standard Nerve Conduction Techniques using constant measured distances were applied to evaluate common peroneal nerve (motor) in both legs of each individual. Data were analyzed and compared between study and control groups using Man Whitney U test setting the significance level p ≤ 0.05.

Results

Anthropometric and cardio respiratory variables were not significantly altered between the study and control groups. The Compound muscle action potential (CMAP) latency of common peroneal nerves of both right [(11.29 ± 1.25 vs. 10.03 ± 1.37), P < 0.001] and left [(11.28 ± 1.38 vs. 10.05 ± 1.37), P < 0.01] legs was found to be significantly prolonged in study group as compared to control group. The Amp-CMAP of common peroneal nerves of both right [(4.57 ± 1.21 vs. 6.22 ± 1.72), P < 0.001] and left [(4.31 ± 1.55 vs. 6.25 ± 1.70), P < 0.001] legs was found significantly reduced in study group as compared to control group. Similarly, the motor nerve conduction velocity (MNCV) of common peroneal nerves of both right [(43.72 ± 3.25 vs. 47.49 ± 4.17), P < 0.001] and left [(42.51 ± 3.82 vs. 46.76 ± 4.51), P < 0.001] legs was also found to be significantly reduced in study group in comparison to control group.

Conclusion

Operating mechanical sewing machine by paddling chronically and arduously could have attributed to abnormal nerve conduction study parameters due to vibration effect of the machine on right and left common peroneal nerves. The results of present study follow the trend towards presymptomatic or asymptomatic neuropathy similar to subclinical neuropathy.

Citations

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Prognostic factors in patients who underwent surgery for common peroneal nerve injury: a nest case–control study
Zhenhui Liu, Maimaiaili Yushan, Yanshi Liu, Aihemaitijiang Yusufu
BMC Surgery.2021;[Epub] CrossRef

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Case Report

Two cases of methyl alcohol intoxication by sub-chronic inhalation and dermal exposure during aluminum CNC cutting in a small-sized subcontracted factory: Jia Ryu, Key Hwan Lim, Dong-Ryeol Ryu, Hyang Woon Lee, Ji Young Yun, Seoung-Wook Kim, Ji-Hoon Kim, Kyunghee Jung-choi, Hyunjoo Kim; Ann Occup Environ Med 2016;28:65. Published online November 15, 2016; DOI: https://doi.org/10.1186/s40557-016-0153-9

Abstract PDF PubReader ePub

Background

Methyl alcohol poisoning has been mainly reported in community. Two cases of methyl alcohol poisoning occurred in a small-sized subcontracted factory which manufactured smartphone parts in Korea.

Case presentation

One young female patient presented with dyspnea and visual disturbance. Another young male patient presented with visual disturbance and myalgia. They treated with sodium bicarbonate infusion and hemodialysis for metabolic acidosis. In addition, he received ethyl alcohol per oral treatment. Her and his urinary methyl alcohol concentration was detected as 7.632 mg/L, 46.8 mg/L, respectively, although they were treated hemodialysis. Results of the working environment measurement showed that the concentration of methyl alcohol (1030.1–2220.5 ppm) in the air exceeded the time weighted average (200 ppm). They were diagnosed with optic neuropathy due to methyl alcohol poisoning and still have visual impairment.

Conclusions

Workers who hired as dispatched employees in a small-sized subcontracted factory were exposed to high concentrations of methyl alcohol. The workplace had poor ventilation system. In addition, workers did not wear proper personal protect equipment. Working environment measurement and annual chekups for workers were not performed. They were in a blind spot to occupational safety and health. More attention is needed to protect vulnerable workers’ health.

