Permanent Encephalopathy from Toluene Inhalation

Knox, J. W. D.; Nelson, Janyce R.

doi:10.1056/nejm196612292752608

Cited by 165 publications

(50 citation statements)

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“…Organic psychosyndrome and other psychic symptoms have been described as effects of long-term exposure to organic solvents (5,7,20,45). In deliberate inhalation, acute symptoms of CNS depression arisE', and in late CNS depression changes occur in the EEG as well (47).…”

Section: Discussionmentioning

confidence: 99%

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Neurophysiological effects of long-term exposure to a mixture of organic solvents.

Seppäläinen¹,

Husman²,

Martenson³

1978

Scand J Work Environ Health

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effects of long-term exposure to a mixture of organic solvents. Scand. j. work environ. & health 4 (1978) [304][305][306][307][308][309][310][311][312][313][314]. Neurophysiological effects of long-term exposure to a mixture of organic solvents was studied among 102 car painters from 27 car repair garages in Helsinki. The reference group consisted of 102 age-matched railroad engineers from the Finnish State Railways. The mean age was 35 years and the exposure time ranged from 1 to 40 years (mean 14.8, SD 8.5). According to measurements the mean concentration of the solvent mixture was relatively low in the garages, namely, 31.8 % of the Finnish threshold limit value (TLV), the range of separate components varying from 4 to 212 % of the respective TLVs. The main components of about 20 organic solvents of the mixture were toluene, xylene, butyl acetate and white spirit. Electroencephalograms (EEGs) of all the 102 exposed and 102 nonexposed subjects were studied, but electroneuromyographic measurements were made of only 59 car painters and 53 referents with a similar age distribution. Motor (MCV and CVSF) and sensory conduction (SCV) velocities, as well as motor distal latencies, were recorded from nerves in the upper and lower extremities. Abnormal EEGs were encountered in 32 car painters and 37 referents. The frequency of abnormal EEGs was in both groups higher than expected on the basis of EEG literature (about 10 0 /0). Twenty-six car painters had a complex of four common symptoms of disturbances in the central nervous system; the same symptom complex was found in 12 engineers. Forty-six percent of the car painters with this symptom complex had an abnormal EEG, while only 26 Ofo of those without this symptom complex had an abnormal EEG. Railroad engineers did not show such a tendency. Abnormally slow MCVs or SCVs and/or prolonged motor distal latencies were found in 12 of the 59 car painters but in none of the 53 engineers studied. Other authors have stressed that many solvents primarily cause neuropathy, while objective signs of central nervous involvement have been minor, if any. Our findings are similar; they showed slight positive signs of slowed nerve conduction velocities among the car painters and no increase in EEG abnormalities in comparison to the reference group of railroad engineers.

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Section: Discussionmentioning

confidence: 99%

“…These include headachE', dizzy spells, memory and sleep disturbances, etc. (5,7,20). Although these symptoms may be purely psychogenic or neurotic in type, part of them may arise from dysfunctions or lesions in thE' CNS, especially in the deep structures.…”

Section: Discussionmentioning

confidence: 99%

Neurophysiological effects of long-term exposure to a mixture of organic solvents.

Seppäläinen¹,

Husman²,

Martenson³

1978

Scand J Work Environ Health

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show abstract

“…Peripheral neuropathy has recently been studied extensively in typical work environments (1,5,7,14), in "sniffers" (8,17,18,23), and in experimental animals (21,27,29,30). In such studies the causes of neuropathy have been n-hexane (14,27,33), trichloroethylene (7), and methyl butyl ketone (1,21,29,31).…”

mentioning

confidence: 99%

Clinical neurological findings among car painters exposed to a mixture of organic solvents.

Husman¹,

Karli²

1980

Scand J Work Environ Health

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“…In Table 4 are reviewed leading solvent constituents in the products abused for intentional inhalation (Suzuki et al 1974;Keane 1978;Metrick and Brenr4er 1982). As the number of abuse cases in which the solvent constituents were identified is few, the cases with remarkable CNS effects after exposure ( Knox and Nelson 1966). The absence of toluene in the samples of the present study makes a contrast to the fact that this solvent has been commonly present in industrial thinner, paint and glue Kumai et al 1983).…”

Section: Discussionmentioning

confidence: 67%