|
Items in cart [0] |
Questions? Call 888-624-8373 |
| Copyright © 2009. National Academy of Sciences. All rights reserved. Terms of Use and Privacy Statement |
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 322
Issues in the Development of
Neurobehavioral Toxicity
Tests in India
Vinod Behari Saxena
Developing countries are a vast entity and each country has its
own specific problems, geographical, economic, social, legal/policy,
as well as technical, so far as occupational health is concerned. Each
country has to explore the resources it can make available to support
the development of neurobehavioral tests of toxicity for early detection
of occupational health and hazards. Part IV of this volume, dealing
with regional issues in the development of neurobehavioral toxicity
tests, is concerned with future development of behavioral tests of
neurotoxicity in occupational health. To understand the topic fully
there are several issues to be discussed:
1. The status of research and development
2. Expected directions in the development of behavioral tests of
neurotoxicity
3. Barriers to the development of behavioral tests of neurotoxicity
4. Recommendations for the development of behavioral tests of
neurotoxicity
These will be considered within the general context of the Indian
subcontinent.
322
OCR for page 323
NEUROBEHAVIORAL TOXICITY TESTS IN INDIA
STATUS OF ENVIRONMENTAL RESEARCH
AND DEVELOPMENT IN INDIA
Recognition of a Need
323
India is well recognized as being among the developing countries
of Asia. It is comparable to developed countries only in the field of
space research. Basically it is an agricultural country that is now
advancing very rapidly in the development of its industrial sector.
Only in one state Uttar Pradesh has the number of industries (both
private and public) approximately doubled within a span of six years
(from 5,334 in 1981 to 9,529 in 1987~. Cottage industries also play an
important role. One can very easily consider that an explosion of
industrial development in India has occurred during the last decade.
With industrial development the number of workers in industries
has also approximately doubled. Statistics for 1983 (Labor Bureau,
1985) show that the labor population was 33.4 percent of the total
population in the country as a whole, whereas it was 29.2 percent of
the population in Uttar Pradesh. With the advancement of scientific
methodology in agriculture and industries, new technology is being
adopted everywhere in the country to increase production and to
save precious time and labor. A large number of chemicals are being
introduced, but unlike the developed countries, the harmful side effects
of this industrialization are not being taken into consideration. Workers
engaged in, and affected by, toxic substances are not given protection
by their employers, be they government or private organizations.
Due to lack of standards in health, hygiene, and safety- practices,
occupational health is very low on the list of national priorities. Workers
are exposed to relatively high doses of neurotoxic substances without
adequate protection. Because of ignorance and, possibly, of no way
to cope with the problems, very little or no attention is paid to early
neurobehavioral changes.
The first awareness of pollution and the need for environmental
protection started with the great jaundice epidemic of 1956 in Delhi,
resulting in the establishment of the Central Public Health Engineer-
ing Research Institute (CPHERI) at Nagpur in December 195~lanuary
1959, and later as the National Environment Engineering Research
Institute (NEERI) under the Council of Scientific and Industrial Researrh
(CSIR). As an institution, NEERI has been a forerunner in the coun-
try to focus attention on air, water, and land pollution.
The second step in the environmental movement in India had, for
all practical purposes, its beginning in 1972, the year of the Stockholm
conference. During the last decade, the environmental movement
OCR for page 324
324
VINOD BEHARI SAXENA
has also received legislative recognition in the form of laws for the
prevention of water and air pollution. Promulgations of the Environment
(Protection) Act of 1980 and the Factories Amendment Act of 1987
are particularly important developments because they seek to make
the agencies responsible for the monitoring and control of pollution
more effective by conferring on them greater powers than they have
hitherto enjoyed.
The third phase started in 1984 when the methyl isocyanide (MIC)
accident of the Bhopal gas tragedy on December 2-3 forced the gov-
ernment and other agencies to review occupational health and safety
programs and created awareness in the general population about the
effects of toxic substances. Epidemiological studies have been carried
out since the MIC accident, but because of ignorance of behavioral
toxicology, not much attention has been paid to neurobehavioral changes,
which are not being assessed by any well-developed neurobehavioral
test battery.
