Occupational exposure to chemicals and sensory organs: a neglected research field

The impact of chronic co-exposure to different heavy metals on small fibers of peripheral nerves. A study of metal industry workers

Background

Chronic exposure to heavy metals affects various organs, among them the brain and peripheral nerves. Polyneuropathy is mainly length-dependent with predominantly sensory symptoms. There have been few studies on small fiber neuropathy due to heavy metal intoxication.

Methods

We investigated 41 metal industry workers, mean age 51.3 ± 10.5 years, with at least 5 years’ professional exposure to heavy metals, and 36 age- and sex-matched healthy controls. We performed neurological examinations, and assessed blood levels of cadmium, lead, and zinc protoporphyrin, urine levels of arsenic, standard, sensory and motor electrophysiological tests in the ulnar and peroneal nerves, sympathetic skin responses from the palm and foot, and quantitative sensation testing from dermatomes C8 and S1.

Discussion

The results of standard conduction tests of all nerves significantly differed between groups. The latency of sympathetic skin responses achieved from the foot was also statistically significantly prolonged in the study group. Significant differences were seen in both C8 and S1 regions for temperature and pain thresholds, and for vibratory threshold only in the S1 region, while the dispersions of low and high temperatures were important exclusively in the C8 region.

Conclusions

We can conclude that co-exposure to many heavy metals results in explicit impairment of peripheral nerves. The lesion is more pronounced within small fibers and is predominantly connected with greater impairment of temperature-dependent pain thresholds. The evaluation of small fiber function should be considered in the early diagnosis of toxic polyneuropathy or in low-dose exposure to heavy metals.

Chronic Cigarette Smoking Associates Directly and Indirectly with Self-Reported Olfactory Alterations: Analysis of the 2011-2014 National Health and Nutrition Examination Survey

INTRODUCTION

Population-based studies show inconsistent effects of cigarette smoking on olfactory function. We aimed to identify direct and indirect associations between measures of smoking exposure/nicotine dependence and altered olfaction in a nationally representative sample of adults.

METHODS

NHANES 2011-2014 (n = 7418) participants (mean age = 57.8 ± 12.2 years) self-reported olfaction and related health and demographic risks. Affirmative answers to three questions defined altered olfaction (olfactory problems in the past years; worse ability since age 25; phantom smells). Smoking (never, former, current) was self-reported by chronicity (pack years, PY) and dependency (time to first cigarette upon waking) and verified by serum cotinine. Associations were tested with logistic regression, reporting odds ratios (ORs) and 95% confidence intervals (CIs), and mediation models.

RESULTS

Estimated prevalence of altered olfaction was 22.3%, with age-related increases. Nearly half of the sample were former/current smokers (47.4%). Controlling for olfactory-related risks, ≥10 PY smokers had significantly greater odds of altered olfaction versus never smokers (OR 1.36, CI: 1.06-1.74). The odds of altered olfaction were heightened among current smokers (≥10 PY) who also had high nicotine dependence (smoked ≤30 min of waking) (OR 1.41, CI: 1.01-1.99). Light smokers (≤10 PY smokers) did not show increased odds versus never smokers. Current smokers who also were heavy drinkers (≥4 drinks/day) had the highest odds for altered olfaction (OR 1.96, CI: 1.20-3.19). Olfactory-related pathologies (sinonasal problems, serious head injury, tonsillectomy, xerostomia) partially mediated the association between smoking and altered olfaction.

CONCLUSIONS

Chronic cigarette smoking was associated with increased odds of self-reported olfactory alterations, directly and indirectly via olfactory-related pathologies.

IMPLICATIONS

Analysis of the US nationally representative data revealed significant positive associations between chronic smoking and alterations in the sense of smell. Rates of smell alteration (self-reported problems in the past year, losses with aging, and phantom smells) increased from 23% among adults to 33% for chronic smokers and 38% for chronic smokers who also reported heavy drinking. Chronic smoking showed associations with smell alteration that were direct and indirect through exposure to olfactory-related pathologies (naso-sinus problems, dry mouth, head/facial injury). Smell alteration can impact smokers' quality of life by challenging the ability to sense warning odors, food flavor, and olfactory-stimulated emotions and memories.

