Role of the neurologist in hazard identification and risk assessment

Environmental Health Perspectives
R G Feldman, R F White

Abstract

This review describes strategies used by a clinical neurologist in the investigation of neurotoxic disease. It emphasizes the need for a high level of suspicion that environmental substances are capable of producing impairments in neurologic and neurobehavioral functions. Because of the difficulties in differentiating neurotoxic from nonneurotoxic disease when presented with common neurological symptoms, it is necessary to rely upon corroborative evidence from past medical records, work and environmental histories, and exposure data, as well as detailed neurological examinations, to reach a conclusion about causation. Sensitive electrophysiologic and neuropsychologic test batteries are useful in identifying subclinical impairments and in providing objective confirmation of abnormalities in the central and peripheral nervous systems. Combining scientific and epidemiologic information with experience and clinical judgment, these sources of information are used in the formulation of a clinical diagnosis. When many patients among a group of people are exposed to neurotoxicants, the effects of the exposure may vary from one to another because of differences in susceptibility, duration of exposure and dosage of neurotoxicant, and oth...Continue Reading

References

Jul 1, 1979·Neurology·R G FeldmanE Landau
Mar 1, 1988·Archives of Environmental Health·R G FeldmanS P Proctor
Feb 1, 1983·Scandinavian Journal of Work, Environment & Health·A M Seppäläinen, M Antti-Poika

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Citations

Apr 1, 1996·Environmental Health Perspectives·A M Evangelista de Duffard, R Duffard
Apr 1, 1996·Environmental Health Perspectives·N FiedlerA Wetherell
Nov 6, 2007·Waste Management·Talib E ButtKehinde O K Oduyemi
Jun 17, 2009·Journal of Occupational and Environmental Medicine·Jonathan S Rutchik

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