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G Sällsten

Publications and source records attributed to G Sällsten.

At least 19 recordsLinked to original sources

Influence of solvent exposure and aging on cognitive functioning: an 18 year follow up of formerly exposed floor layers and their controls.

OBJECTIVES: To extend our knowledge of how exposure to neurotoxic substances during working life affects cognitive functioning in the long term. Does long term occupational exposure to organic solvents lead to aggravated cognitive impairment later in life? METHODS: A follow up was conducted of floor layers exposed to solvents and their unexposed referents (carpenters) 18 years after the baseline assessment. The pattern of cognitive changes in the two groups was compared, with the same 10 neuropsychological tests from the test battery for investigating functional disorders (TUFF) that were used at baseline. The study included 41 floor layers and 40 carpenters. A medical examination focused on health at the present and during the past 18 years. An extensive exposure assessment made in the initial study included questionnaires, interviews, and measurements. Additional exposure during the follow up period was minor, as explored in interviews at follow up. RESULTS: The entire group of floor layers did not deteriorate significantly more over time than did the carpenters. However, among the oldest subjects (>60 years), only floor layers showed decline in visual memory. Moreover, the most highly exposed floor layers deteriorated significantly more than their referents in visual memory and perceptual speed, and they tended to display larger decrements in motor speed. Significant dose effect relations were found; higher cumulative exposure was associated with decrements in visual episodic memory, perceptual speed and attention, and visuospatial skill. CONCLUSIONS: The hypothesis that floor layers would deteriorate more in cognitive performance than their unexposed referents over a period of 18 years was partly supported by the results of this study. The results are consistent with the view that the negative effects of exposure to solvents may interact with the normal aging process, primarily at heavy exposure.

Adhesives↗

Mortality from cardiovascular diseases and exposure to inorganic mercury.

OBJECTIVE: To study the mortality from cardiovascular and other chronic non-neoplastic diseases after long term exposure to inorganic mercury. Limited information is available on the effect of chronic exposure to mercury on the cardiovascular system. METHODS: The mortality was studied among 6784 male and 265 female workers from four mercury mines and mills in Spain, Slovenia, Italy, and the Ukraine. Workers were employed between 1900 and 1990; the follow up period lasted from the 1950s to the 1990s. The mortality of the workers was compared with national reference rates. RESULTS: Among men, there was a slight increase in overall mortality (standardised mortality ratio (SMR) 1.08, 95% confidence interval (95% CI) 1.04 to 1.12). An increased mortality was found from hypertension (SMR 1.46, 95% CI 1.08 to 1.93), heart diseases other than ischaemic (SMR 1.36, 95% CI 1.20 to 1.53), pneumoconiosis (SMR 27.1, 95% CI 23.1 to 31.6), and nephritis and nephrosis (SMR 1.55, 95% CI 1.13 to 2.06). The increase in mortality from cardiovascular diseases was not consistent among countries. Mortality from hypertension and other heart diseases increased with estimated cumulative exposure to mercury; mortality from ischaemic heart disease and cerebrovascular diseases increased with duration of employment, but not with estimated exposure to mercury. Results among women were hampered by few deaths. CONCLUSION: Despite limited quantitative data on exposure, possible confounding, and likely misclassification of disease, the study suggests a possible association between employment in mercury mining and refining and risk in some groups of cardiovascular diseases.

Cardiovascular Diseases↗

Heterogeneity in sources of exposure variability among groups of workers exposed to inorganic mercury.

Many exposure assessment strategies rely on the occupational group as the unit of analysis in which workers are classified on the basis of job title, location, or on other characteristics related to the workplace or the job. Although statistical methods that combine exposure data collected on workers from different occupational groups are more efficient, the underlying assumption that the degree of variation over time and among workers is the same for all groups has yet to be fully investigated. Given the utility of different modeling approaches when assessing exposures, we investigated assumptions of homogeneity of variance within and between workers using both random- and mixed-effects models. In our study of four groups of workers exposed to inorganic mercury (Hg) at a chloralkali plant, there was no evidence of significant heterogeneity in the levels of variation over time or between workers for air Hg levels. For the biological monitoring data, however, our findings indicate that groups did not share common levels of variability and that it was not appropriate to pool the data and obtain single estimates of the within- and between-worker variance components. Classification of job group as a random or fixed effect had no effect on the results and yielded the same conclusions when the models were compared. To illustrate effects related to the proper specification of a model, the likelihood of exceeding certain levels (which is a function of the parameters of the underlying distribution of the natural log-transformed exposures) was evaluated using the results obtained from the different models. Although the probability that workers' mean exposures exceeded occupational exposure limits for air, urine and blood Hg was generally low (<10%) for all groups except maintenance workers, the estimated values sometimes varied depending upon the particular model that was applied. Given the growing use of random- and mixed-effects models that combine data across occupational groups, additional studies are warranted to evaluate whether it is reasonable to assume common variances and covariances among measurements collected on workers from different groups.

