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Low-level exposures to organophosphorus esters and peripheral nerve function.

Marcello Lotti1

  • 1Università degli Studi di Padova, Dipartimento di Medicina Ambientale e Sanità Pubblica, Azienda Ospedaliera, Via Giustiniani 2, 35148 Padua, Italy. lottitox@unipd.it

Muscle & Nerve
|April 5, 2002
PubMed
Summary

This review found no evidence that low-level, prolonged exposure to organophosphorus esters causes peripheral nerve dysfunction. Existing evidence does not support claims of neuropathy without prior cholinergic toxicity from these chemical exposures.

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Area of Science:

  • Toxicology
  • Neuroscience
  • Epidemiology

Background:

  • Organophosphorus esters are widely used as insecticides and nerve agents.
  • High doses cause well-established cholinergic syndrome, intermediate syndrome, and delayed polyneuropathy.
  • Peripheral neuropathy typically follows cholinergic toxicity.

Purpose of the Study:

  • To evaluate evidence linking low-level, prolonged organophosphorus ester exposure to peripheral nerve dysfunction.
  • To assess claims of neuropathy development without preceding cholinergic toxicity.

Main Methods:

  • Review of epidemiological and clinical studies on organophosphorus ester exposure.
  • Critical assessment of studies involving subjects with current or past exposures.
  • Analysis of dose-effect relationships and exposure data.

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Main Results:

  • Changes in peripheral nerve function in reviewed studies were mild, inconsistent, and unexplained.
  • Most studies lacked adequate exposure data.
  • No support found for individual hypersusceptibility to delayed polyneuropathy.

Conclusions:

  • There is no evidence of peripheral nerve dysfunction from low-level, prolonged exposure to organophosphate insecticides or nerve agents.
  • The proposed relationship of neuropathy without cholinergic toxicity in low-level exposures is not supported by current evidence.