Cadmium

Two train conductors developed tight chests, painful breathing, muscle cramps and nausea after fighting a fire in a battery box under a passenger coach. Shortly thereafter they became anosmic and had excessive fatigue, persistent headaches, sleep disturbances, irritability and unstable moods and developed hypertension. Urinary cadmium and nickel levels were elevated. Neurobehavioral testing showed, in comparison to referents, prolonged reaction times, abnormal balance, prolonged blink reflex latency, severely constricted visual fields, decreased vibration sense and low scores on Culture Fair, block design and digit symbol. Immediate verbal and visual recall were normal but delayed recall was reduced. Scores on overlearned information were normal. Performance of grooved pegboard and trail making A and B were abnormal and they made many errors on finger-tip-number-writing. Repeat testing 6 and 12 months after exposure showed persistent abnormalities. Cadmium and vinyl chloride are the most plausible major neurotoxic chemicals but others may have been in the fumes.