Chronic solvent-induced encephalopathy: course and prognostic factors of neuropsychological functioning

Abstract

PurposeWorking in conditions with daily exposure to organic solvents for many years can result in a disease known as chronic solvent-induced encephalopathy (CSE). The aims for this study were to describe the neuropsychological course of CSE after first diagnosis and to detect prognostic factors for neuropsychological impairment after diagnosis.MethodsThis prospective study follows a Dutch cohort of CSE patients who were first diagnosed between 2001 and 2011 and underwent a second neuropsychological assessment 1.5–2 years later. Cognitive subdomains were assessed and an overall cognitive impairment score was calculated. Paired t tests and multivariate linear regression analyses were performed to describe the neuropsychological course and to obtain prognostic factors for the neuropsychological functioning at follow-up.ResultsThere was a significant improvement on neuropsychological subdomains at follow-up, with effect sizes between small and medium (Cohen’s d 0.27–0.54) and a significant overall improvement of neuropsychological impairment with a medium effect size (Cohen’s d 0.56). Prognostic variables for more neuropsychological impairment at follow-up were a higher level of neuropsychological impairment at diagnosis and having a comorbid diagnosis of a psychiatric disorder at diagnosis.ConclusionsResults are in line with previous research on the course of CSE, stating that CSE is a non-progressive disease after cessation of exposure. However, during follow-up the percentage patients with permanent work disability pension increased from 14 to 37%. Preventive action is needed in countries where exposure to organic solvents is still high to prevent new cases of CSE.Electronic supplementary materialThe online version of this article (10.1007/s00420-018-1328-1) contains supplementary material, which is available to authorized users.

Occupational fatigue and health of gas station workers: A review

“…In addition, the remaining two studies were prospective studies. For 11 years, van Valen et al followed a cohort of Dutch patients who were diagnosed with CSE for the first time and later performed a second neuropsychological assessment [30]. Moreover, pregnant workers (N = 792) in a large petrochemical industry were enrolled and followed up until delivery (1996)(1997)(1998) to investigate the effects of benzene exposure and occupational stress on infant birth weight [61].…”

“…In addition to their physiological effects, organic solvents have toxic effects on the central nervous system. Evidence shows that the brain is susceptible to organic solvents, which can cause serious changes in neural development and ultimately lead to cognitive deficits [27][28][29][30]. In a previous study, petrol sniffing had an immediate effect on psychomotor performance that occurred within 3-5 minutes and continued for 5-6 hours [31].…”

“…A prospective study also confirmed that organic solvents may cause neurological damage of varying degrees of severity. A small group of workers chronically exposed to organic solvents were found to have a syndrome called chronic solvent encephalopathy (CSE) [30]. Van Valen et al followed a cohort of Dutch patients with CSE and found that CSE is indeed a non-progressive disease after cessation of exposure to the causative agents [30].…”

“…A small group of workers chronically exposed to organic solvents were found to have a syndrome called chronic solvent encephalopathy (CSE) [30]. Van Valen et al followed a cohort of Dutch patients with CSE and found that CSE is indeed a non-progressive disease after cessation of exposure to the causative agents [30]. Neuropsychological impairment and psychological symptoms improved over time in patients with CSE.…”

Unexpected sequelae of the COVID-19 pandemic: A strange case of myoclonus in the Tasmanian winter

“…4 No specific treatments exist, and acute manifestations mostly resolve with the removal of the exposure. 10 Despite the frequency of use of organic solvents, the long-term outcomes of toxic exposures are poorly defined and largely unknown. 11…”