J Clin Neurol.  2010 Jun;6(2):64-72. 10.3988/jcn.2010.6.2.64.

Occupational Neurologic Disorders in Korea

  • 1Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. yanghokm@ulsan.ac.kr
  • 2Department of Occupational and Environmental Medicine, Dongguk University School of Medicine, Ilsan Hospital, Goyang, Korea.
  • 3Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Korea.


This article presents a schematic review of the clinical manifestations of occupational neurologic disorders in Korea and discusses the toxicologic implications of these conditions. Vascular encephalopathy, parkinsonism, chronic toxic encephalopathy, cerebellar dysfunction, peripheral neuropathy, and neurodegenerative diseases are common presentations of occupational neurotoxic syndromes in Korea. Few neurotoxins cause patients to present with pathognomic neurologic syndrome. Detailed neurologic examinations and categorization of the clinical manifestations of neurologic disorders will improve the clinical management of occupational neurologic diseases. Physicians must be aware of the typical signs and symptoms of possible exposure to neurotoxins, and they should also pay attention to less-typical, rather-vague symptoms and signs in workers because the toxicologic characteristics of occupational neurologic diseases in Korea have changed from typical patterns to less-typical or equivocal patterns. This shift is likely to be due to several years of low-dose exposure, perhaps combined with the effects of aging, and new types of possibly toxicant-related neurodegenerative diseases. Close collaboration between neurologists and occupational physicians is needed to determine whether neurologic disorders are work-related.


occupational disease; neurologic disorders; toxicology

MeSH Terms

Cerebellar Diseases
Cooperative Behavior
Nervous System Diseases
Neurodegenerative Diseases
Neurologic Examination
Neurotoxicity Syndromes
Occupational Diseases
Parkinsonian Disorders
Peripheral Nervous System Diseases

Cited by  1 articles

An aggravated return-to-work case of organic solvent induced chronic toxic encephalopathy
Sangyun Seo, Jungwon Kim
Ann Occup Environ Med. 2018;30(1):.    doi: 10.1186/s40557-018-0232-1.