Centers for Occupational Health and Safety
In the field of occupational health and safety, the five following
institutes/centers have been operating in India during the last few
decades, but none has a separate department/unit dealing with
neurobehavioral changes resulting from exposure to toxic substances
and their assessment with the help of a neurobehavioral test battery:
1. National Institute of Occupational Health (NIOH); Indian Council
of Medical Research, Ahmadabad
2. All India Institute of Hygiene and Public Health, Calcutta
3. Industrial Toxicology Research Centre (ITRC), Lucknow
4. Central Labour Institute (CLI), Bombay
5. Occupational Health Services (OHS), Bharat Heavy Electricals,
Ltd. Centre, Tiruchirappalli
These institutes are working mainly in the field of epidemiological
studies, animal studies, neurological studies, and general occupational
health and hygiene problems. Only the OHS center of BHEL and one
OHS unit of ITRC have been carrying out some work in neurobehavioral
toxicology since 1980 but without developing their own test battery
or even with any total battery from the developed countries. Not
until December 1987 and January 1988 did NIGH, Ahmadabad, establish
a Department of Behavioral Toxicology, which will begin studies in
the near future.
The health problems of Indian workers are especially serious. Workers
are more prone to accidents, etc., because many are illiterate or, even
OCR for page 325
NEUROBEHAVIORAL TOXICITY TESTS IN INDIA
325
when literate, are not aware that the environment in which they are
working may, in any way, be harmful to them. They continue working
without any awareness of the toxicity of their work environment.
The situation is further complicated by the fact that the majority of
owners of industries are themselves not aware of the danger to which
they are exposing their employees. The role of psychology in the
industrial setup is restricted to placing the right worker on the right
job and to matters affecting productivity. Psychologists have little to
do with detection of toxic effects caused by exposure of workers to
toxic substances in industries and in agriculture.
When such are the state of awareness and concerns about occupa-
tional health" where even conventional precautions and care are not
being observed the very limited status of the developing field of
behavioral toxicology can easily be understood. The field has just
reached the country, and the majority of scientists, policy makers,
and industrialists, as well as the general public, do not even know
that such a field exists, let alone applying it. Moreover, when people
are told about them, studies in neurobehavioral toxicology are generally
considered an extravagance. In brief, it can be stated that research
work in this field is in an early budding stage.
DEVELOPMENT OF A PROGRAM AT
KANPUR UNIVERSITY
It was not until 1980 that the Department of Psychology, Pandit
Prithi Nath (PPN) College, Kanpur University, started work in this
discipline, stimulated by the research work of Dr. Helena Hanninen.
At present about six research investigators are working in this field.
Most of the research is ex post facto field studies planned to assess
effects of various toxic substances on different behavioral parameters
with the help of neurobehavioral tests. Up to the present time, the
effects of the following toxins have been explored: organic solvents,
larvicides, pesticides, and insecticides; lead, chromium oxide, and
carbon monoxide. Findings of five studies are summarized here in
brief as examples of research that can be helpful in initiating a systematic
program during its early stages of development.
All the studies were conducted not with the objective of treatment
referral or withdrawal from exposure, but to detect whether toxic
substances in the workplace had caused neurobehavioral changes in
a population of exposed workers. The exposures had been to chronic
low doses over long terms. No environmental monitoring or
biomonitoring was done for want of facilities. All tests used in the
studies were selected in view of the objectives of studies and guide-
OCR for page 326
326
VINOD BEHARI SAXENA
lines proposed for the selection of tests by the World Health Organi-
zation (WHO):
· Tests known to measure functions that are affected by several
neurotoxic agents
· Tests that have yielded positive results in earlier, corresponding
studies
Consideration of costs in terms of time and money
· Tests that are reasonably motivating and relatively indepen-
dent of the subjects' cultural and educational backgrounds.
Out of the ten proposed functional domains, only four to five have
been studied for want of test facilities and practical requirements
necessary for the study.
One of the studies was conducted by Kumar and Saxena (1985~. It
was designed to look at the effect of long-term exposure to organic
solvents on the performance of two groups of workers (100 workers
in each group) from gasoline filling stations and the paint industry.
