Neurologic Effects Associated with Daily Occupational Exposure to Ethanol Vapor and Mist

What is it about?

This case report describes the clinical neurological and neuropsychological findings in a machinist who was occupationally exposed to the vapors of 200 proof 100% ethanol daily for 3 years.

Featured Image

Photo by Obi Onyeador on Unsplash

Photo by Obi Onyeador on Unsplash

Why is it important?

There are very few clinical case reports in the peer reviewed medical literature describing the clinical manifestations associated with chronic occupational exposure to ethanol vapors and mists. Modeling of ambient air ethanol vapor concentrations does not effectively take into account exposure to the mist generated from turning machine parts. In addition, few reports take into account how medications used to treat anxiety and other neurological and neuropsychiatric disorders interact with exposure to ethanol vapor and mists nor how recreational ethanol consumption may interact with occupational ethanol vapor and mist exposures. This case report indicates that reversible neurological symptoms can occur at ambient air ethanol vapor concentrations below the OSHA PEL in those individuals who: 1) work in close proximity to the source of ethanol vapor and mist; and, 2) who also consume ethanol recreationally and/or take medications such as escitalopram. Ethanol increases the nervous system side effects of escitalopram such as dizziness, drowsiness, and difficulty concentrating. This case report is also important because it demonstrates the misuse of post-chelation urinalysis for heavy metal exposures. The unchallenged blood and hair levels of manganese and the patient's symptoms did not support a diagnosis of manganese toxicity in this case. Despite this, he was subjected to the risks associated post-chelation urinalysis for heavy metals. The American College of Medical Toxicology (2017) has issued a position statement indicating that “post-challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may be harmful”.

Perspectives