Function testing for chemical brain damage: a review

Testing of neurobehavioral functions for evaluation of the effects of chemicals on the human brain from community (i.e., environmental) exposures is logical and may be a preferred initial step. Sensitivity is improved (1) by adjusting individual tests for influential factors, found by regression modeling and by retaining significant coefficients; and (2) by the calculation of predicted values for each test for each subject. This two-part approach allows for adjustments in age, sex, educational level, and other factors before comparisons are made. Visual fields, color discrimination, reaction time, balance, and digit symbol are the most sensitive tests, followed by 6 sensitive psychological tests and less-discriminating physiological measurements. Hydrogen sulfide, polychlorinated biphenyls, and arsenic are the most toxic chemicals, followed by chlorine, chlorpyrifos, formaldehyde, nickel carbonyl, and ammonia. The least toxic chemicals, which are hydrochloric acid and chlorine, were determined 7 wk following a community spill. The least toxic chemical among those identified herein is methyl ter butyl ether.