Letter from Dr Peter Julu, Specialist
Autonomic Neurophysiologist and Consultant Physician
EARLY EVIDENCE
OF SPECIFIC
AUTONOMIC NEUROPATHY
IN AIRCREWS
I have carried out target-organ specific examination
of the autonomic nervous system in a group of aircrews (n = 9)
who developed chronic neurological symptoms during the course
of their duties and compared the outcomes with a group of coal
miners (n = 6) who also became ill following exposure to carbon
monoxide due to ventilation accidents, in order to establish the
pattern of autonomic dysfunctions in the two groups. The neurological
sequelae I found in miners exposed to carbon monoxide and aircrews
complaining of ill health consist of a patchy pattern of dysfunctions
of the autonomic target organs in various parts of body but mainly
in the skin, in the large blood vessels including the heart and
in the brain. These neurological sequelae can explain the
symptoms and ill health in these two groups of patients. Cholinergic
functions are selectively preserved while monoaminergic functions
deteriorate in the brain and in the skin among the aircrews. The
imbalance between cholinergic and monoaminergic functions in the
brain can explain cognitive dysfunction and impairment of short-term
memory. The pattern of autonomic dysfunctions in the aircrews
is distinctively different from that in miners exposed to carbon
monoxide.
I am continuing to see more aircrews in my clinics
and the pattern of autonomic dysfunctions in these patients is
consistent. This is a compelling reason for further investigation,
first to confirm the findings in the aircrews by examining a larger
number and then to investigate possible common toxic agents among
sheep farmers and aircrews. This is so because the pattern of
autonomic dysfunctions in sheep farmers and the aircrews is identical.
17 June 2007
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