Polyneuritis Incidence in Shoe Factory Workers: Cases Report and Etiological Considerations

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Abstract
This study describes an outbreak of polyneuropathies in an artificial leather shoe factory. Thirty-seven females employed in the factory were examined; clinical findings and hematochemical data suggest a possible role of tricresylphosphate (TCP) in the genesis of these polyneuropathies. A high percentage of subjects evidenced definite signs of upper-motor neuron involvement, which appeared at an early or late stage of the disease. A statistically significant (P < .0 0 1 ) reduction of red-blood-cell acetylcholinesterase (AChE) was found in the subjects. The ascertained upper-motor neuron involvement suggests a connection with previously described intoxications by TCP—by ingestion or occupational poisoning. The reduction of AChE seems attributable to TCP, and not to n-hexane, whose anti-AChE activity has never been demonstrated.