In 1995, physicians from four member clinics of the Association of Occupational and Environmental Clinics (AOEC), in Cincinnati, Ohio, Morgantown, West Virginia, Lansing, Michigan, and Atlanta, Georgia, discovered that they had all been evaluating large numbers of railroad employees. Most of the patients were employed by CSX Railroad, although many had worked for predecessor companies such as the C&O, CC&O, L&N, and Seaboard Coast Lines. The earliest of the patients had been seen in approximately 1986, but the majority had been seen since 1992. The total number of patients seen was estimated by the reporting clinics to be approximately 400. The patients described varying but intense, long-term exposures to a variety of organic solvents, including carbon tetrachloride, trichloroethane, and trichlorethylene, through both inhalation and skin absorption. In most cases, the presenting complaints related to central nervous system function, involving both cognition and affect, although some of the West Virginia patients had been referred for evaluation of abnormal liver-function tests. In some cases, there were complaints related to other organ systems, such as musculoskeletal and respiratory symptoms. Many of the patients were pursuing litigation against the railroad under the Federal Employers' Liability Act.
West Virginia University, School of Medicine, Institute of Occupational and Environmental Health, Morgantown, West Virginia