Performance was measured by using a psychological test battery
containing Benton Visual Retention test, Bourdon-Wiersma Vigilance
test, Santa Ana Dexterity test, and a screening questionnaire. Results
were compared with those of comparable groups of unexposed workers
matched on mean age, education, and salary, with exposure duration
of (1) up to five years and (2) more than five years. The results of the
study revealed that exposure to gasoline is more harmful for memory
(immediate, as well as delayed) than exposure to paint solvents when
exposures were as long as five years. Both chemicals became equally
toxic when the duration of exposure increased, although gasoline
caused no further impairment whereas paint solvent led to continuing
deterioration. In perceptional accuracy/vigilance measures the same
phenomenon was found. In this case, however, gasoline caused im-
pairment but not as much as paint solvents. As the duration of
exposure increased, gasoline remained the more toxic of the two.
This trend was not found in cases of manual dexterity, where both
solvents were equally toxic irrespective of the duration of exposure
and both maintained their toxicity even after five years. It may be
concluded that exposure to both solvents causes impairment of behavioral
functions in the exposed worker, with gasoline being the more harmful
of the two at least in case of immediate memory and perceptual accuracy.
Another of the studies (Singh and Saxena, 1987a) was designed to
determine the effect of long-term, low-dose exposure to a mixture of
organic solvents (used as thinner for paint) on memory and subjective
symptoms. The scores of 24 spray painters from an automobile workshop
OCR for page 327
NEUROBEHAVIORAL TOXICITY TESTS IN INDIA
327
were recorded on Postgraduate Institute (PGI) memory questionnaire
and a questionnaire on subjective symptoms. These results were compared
with the scores of a group of workers from the upholstery section of
the same workshop. Significant differences were found in four (memory
total, mental balance, concentration, and recall) of ten aspects of memory,
with a better performance by the unexposed workers. On comparing
the extent of impairment of different aspects of memory, attention
and concentration (digit span) were found to be most affected. Sub-
jective symptoms did not clearly differentiate between the two samples,
significant differences were found in only 3 of 40 symptoms. In total,
however, the results indicate some deterioration in psychological
functioning of workers as a result of exposure to organic solvents.
Exposure to Larvicides, Pesticides, and Insecticides
Singh and Saxena (1987b) have reported results of yet another study
planned to measure possible effects of long-term exposure to larvicide
(organophosphate), fenvalerate (synthetic pyrethroid), and Gammexane
(organochlorine). The performances of three groups of workers (100,
30, and 22, respectively) from related departments were measured on a
psychological test battery comprising PGI memory test, Santa Ana Dex-
terity test, Bourdon-Wiersma Vigilance test, a questionnaire on subjective
symptoms, and a screening questionnaire. The results were compared
with those of a comparable group of unexposed workers matched on
mean age, education, and salary. Results were as follows: (1) The
group exposed to larvicide was found to have significantly poorer per-
formance on memory, vigilance, and dexterity tests than the control
group. The exposed workers also reported certain subjective symptoms
indicating that exposure to larvicide impaired psychological function-
ing. (2) The group exposed to fenvalerate was found to be affected in
measures of memory, manual dexterity, and perceptual accuracy. (3)
The third group exposed to Gammexane was found to have impaired
memory, manual dexterity, and vigilance. They also reported the pres-
ence of such symptoms as hostility and destructiveness.
Comparisons among the three exposed groups were made with
the help of multiple regression analysis in which the effect of poten-
tially confounding variables such as age and education were partialled
out. All three groups of compounds were found capable of causing
impairment in the psychological functioning of workers, organophosphate
compounds being the most toxic followed by organochlorine and synthetic
pyrethroid compounds, respectively.
OCR for page 328
328
VINOD BEHARI SAXENA
Exposures in the Leather Industry
Siddiqi and Saxena (1988) studied on 300 workers, 250 of whom
were occupationally exposed to chemicals used in the leather indus-
try (50 workers for each stage of tanning: liming, pretanning, tan-
ning, dying, and finishing) and 50 workers as a control group matched
on mean age, education, salary, and length of service. Exposure du-
ration was defined in terms of length of service (i.e., less than five
years and more than five years). The following measures were used
a screening questionnaire, the Santa Ana Dexterity test, a subjective
symptoms questionnaire, and EPI. Results showed that exposure to
chemicals in aB five stages of tanning causes impairments in behavioral
functions of the workers. Exposure to chromium oxide during the
tanning process had its most adverse effects on perceptual accuracy
and manual dexterity. Remote memory, recent memory, and delayed
recall were not affected. When results were interpreted in terms of
exposure duration, it was observed that exposure up to five years
caused impairment in the performance of workers on all the functional
domains under study except remote memory and recent memory.