Toxicologic Pathology Analysis for Translational Neuroscience

A half-day American College of Toxicology continuing education course presented key issues often confronted by translational neuroscientists when predicting human risk from animal-derived toxicologic pathology data. Two talks correlated discrete structures with major functions in brains of rodents and nonrodents. The third lecture provided practical advice to obtain highly homologous rodent brain sections for quantitative morphometry in developmental neurotoxicity testing. The last presentation discussed demographic influences (eg, species, strain, sex, age), physiological attributes (eg, body composition, brain vascularity, pharmacokinetic/pharmacodynamic patterns, etc), and husbandry parameters (eg, group housing) recognized to impact the actions of neuroactive chemicals. Speakers described common cases of real-world challenges to animal data interpretation encountered when designing studies or extrapolating biological responses across species. The efficiency of translational neuroscience efforts will likely be enhanced as new methods (eg, high-resolution non-invasive imaging) improve our capability to cross-connect subtle anatomic and/or biochemical lesions with functional changes over time.

Toluene inhalation exposure for 13 weeks causes persistent changes in electroretinograms of Long-Evans rats

Studies of humans chronically exposed to volatile organic solvents have reported impaired visual functions, including low contrast sensitivity and reduced color discrimination. These reports, however, lacked confirmation from controlled laboratory experiments. To address this question experimentally, we examined visual function by recording visual evoked potentials (VEP) and/or electroretinograms (ERG) from four sets of rats exposed repeatedly to toluene. In addition, eyes of the rats were examined with an ophthalmoscope and some of the retinal tissues were evaluated for rod and M-cone photoreceptor immunohistochemistry. The first study examined rats following exposure to 0, 10, 100 or 1000ppm toluene by inhalation (6hr/d, 5d/wk) for 13 weeks. One week after the termination of exposure, the rats were implanted with chronically indwelling electrodes and the following week pattern-elicited VEPs were recorded. VEP amplitudes were not significantly changed by toluene exposure. Four to five weeks after completion of exposure, rats were dark-adapted overnight, anesthetized, and several sets of electroretinograms (ERG) were recorded. In dark-adapted ERGs recorded over a 5-log (cd-s/m(2)) range of flash luminance, b-wave amplitudes were significantly reduced at high stimulus luminance values in rats previously exposed to 1000ppm toluene. A second set of rats, exposed concurrently with the first set, was tested approximately one year after the termination of 13 weeks of exposure to toluene. Again, dark-adapted ERG b-wave amplitudes were reduced at high stimulus luminance values in rats previously exposed to 1000ppm toluene. A third set of rats was exposed to the same concentrations of toluene for only 4 weeks, and a fourth set of rats exposed to 0 or 1000ppm toluene for 4 weeks were tested approximately 1year after the completion of exposure. No statistically significant reductions of ERG b-wave amplitude were observed in either set of rats exposed for 4 weeks. No significant changes were observed in ERG a-wave amplitude or latency, b-wave latency, UV- or green-flicker ERGs, or in photopic flash ERGs. There were no changes in the density of rod or M-cone photoreceptors. The ERG b-wave reflects the firing patterns of on-bipolar cells. The reductions of b-wave amplitude after 13 weeks of exposure and persisting for 1year suggest that alterations may have occurred in the inner nuclear layer of the retina, where the bipolar cells reside, or the outer or inner plexiform layers where the bipolar cells make synaptic connections. These data provide experimental evidence that repeated exposure to toluene may lead to subtle persistent changes in visual function. The fact that toluene affected ERGs, but not VEPs, suggests that elements in the rat retina may be more sensitive to organic solvent exposure than the rat visual cortex.

Fundamentals of translational neuroscience in toxicologic pathology: optimizing the value of animal data for human risk assessment

A half-day Society of Toxicologic Pathology continuing education course on "Fundamentals of Translational Neuroscience in Toxicologic Pathology" presented some current major issues faced when extrapolating animal data regarding potential neurological consequences to assess potential human outcomes. Two talks reviewed functional-structural correlates in rodent and nonrodent mammalian brains needed to predict behavioral consequences of morphologic changes in discrete neural cell populations. The third lecture described practical steps for ensuring that specimens from rodent developmental neurotoxicity tests will be processed correctly to produce highly homologous sections. The fourth talk detailed demographic factors (e.g., species, strain, sex, and age); physiological traits (body composition, brain circulation, pharmacokinetic/pharmacodynamic patterns, etc.); and husbandry influences (e.g., group housing) known to alter the effects of neuroactive agents. The last presentation discussed the appearance, unknown functional effects, and potential relevance to humans of polyethylene glycol (PEG)-associated vacuoles within the choroid plexus epithelium of animals. Speakers provided real-world examples of challenges with data extrapolation among species or with study design considerations that may impact the interpretability of results. Translational neuroscience will be bolstered in the future as less invasive and/or more quantitative techniques are devised for linking overt functional deficits to subtle anatomic and chemical lesions.