Analysis of Variance↗

A small dose of ethanol increases the exhalation of mercury in low-level-exposed humans.

Inorganic mercury is mainly eliminated by urinary and fecal excretion, but it is also eliminated by exhalation and sweat. There are only a few reports on exhalation of mercury in humans. In volunteers with short-term mercury exposure, an increased exhalation of mercury was found after alcohol intake. The aim of this study was to determine mercury in end-exhaled air and the influence of ethanol on mercury exhalation in subjects with long-term mercury exposure from diet, amalgam fillings, or the work environment. Fourteen subjects, with different grades of mercury exposure, were given 0.2 g ethanol/kg body weight. Measurements of mercury in end-exhaled air were performed before and after alcohol intake. Mercury in end-exhaled air could be detected in all subjects. In 10 individuals without amalgam fillings the mercury concentration was 3 to 12 pg/L. A marked increase, in general about fivefold, in mercury concentrations in end-exhaled air was seen in all subjects 30 min after intake of alcohol, regardless of the level of mercury exposure. Higher ethanol doses resulted in higher mercury levels in end-exhaled air and longer time periods before a return to background levels. An increase was seen even after an ethanol dose of only 0.1 g ethanol/kg body weight (about 0.08 L wine). The decrease in exhaled mercury at higher alcohol doses followed approximately zero-order kinetics and probably reflects the elimination of ethanol in tissues. In conclusion, low levels of mercury can be detected in end-exhaled air also in individuals without amalgam fillings. About a fivefold increase was seen 30 min after alcohol intake, and the relative increase seemed to be independent of the body burden of mercury. Exhalation of mercury represents only a small percentage of the total elimination of mercury.

Adult↗

Variability in airborne and biological measures of exposure to mercury in the chloralkali industry: implications for epidemiologic studies.

Exposure assessment is a critical component of epidemiologic studies, and more sophisticated approaches require that variation in exposure be considered. We examined the intra- and interindividual sources of variation in exposure to mercury vapor as measured in air, blood, and urine among four groups of workers during 1990-1997 at a Swedish chloralkali plant. Consistent with the underlying kinetics of mercury in the body, the variability of biological measures was dampened considerably relative to the variation in airborne levels. Owing to the effects of intraindividual variation, estimating workers' exposures from a few measurements can attenuate measures of effect. To examine such effects on studies relating long-term exposure to a continuous health outcome, we evaluated the utility of each exposure measure by comparing the necessary sample sizes required for accurate estimation of a slope coefficient obtained from a regression analysis. No single measure outperformed the others for all groups of workers. However, when workers were evaluated together, creatinine-corrected urinary mercury better discriminated workers' exposures than airborne or blood mercury levels. Thus, pilot studies should be conducted to examine variability in both air and biomonitoring data because quantitative information about the relative magnitude of the intra- and interindividual sources of variation feeds directly into our efforts to design an optimal sampling strategy when evaluating health risks associated with occupational or environmental contaminants.

Adult↗

Tissue levels of mercury determined in a deceased worker after occupational exposure.