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A new direct extraction by gas-chromatography with flame ionization detector coupled to head space method for the determination of alcohol content of high matrix wine products
Onur Kenan ULUTAŞ, Aysel BERKKAN
Revue Roumaine de Chimie.2023; 67(10-12): 569. CrossRef
ALCOHOL-BASED HAND SANITIZER: ABUSE DURING LOCKDOWN AMIDST COVID-19 PANDEMIC
BEDANTA SARMA, SENTHIL KUMARAN M
Asian Journal of Pharmaceutical and Clinical Research.2021; : 14. CrossRef
Formaldehyde Reacts with Amino Acids and Peptides with a Potential Role in Acute Methanol Intoxication
David Sýkora, Jindřich Jindřich, Vladimír Král, Milan Jakubek, Ameneh Tatar, Zdeněk Kejík, Pavel Martásek, Sergey Zakharov
Journal of Analytical Toxicology.2020; 44(8): 880. CrossRef
Chronic methanol toxicity through topical and inhalational routes presenting as vision loss and restricted diffusion of the optic nerves on MRI: A case report and literature review
Christianne V. Mojica, Esteban A. Pasol, Mercedes L. Dizon, Wenceslao A. Kiat, Timothy Reynold U. Lim, Jacqueline C. Dominguez, Vincent V. Valencia, Bernardo Joaquin P. Tuaño
eNeurologicalSci.2020; 20: 100258. CrossRef
Screening of Workers with Presumed Occupational Methanol Poisoning: The Applicablility of a National Active Occupational Disease Surveillance System
Huisu Eom, Jihye Lee, Eun-A Kim
Safety and Health at Work.2019; 10(3): 265. CrossRef
Methanol as an Unlisted Ingredient in Supposedly Alcohol-Based Hand Rub Can Pose Serious Health Risk
Alan P. L. Chan, Thomas Y. K. Chan
International Journal of Environmental Research and Public Health.2018; 15(7): 1440. CrossRef
Toxic Effects of Methanol among Illegally Dispatched Workers at Aluminum CNC Cutting Process in Small-Scale, Third-Tier Subcontractor Factories of Smartphone Manufacturers in the Republic of Korea
Chung Won Kang, Hyunjoo Kim, Kyongsok Shin, Jia Ryu, Kyunghee Jung-Choi, Key Hwan Lim, Jin-Ha Kim
International Journal of Environmental Research and Public Health.2018; 15(7): 1332. CrossRef
Methanol-Induced Encephalopathy: a Case Report
Hyun Jin Kim, Moon Kyung Sunwoo, Jang Han Lee, Yong Sun Choi, Dae Yoon Kim
Investigative Magnetic Resonance Imaging.2017; 21(1): 61. CrossRef
Neurological Complications Resulting from Non-Oral Occupational Methanol Poisoning
Ji-Hyun Choi, Seung Keun Lee, Young-Eun Gil, Jia Ryu, Kyunghee Jung-Choi, Hyunjoo Kim, Jun Young Choi, Sun Ah Park, Hyang Woon Lee, Ji Young Yun
Journal of Korean Medical Science.2017; 32(2): 371. CrossRef
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Hümeyra Yıldırım Can, Halil Kırbıyık
The Bulletin of Legal Medicine.2017; 22(3): 228. CrossRef

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Case Report

A Case of Polyneuropathy Associated with Methyl Bromide Intoxication: Hyung Jae Lee, Se Won Oh, Jong Seong Lee, Hong Jae Chae, Jai Dong Moon; Korean Journal of Occupational and Environmental Medicine 2007;19(3):238-243. Published online September 30, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.3.238

Abstract PDF

BACKGROUND
The diagnosis and treatment of intoxication induced by methyl bromide depends on the patient's exposure history. In the present case, the patient showed various neurologic symptoms which were helpful to confirm the diagnosis and to determine the concentration of bromide ion in his body. The reduction rate of bromide ion concentration was another important clue to estimate the patient's health state in treatment.
CASE
REPORT: Some neurologic disorders were manifested in a 35-year-old man who had been engaged in a fumigation company for 12 years. Although he had been complaining of abnormal symptoms for 10 days, he had left his work only 3 days before being admitted to our hospital in serious state via the emergency department. Comprehensive clinical evaluations confirmed he was suffering from polyneuropathy, optic neuropathy and cerebellar signs. We diagnosed his condition as methyl bromide intoxication, and ruled out other possible diseases, after taking his occupational history and evaluating the elevation of bromide ion concentration in the sampled blood, urine and cerebrospinal fluid. With decreasing bromide ion concentration, his abnormal symptoms improved and he was discharged 22 days after admission without any neurologic sequela.
CONCLUSION
This case report confirmed the usefulness of measuring the concentrations of bromide ion in the diagnosis of methyl bromide intoxication. We therefore suggest that the regular measuring of bromide ion concentration be included in the occupation specified health examination.

