February 22, 1980

The Role of the Physician in Occupational Epidemics

Author Affiliations

Mayo Clinic Rochester, Minn

JAMA. 1980;243(8):771. doi:10.1001/jama.1980.03300340047022

Two epidemics of neuropathy, initially seen as urinary retention and impotence, described in this issue of The Journal by Keogh and co-workers (p 746) and by Kreiss and co-workers (p 741) and linked by them to exposure to an industrial toxin, are unusual and instructive.

Several recent epidemics of neuropathy come to mind, but none like the present one. Only a few years ago, the swine influenza immunization program in the United States was found to be associated with an increased frequency of a paralytic disorder, Guillain-Barré syndrome.1 Before that, a group of workers experienced a sensory ataxic neuropathy from formulating an ant pesticide, chlordecone.2 Methyl-n-butyl ketone exposure in several Ohio plants produced a serious outbreak of a sensory motor neuropathy.3 Worldwide, a serious outbreak of diffuse neuropathy in Japan resulted from eating fish taken from Minimata Bay heavily contaminated with methyl mercury.4 In