Percutaneous neurotoxicity is reviewed. It is reported that percutaneous absorption of neurotoxic agents is a major, but widely unacknowledged route of intoxication in the occupational setting and in the home. There are no qualitative differences between the neuropathologic response to toxic agents absorbed through skin and that induced by toxins entering in other ways. Neurotoxic substances in the domestic environment are examined, including hexachlorophene (70304), acetyl-ethyl-tetramethyl-tetralin (88299), zinc-pyridinethione (13463417), and 2,4-dinitro-3-methyl-6-tert- butylanisole (83669). Symptoms of neurotoxicity, animal studies of distribution and toxicity, and acceptable exposures are discussed. Neurotoxic chemicals in the industrial setting are considered. The aliphatic hexacarbon compounds, n-hexane (110543) and methyl-n-butyl- ketone (591786), are discussed. Animal studies reveal multifocal axonal swellings and associated focal demyelination in affected distal regions of long and large diameter central and peripheral nervous system nerve fibers. Neuropathy resulting from industrial exposures to Lucel-7 (67016528), a foaming agent, is described. Experimental studies are discussed which confirm that percutaneous intoxication with Lucel-7 induces widespread nervous system degeneration which is both rapid and severe. Percutaneous absorption of organophosphorus compounds produces both cholinergic crisis and delayed neuropathy, which are described. Animal studies and accidental human poisonings show clinical reversibility of peripheral neuropathy in mild cases; however, permanent damage of spinal cord tracts may also result. The authors conclude that experimental studies to determine the effects of topically applied compounds on the nervous system are imperative for public health and environmental control, particularly with regard to industrial solvent exposures. The range and depth of studies to evaluate fragrance chemicals for neurotoxic effects should also be expanded.
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