Citations

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Acute Occupational Poisoning in Korea
Hyunjoo Kim, Jia Ryu
The Ewha Medical Journal.2016; 39(4): 99. CrossRef
Compensation for Occupational Neurological and Mental Disorders
Dong-Mug Kang, Inah Kim
Journal of Korean Medical Science.2014; 29(Suppl): S59. CrossRef
Occupational Neurologic Disorders in Korea
Yangho Kim, Kyoung Sook Jeong, Yong-Hun Yun, Myoung-Soon Oh
Journal of Clinical Neurology.2010; 6(2): 64. CrossRef
Occupational Neurological Disorders in Korea
Eun-A Kim, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S26. CrossRef

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Case Report

A Case of Peripheral Polyneuropathy Induced by Occupational 2,5-hexanedione Exposure: Seong Yong Cho, Yong Seok Jang, Eun Kyung Choi, Jin Seok Kim, Jay Young Yu, Kuck Hyun Woo, Tae Seong Choi; Korean Journal of Occupational and Environmental Medicine 2007;19(1):73-80. Published online March 31, 2007; DOI: https://doi.org/10.35371/kjoem.2007.19.1.73

Abstract PDF

OBJECTIVES
This study is a case report of 2,5-hexanedione induced occupational peripheral polyneuropathy. We also investigated the peripheral nerve function of all workers who had been exposed to 2,5-hexanedione in the same process.
METHODS
In June, 2006, a 2,5-hexanedione exposed worker complained of both hand numbness. He received neurologic, radiologic, laboratorial and electrophysiologic evaluation, including measurements of workplace environment. Five months after cessation of exposure to 2,5-hexanedione, a follow-up electrophysiologic examination was done. We evaluated the peripheral nerve function of 2,5-hexanedione exposed workers by comparing 13 male 2,5-hexanedione exposed workers who were in same company with the patient and 5 male workers who had not been exposed to 2,5-hexanedione.
RESULTS
Under electrophysiologic examination, there were abnormalities in sensory and motor nerve velocity, terminal latency, and F-latency of both median nerve and ulnar nerve. After 5 months, the patient symptoms and the results of follow-up electrophysiologic examinations were improved. Comparing the 2,5-hexanedione exposed group with the unexposed group, the sensory nerve velocity of the median and ulnar nerves in the exposed group was decreased. The motor nerve velocity of the peroneal nerve, and sensory nerve velocity of the median and sural nerves were decreased. Terminal latency of median, ulnar, peroneal, and tibial nerves in the exposed group were increased compared with the unexposed group(<0.05).
CONCLUSIONS
2.5-hexandione can induce peripheral polyneuropathy in male workers.

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Occupational Neurological Disorders in Korea
Eun-A Kim, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S26. CrossRef
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Kyung-Sick Jung, Nam-Soo Kim, Jong-Dae Lee, Young HwangBo, Bu-Soon Son, Byung-Kook Lee
Korean Journal of Environmental Health Sciences.2009; 35(6): 468. CrossRef
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Case Report

A case of Peripheral Neuropathy After High Electrical Injury: Jun Seok Son, Chang Ho Chae, Young Wook Kim, Keong Bum Min, Cheol Ho Yi; Korean Journal of Occupational and Environmental Medicine 2006;18(4):345-351. Published online December 31, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.4.345

Abstract PDF: BACKGROUND
With increasing industrial development, opportunities are growing to contact electricity in the workplace or home. Therefore, the risk of electrical accident has been increased gradually. In general, electrical injuries involve the extremities and result in amputation or severe disability of limbs. Delayed spinal cord injury and peripheral neuropathies following electrical accidents are extremely rare.
CASE
REPORT: A 32-year-old man with 10 years working experience at a CRT-monitor manufacturer with repetitive exposures to high voltage current visited our hosipital. He complained of left leg weakness and atrophy, and intermittent pain. The symptoms were progressive. Other symptoms occurred such as nocturia, hesitancy, and weak urinary stream. We examined the patient and conducted EMG, L-spine MRI, neurometer test, isokinetic strength test, and physical examination. The results showed neural injuries due to anterior horn lesions or compression of the left femoral nerve pathway, with a consequent diagnosis of neurogenic bladder.

