Neurophysiological and psychological disorders and occupational exposure to organic solvents.

A number of reports, particularly from Scandinavian countries, claim that painters and workers in other trades in which prolonged occupational exposure to organic solvents may occur develop a type of mental illness characterized principally by impairment of memory and co-ordination and some deterioration of personality. The condition, called 'organic solvent disease', is recognized as a cause of premature retirement and is classed as an occupational disease in certain countries. The conclusions of these reports have been contested and the existence of such a disease entity has been questioned. The publications reporting adverse neurological, neurophysiological and psychological disorders in solvent-exposed workers, and the methods used to determine adverse effects, have therefore been evaluated. In addition, data from animal behavioural studies have been examined but were found to have little or no to have little or no relevance to the reported human disease. The human data indicate that, of the solvents studied, only CS2 provided clear evidence of neurotoxic damage detectable by clinical and pathological examination as well as by neurophysiological measurements (e.g. nerve conduction velocity and nerve action potentials) or neuropsychological techniques (e.g. Rorschach inkblot test and WAIS intelligence tests). In the case of several other solvents and mixtures of solvents commonly used in industry, the evidence of CNS impairment, based principally on the response to questionnaires and the results of neuropsychological and neurophysiological examinations was questionable. A critical evaluation of the reliability of these methods in detecting minor deviations from normal and of their ability to provide acceptable evidence of CNS dysfunction or damage leaves little doubt that these methods are of value in investigating personality, intelligence and memory in the clinical examination of individual patients. However, evidence indicates that they are not suitable for use in epidemiological studies, principally because the variability of response in normal individuals is ill-defined and insufficiently investigated. The same conclusion was arrived at in evaluating the contribution of electroencephalography, computerized axial tomography scanning and other electrophysiological examinations to the diagnosis of brain changes in groups of solvent-exposed and unexposed workers. Furthermore, the personality changes identified (by neuropsychological tests) in painters and other workers exposed to solvents could well be produced by ageing, exposure to lead or mercury, excessive alcohol intake, psychoactive drugs or the ordinary stresses of everyday life.(ABSTRACT TRUNCATED AT 400 WORDS)