Extrapyramidal and other neurologic manifestations associated with carbon disulfide fumigant exposure

Three groups of pesticide-exposed grain workers from three different work facilities experienced chronic central and peripheral nervous system dysfunction that appeared to be exposure related. The grain inspectors, malt laboratory workers, and grain elevator workers displayed higher prevalence rates of atypical parkinsonism, cerebellar signs, hearing loss, and sensory changes than would be expected in a nonneurologic control population. The 21 self-selected patients included in this report exhibited cogwheel rigidity in 80% (17/21), decreased associated movements in 71% (15/21), distal sensory shading in 62% (13/21), intention tremulousness in 52% (11/21), resting tremulousness in 48% (10/21), and nerve conduction abnormalities in 44% (7/16). Carbon disulfide, a major component of the fumigant mixtures used, has been associated in the rayon industry, since the 1930s, with similar neurologic symptoms.