Neurotoxic chemical exposure scenarios and suggested solutions

This manuscript reports the results of a problem-solving exercise presented to participants at a Workshop on Neurotoxicology Testing in Human Populations held in Rougemont, North Carolina in October, 1983. Response recommendations are the consensus of workshop participants. These are not comprehensive or definitive solutions and should be interpreted with caution. Each exposure scenario represents a "real world" situation previously encountered by neurologists and epidemiologists. Ideally, a toxin affects a single, easily tested modality early in the illness before producing a complex neurological syndrome. Unfortunately this rarely happens; difficult choices and compromises about testing are usually necessary. At the end of each scenario likely areas of early subtle dysfunction were discussed and possible testing methods were outlined. Working participants were instructed to comment on the approach to the scenarios and to add to or dispute the proposed tests. It is clear that there are no right or wrong answers; however, the participants were urged to try to reach some sort of consensus. In each instance participants assumed that they were being notified by the company and not by a state or federal agency, and were to determine what would be the most reasonable and effective way to offer help or obtain outside assistance in these situations.