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Department of Neurology, Boston University School of Medicine and Boston Veterans' Administration Medical Center, Boston, Massachusetts (Drs. Feldman, Niles, and Sax, and Ms. Kelly-Hayes); the Department of Biomathematics, University of California, Los Angeles, California, (Dr. Dixon); the Department ofBiostatistics, University of Washington, School ofPubiicHealth, Seattle, Washington (Dr. Thompson); and the American Public Health Association, Washington, D.C. tDr. Landau).
We conducted a double-blind controlled study of individuals exposed to arsenic trioxide in a copper-smelting factory. Subjects fell into three categories of peripheral neuropathy: none, subclinical, and clinical. The subclinical group had no symptoms or signs of numbness or reduced reflexes, but did have reduced nerve conduction velocity and amplitude measurements. Clinical neuropathy groups had signs and symptoms of neuropathy and electrophysiologic abnormalities. The clinical and subclinical groups correlated with increased content of arsenic in urine, hair, and nails. The incidence of subclinical and clinical neuropathy was greater in arsenic workers than in unexposed controls.
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