1. EPA US. Toxic Substances Control Act (TSCA). Chemical substance inventory-revised inventory synonym and preferred name file. 2000. Washington, DC: Office of Pollution, Prevention, and Toxics.
2. Levin SM, Lilis R. Rom WN, Markowitz SB, editors. Carbon disulfide. Environmental and Occupational Medicine. 2006. 4th ed. Philadelphia: Lippincott Williams & Wilkins: 1219–1225.
3. Resenberg NL. Resenberg NL, editor. Recognition and evaluation of work-related neurologic disorders. Occupational and Environmental Neurology. 1995. Boston: Butterworth-Heinemann;9–45.
4. Park J, Hisanaga N, Kim Y. Transfer of occupational health problems from a developed to a developing country: lessons from the Japan-South Korea experience. Am J Ind Med. 2009. 52:625–632.
5. Lee EI, Kim SD, Kim HJ, Kim KJ, Yum YT. Carbon disulfide poisoning in Korea with social and historical background. J Occup Health. 1996. 38:155–161.
6. Kim Y, Kim KS, Yang JS, Park IJ, Kim E, Jin Y, et al. Increase in signal intensities on T1-weighted magnetic resonance images in asymptomatic manganese-exposed workers. Neurotoxicology. 1999. 20:901–907.
7. Shin JY, Leem JH, Kim YK, Park SG, Lee JN, Kim HC, et al. A case of peripheral polyneuropathy occurring in a small enterprise processing mobile phone cases. Korean J Occup Environ Med. 2005. 17:138–143.
8. Cho SI, Jhun HJ, Yim SH, Lee YK, Lee SY, Kim MJ, et al. Health evaluation of Korean carbon disulfide poisoned subjects after exposure has ceased. 2005. Seoul: Institute of Work. Environment and Health;13.
9. Lee KB, Byoun HJ, Choi TS, Cho WY, Kim HK. Clinical manifestation of chronic carbon disulfide intoxication. Korean J Intern Med. 1990. 39:245–251.
10. Choi JW, Jang SH. A review on the carbon disulfide poisoning experienced in Korean. Korean J Occup Environ Med. 1991. 3:11–20.
11. Kim DS, Kim SD, Cha CW. A study of the peripheral neuropathy among the workers exposed to carbon disulfide. Korean J Prev Med. 1993. 26:282–292.
12. Lee EI, Cha CW. Health status of workers exposed to carbon disulfide at a viscose rayon factory in Korea. Korean J Occup Environ Med. 1992. 4:20–31.
13. Park JT, Kim HJ, Yum YT, Paek DM. An analytic study on the effect of carbon disulfide on blood pressure. Korean J Prev Med. 1994. 27:581–596.
14. Koo JR, Jeong SC, Kwon HM, Kim BS, Kwon YJ, Cho WY, et al. Renal symptoms and kidney biopsy findings of chronic CS2 intoxication. Korean J Intern Med. 1990. 38:664–673.
15. Chuang WL, Huang CC, Chen CJ, Hsieh YC, Kuo HC, Shih TS. Carbon disulfide encephalopathy: cerebral microangiopathy. Neurotoxicology. 2007. 28:387–393.
16. Cha JH, Kim SS, Han H, Kim RH, Yim SH, Kim MJ. Brain MRI findings of carbon disulfide poisoning. Korean J Radiol. 2002. 3:158–162.
17. Lee E, Kim MH. Cerebral vasoreactivity by transcranial Doppler in carbon disulfide poisoning cases in Korea. J Korean Med Sci. 1998. 13:645–651.
18. Miura T. Miura T, editor. Work and health in rayon and staple industry. History of work and health. 1981. Vol 4. Kawasaki: Institute for Science of Labour;203–236.
19. Harada M. Gold and mercury. 2002. Tokyo: Kodansha.
20. Fitsanakis VA, Au C, Erikson KM, Aschner M. The effects of manganese on glutamate, dopamine and gamma-aminobutyric acid regulation. Neurochem Int. 2006. 48:426–433.
21. Lucchini R, Kim Y. Vojtisek Max, Prakash Ram, editors. Health Effects of Manganese. Metals and Neurotoxicity. 2009. India: Society for Science and Environment;119–147.
22. Calne DB, Chu NS, Huang CC, Lu CS, Olanow W. Manganism and idiopathic parkinsonism: similarities and differences. Neurology. 1994. 44:1583–1586.
23. Yamada M, Ohno S, Okayasu I, Okeda R, Hatakeyama S, Watanabe H, et al. Chronic manganese poisoning: a neuropathological study with determination of manganese distribution in the brain. Acta Neuropathol. 1986. 70:273–278.
24. Newland MC, Ceckler TL, Kordower JH, Weiss B. Visualizing manganese in the primate basal ganglia with magnetic resonance imaging. Exp Neurol. 1989. 106:251–258.
25. Nelson K, Golnick J, Korn T, Angle C. Manganese encephalopathy: utility of early magnetic resonance imaging. Br J Ind Med. 1993. 50:510–513.
26. Kim Y, Kim JW, Ito K, Lim HS, Cheong HK, Kim JY, et al. Idiopathic parkinsonism with superimposed manganese exposure: utility of positron emission tomography. Neurotoxicology. 1999. 20:249–252.