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Case Report

A case of peripheral polyneuropathy occurring in a small enterprise processing mobile phone cases: Joo Youn Shin, Jong Han Leem, Yong Kyu Kim, Shin Goo Park, Jee Na Lee, Hwan Chul Kim, Chang Hwan Kim, Kyong Up Cho, Mi Jang; Korean Journal of Occupational and Environmental Medicine 2005;17(2):138-143. Published online June 30, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.2.138

Abstract PDF

OBJECTIVES
We report a case of n-hexane-induced occupational peripheral polyneuropathy. The patient had been cleaning mobile phone cases using n-hexane for 3 years without proper protection in the workplace.
Method
: Physical examinations, detailed history taking, laboratory studies and electrophysiological study were done. The n-hexane concentration in the ambient air of the workplace was analysed.
RESULTS
The findings of the electrophysiological study revealed that the worker's neurologic symptoms were due to peripheral polyneuropathy. The average n-hexane concentration in the ambient air sampled at the workplace for 59 minutes was 1411.24ppm, from which the 8 hour time-weighted-average(TWA) was estimated as 882ppm. Because other alternative causes for peripheral polyneuropathy were ruled out by laboratory findings and detailed history taking, this TWA level strongly suggested that the disease was caused by n-hexane exposure.
Conclusion
: Although the neuro-toxicity of n-hexane is relatively well known, many problems have been identified in the management of this toxic material in terms of preventing toxic diseases in the workplace. We expect that this case will help in the planning of health management strategies for using n-hexane in the workplace.

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Kyung Ehi Zoh, Mijin Park, Domyung Paek
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Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(1): 58. CrossRef
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Yangho Kim, Kyoung Sook Jeong, Yong-Hun Yun, Myoung-Soon Oh
Journal of Clinical Neurology.2010; 6(2): 64. CrossRef

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Original Article

Evaluation of Early Neurologic Abnormalities on the Workers Exposed to Acrylamide: Seong Soon Kim, Hae Kwan Cheong, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 2000;12(3):367-383. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.367

Abstract PDF

OBJECTIVES
Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure.
METHODS
Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done.
RESULTS
The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2).
CONCLUSIONS
The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.

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Usefulness of Color Vision Test for Early Detection of Neurological Damages by Neurotoxic Substances
Eun-Hee Lee, Kyungho Choi, Hong Jae Chae, Domyung Paek
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Original Article

Polyneuropathy by Occupational Exposure to Acrylamide: Hae Kwan Cheong, Yong Wook Kwon, Kyung Yun Uh, Byung Joon Kim, Jeong Sun Yang, Cheol Jung, Youngwoo Jin, Mi Young Lee, Seong Kyu Kang; Korean Journal of Occupational and Environmental Medicine 1998;10(3):388-403. Published online August 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.3.388

Abstract PDF

Authors report a first Korean case of polyneuropathy in an acrylamide producing factory together with an environmental and epidemiologic survey for the ten workers of the same workplace and 46 workers in the production and manufacturing acrylamide in Ulsan, Korea. The case is 30 years old man who worked in the prcduction of the acrylamide for two years. In August, 1997, he had a weakness of the lower extremity with loss of body weight of 15 Kg which progressed to paresthesia of the limbs, the loss of vibration sense, difficulty in walking, speech disturbance, dysuria, constipation, difficulty in erection and swallowing difficulty. Neurologic examination showed a complete loss of vibration and position sense, and loss of deep tendon reflex in all the limbs. There was a contact dermatitis-like skin lesion on the feet. Electrodiagnostic test showed a generalized polyneuropathy of moderate degree involving motor and sensory component of peripheral and cranial nerves. After 8 months' cessation from exposure and supportive care, his symptoms were completely resolved, but abnormality in electrodiagnostic test and vibrotactile perception threshold still persisted, although much improved than before. There were 11 workers in the same workplace of the case, producing acrylamide by microorganism as a catalyst. Environmental monitoring of the workplace revealed air-borne concentration of the acrylamide to be from 0.05 to 0.23 mg/m(3) by personal sampling and from 7.65 to 11.65 mg/m(3) by area sampling during filter exchanging process, which far exceeds TLV-TWA of 0.03 mg/m(3). However acrylamide was not detected from the plasma of the workers. Symptom questionnaire showed a markedly higher complain of neurologic symptoms, compared to the workers of the other acrylamide producing companies. Electrodiagnostic test showed a several workers are in the lower normal range without definite abnormality. Vibrotactile perception threshold by Vibratron II showed a significantly increased threshold in the workers of the same workplace compared to the other acrylamide workers and significantly decreased test score of color vision compared to normal controls. After improvement of the production process and strict wearing of the protective device, most workers reported the improvement of clinical symptoms, but vibrotactile perception threshold was not improved. These result suggests the need for the effective environmental monitoring together with a periodic biological monitoring. Development of effective screening test is urgently needed to control and assess the skin absorption of acrylamide.

