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Evaluation of workers presenting with neurologic symptomatology creates a unique diagnostic and management challenge to health care providers for several reasons. First, employee education and training on hazardous materials has heightened the average worker's level of awareness and concern regarding potential adverse health effects from exposure to toxicants. Second, thousands of new commercial products are introduced annually into our society, where fewer than 26% of substances currently in use have undergone toxicologic analysis and testing. Third, there is significant variability with respect to the clinical assessment of the neurologic system from one individual to the next, which is compounded by the fact that definitive clinical signs of neurotoxicity may not be detected until late in the disease process. Finally, the clinician must be able to differentiate between primary neurologic disorders and those secondary neurologic disorders whose origin is causally related to a neurotoxicant exposure in the workplace.
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