OBJECTIVES: To examine mercury (Hg) and selenium (Se) levels in autopsy samples from a thermometer worker who had been exposed over a long period to, and monitored for, mercury vapor. CASE REPORT: Hg and Se levels were determined using radiochemical neutron activation analysis in a worker who had commited suicide 4 weeks after the end of 14 years of exposure and in an unexposed age-matched referent. Histochemical staining of cerebellum was performed according to the method of Danscher and Schroder. RESULTS: The Hg concentrations (wet weight) were 25 microg/g in the kidney cortex, 1.2 microg/g in the liver, 0.72 microg/g in the lung, 0.025 microg/g in the testis, and 0.014-0.018 microg/g in the cerebellum (gray matter, dentate nucleus, and white matter). The Se level in the kidney cortex was high, 4.6 microg/g, whereas the concentration detected in the other tissue samples was normal. Light microscopy of the cerebellum was normal, and no histochemical staining for mercury was observed. Autopsy samples from the referent showed low Hg and Se levels consistent with other reports. CONCLUSIONS: The observed kidney-Hg, which was 50-100 times higher than that occurring in the general population, is in agreement with previous sparse data from ongoing occupational exposure. The high Se level detected in the kidney indicates coaccumulation with mercury. The low Hg concentration found in the cerebellum was unexpected, since some reports have shown much higher brain-Hg long after the cessation of exposure.

Adult↗

Cadmium, mercury, and lead in kidney cortex of the general Swedish population: a study of biopsies from living kidney donors.

Cadmium, mercury, and lead concentrations were determined in deep-frozen kidney cortex biopsies taken from 36 living, healthy Swedish kidney donors (18 males and 18 females), who were 30-71 (mean 53) years of age. Information about occupation, smoking, the presence of dental amalgam, and fish consumption could be obtained for 27 of the donors. The samples (median dry weight 0.74 mg) were analyzed using inductively coupled plasma mass spectrometry, and the results were transformed to wet-weight concentrations. The median kidney Cd was 17 micrograms/g (95% confidence interval, 14-23 micrograms/g), which was similar in males and females. In 10 active smokers, the median kidney Cd was 24 micrograms/g, and in 12 who never smoked, it was 17 micrograms/g. The median kidney Hg was 0.29 micrograms/g, with higher levels in females (median 0.54 micrograms/g) than in males (median 0.16 micrograms/g). Subjects with amalgam fillings had higher kidney Hg (median 0.47 micrograms/g, n = 20) than those without dental amalgam (median 0.15 micrograms;g/g, n = 6), but kidney Hg was below the detection limit in some samples. Nearly half of the samples had kidney Pb below the detection limit. The median kidney Pb was estimated as 0. 14 micrograms/g. This is the first study of heavy metals in kidney cortex of living, healthy subjects, and the results are relatively similar to those of a few previous autopsy studies, indicating that results from autopsy cases are not seriously biased in relation to kidney metal concentrations in the general population. Cd concentrations in those who never smoked were relatively high, indicating considerable Cd intake from the diet in Sweden. The effect of dental amalgam on kidney Hg was as expected, although the reason for the difference in Hg levels between males and females is unclear.

Adult↗

Cancer occurrence among European mercury miners.

OBJECTIVES: To study the carcinogenicity of inorganic mercury in humans. METHODS: We studied the mortality from cancer among 6784 male and 265 female workers of four mercury mines and mills in Spain, Slovenia, Italy and the Ukraine. Workers were employed between the beginning of the century and 1990; the follow-up period lasted from the 1950s to the 1990s. We compared the mortality of the workers with national reference rates. RESULTS: Among men, there was no overall excess cancer mortality; an increase was observed in mortality from lung cancer (standardized mortality ratio [SMR] 1.19, 95 percent confidence interval [CI] 1.03-1.38) and liver cancer (SMR 1.64, CI 1.18-2.22). The increase in lung cancer risk was restricted to workers from Slovenia and the Ukraine: no relationship was found with duration of employment or estimated mercu ry exposure. The increase in liver cancer risk was present both among miners and millers and was stronger in workers from Italy and Slovenia: there was a trend with estimated cumulative exposure but not with duration of employment, and the excess was not present in a parallel analysis of cancer incidence among workers from Slovenia. No increase was observed for other types of cancer, including brain and kidney tumours. Among female workers (Ukraine only), three deaths occurred from ovarian cancer, likely representing an excess. CONCLUSIONS: Exposure to inorganic mercury in mines and mills does not seem strongly associated with cancer risk, with the possible exception of liver cancer; the increase in lung cancer may be explained by co-exposure to crystalline silica and radon.

Carcinogens↗

Blood lead in Uruguayan children and possible sources of exposure.