Citations

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Dermal and neural toxicity caused by acrylamide exposure in two Korean grouting workers: a case report
Heeyun Kim, Sang Gil Lee, Jeongbae Rhie
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef
Occupational Neurologic Disorders in Korea
Yangho Kim, Kyoung Sook Jeong, Yong-Hun Yun, Myoung-Soon Oh
Journal of Clinical Neurology.2010; 6(2): 64. CrossRef
Occupational Neurological Disorders in Korea
Eun-A Kim, Seong-Kyu Kang
Journal of Korean Medical Science.2010; 25(Suppl): S26. CrossRef
Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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Original Article

Study on the Progression of Biological Effects of Workers Following Termination of CS2 Exposure: In Cases of Peripheral Polyneuritis and Retinal Change: Y T Yum, K J Kim, S D Kim, E I Lee, H K Park, H R Jung, H K Kwon; Korean Journal of Occupational and Environmental Medicine 1994;6(2):348-363. Published online September 30, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.2.348

Abstract PDF

The object of this study was to evaluate the possibility of new development of polyneuropathy and microaneurysm in dundus in workers who did not have polyneuropathy and microaneurysm in dundus in the electromyogram(EMG) and ophthalmoscopic examination. The total number of subjects was 144 workers who had the EMG and funduscopic examination done at leat twice. There were two kinds of subjects. The one of subjects was a total of 120 workers who were examined at least twice in their annual health examination for carbon disulfide poisoning. The other subjects were 3 total of 24 volunteer workers who worked in the rayon manufacturing factory. The results were as follows; 1. There was no cases of polyneuropathy or microaneurysm in volunteers. 2. The new cases of polyneuropathy were detected in 12 (14.3%) out of 84 subjects, and those of microaneurysm in fundus were detected in 30 (26.5%) out of 113 subjects. 3. We investigated the variables showing difference between the new cases and other cases who had no polyneuropathy or microaneurysm in fundus in repeated examinations. The both of polyneuropathy and microaneurysm cases had higher commulative exposure index, and most of them were workers in the department of spinning where the concentration of CS0 in air was highest in the rayon manufacturing company. 4. There were no statistically significant variables by logistic regression analysis in the polyneuropathy cases, The cummulative index and the department were the statistically significant variable in the development of microaneurysms. ' 5. Above findings showed that workers who had high exposure history of CS2 as the workers in spinning department, had greater chance to develop the polyneuropathy or microaneurysm. But tHere were some limitations to conclude the association between the CS2 exposure and development of polyneuropatHy or microaneurysm. Limitations are follows short follow-up period, small number of cases, and possibility of measurement error including imperfect sensitivity or specificity of electrodiagnostic test and examiner's difference of ophthalmoscopic examination. Therefore more cases and longer follow-up period are needed to study the progression of polyneuropathy or microaneurysm.

Citations

Citations to this article as recorded by

Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef
Carbon Disulfide Poisoning in Korea with Social and Historical Background
Eunil Lee, Soonduck Kim, Haejoon Kim, Kwangjong Kim, Yongtae Yum
Journal of Occupational Health.1996; 38(4): 155. CrossRef

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