Zebrafish model systems for developmental neurobehavioral toxicology

Zebrafish offer many advantages that complement classic mammalian models for the study of normal development as well as for the teratogenic effects of exposure to hazardous compounds. The clear chorion and embryo of the zebrafish allow for continuous visualization of the anatomical changes associated with development, which, along with short maturation times and the capability of complex behavior, makes this model particularly useful for measuring changes to the developing nervous system. Moreover, the rich array of developmental, behavioral, and molecular benefits offered by the zebrafish have contributed to an increasing demand for the use of zebrafish in behavioral teratology. Essential for this endeavor has been the development of a battery of tests to evaluate a spectrum of behavior in zebrafish. Measures of sensorimotor plasticity, emotional function, cognition and social interaction have been used to characterize the persisting adverse effects of developmental exposure to a variety of chemicals including therapeutic drugs, drugs of abuse and environmental toxicants. In this review, we present and discuss such tests and data from a range of developmental neurobehavioral toxicology studies using zebrafish as a model. Zebrafish provide a key intermediate model between high throughput in vitro screens and the classic mammalian models as they have the accessibility of in vitro models and the complex functional capabilities of mammalian models.

STP position paper: Recommended practices for sampling and processing the nervous system (brain, spinal cord, nerve, and eye) during nonclinical general toxicity studies

The Society of Toxicologic Pathology charged a Nervous System Sampling Working Group with devising recommended practices to routinely screen the central nervous system (CNS) and peripheral nervous system (PNS) in Good Laboratory Practice-type nonclinical general toxicity studies. Brains should be weighed and trimmed similarly for all animals in a study. Certain structures should be sampled regularly: caudate/putamen, cerebellum, cerebral cortex, choroid plexus, eye (with optic nerve), hippocampus, hypothalamus, medulla oblongata, midbrain, nerve, olfactory bulb (rodents only), pons, spinal cord, and thalamus. Brain regions may be sampled bilaterally in rodents using 6 to 7 coronal sections, and unilaterally in nonrodents with 6 to 7 coronal hemisections. Spinal cord and nerves should be examined in transverse and longitudinal (or oblique) orientations. Most Working Group members considered immersion fixation in formalin (for CNS or PNS) or a solution containing acetic acid (for eye), paraffin embedding, and initial evaluation limited to hematoxylin and eosin (H&E)-stained sections to be acceptable for routine microscopic evaluation during general toxicity studies; other neurohistological methods may be undertaken if needed to better characterize H&E findings. Initial microscopic analyses should be qualitative and done with foreknowledge of treatments and doses (i.e., "unblinded"). The pathology report should clearly communicate structures that were assessed and methodological details. Since neuropathologic assessment is only one aspect of general toxicity studies, institutions should retain flexibility in customizing their sampling, processing, analytical, and reporting procedures as long as major neural targets are evaluated systematically.

Long-term occupational exposure to organic solvents affects color vision, contrast sensitivity and visual fields

The purpose of this study was to evaluate the visual outcome of chronic occupational exposure to a mixture of organic solvents by measuring color discrimination, achromatic contrast sensitivity and visual fields in a group of gas station workers. We tested 25 workers (20 males) and 25 controls with no history of chronic exposure to solvents (10 males). All participants had normal ophthalmologic exams. Subjects had worked in gas stations on an average of 9.6±6.2 years. Color vision was evaluated with the Lanthony D15d and Cambridge Colour Test (CCT). Visual field assessment consisted of white-on-white 24–2 automatic perimetry (Humphrey II-750i). Contrast sensitivity was measured for sinusoidal gratings of 0.2, 0.5, 1.0, 2.0, 5.0, 10.0 and 20.0 cycles per degree (cpd). Results from both groups were compared using the Mann–Whitney U test. The number of errors in the D15d was higher for workers relative to controls (p<0.01). Their CCT color discrimination thresholds were elevated compared to the control group along the protan, deutan and tritan confusion axes (p<0.01), and their ellipse area and ellipticity were higher (p<0.01). Genetic analysis of subjects with very elevated color discrimination thresholds excluded congenital causes for the visual losses. Automated perimetry thresholds showed elevation in the 9°, 15° and 21° of eccentricity (p<0.01) and in MD and PSD indexes (p<0.01). Contrast sensitivity losses were found for all spatial frequencies measured (p<0.01) except for 0.5 cpd. Significant correlation was found between previous working years and deutan axis thresholds (rho = 0.59; p<0.05), indexes of the Lanthony D15d (rho = 0.52; p<0.05), perimetry results in the fovea (rho = −0.51; p<0.05) and at 3, 9 and 15 degrees of eccentricity (rho = −0.46; p<0.05). Extensive and diffuse visual changes were found, suggesting that specific occupational limits should be created.