Blood samples and questionnaire background data were collected from 96 children (age 2-14 years) living in urban, suburban, or rural areas with varying traffic intensity and industrial lead pollution in Uruguay. Spot samples of tap water were collected from the homes of 44 children, and samples of top soil were taken from seven areas. Samples of air-borne dust were collected in central and suburban Montevideo. Blood lead concentrations (B-Pb) in children ranged between 47 and 191 (mean 96) micrograms/L and exceeded in 36% of the children 100 micrograms/L, the intervention level adopted by the United States Centers for Disease Control. Lead in tap water ranged from 0.2 to 230 (mean 15) micrograms/L and exceeded in 39% of the samples the maximum level recommended by WHO, 10 micrograms/L. Lead pipes were used in parts of the water supply systems. Lead in air varied between different locations from 0.15 to 1.7 micrograms/m3, highest in the very center of Montevideo. The median soil lead ranged from 6 to 2100 micrograms/g and was highest in industrially polluted areas. At multiple regression analysis, B-Pb was significantly associated only with age (P = 0.032) and traffic intensity at school (P = 0.045). No significant impact on B-Pb of lead in water or soil could be established.

Adolescent↗

Polychlorinated dibenzo-p-dioxin and dibenzofuran levels and patterns in polyvinylchloride and chloralkali industry workers.

The production of chlorine and vinyl chloride (VCM) is associated with the formation of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). The objective of the present study was to determine whether the levels and congener patterns of PCDDs and PCDFs in the blood of workers involved in the production of such substances could be related to their occupational environment. PCDD and PCDF levels in blood plasma from VCM and chloralkali workers and in referents were determined by means of high-resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS) techniques and the results were evaluated through principal component analysis (PCA). The overall levels of PCDDs and PCDFs were low, but the relative congener distribution detected in the workers differed from that found in the referents. 1,2,3,4,6,7,8-HpCDF, 1,2,3,4,7,8- and 1,2,3,6,7,8-HxCDFs are congeners related to work in VCM and chloralkali industries. Exposure to PCDDs and PCDFs in these industrial environments changes the congener-distribution pattern in the blood of workers as compared with referents. A combination of isomer-specific analysis of PCDDs and PCDFs in blood plasma and PCA is suitable for the differentiation between nonoccupational and occupational exposure and provides a means of assessing workers' exposure situation in different occupational settings.

Animals↗

Urinary excretion of mercury, copper and zinc in subjects exposed to mercury vapour.

The excretion of mercury, copper and zinc in urine, and mercury in whole blood and plasma, was determined in 40 chloralkali workers exposed to mercury vapour and 40 age-matched referents. The Hg concentrations in whole blood, plasma and urine were higher in the exposed group (35 nmol l-1, 30 nmol l-1, and 11.5 nmol mmol-1 creatinine, respectively) in comparison with the reference group (15 nmol l-1, 6.3 nmol l-1, and 1.8 nmol mmol-1 creatinine, respectively). The urinary copper excretion was similar in the two groups, while U-Zn excretion was significantly higher (P = 0.04) in the exposed group, median 0.83 mumol mmol-1 creatinine versus 0.76 munmol mmol-1 creatinine in the reference group. In a subgroup of exposed workers with current U-Hg above 11.5 nmol l-1 mmol-1 creatinine (20 micrograms g-1 creatinine) the median U-Zn was 1.1 mumol mmol-1 creatinine. In both groups smokers had high U-Zn levels than non smokers. When both U-Hg and smoking were taken into account in a linear regression model, there was a significant association between U-Hg and U-Zn in the combined group of exposed and referents (P = 0.002). This study indicates that mercury exposure in humans, as in animals, causes increased urinary excretion of zinc. The mechanisms may be induced synthesis of metallothionein in the kidneys, displacement of Zn from preexisting metallothionein by Hg, or a decreased reabsorption of zinc in the kidneys owing to a slight tubular dysfunction.

Adolescent↗

Exposure to mercury vapor and impact on health in the dental profession in Sweden.

