Neuropsychiatric effects were examined among 206 men, of whom 135 had been house painters and 71 had been house carpenters, affiliated with their respective trade unions for at least 10 years before 1970. Their lifetime organic solvent exposure was evaluated through the aid of an interview. Relevant potential confounding factors were accounted for in the statistical analysis. Neuropsychiatric symptoms compatible with chronic toxic encephalopathy were more common among the painters than among the carpenters, and these symptoms became increasingly prevalent with increasing cumulative solvent exposure. On only one of 12 psychometric tests, block design, did the painters perform worse than the carpenters, and in this test the painters' performance deteriorated with increasing cumulative exposure. For the majority of the psychometric tests, and for the coordination tests, there were no differences between the painters and carpenters, but the painters with "low" exposure tended to show better, and "heavily" exposed painters worse, results than the carpenters. The 52 painters with the heaviest cumulative exposures and 45 carpenters were examined for psychiatric diagnosis according to DSM-III, with electroencephalography and auditory evoked potential, P-300. Three painters and two carpenters had diagnoses compatible with an organic mental disorder. There were no overall differences between the painters and carpenters, either for the visually examined electroencephalograms or the P-300 latencies. The excess of neuropsychiatric symptoms among the painters was probably causally linked to solvent exposure. However, these symptoms seemed only rarely, if ever, serious enough to entail a psychiatric diagnosis. Concerning other outcomes, the investigation may not lead to a determination of whether the exposure-response relationship among the painters, with no difference between the entire group of painters and carpenters, is caused by solvent exposure or by selection factors within the group of painters.

Neuropsychiatric function of housepainters with previous long-term heavy exposure to organic solvents.

Objective: Individuals chronically abusing organic solvents have been reported in the medical literature for almost four decades to have a variety of neurological abnormalities. Most have been sing...

Neuropsychologic impairment and MRI abnormalities associated with chronic solvent abuse.

One hundred eight-seven workers (mean age +/- SD; 42 +/- 8.8 years) in two paint manufacturing plants were examined to determine if sustained low-level exposure to mixed organic solvents resulted in the painters' syndrome (a psycho-organic syndrome). The test battery consisted of a medical and occupational questionnaire, the Present State Examination, the Zung Depression Scale, the Scandinavian Questionnaire 16, a neuropsychological battery, and vibration thresholds. Solvent exposure, expressed as total hydrocarbon of combined selected solvents, was quantitated using 13-15 years of personal breathing zone samplings. Linear regression analysis controlling for several confounding variables demonstrated significant correlations between increasing exposure to mixed organic solvents and neurobehavioral performance for vibration threshold and several neuropsychological tests. Dose-related effects of chronic solvent exposure on neurobehavioral outcomes (all subclinical) were shown, but "typical" symptoms characteristic of the painter's syndrome were not found.

Dose-related subclinical neurobehavioral effects of chronic exposure to low levels of organic solvents.

Central nervous system effects of chronic toluene abuse—Clinical, brainstem evoked response and magnetic resonance imaging studies

Long term occupational exposure to organic solvents may cause adverse effects to the central nervous system. This collaborative study between six Swedish departments of occupational medicine examines the overall prognosis in terms of working capacity, symptoms, and psychometric test performance for individuals occupationally exposed to organic solvents. After re-analyses of the data from an initial clinical investigation of 111 men, the subjects were divided into two subgroups: one group of 65 with symptoms but no impairment on the tests and one group of 46 with toxic encephalopathy (symptoms and test impairment). At least five years after the initial examination the subjects were asked to attend a re-examination that included a structured medical interview and a psychometric investigation. The results indicate that effects on the central nervous system persist even when exposure has ceased. In the group of 46 more men had stopped working and were receiving sickness or early retirement pensions. This group also had reduced activity levels with regard to everyday life, leisure activities, and education or training and more neuropsychiatric symptoms. There was no support for the view that a solvent induced toxic encephalopathy is a progressive disease comparable with presenile dementia such as Alzheimer's disease or Pick's disease. If a worker was removed from exposure when he presented symptoms without signs of impairment in intellectual function recovery was seen in most cases.

https://oem.bmj.com/content/oemed/47/2/75.full.pdf

E.O. Errebo-Knudsen

Papers

Organic solvents and presenile dementia (the painters' syndrome). A critical review of the Danish literature