Clinical academics in the Centre provide a clinical service to the Newcastle upon Tyne Hospitals NHS Foundation Trust through out-patient clinics and in-patient care. The case-mix includes acute poisonings, chronic toxicological diseases and individual special interest areas such as clinical neurotoxicology, occupational toxicology and radiation medicine. The clinicians also participate in a national on-call service for the Health Protection Agency, providing expert advice on the management of patients exposed in a chemical incident or involved in major incidents.
On occasion, patients are seen in the clinic with a history and clinical findings suggesting a causative association with exposure to an environmental agent. The putative toxic mechanisms underlying the clinical problem are then investigated by research scientists in an appropriate research project and the outcome applied, where relevant, to the clinical management of the patients. Similarly, basic research in the laboratory may provide diagnostic biomarkers that are applicable in the patient investigation. Examples of this relationship include the observation that patients with multiple system atrophy had a history of prolonged high level exposure to trichloroethylene. This stimulated a research project which identified a neurotoxic metabolite and a possible mechanism for specific toxicity to striatonigral neurones.