Possible adverse effects of mercury exposure in dentistry have been discussed in several studies. The objective of the present study was to carry out detailed measurements of mercury exposure in the dental profession in Sweden, and to search for adverse health effects from such exposure. We examined 22 dentists and 22 dental nurses, working in teams, at six Swedish dental clinics. Measurements of air mercury, performed with personal, active air samplers, showed a median air Hg of 1.8 micrograms/m3 for the dentists, and 2.1 micrograms/m3 for the dental nurses. Spot measurements with a direct reading instrument displayed temporarily elevated air Hg, especially during the preparation and application of amalgam. The average concentration of mercury in whole blood (B-Hg) was 18 nmol/L, in plasma (P-Hg) 5.1 nmol/L, and in urine (U-Hg) 3.0 nmol/mmol creatinine. Possible effects on the central nervous system (CNS) were registered with three questionnaires: Q16, Eysenck Personality Inventory (EPI), and the Profile of Mood Scales (POMS). In the Q16, the number of symptoms was statistically significantly higher in the dentistry group compared with an age- and gender-matched control group (n = 44). The urinary excretion of albumin and urinary activity of the tubular enzyme N-acetyl-beta-glucose-aminidase (NAG) did not differ between the two groups. The results confirm that exposure to mercury in the dental profession in Sweden is low. The air Hg levels were mainly influenced by the method of amalgam preparation and inserting, and by the method of air evacuation during drilling and polishing.

Adult↗

Dose-dependent elimination kinetics for mercury in urine: observations in subjects with brief but high-level exposure.

OBJECTIVES: To study the elimination kinetics for mercury in urine (U-Hg) after brief but high-level exposure. METHODS: U-Hg was examined in 11 workers after 2-10 days of exposure to inorganic Hg and after symptoms and signs of Hg intoxication had appeared. Initial U-Hg excretion varied between 60 and 2360 micrograms/g creatinine. The subjects were followed up for 1-11 months. In each subject, one- and two-compartment models were fitted to the U-Hg values, assuming an exponential decrease, by weighted non-linear least-squares regression (weight = 1/U-Hg). RESULTS: The data indicated two elimination phases in subjects with initial U-Hg above 600 micrograms/g. In the two-compartment models, there was a fast phase with a half-time of 2-16 days, and a slow phase with a half-time of more than a month. The fast phase contributed 70-90% to the sum of the Y intercepts. CONCLUSIONS: The kinetics of U-Hg excretion after cessation of exposure seems to be dose-dependent and, at least in certain cases, to have two phases. The explanation for the fast phase may be that the capacity of certain binding sites in the kidney was exceeded.

Accidents, Occupational↗

Long-term use of nicotine chewing gum and mercury exposure from dental amalgam fillings.

In experimental studies, chewing gum has been shown to increase the release rate of mercury vapor from dental amalgam fillings. The aim of the present study was to investigate the influence of long-term frequent chewing on mercury levels in plasma and urine. Mercury levels in plasma (P-Hg) and urine (U-Hg), and urinary cotinine were examined in 18 subjects who regularly used nicotine chewing gum, and in 19 referents. Age and number of amalgam surfaces were similar in the two groups. Total mercury concentrations in plasma and urine were determined by means of cold vapor atomic absorption spectrometry. Urinary cotinine was determined by gas chromatography-mass spectrometry. The chewers had been using 10 (median) pieces of gum per day for the past 27 (median) months. P-Hg and U-Hg levels were significantly higher in the chewers (27 nmol/L and 6.5 nmol/mmol creatinine) than in the referents (4.9 nmol/L and 1.2 nmol/mmol creatinine). In both groups, significant correlations were found between P-Hg or U-Hg on the one hand and the number of amalgam surfaces on the other. In the chewers, no correlations were found between P-Hg or U-Hg and chewing time per day or cotinine in urine. Cotinine in urine increased with the number of pieces of chewing gum used. The impact of excessive chewing on mercury levels was considerable.

Adult↗

In vivo XRF analysis of mercury: the relation between concentrations in the kidney and the urine.

The objective of this study was to determine the concentrations of mercury in organs of occupationally exposed workers using in vivo x-ray fluorescence analysis. Twenty mercury exposed workers and twelve occupationally unexposed referents participated in the study. Their mercury levels in kidney, liver and thyroid were measured using a technique based on excitation with partly plane polarized photons. The mercury levels in blood and urine were determined using atomic absorption spectrophotometry. The detection limit for mercury in the kidney was exceeded in nine of the exposed workers, but in none of the referents. The mean kidney mercury concentration (including estimates below the detection limits) was 24 micrograms g-1 in the exposed workers, and 1 microgram g-1 in the referents. The association between mercury in the kidney and in urine was statistically significant, but it was unclear whether the relation was linear. The measurements on liver (n = 10) and thyroid (n = 8) in the exposed workers showed mercury levels below the detection limit. The study shows that it is now possible to measure the mercury concentrations in kidneys of occupationally exposed persons, using in vivo x-ray fluorescence. The estimated concentrations are in reasonable agreement with the limited human autopsy data, and the results of animal studies.

