Toxic polyneuritis in Bombay due to ortho-cresyl-phosphate poisoning

Abstract

Since 1930 poisoning with ortho-cresyl-phosphate has been recognized as a cause of peripheral poly-neuritis (Smith, Elvove, and Frazier, 1930). Ortho-cresyl-phosphate (O.C.P.) is widely used as a plasticiser and in the production of heat-stable lubricating oils. Many cases of industrial poisoning with O.C.P. have been reported since then but as a result of strict precautionary measures it has now become a rarity. However, the occasional contamina-tion of food with O.C.P. is not uncommon. Poisoning with O.C.P. was first reported in patients with pulmonary tuberculosis who under-went treatment with phospho-creosote (Hunter, 1956), and physicians became well versed in the clinical picture of poisoning with O.C.P. after the outbreak of polyneuritis, described as 'Jamaica ginger paralysis ' which occurred in the U.S.A. in 1930 (Burley, 1932). A similar picture appeared in Holland in women who used Apiol (containing O.C.P.) as an abortifacient (Guttmann, 1932). In 1937, there was an outbreak of sudden peripheral polyneuritis in Durban, produced by the use of Bestol superfine cooking oil. This was subsequently traced to the original oil which had been sent from England in large drums previously used for storing lubricating oil containing O.C.P. (Sampson, 1942). Humpe (1942) reported five cases of peripheral polyneuritis caused by the accidental consumption of fat contaminated with O.C.P. An outbreak of the characteristic polyneuritis due to O.C.P. occurred in Morocco, when about 10,000 persons were affected, and the source was traced to a lubricant which had been used to adulterate the cooking oil