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Article
February 22, 1980

Neurological Dysfunction of the Bladder in Workers Exposed to Dimethylaminopropionitrile

Author Affiliations

From the Occupational Health Program, Harvard School of Public Health (Drs Kreiss and Wegman); and the Departments of Neurology and Urology, Boston University School of Medicine, Boston (Drs Niles, Siroky, Krane, and Feldman). Dr Kreiss is now with the Bureau of Epidemiology, Center for Disease Control, Atlanta.

JAMA. 1980;243(8):741-745. doi:10.1001/jama.1980.03300340017012
Abstract

Neurogenic bladder dysfunction, characterized by hesitancy, need to strain, decreased stream, and increased duration of urination, developed in 104 (63%) of 166 employees working in the manufacture of polyurethane foam. Highest rates of illness (69%) occurred in production workers, and no illness occurred in office or warehouse workers. Onset of the epidemic coincided with introduction of a catalyst, dimethylaminopropionitrile (DMAPN), and monthly case incidence rates increased as DMAPN use increased. Outbreak ceased abruptly when DMAPN use was stopped. Of eight patients who underwent neurourologic testing during recovery, seven lacked either detrusor reflex or normal sensation of bladder filling; seven had a subclinical sensory abnormality; three had prolonged sacral-evoked responses; and two of these three had limb motor neuropathies. Dimethylaminopropionitrile is unique among known neurotoxins in producing urinary symptoms more frequently than limb nerve symptoms.

(JAMA 243:741-745, 1980)

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