Adult↗

People with high mercury uptake from their own dental amalgam fillings.

OBJECTIVES: To describe people with high mercury (Hg) uptake from their amalgam fillings, and to estimate the possible fraction of the occupationally unexposed Swedish population with high excretion of urinary Hg. METHODS: Three case reports are presented. The distribution of excretion of urinary Hg in the general population was examined in pooled data from several sources. RESULTS: The three cases excreted 23-60 micrograms of Hg/day (25-54 micrograms/g creatinine), indicating daily uptake of Hg as high as 100 micrograms. Blood Hg was 12-23 micrograms/l, which is five to 10 times the average in the general population. No other sources of exposure were found, and removal of the amalgam fillings resulted in normal Hg concentrations. Chewing gum and bruxism were the probable reasons for the increased Hg uptake. Extrapolations from data on urinary Hg in the general population indicate that the number of people with urinary excretion of > or = 50 micrograms/g creatinine could in fact be larger than the number of workers with equivalent exposure from occupational sources. CONCLUSION: Although the average daily Hg uptake from dental amalgam fillings is low, there is a considerable variation between people; certain people have a high mercury uptake from their amalgam fillings.

Adult↗

Respiratory symptoms and asthma among workers exposed to paper dust: a cohort study.

The aim of the present cohort study was to investigate whether exposure to paper dust causes increased risk for respiratory symptoms or asthma. The cohort included all workers at a soft paper mill who had worked there for more than 1 year 1960-1986 (n = 1,697). Randomly selected inhabitants of the mill town (n = 781) were used as unexposed referents. Both groups were investigated using a postal questionnaire. From the paper mill cohort, workers with high cumulative exposure (n = 313), with medium cumulative exposure (n = 321), and with low cumulative exposure (n = 338) to paper dust were selected. In the 1960s and 1970s, the dust levels were between 5 and 10 mg/m3. After adjustment for smoking and gender, paper dust exposure resulted in elevated prevalence ratios for chronic cough, chronic phlegm, wheeze, and breathlessness. The prevalence ratios ranged from 1.3 to 2.5. No significantly increased risk of asthma was found among the exposed, incidence rate ratio 1.4 (95% confidence interval 0.93-1.8). Among the exposed, there was an insignificantly increasing incidence rate ratio, 1.0, 1.4, 2.1, with increasing cumulative exposure. In conclusion, an increased risk for respiratory symptoms was observed among workers exposed to paper dust, but the study does not permit any definite conclusions regarding asthma and paper dust exposure.

Adult↗

Mercury and proteins in cerebrospinal fluid in subjects exposed to mercury vapor.

Mercury (Hg) and protein levels in cerebrospinal fluid (CSF), and mercury in plasma (P), erythrocytes (Ery), and urine (U), were determined in 10 workers exposed to mercury vapor for 2-28 (median 13) years and in 16 occupationally unexposed referents. CSF-Hg was analyzed using radiochemical neutron activation analysis and P-Hg, Ery-Hg, and U-Hg were analyzed using cold-vapor atomic absorption spectrometry. P-Hg and U-Hg were significantly higher, but Ery-Hg was similar in the exposed workers (37 nmole/liter, 16 nmole/mmole creatinine, and 56 nmole/liter, respectively) compared with the referents (7.1 nmole/liter, 1.9 nmole/mmole creatinine, and 52 nmole/liter, respectively). CSF-Hg was correlated to P-Hg, and in workers with current high exposure (P-Hg > 50 nmole/liter), the CSF-Hg was significantly higher than in the reference group (1.08 versus 0.35 nmole/liter; P = 0.002). In two individuals, studied after ceased occupational exposure, a decrease of CSF-Hg was seen. There were no indications of changes in the CSF protein pattern in the exposed workers.

Adult↗