Effects of pyridine inhalation exposure on olfactory epithelium in mice

Olfactory neurons in the nasal mucosa have the capacity to regenerate continuously along the lifespan by neurogenesis processes starting with progenitor cells close to the basal lamina. The cellular turnover into olfactory neuroepithelium may be modified by environmental stimuli insofar as nasal mucosa is directly in contact with airborne chemicals. However, few studies have been focused on selective changes, especially those concerning mature olfactory neurons and basal cells during specific inhalation exposure. Among chemicals, solvents are known to induce changes in smell abilities and concomitant histological and cellular modifications related to the type of molecule, concentration and time of exposure. This study was designed to characterize smell sensitivity (using behavioral tests) and immunohistochemical effects on olfactory neuroepithelium induced by pyridine exposure in mice. Olfactory marker protein (OMP) and proliferating cell nuclear antigen (PCNA) were used to characterize respectively mature olfactory neurons and basal cells. Results showed that inhalation exposure to pyridine had no impact on smell sensitivity whatever the concentration used and the time of exposure. These findings were in agreement with immunohistochemical measurements showing the same cellular kinetic whatever the condition of exposition to pyridine. Indeed, OMP-positive cells increased and PCNA-positive cells decreased as early as the beginning of exposure and cell amounts remained stable at this level until the end of exposure. These findings suggest that pyridine could have the property to rapidly activate a cellular turnover from basal cell progenitors. Rather than toxic effects, the present findings suggest that the metabolites of pyridine might have cell cycle activation properties.

Neural system antigens are recognized by autoantibodies from patients affected by a new variant of endemic pemphigus foliaceus in Colombia

BACKGROUND

Endemic pemphigus foliaceus (EPF), is also known as "fogo selvagem" or "wild fire," reflecting the intense burning sensation of the skin reported by patients with this disease. Based on this finding, we tested for neural autoreactivity in patients affected by a new variant of EPF (El Bagre-EPF).

METHODS

We tested 20 El Bagre-EPF patients, 20 normal controls from the endemic area, and 20 age- and sex-matched normal controls from outside the endemic area. We tested for autoreactivity to several immunoglobulins and complement. Both human skin and bovine tail were used as antigens.

RESULTS

We detected autoreactivity to neural structures, mechanoreceptors, nerves, perineural cell layers of the arachnoid envelope around the optic nerve, brain structures, and to neuromuscular spindles; these structures colocalized with several neural markers. The patient antibodies also colocalized with desmoplakins 1 and 2, with the armadillo repeat protein deleted in velo-cardio-facial syndrome and with p0071 antibodies. Autoreactivity was also found associated with neurovascular bundles innervating the skin, and immunoelectron microscopy using protein A gold against patient antibodies was positive against the nerve axons. Paucicellularity of the intraepidermal nerve endings and defragmentation of the neural plexus were seen in 70% of the cases and not in the controls from the endemic area (p<0.005). Neuropsychological and/or behavioral symptoms were detected in individuals from the endemic area, including sensorimotor axonal neuropathy.

CONCLUSIONS

Our findings may explain for the first time the "pose of pemphigus," representing a dorsiflexural posture seen in EPF patients vis-a-vis the weakness of the extensor nerves, and furthermore, the autoreactivity to nerves in EPF could explain the "burning sensation" encountered in EPF disease.

Toxin-induced chemosensory dysfunction: a case series and review

BACKGROUND

Toxic chemical exposures are estimated to account for 1-5% of all olfactory disorders. Both olfactory neurons and taste buds are in direct contact with environmental agents because of their relatively unprotected anatomic locations, thereby making them susceptible to damage from acute and chronic toxic exposures. The aim of this study was to illustrate different aspects of the diagnostic and therapeutic approach to this disorder using a series of case reports and review of the literature.

