Chronic solvent-induced encephalopathy Diagnosis and course

Worldwide millions of people are occupationally exposed to organic solvents. These are people working for example as spray painter, printer, industrial cleaner, paint or glue manufacturer. After inhalational or dermal uptake the group of organic solvents is capable of affecting neuronal structures in the brain due to their lipophilic and hydrophilic properties; Organic solvents can be absorbed by fatty tissue and in cell membranes. The resulting neurotoxic effects may be experienced as nausea, dizziness, headache, and problems in concentration. When workers are exposed to solvents during many years, some workers develop a syndrome, characterized by complaints that remain chronic. Various denominations exist for this syndrome that we refer to as Chronic Solvent-induced Encephalopathy (CSE), for example: ‘occupational solvent encephalopathy’, ‘solvent intoxication’, ‘toxic solvent syndrome’, ‘painters disease’, ‘psycho-organic syndrome’, and ‘chronic toxic encephalopathy’. Patients with CSE often complain about fatigue, mood changes, memory loss, difficulty in concentration, loss of initiative and headache. Unlike the acute neurotoxic effects, the symptoms do not disappear after cessation of exposure to organic solvents, but often continue to exist.
The aims of this thesis were to report on the incidence of Chronic Solvent-induced Encephalopathy from 1997 until 2017 in the Netherlands, to evaluate a screening programme for Dutch painters, to improve the neuropsychological part of the diagnostic process by establishing standardized, valid and detailed diagnostic guidelines contributing to international harmonisation of diagnostics, and to study the course of the disease and prognostic factors of neuropsychological functioning of CSE patients.