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Cited by 18Toxic Organic Pollutants ImpactPesticide Exposure and ToxicityMedical Case Reports and Studies

Neurological and Neurophysiological Findings in Workers with Chronic 2,3,7,8‐Tetrachlorodibenzo‐p‐Dioxin Intoxication 50 Years After Exposure

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Pelclova, Daniela, Urban, Pavel, Fenclova, Zdenka, Vlckova, Stepanka, Ridzon, Petr, Kupka, Karel, Meckova, Zuzana, Bezdicek, Ondrej +3 more·2018·Basic & Clinical Pharmacology & Toxicology
DOI 10.1111/bcpt.12899
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Abstract

The last eight survivors of 80 workers accidentally exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) during production of herbicides based on trichlorophenoxyacetic acid in 1965-1967 in a chemical factory were followed. All were men, mean age 72.4 ± 1.3 years. Their current median TCDD blood level was 112 (46-390) pg/g lipids. Neurological examination revealed central nervous system impairment in all individuals and signs of polyneuropathy in 87.5%, which was confirmed by a nerve conduction study (NCS) in 75%. A Lanthony test demonstrated acquired dyschromatopsia in 87.5% of the patients, with deterioration of mean colour confusion index (CCI) from 1.52 ± 0.39 in 2010 to 1.73 ± 0.41 in 2016. Single-photon emission computer tomography (SPECT) of the brain showed focal reduction of perfusion in various brain locations in all patients and worsening in six patients. Visual-evoked potentials (VEP) was abnormal in 62.6% of individuals. Most patients complained of psychological problems. The neuropsychological test battery showed most positive impairments in the Trail Making Test evaluating processing speed (average level in the range of mild neurocognitive impairment), which correlated with mean CCI (p < 0.05). CONCLUSION: Fifty years after exposure, blood levels of TCDD are still 10 times higher than the general population. NCS, VEP, Lanthony test and SPECT findings deteriorated from examination of these patients in 2004 and in 2010. The total of abnormal tests per patient in 2016 is very high. Minor differences among patients and their reduced count may explain why the number of impairments in 2016 does not correlate with TCDD blood level.

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Authors
Pelclova, D., Urban, P., Fenclova, Z., Vlckova, S., Ridzon, P., Kupka, K., Meckova, Z., Bezdicek, O., Navratil, T., Rosmus, J., & Zakharov, S.
Affiliations
  • Department of Occupational Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
  • Charles University (CZ)
  • Institute of Nuclear Medicine First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
  • Department of Neurology First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
  • J. Heyrovsky Institute of Physical Chemistry of the CAS, v.v.i. Prague Czech Republic
  • State Veterinary Administration (CZ)
ORCID
Venue
Basic & Clinical Pharmacology & Toxicology
Publisher
Wiley
Published
2017-09-27
Volume
122
Issue
2
Pages
271-277
ISSN
  • 1742-7835 (ISSN-L)
  • 1742-7843
DOI
10.1111/bcpt.12899
OpenAlex
W2751697568
Cited by
18
References
0
Citations by year
2026: 2 · 2025: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 3
FWCI
1.18
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Basic & Clinical Pharmacology & Toxicology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Všeobecná Fakultní Nemocnice v Praze
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
  • Life Sciences › Agricultural and Biological Sciences › Plant Science › Pesticide Exposure and Toxicity
  • Health Sciences › Medicine › Surgery › Medical Case Reports and Studies
Keywords
2,3,7,8-tetrachlorodibenzo-p-dioxin, TCDD, occupational exposure, herbicide production, long-term neurotoxicity, polyneuropathy, central nervous system impairment, visual evoked potentials, neurocognitive impairment, processing speed, mental illness
MeSH terms
Accidents, Occupational, Polychlorinated Dibenzodioxins, Aged, Brain, Cerebrovascular Circulation, Chemical Industry, Cognition, Evoked Potentials, Visual, Herbicides, Humans, Male, Neural Conduction, Neurologic Examination, Neuropsychological Tests, Polyneuropathies, Time Factors, Tomography, Emission-Computed, Single-Photon, Occupational Health, Occupational Exposure, Neurotoxicity Syndromes, Color Vision, Perfusion Imaging

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