METHODS

Cases were selected for inclusion based on a retrospective chart review of patients who presented to a university-based nasal dysfunction clinic with toxin-induced olfactory or gustatory dysfunction between January 1985 and December 2008. Workup included complete history, otolaryngologic examination, psychophysical testing, and imaging.

RESULTS

Patient ages ranged from 31 to 67 years (mean, 49.3 years). Etiology of chemosensory impairment included exposure to ammonia, isodecanes, hairdressing chemicals, chemotherapy, gasoline, and intranasal zinc. Five of the seven patients (71%) presented with olfactory dysfunction alone, one patient (14%) presented with dysgeusia alone, and one patient (14%) presented with both smell and taste loss. Only one patient (14%) reported parosmias. Tests of olfaction revealed normosmia in one patient (14%), mild-to-moderate hyposmia in one patient (14%), and severe hyposmia to anosmia in five patients (72%). Both patients who reported taste disorders had hypogeusia on testing.

CONCLUSION

This case series illustrates the wide spectrum of this disorder and provides a framework for the workup and treatment of these patients.

Exploring new frontiers in occupational epidemiology: the Hunter Community Study (HCS) from Australia

This article describes a pioneering longitudinal investigation from Australia known as the Hunter Community Study (HCS). The HCS investigates retired and near-retired persons randomly selected in a regional area on the heavily populated east coast. As it collects detailed survey, clinical, and biological measures, the HCS is more comprehensive than most other research of this nature. The HCS also has significant occupational implications at an international level, being one of the first Australian studies to take a full, lifetime occupational history linked to job exposures. Longitudinal cohort studies with exposure assessment, such as the HCS offer epidemiologists around the world a clear opportunity for examining and evaluating the long-term risks of employment across a variety of workplace settings. It is only with detailed datasets that continuing progress can be made in elucidating mechanisms of occupational disease causation in the new millennium.

Effects of CO2 inhalation exposure on mice vomeronasal epithelium

Nasal epitheliums are the first sites of the respiratory tract in contact with the external environment and may therefore be susceptible to damage from exposure to many toxic volatile substances (i.e., volatile organic components, vapors, and gases). In the field of inhalation toxicology, a number of studies have considered the main olfactory epithelium, but few have dealt with the epithelium of the vomeronasal organ (VNO). However, in several species such as in rodents, the VNO (an organ of pheromone detection) plays an important role in social interactions, and alterations of this organ are known to induce adaptative behavioral disturbances. Among volatile toxicants, health effects of inhaled gases have been thoroughly investigated, especially during CO(2) inhalation because of its increasing atmospheric concentration. Therefore, this work was designed to examine the effects of 3% CO(2) inhalation on VNO in two different exposure conditions (5 h/day and 12 h/day) in mice. Behavioral sensitivity tests to urine of congener and histological measurements of VNO were conducted before, during (weeks 1-4), and after (weeks 5-8) CO(2) inhalation exposures. Results showed no significant modifications of behavioral responses to urine, but there were significant changes of both cell number and thickness of the VNO epithelium. Moreover, the findings indicated a selectively dose-dependent effect of CO(2), and further research could use other gases in the same manner for comparison.

Carbon dioxide effects on olfactory functioning: behavioral, histological and immunohistochemical measurements

Most studies on toxic inhalation focus on solvent effects and few have dealt with gases on olfactory functioning. Among gases, the effects of carbon dioxide on general physiology have been well investigated contrary to the impact on olfactory neuroepithelium. Thus, this work was designed to evaluate in mice the possible effects of 3% CO(2) in two exposure periods: a 5h/day and a 12h/day conditions. Behavioral, histological and immunohistochemical observations were conducted every 2 weeks, i.e. before (W0), during (W2, W4) and after exposure (W6, W8). Firstly, behavioral evaluations of odor sensitivity showed differences in relation to the odor tested, i.e. no effect with congener urine odor and a reinforcement of 2,4,5-trimethythiazoline (TMT) (predator odor) repulsion. Secondly, histological evaluations showed a similar evolution of the epithelium thickness, i.e. a decrease along the exposure as well as during the post-exposure period and an increase of cell number (whatever the phenotype) although the kinetic appeared different in both experimental conditions. Thirdly, immunohistochemical quantification of olfactory marker protein (OMP)- and proliferating cell nuclear antigen (PCNA)-positive cells revealed that the number of mature olfactory neurons increased at the early beginning of exposure period in both conditions. While a decrease was observed in the following weeks (W4-W8) for the 12h/day condition, a stable amount of OMP-positive cells was maintained in the 5h/day condition. In contrast, the number of PCNA-positive cells followed a similar evolution, i.e. a constant decrease along the experiment. These findings indicate that the effects of CO(2) inhalation exposure are selectively dose-dependent.

