The course of chronic solvent induced encephalopathy: A systematic review

• Published in: Neurotoxicology (Park Forest South) Vol. 30; no. 6; pp. 1172 - 1186
• Main Authors: van Valen, Evelien, Wekking, Ellie, van der Laan, Gert, Sprangers, Mirjam, van Dijk, Frank
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier B.V 01.11.2009; Elsevier
• Subjects: Adult; Biological and medical sciences; Brain Damage, Chronic - chemically induced; Brain Damage, Chronic - epidemiology; Brain Damage, Chronic - physiopathology; Chemical and industrial products toxicology. Toxic occupational diseases; Chronic solvent induced encephalopathy; Databases, Factual - statistics & numerical data; Disease Progression; Female; Follow-up; Humans; Male; Medical sciences; Middle Aged; Neuropsychological Tests; Neurotoxicity Syndromes - complications; Neurotoxicity Syndromes - epidemiology; Neurotoxicity Syndromes - etiology; Organic solvents; Prognostic study; Retrospective Studies; Review; Solvents; Solvents - toxicity; Systematic review; Toxicology; Young Adult; Systematic review; Prognostic study; Review; Organic solvents; Chronic solvent induced encephalopathy; Follow-up; Nervous system diseases; Prognosis; Cerebral disorder; Organic solvent; Chronic; Follow up study; Encephalopathy; Central nervous system disease; Bibliographic review
• ISSN: 0161-813X; 1872-9711
• DOI: 10.1016/j.neuro.2009.06.002

Worldwide millions of workers are exposed to organic solvents. Long term exposure leads in some workers to the development of Chronic Solvent induced Encephalopathy (CSE). The first reports about CSE came from the European Nordic countries in the 1970s. In spite of decades of experience with this disease, little is known about the course and prognostic factors of CSE. To provide an overview of the evidence about the course and prognostic factors of CSE. A systematic review was conducted. Databases PubMed, PsycINFO (1970–2008) and EMBASE (1980–2008) were searched with the search strategy: solvent AND follow up AND (encephalopathy OR chronic intoxication). Inclusion criteria were: written in English, study population of CSE patients, follow-up time of at least 1 year. Included articles were assessed on methodological quality. Sixty unique articles were retrieved of which sixteen met the inclusion criteria. Data extraction provided information about domains of neurology, neuropsychology, physical and mental health perceptions, and social consequences. In a number of studies no significant changes, and in other studies improvement of functioning could be measured. Prognostic factors resulting from included studies were summarized for each domain indicating a potential positive influence of younger age and lower exposure variables. Due to the large heterogeneity of methodology no levels of evidence could be obtained. This review shows that there is a need for future research that addresses a variety of domains of functioning, hopefully resulting in an overall prognostic model for CSE. Studies in this review are in agreement about CSE being a non-progressive disease in which no severe deterioration of functioning occurs after diagnosis. In a number of studies no significant changes, and in other studies improvement of functioning could be measured. Presumably cessation of exposure might be one of the causal factors for the non-progressive character of the disease as has been found. Future studies are needed to clarify the role of various prognostic factors on the course of CSE.