Mental balance, digit span, delayed recall, immediate recall, retention
of similar pairs, retention of dissimilar pairs, visual retention, and
overall memory were affected by exposures even after five years. In
brief, it may be stated that deterioration increases with increasing
exposure in behaviors involving memory, manual dexterity, perceptual
accuracy, subjective symptoms, and neuroticism.
Effects of Exposure to Lead
A study by Saxena and Saxena (1988) focused on effects of long-
term, low-dose exposure to lead on the performance of 150 workers
from a battery factory. Performance was measured by a psychologi-
cal test battery comprising the Benton Visual Retention test, digit
span, Bourdon-Wiersma Vigilance test, Santa Ana Dexterity test, EPI,
and NSQ. These measures were compared with those of a control
group of unexposed workers matched on mean age, education, and
salary. Duration of exposure was (1) less than 5 years, (2) between 5
and 10 years, and (3) more than 10 years. The results established that
exposure to lead was detrimental to measures of memory (both visual
and auditory), perceptual accuracy/vigilance, and manual dexterity.
The longer the duration of exposure, the greater was the impairment
in these functional domains. Significantly lower levels of extroversion,
neuroticism, tendermindedness, depression, and anxiety were observed
in the unexposed group of workers than in exposed workers. Duration
OCR for page 329
NEUROBEHAVIORAL TOXICITY TESTS IN INDIA
329
of exposure differentially affected some but not all behaviors. For
example, subjective symptoms (factitious behavior, suspiciousness,
impatience, self-absorption, and attacking others) were significantly
higher in the exposed group of workers than in the unexposed Ruin
when the exposure duration was more than 10 years.
-a--- =--~r
EXPECTED DIRECTIONS IN THE DEVELOPMENT
OF BEHAVIORAL TESTS OF NEUROTOXICITY
Most of the tests in the studies described above were adopted from
the test battery being used at the Institute of Occupational Health,
Helsinki, and from that suggested by WHO. As far as the development
of test batteries in India is concerned, the work done has been negli-
gible. The only instrument developed so far is a questionnaire on
subjective symptoms, which still needs standardization. It covers
subjective symptoms related to affective behavior, ingestive behavior,
social behavior, attention, arousal, and consciousness. We have studied
the potential usefulness a long list of available psychological tests:
intelligence, interest, adjustment, aptitude, job involvement and sat-
isfaction, anxiety, and personality. We have examined questionnaires,
projective tests, performance tests for motor ability (speed and coor-
dination), and such standardized tests as WAIS, DAT, 16PF, EPI, TAT,
and CAT. Our conclusion is that the majority of the tests are not
applicable to the total population of the country because they are not
culture free in their current forms and, more specifically, because
they present language problems.
Similarly, from the literature of behavioral toxicology it has been
noticed that all agencies in developed countries involves! in studying
the effects of neurobehavioral toxicity are using their own behavioral
test batteries for different toxic substances. In the recent past, WHO
has suggested a test battery that can be used and developed by all
nations and services. This may be proper and applicable in nations
where the working conditions and the control of occupational hazards
are of high level. However, for certain regions/nations where little,
if any, attention has been paid to such conditions, the working conditions
are poor; regulations concerning exposure and control of occupational
hazards are minimum; and occupational health care is not among the
top priorities of government. In these developing regions, occupational
health questions need deep and exhaustive exploration in view of the
geographic, economic, social, psychological, and legal perspective of
occupational health. Only after deciding about acceptable Threshold
Limit Values (TLVs) for different toxic substances, can the WHO test
battery be used, with suitable modifications and adaptations, for the
OCR for page 330
330
VINOD BEHARI SAXENA
identification of workers adversely affected. It is evident that in so
far as development and adaptation of neurobehavioral tests are con-
cerned, developing countries have contributed nothing or very little.
This is attributable not to a lack of willingness or the capability of
researchers but rather to the unfavorable circumstances in developing
countries that do not recognize the important contributions neuro-
behavioral toxicology can- make to the prevention of tragic occupa-
tional hazards. Thus it seems that a giant task lies ahead. If we
really are to be on a par with developed countries, we will have to
work hard.
It is useful to consider some of the directions in which actions are
now needed. Priority should be given to the development of a test
battery for preliminary screening comprised of elementary tests cov-
ering all the functional domains described by WHO. It should then
be applied to find out the domains that are being affected by exposure
to various toxic substances. This battery should be a general test
battery to be used in all epidemiological studies. It should be easy to
administer, of about half an hour's duration, and portable. The battery
will be helpful in narrowing down the areas of psychological functions
to be studied in depth.
The construction, development, and adaptation of tools of a more
sensitive nature, covering all the functional areas found during preliminary
screening to be affected by various toxicants, are necessary. Guidelines
prescribed by WHO should be taken into consideration. These tests
should be sensitive enough to detect even the slightest behavioral
disorder, and they should be applied periodically to screen out susceptible
workers. It would be desirable if these tests could be used in laboratory
studies and experimental research, with volunteers performing under
various concentrations of the toxic substances being studied. In this
way,-maximum allowable concentrations can be determined.
Consideration should be given to the development of a test battery
whose scores can be compared with tests being used in other countries.
This is essential in order to encourage the exchange of technical
knowledge, possibly saving time and money in needlessly replicating
studies. Comparing our results with those of other countries earl provide
checks on the validity and reliability of our tests and can make pos-
sible the comparison of work conditions.
The preparation of culture-free tests that can be used by different
countries is another important consideration. Such instruments require
preliminary trials to find out if they are culture free. These types of
tests are essential because India is such a vast country having various
subcultures, each with its own language, that if we want to enact
uniform rules regarding occupational health services, a uniform screening
battery is necessary.
OCR for page 331
NE UR OB EHA VIORAL TOXICITY TE S TS IN INDIA
331
In brief, it may be concluded that in the development of behav-
ioral tests of neurotoxicity all tests must possess the following char-
acteristics: (1) the tests should be simple to administer; (2) they must
be unambiguous in interpretation; (3) measures derived from them
must be indicators of nervous system dysfunction; (4) tests should be
comprehensive; and (5) as far as possible, they should be culture free.
BARRIERS TO TEST DEVELOPMENT
The expected direction of development of neurobehavioral tests of
neurotoxicity depends on overcoming a number of obstacles. Until-
and unless- a suitable test development environment is created, with
a interdisciplinary approach and coordinated research programs, the
scientific and systematic development of tests will not be possible.
There are several obstacles that need to be addressed before carrying
out such a research program. These were discussed in depth by
participants in the First Asian Conference on Behavioral Toxicology
and Clinical Psychology arranged by the Department of Psychology,
Kanpur, in January 1987 (Saxena, 1988~. They are summarized be-
low.
Public Awareness
The first and most important constraint is the lack of awareness of
neurobehavioral toxicology and its usefulness among persons who
should be concerned. A favorable attitude toward the field and a
policy of support by governments are a must. Neurobehavioral toxi-
cologists can contribute significantly through research and publication
in scientific journals. However, such works are not likely to reach
beyond those involved in the field itself. Implementation of scientific
findings is the responsibility of industry, labor, and human resource
departments of the state and central governments. To create awareness
among the population as a whole is primarily a function of government.
Without this support, effective measures to assess risks and control
exposures to toxic conditions are not possible.
Interdisciplinary Coordination
The modern scientific era is based on interdisciplinary approaches
to the development of systematic bodies of knowledge. India, too, is
using this approach in many fields, but the field of occupational health
and safety is an exception. Engineering departments design safe ma-
chines to minimize the risks of accident. Medical departments pro-
vide medical care to the worker on the basis of manifest symptoms.
OCR for page 332
332
VINOD BEHARI SAXENA
Social welfare departments engage in general social welfare activi-
ties. There is no recognized role for psychologists in India except for
the selection of workers.
The government provides protection in cases of fatal and serious
accidents only through compensation and general medical care un-
der employment insurance schemes, facilities available only to regis-
tered workers and not to daily wage earners or unregistered workers
of many small and cottage industries.
The importance of interdisciplinary coordination is especially ap-
parent in relations between neurobehavioral toxicologists and medi-
cal specialists. General medical personnel—even those who are working
as industrial medical officers are not ready to accept that behav-
ioral tests of toxicity can detect neurological damage or that these
tests can be used for the early detection of damage. Because, at
present, all epidemiological studies are carried out by medical personnel,
fuller understanding and collaboration between the two disciplines
are essential if the development of behavioral tests of neurotoxicity is
to be possible.
Tack of Appropriate Standards
The present baseline Maximum Allowable Concentrations (MACs)
and Threshold Limit Values (TLV's) are based on the international
standard indices. None have been established by Indian researchers
for Indian workers. One reason is that there is no single agency for
the nation as a whole to oversee the development of suitable standards.
The only alternative is to apply standards established in other regions
of the world which differ in many ways from conditions in India.
We need to plan the development of suitable standards basically
in provinces and industries where the risk of toxic exposures may be
great. Implementation of research plans is totally different from planning
them, of course. As noted earlier, a whole network of awareness,
government policy, and interdisciplinary cooperation needs to be in
place if satisfactory MACs and TLVs are to be established so that
standards of occupational health and safety may be raised.
Illiteracy
Most of the population working in industry, specifically in min-
ing, tobacco, and those industries where toxicants are used, is illiter-
ate. Workers are often hesitant in responding to test batteries or
questionnaires. A hidden fear is that, if they fail on the tests, they
will be removed from their jobs. Thus, both the employee and the
OCR for page 333
NEUROBEHAVIORAL TOXICITY TESTS IN INDIA
333
employer are hesitant to cooperate in carrying out research. More-
over, there are certain taboos prevailing as far as mental health is
concerned, and workers are especially sensitive to questions related
to mood, affect, etc.
Drug Abuse and Stress
As in other developing countries, Indian workers suffer from mal-
nutrition, drug abuse, and the like. So it is difficult to ascertain
whether the particular dysfunctioning observed in a person occurs
because of exposure to a toxicant, because the worker is a drug addict,
or because the worker's general health is extremely poor. Similarly,
it is difficult to isolate the effects of heat, noise, and other stresses
from the effects of exposures to toxic substances. This makes the
development and standardization of tests and the comparison of test
results difficult.
Control of Exposure
The lack of awareness of neurobehavioral toxicology in India has
meant that volunteers are not readily available to assist in the devel-
opment of appropriate tests. The development of sensitive tests and
the assessment of reactions to varying concentrations of potentially
toxic substances would be facilitated if experimental studies could be
conducted.
Field studies are also difficult to conduct with full accuracy and
effectiveness because (1) concentration levels of toxic substances in
industry are variable over both short and long durations; (2) it cannot
be said with certainty that a worker is exposed to only one toxic
substance even in the workplace, and he may also reside in a highly
polluted area; and (3) it is difficult to find comparable control groups
of unexposed workers from the same industry.
Financial Support
Neurobehavioral toxicologists do not get financial assistance from
any government or social agencies. Without support, the development,
standardization, and adaptation of behavioral tests of neurotoxicity
are not possible. Without public or private financial support the
development of neurobehavioral toxicology in India will be slow and
will never come up to par with the state of the discipline in devel-
oped countries.
OCR for page 334
334
VINOD BEHARI SAXENA
RECOMMENDATIONS FOR
DEVELOPING COUNTRIES
In view of the state of development of behavioral tests of neuro-
toxicity and the facilities available in developing countries the fol-
lowing recommendations are made.
Training and Education
The most important factors indicating the need for training and
education in neurobehavioral toxicology are the lack of awareness
about neurotoxic chemicals and the shortage of trained personnel in
developing countries. As with occupational health in general, three
levels of education and training are needed: public awareness, training
for the specific procedures, and professional specialization. It is well
recognized that developing countries differ widely in their ability to
fulfill these needs. To create public awareness of neurobehavioral
toxicology is a matter of general education; the objective is to provide
an understanding of the principles and contributions this field may
make in fostering correct attitudes in the workplace, where exposure
to neurotoxic materials may occur, and to permit proper participation
in any preventive action taken. The target groups include legislators,
policy makers, managers, and workers. Specific task training may
include administrators, managers, workers, designers, medical.and
paramedical personnel, chemists and engineers, and occupational health
and safety technicians. Specialization involves the education of fully
qualified professionals in the field of neurobehavioral toxicology.
Training programs in neurobehavioral toxicology should be di-
rected to existing problems and to the current level of practice of
occupational health in general and neurobehavioral toxicology in
particular. When training programs are established, the development
of behavioral tests of neurotoxicity and their application will be greatly
facilitated. An important step can be taken when agencies of developed
countries and international agencies such as WHO hold workshops,
seminars, and conferences to support the objectives discussed above
and also to train persons for the further development of neurobehavioral
tests.
Inclusion of Neurobehavioral Toxicology as a
Full Partner in Occupational Health Programs
Occupational health programs differ among developing countries
and range from very early to relatively advanced stages. Neurobehavioral
OCR for page 335
NE UROB EHA VIORAL TOXICITY TE S TS IN INDIA
335
toxicology needs to be included as a part of occupational health prac-
tice regardless of its stage of development in a country. This principle
can only be followed if the practical aspects of neurobehavioral toxi-
cology are explained and implemented through appropriate actions
at national levels. The World Health Organization and the Interna-
tional Labor Organization should use their influence until this goal is
achieved.
Applied Research
Applied research is needed in developing countries to clarify the
actual magnitude of the problems surrounding the development of
behavioral tests of neurotoxicity. Research should focus on applied
rather than basic questions. Developing countries have to learn from
both the positive and the negative experiences of the developed nations.
They should not repeat the mistakes made by the latter but should
attempt to take shorter routes to reach a stage of modern occupational
health care appropriate for their special needs.
Communication Networks
Development of test batteries is essential both for preliminary screening
and for more extensive investigation. Comparison with findings obtained
in other countries can facilitate the process. For this purpose it would
seem advisable to encourage the creation of communication networks
both internally and internationally. A center should be established
in each developing country by appropriate international organizations,
with the responsibility of fostering the development of neurobehavioral
tests. Such centers should exchange information, passing it along to
researchers working on the development of neurobehavioral tests.
Each center should also get feedback from field workers and the results
obtained from the development of such tests. Thus, the exchange of
knowledge within a country and among countries will facilitate the
development of usable and acceptable behavioral tests of neurotoxicity
internationally.
REFERENCES
Kumar, P., and V. B. Saxena. 1985. Disturbances in Psychological Functions of Workers
Occupationally Exposed to Organic Solvent. Unpublished doctoral thesis, Kanpur
University, India.
Labour Bureau. 1985. Pocket Book of Labour Statistics. Chandigarh, India: Ministry
of Labour and Rehabilitation, Government of India.
OCR for page 336
336
VINOD BEHARI SAXENA
Saxena, A., and V. B. Saxena. 1988. Behavioral Effects of Occupational Exposure to
Lead. Unpublished doctoral thesis, Kanpur University, India.
Saxena, V. B., ed. 1988. Proceedings of the First Asian Conference on Behavioral
Toxicology and Clinical Psychology. Kanpur, India: Alka Printers.
Siddiqi, J., and V. B. Saxena. 1988. Behavioral Disorders in Workers Exposed to
Chemicals (Chromium Oxide and Dyes) Used in Leather Industry. Unpublished
doctoral thesis, Kanpur University, India.
Singh, J., and V. B. Saxena. 1987a. Memory and subjective symptoms in automobile
painters. Indian Psychological Review 32(2):5-12.
Singh, J., and V. B. Saxena. 1987b. Psychological Performance and Subjective Symp-
toms of Workers Occupationally Exposed to Past Control Substances. Unpublished
doctoral thesis, Kanpur University, India.
Representative terms from entire chapter:
toxic substances