Symptoms of chronic solvent encephalopathy: Euroquest questionnaire study

The aim was to study the symptomatology of chronic solvent encephalopathy (CSE), and the persistence of the symptoms. We examined how Euroquest, a neurotoxic symptom questionnaire, distinguished workers with verified CSE from unexposed employees, and evaluated symptom cut-off for CSE. Another aim was to study the effect of age on the responses. CSE cases confirmed at the Finnish Institute of Occupational Health had completed Euroquest either before their first investigation procedure (CSE-1 group, n=33), or before attending a routine control for previously diagnosed CSE (CSE-2, n=43). Non-exposed carpenters served as referents (n=292). We studied responses to single questions and to symptom domains. The domain with the highest AUC (area under the ROC: Receiver Operating Characteristic Curve) value was chosen to study cut-off points. CSE groups reported nearly all 59 symptoms more frequently than the carpenters. There was only little difference between younger and older carpenters. CSE-1 reported 12 symptoms more often than CSE-2, but no significant differences were found in the memory and concentration domain, which had the highest AUC, above 0.9. Using a three out of 10 symptoms cut-off point, 97% of the CSE-1 cases and 80% of the carpenters were classified correctly. At a four-symptom cut-off, the sensitivity was 93% and specificity 87%. The memory and concentration as core symptoms distinguished CSE cases from unexposed workers and remain, even after cessation of exposure. The effect of age on Euroquest was minor. Euroquest is recommended for the screening of CSE in solvent-exposed work-force and in the diagnostic process of CSE. We propose three memory and concentration symptoms as cut-off to minimize under-detection.

Uptake and intracellular distribution of various metal ions in human monocyte-derived dendritic cells detected by Newport Green DCF diacetate ester

BACKGROUND

The attempt to visualise intracellular protein metal complexes has currently been difficult due to the unavailability of probes for such molecular structures. Newport Green DCF diacetate ester is a cell permeant acetate ester, which becomes fluorescent after hydrolysis. This molecule is initially uncharged, allowing it to pass through cell membranes. Once in the cell, it is hydrolysed and becomes charged, hindering its escape from the cell and allowing it to bind charged protein metal complexes, which then become fluorescent.

METHODS

In this study, we exposed cultured human monocyte-derived dendritic cells (mDC) to a variety of metal ions with the aim of having the cells take up and process protein metal complexes. Newport Green DCF diacetate ester was used to fluorescently label intracellular protein metal complexes.

RESULTS

Flow cytometry analysis and confocal imaging showed specific staining for mDC exposed to aluminium, chromium, nickel, titanium and zirconium ions. The intensity of staining varied between ion types, whereby Ti(III) resulted in the brightest fluorescence signal. Aluminium, Cr(III), Ni, Ti(IV) and Zr(IV) were also clearly detectable.

CONCLUSION

For the first time, intracellular metal ion protein complexes undergoing cellular processing were successfully visualised in human mDC using flow cytometry and confocal microscopy.

“Current Pathology Techniques” Symposium Review: Advances and Issues in Neuropathology

Our understanding of the mechanisms that incite neurological diseases has progressed rapidly in recent years, mainly owing to the advent of new research instruments and our increasingly facile ability to assemble large, complex data sets acquired across several disciplines into an integrated representation of neural function at the molecular, cellular, and systemic levels. This mini-review has been designed to communicate the principal technical advances and current issues of importance in neuropathology research today in the context of our traditional neuropathology practices. Specific topics briefly addressed in this paper include correlative biology of the many facets of the nervous system; conventional and novel methods for investigating neural structure and function; theoretical and technical issues associated with investigating neuropathology end points in emerging areas of concern (developmental neurotoxicity, neurodegenerative conditions); and challenges and opportunities that will face pathologists in this field in the foreseeable future. We have organized this information in a manner that we hope will be of interest not only to professionals with a career focus in neuropathology, but also to general pathologists who occasionally face neuropathology questions.

