In Norway's only viscose rayon plant, carbon disulfide (CS2) concentrations in ambient air usually were between 30 and 50 mg/m3 during the first 23 years of production. From 1970/1971 until the factory was closed in 1982, corresponding values were 10-25 mg/m3. Through all of these years, high peak exposures of CS2 and H2S occurred. In 1986, 16 of the 24 men still at work in 1982 and with at least 10 years' experience in the spinning room agreed to participate in this study. Clinical neurological examination demonstrated abnormalities in 15; neuropsychological tests showed impairments of probable organic origin in 14. Thirteen had cerebral atrophy demonstrated by cerebral computed tomography (CT). Electromyography (EMG) was abnormal in six, neurography in 11. Regional cerebral blood flow measurements indicated flow asymmetries in eight, whereas Doppler investigation of the extracranial carotid and vertebral arteries, electroencephalography (EEG), and evoked response investigations were mostly normal. Based on these results and the exposure data, a diagnosis of CS2-induced encephalopathy was reached in eight workers; another six had an encephalopathy in which CS2 exposure was regarded as a partial cause. Correspondingly, seven had a neuropathy probably caused by CS2 exposure alone; in three others, CS2 was found to be the partial cause of a neuropathy. This indicates that long-term, relatively moderate exposure to CS2 in association with high peak exposures to CS2 and H2S involves a substantial risk of developing neurotoxic disease.
The present paper reports a family settled in the northern part of Norway, with a hereditary neurological disorder consisting clinically of spastic paraplegia associated with neurogenic bladder disturbances and syndactylia. Nine out of 22 members in three generations exhibit these clinical features. The bladder disturbances, being incomplete supranuclear bladder paresis (uninhibited neurogenic bladder), were the main complaint and occurred at an early stage of the disease. The family probably represents an unusual form of hereditary spastic paraplegia (HSP). The mode of inheritance is considered to be autosomal dominant.
During 1982, 7 female patients were admitted to the Department of Neurology, The National Hospital, Oslo, with cerebral infarction (6 patients) or transitory ischemic attacks (1 patient). These patients were remarkable in that they had similar risk factors for cerebrovascular disease--use of estrogen preparations (7 patients) and smoking (6 patients). These case reports suggest that the combination of estrogen preparations and smoking may have a possible potentiating effect in increasing the risk of cerebrovascular disease. (author's modified)