Page E H, Pajeau A K, Arnold T C, Fincher A R, Goddard M J
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226-1998, USA.
Am J Ind Med. 2001 Jul;40(1):107-13. doi: 10.1002/ajim.1077.
Two workers from a headlight subassembly plant developed severe peripheral neuropathy. These workers had extensive, but brief (1-2 months) dermal and inhalational exposure to nitromethane, a solvent.
Environmental sampling was performed for nitromethane and ethyl cyanoacrylate. Medical records, including electrodiagnostic studies, were reviewed. Literature on nitromethane, ethyl cyanoacrylate, and other exposures in the workplace was reviewed.
Electromyography and nerve conduction studies performed on these patients were consistent with a severe, axonal neuropathy. No etiology was discovered despite an extensive medical evaluation. Environmental sampling revealed exposure to nitromethane at the threshold limit value.
The history of acute onset of severe peripheral neuropathy temporally associated with exposure to nitromethane is suggestive of a toxic neuropathy. While it cannot be definitively concluded that these two workers developed peripheral neuropathy secondary to exposures at work, occupational exposure to nitromethane appears to be the most likely etiology.
一家前照灯组件厂的两名工人患上了严重的周围神经病变。这些工人曾大量但短暂（1 - 2个月）地通过皮肤接触和吸入一种溶剂——硝基甲烷。
对硝基甲烷和氰基丙烯酸乙酯进行了环境采样。查阅了包括电诊断研究在内的医疗记录。回顾了关于硝基甲烷、氰基丙烯酸乙酯及其他工作场所暴露的文献。
对这些患者进行的肌电图和神经传导研究结果与严重的轴索性神经病变相符。尽管进行了全面的医学评估，但未发现病因。环境采样显示硝基甲烷暴露量处于阈限值。
严重周围神经病变急性起病且与接触硝基甲烷在时间上相关的病史提示为中毒性神经病变。虽然不能确切得出这两名工人的周围神经病变是工作暴露所致，但职业性接触硝基甲烷似乎是最可能的病因。