Chemobrain: a translational challenge for neurotoxicology

Neurotoxicity is a frequent accompaniment of cancer chemotherapy, and held by many oncologists to be the major dose-limiting side effect. It appears in many forms, but attracted attention during the past decade primarily because of complaints by patients of impaired cognitive function they have labeled as "chemobrain". Neuropsychological testing confirmed the validity of these complaints and has generated a substantial literature examining different aspects of cognitive impairment in various clinical populations undergoing a variety of treatments. Cognitive impairment is far from the only manifestation of neurotoxicity induced by chemotherapy, however. It alters sensory function and motor function as well. A critical need for patients is a suite of methods that will enable clinicians to trace the onset and progression of neurotoxicity so as to guide and balance decisions about the course of chemotherapy. This commentary describes some of the potential methods and encourages neurotoxicologists to enlist their unique skills in the service of these needs.

Colour vision defects in occupational chronic solvent encephalopathy

Occupational chronic solvent encephalopathy (CSE) is associated with a number of neurobehavioural disorders including defects of visual perception. The purpose of this study was to characterize colour vision defects in CSE patients. Colour vision was tested in bright illumination with the Farnsworth-Munsell 100-hue test in workers who had CSE due to occupational exposure to common industrial solvents. Before assessing colour vision, the subjects' ocular health and visual functions were evaluated. On the basis of this evaluation, 36 subjects with healthy eyes were selected and their colour vision was tested monocularly. The colour vision performance of the patient group was, statistically, significantly inferior to that of a control group matched by age at a group level. A mixed form of reduced colour sensitivity was found in 42% (n=15/36) of the cases, affecting the entire range of Munsell hues. No association was found between the length and intensity of exposure and colour vision performance. Our results show that CSE patients can have significantly impaired colour discrimination ability, although their eyes are healthy and their other visual functions are normal. This may indicate toxic damage to higher level visual processing, possibly the colour selective regions of the cerebral cortex.

Effects of toluene inhalation exposure on olfactory functioning: behavioral and histological assessment

Exposure to pollutant or toxic substances is known to induce adverse health effects but few studies have been devoted to study the impact on olfactory functioning although neuroreceptors in the nasal cavity are directly in contact with volatile molecules. Thus, this work was designed to evaluate in mice the potential modifications of the olfactory functioning during (1 month) and after (1 month) a prolonged toluene exposure at both sensitive/perceptive and cellular levels. Mice were exposed to 1000ppm of toluene for 5h/day, 5days/week for 4 weeks. Firstly, behavioral evaluation (T-maze test) to toluene sensitivity showed a constant decrease during all the 4 weeks of exposure (W1-W4) which continued during 2 weeks after the exposure (W5, W6). In contrast, during the last 2 weeks of the experiment (W7, W8), the sensitivity of mice to toluene went back to normal. Secondly, structural modifications, i.e. density of cells and thickness of olfactory epithelium were observed soon after the outset of exposure. The number of cells did not change at the beginning of exposure (W1, W2), decreased markedly later (W3, W4), increased significantly the first week of the recovery period (W5) and stayed stable during the following weeks (W6-W8). Concerning the thickness of neuroepithelium, the results at W1 showed a decrease followed by an increase suggesting an inflammatory process (W2, W3). In contrast, the results of W4 revealed an abrupt decrease of the thickness whereas the return to normal arose immediately at the outset of recovery period.

Olfactory toxicity: long-term effects of occupational exposures

OBJECTIVE

To present and discuss the results of research on olfactory function impairments related to chronic occupational exposure to industrial chemicals.

METHODS

This review is mainly focused on the results of epidemiological studies on olfactory function, evaluated using quantitative testing methods, in workers chronically exposed to airborne industrial chemicals. Papers published in peer-reviewed scientific journals were mainly considered.

RESULTS

The prevalence of olfactory impairments related to occupational exposure to chemicals is unknown: frequencies ranging 0.5-5% of all olfactory dysfunctions have been proposed, considering both exposure to chemicals and the use of pharmaceutical drugs, but the real relevance of this problem is possibly overlooked, especially considering that occupational exposure may account for a significant part of "idiopathic" smell disorders, i.e., the 10-25% of all olfactory problems within the general population. An adverse effect has been reported in workers chronically exposed to some metals as cadmium, chromium, manganese, arsenic, mercury, and organic lead, and to other chemicals as acrylates, styrene, and solvent mixtures. The results of relevant studies are discussed. A problem in the evaluation of data is that different methods have been applied in different studies, affecting the comparability of results.