27. Park J, Kim Y, JW Kim. Webster LR, editor. High Signal Intensities on T1-Weighted MRI in the Spectrum of Manganese Symptomatology. Neurotoxicity syndrome. 2007. New York: Novapublisher;249–260.
28. Iregren A. Manganese neurotoxicity in industrial exposures: proof of effects, critical exposure level, and sensitive tests. Neurotoxicology. 1999. 20:315–323.
29. Zoni S, Albini E, Lucchini R. Neuropsychological testing for the assessment of manganese neurotoxicity: a review and a proposal. Am J Ind Med. 2007. 50:812–830.
30. Lim Y, Yim HW, Kim KA, Yun IG. Review on manganese poisoning. Korean J Occup Health. 1991. 30:13–18.
31. Park CY, Roh YM, Koo JW, Lee SH. Manganese exposure in ore crushing. Korean J Occup Environ Med. 1991. 3:111–118.
32. Kim Y, Kim JW, Ito K, Hisanaga N, Cheong HK, Kim KS, Moon Y. Positron emission tomography (PET) in differentiating manganism from idiopathic parkinsonism. J Occup Health. 1999. 41:91–94.
33. Kim Y. Neuroimaging in manganism. Neurotoxicology. 2006. 27:369–372.
34. Mena I, Marin O, Fuenzalida S, Cotzias GC. Chronic manganese poisoning. Clinical picture and manganese turnover. Neurology. 1967. 17:128–136.
35. Rodier J. Manganese poisoning in Moroccan mines. Br J Ind Med. 1955. 12:21–35.
36. Kim Y, Kim JM, Kim JW, Yoo CI, Lee CR, Lee JH, et al. Dopamine transporter density is decreased in parkinsonian patients with a history of manganese exposure: what does it mean? Mov Disord. 2002. 17:568–575.
37. World Health Organization. Chronic effects of organic solvents on the central nervous system and diagnostic criteria. 1985. Copenhagen: World Health Organization.
38. Baker EL, Seppalainen AM. Workshop on neurobehavioral effects of Solvents. Human aspects of solvent neurobehavioral effects. Neurotoxicology. 1986. 7:45–56.
39. World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 1992. 10th Revision (ICD-10). Geneva: World Health Organization.
40. American Psychiatric Association. Diagnostic and statistical manual for mental disorders. 1994. 4th ed. Washington, DC: American Psychiatric Press.
41. Keski-Säntti P, Mäntylä R, Lamminen A, Hyvärinen HK, Sainio M. Magnetic resonance imaging in occupational chronic solvent encephalopathy. Int Arch Occup Environ Health. 2009. 82:595–602.
42. Cheon YH. Toxic encephalopathy in a worker exposed to organic solvents; a case report. Korean J Occup Environ Med. 1991. 3:216–219.
43. Kang SK, Rhee KY, Chung HK, Lee YJ. A case of demyelinating lesion in central nervous system due to organic solvents. Korean J Occup Environ Med. 1992. 4:110–117.
44. Kang SK. Occupational neurologic disease-chronic toxic encephalopathy. Industrial Health (monthly magazine by Korean Industrial Health Association). 2000. 04. 5–13.
45. Kim JH, Ryu SJ, Kim BG, Jhun HJ, Park JT, Kim HJ. A case of trichloroethylene intoxication with neuropsychiatric symptoms. Korean J Occup Environ Med. 2008. 20:54–61.
46. Kim EA. Occupational neurologic disease-chronic toxic encephalopathy. Industrial Health (monthly magazine by Korean Industrial Health Association). 2006. 02. 4–8.
47. Kim EA. Occupational neurologic disease-chronic solvent poisoning. Industrial Health (monthly magazine by Korean Industrial Health Association). 2005. 10. 5–9.
48. van der Hoek JA, Verberk MM, Hageman G. Criteria for solvent-induced chronic toxic encephalopathy: a systematic review. Int Arch Occup Environ Health. 2000. 73:362–368.
49. Kaukiainen A, Akila R, Martikainen R, Sainio M. Symptom screening in detection of occupational solvent-related encephalopathy. Int Arch Occup Environ Health. 2009. 82:343–355.
50. De Haro L, Gastaut JL, Jouglard J, Renacco E. Central and peripheral neurotoxic effects of chronic methyl bromide intoxication. J Toxicol Clin Toxicol. 1997. 35:29–34.
51. Geyer HL, Schaumburg HH, Herskovitz S. Methyl bromide intoxication causes reversible symmetric brainstem and cerebellar MRI lesions. Neurology. 2005. 64:1279–1281.
52. Lee HJ, Oh SW, Lee JS, Chae HJ, Moon JD. A case of polyneuropathy associated with methyl bromide intoxication. Korean J Occup Environ Med. 2007. 19:238–243.
53. Choi KD, Shin JH, Kim DS, Jung DS, Park KH, O CJ, et al. A case of chronic methyl bromide poisoning associated with cerebellar ataxia, polyneuropathy and optic neuropathy. J Korean Neurol Assoc. 2002. 20:307–310.
54. Park HJ, Lee KM, Nam JK, Park NC. A case of erectile dysfunction associated with chronic methyl bromide intoxication. Int J Impot Res. 2005. 17:207–208.
