Twenty automechanics possessing increased whole blood values of one or more of the following heavy metals; chromium, copper, lead, manganese and nickel, were studied for peripheral nerve affection by means of electromyography (both sensoric and motoric nerve potentials were recorded). The heavy metal contents were related to the findings of denervation, distal motor latency, distal sensory latency, motoric and sensoric conduction velocities. Apart from two workers, in whom only lead was assayed, the remaining group of 18 were assayed for all heavy metals under study. Six workers showed increased distal motor and/or sensory latency and seven decreased nerve conduction velocity (four motoric and three sensoric affections). Of the workers with nerve affection, three showed increased levels of lead (nickel and chromium also raised). Four workers showed increased lead, nickel and chromium and one of lead, chromium and manganese. All in all, 10 out of 20 workers (50 percent) with elevated lead levels showed definite signs of peripheral neuropathy and seven out of 14 with raised nickel values showed these signs but they could all be accounted for by the increased lead levels. All except seven workers with raised lead levels in the whole group showed values above the critical limit of 80.0 mug/100 ml in whole blood. The data argue for the highly toxic effect of lead and other heavy metals on the peripheral nervous system and stress the diverse toxic exposure which automechanics undergo during their work. The possibility of there being a synergistic action between heavy metals and components of mineral oil and petroleum is discussed.