CONCLUSIONS

To date, knowledge of the effect of chronic occupational exposure to industrial chemicals on olfactory function is largely incomplete, but supports the hypothesis that olfactory neuroepithelium is susceptible to environmental exposures to chemicals. Occupational-related olfactory impairment is usually sub-clinical, and can be only detected using adequate quantitative olfactory function testing procedures. Available data show the need for further good quality research in this field.

Evidence for autonomic responses to pungent chemical stimuli applied to the skin vs inhaled via the nasal cavity

AIM OF THE STUDY

Chemical stimuli can produce different sensations from tingling to pain. Responses to chemical stimuli differ in relation to many factors. This study aims at examining two factors, i.e. the localization of their application and the implied sensory modality.

METHODS

Twenty volunteer students participated in the experiment. Skin conductance responses (SCRs) were recorded to compare the autonomic nervous activation to maximal stimulation with the same irritant stimulus (mustard oil (MO) diluted at 25%) applied to the skin or delivered into the nasal cavity.

RESULTS

The SCRs obtained following maximal nasal stimulation with MO were significantly different from those obtained following maximal skin stimulation. Application of MO on skin elicited higher SCR amplitude as well as a longer rising time and latency when compared to nasal stimulation.

CONCLUSIONS

These findings indicate that the autonomic nervous activation following maximal chemical irritation differ in temporal, amplitude and shape response characteristics. These results are discussed in terms of cutaneous and nasal innervation's.

Neurobehavioral science in hazard identification and risk assessment of neurotoxic agents--what are the requirements for further development?

OBJECTIVES

Modern neurobehavioral methods find useful application in research into the early effects of exposure to neurotoxic agents in the environment. This paper briefly describes the history and evolution of neurobehavioral toxicology, reviews some current trends in research in this specific discipline and identifies the most important needs and challenges to be addressed in future studies.

METHODS

All published literature was considered, including ad hoc meeting reports. Further information was obtained directly from experts in the field.

RESULTS

The number of studies (including those in occupational, environmental and pediatric exposure) using neurobehavioral evaluation is constantly increasing. Regulatory agencies are using scientific data obtained through neurobehavioral assessment, which includes other areas such as neurosensory toxicology. However, further development of this discipline is facing a number of problems and issues. Three major areas that deserve further attention have been identified: (1) specific technical issues regarding testing development, (2) epidemiological issues regarding the study design, including the need for meta-analysis/multi-center studies and for longitudinal observation, and statistical issues regarding the most adequate models for the analysis and treatment of complex neurobehavioral datasets, and (3) the need for scientific consensus on the significance of adverse effects identified with neurobehavioral methods.

CONCLUSIONS

The importance of neurobehavioral toxicology in the evaluation of mechanisms of action and for preventive purposes is progressively growing. Further development is needed for the advancement of this discipline through collaboration between experts from different fields.

An integrative approach considering acute symptoms and intensity ratings of chemosensory sensations during experimental exposures

Even at low concentrations airborne chemicals can excite olfactory and trigeminal receptors and inform the organism about the presence of airborne chemicals. Acutely, malodors or sensory irritations might trigger symptoms (e.g., bad air quality, eye irritations) and in the long-run functional impairment of chemoreception might occur. In humans, knowledge about short-term adaptational processes and effects of exposure peaks on these systems is limited. Therefore, two different experiments with human volunteers were conducted. In experiment A exposures (4h) with fluctuating concentrations of 2-ethylhexanol (1.5, 10, 20ppm C(TWA)) were investigated, experiment B used similar but constant vapor concentrations. Olfactory- and trigeminal-mediated symptoms and intensities of odor, eye, and nasal irritations were recorded. All measures showed a dose-dependent response and peak exposure effects. In the course of the 4h exposures solely olfactory symptoms decreased. Nasal irritations remained nearly unchanged across the 4h, eye irritations slightly increased. Inter-individual differences related to the personality trait of self-reported chemical sensitivity had only minor effects on chemosensory symptoms in experiment B and no effect on intensity ratings in both experiments. Chemosensory effects seem to be amplified by exposure peaks and less adaptive than assumed.