55. Park TH, Kim JI, Son JE, Kim JK, Kim HS, Jung KY. Two case of neuropathy by methyl bromide intoxication during fumigation. Korean J Occup Environ Med. 2000. 12:547–553.
56. Lee JH, Chung WC, Choi SY, Park KH, Kim SW. A case of methyl bromide intoxication with continual residual neurologic symptoms. Korean J Intern Med. 1984. 27:621–624.
57. Lee JH, Lee MS, Ahn SH, Seo GS, Kim HR, Choi SC, et al. 3 cases of acute methyl bromide intoxication. Korean J Med. 1998. 55:432–435.
58. Kim YJ, Kim YH, Jeong KS, Sim CS, Choy NR, Kim JC, et al. A case of acute organotin poisoning. Korean J Occup Environ Med. 2006. 18:255–262.
59. Kim SH, Yoo CI, Kwon JH, Bae JH, Weon YC, Kim Y. A case of cerebellar dysfunction after acute organotin poisoning. Korean J Occup Environ Med. 2009. 21:289–292.
60. Besser R, Krämer G, Thümler R, Bohl J, Gutmann L, Hopf HC. Acute trimethyltin limbic-cerebellar syndrome. Neurology. 1987. 37:945–950.
61. Feldman RG. Occupational neurology. Yale J Biol Med. 1987. 60:179–186.
62. Nebuchennykh M, Løseth S, Jorde R, Mellgren SI. Idiopathic polyneuropathy and impaired glucose metabolism in a Norwegian patient series. Eur J Neurol. 2008. 15:810–816.
63. Kiel BD. Polyneuritis for n-hexane poisoning in rubber industries. J RIMSH. 1974. 6:423–429.
64. Occupational Safety and Health Research Institute (OSHRI). Peripheral neuropathy in workers exposed to n-hexane in a LCD frame manufacturer. 2005. Korea: OSHRI.
65. Kim EA. Occupational neurologic disease-peripheral neuropathy. Industrial Health (monthly magazine by Korean Industrial Health Association). 2005. May. 4–9.
66. Cho SY, Jang YS, Choi EK, Kim JS, Yu JY, Woo KH, et al. A case of peripheral polyneuropathy induced by occupational 2,5-hexanedione exposure. Korean J Occup Environ Med. 2007. 19:73–80.
67. Cheong HK, Kwon YW, Uh KY, Kim BJ, Yang JS, Jung C, et al. Polyneuropathy by occupational exposure to acrylamide. Korean J Occup Environ Med. 1998. 10:388–413.
68. Johnson FO, Atchison WD. The role of environmental mercury, lead and pesticide exposure in development of amyotrophic lateral sclerosis. Neurotoxicology. 2009. 30:761–765.
69. Oh SS, Kim EA, Lee SW, Kim MK, Kang SK. A case of amyotrophic lateral sclerosis in electronic parts manufacturing worker exposed to lead. Neurotoxicology. 2007. 28:324–327.
70. Kim EA. Occupational neurologic disease-amyotrophic lateral sclerosis. Industrial Health (monthly magazine by Korean Industrial Health Association). 2005. 12. 4–8.
71. Chancellor AM, Slattery JM, Fraser H, Warlow CP. Risk factors for motor neuron disease: a case-control study based on patients from the Scottish Motor Neuron Disease Register. J Neurol Neurosurg Psychiatry. 1993. 56:1200–1206.
72. McGuire V, Longstreth WT Jr, Nelson LM, Koepsell TD, Checkoway H, Morgan MS, et al. Occupational exposures and amyotrophic lateral sclerosis. A population-based case-control study. Am J Epidemiol. 1997. 145:1076–1088.
73. Weisskopf MG, Morozova N, O'Reilly EJ, McCullough ML, Calle EE, Thun MJ, et al. Prospective study of chemical exposures and amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry. 2009. 80:558–561.
74. Jeong WS, Cheon JS, Chang HI. A case of organic mental disorder associated with subacute mercury poisoning. J Korean Neuropsychiatr Assoc. 1985. 24:168–172.
75. Wee KS, Choi TS, Lee SJ, Cho WY, Kim HK. A clinical study of chronic mercury poisoning. Korean J Intern Med. 1990. 38:51–57.
76. Kim BS, Hong YC, Lim HS, Kim JY, Lee JK, Huh BY. Four cases of chronic mercury poisoning. J Korean Acad Fam Med. 1988. 9:27–32.
77. Kim EA. Mercury poisong in wastes recycling workers. Industrial Health (monthly magazine by Korean Industrial Health Association). 2006. Apr. 11–14.
78. Gregory AC 2nd, Shendell DG, Okosun IS, Gieseker KE. Multiple Sclerosis disease distribution and potential impact of environmental air pollutants in Georgia. Sci Total Environ. 2008. 396:42–51.
79. Gatley MS, Kelly GA, Turnbull IW. A case of organic solvent exposure and temporal lobe demyelination. J Soc Occup Med. 1991. 41:83–85.
80. Landtblom AM, Flodin U, Karlsson M, Pålhagen S, Axelson O, Soderfeldt B. Multiple sclerosis and exposure to solvents, ionizing radiation and animals. Scand J Work Environ Health. 1993. 19:399–404.
Full Text Links
  • JCN
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr