Chronic Exposure

Adverse physiologic effects due to chronic subacute cyanide exposure have been proposed but are poorly defined. Studies of workers chronically exposed to cyanide have demonstrated a higher incidence of thyroid disease and vitamin B12 deficiency.10 Linamarin is a cyanogenic glycoside found in the cassava plant, a significant source of carbohydrate in many developing countries. In areas of the world where cassava ingestion is high, goiter and tropical ataxic neuropathy are endemic, and plasma and urinary levels of cyanide are elevated. A recent epidemiologic survey in Cuba of patients with optic neuropathy showed that poorly nourished smokers were at greatest risk and implicated an etiologic association between elevated levels of cyanide found in cigarette smokers and dietary deficiency of the natural cyanide scavengers vitamin B12 and b carotene.4

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