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Detecting chronic solvent encephalopathy in occupations at risk.

https://arctichealth.org/en/permalink/ahliterature124649
Source
Neurotoxicology. 2012 Aug;33(4):734-41
Publication Type
Article
Date
Aug-2012
Author
Heidi Furu
Markku Sainio
Hanna Kaisa Hyvärinen
Ritva Akila
Beatrice Bäck
Sanni Uuksulainen
Ari Kaukiainen
Author Affiliation
Finnish Institute of Occupational Health, Helsinki, Finland. heidi.furu@fimnet.fi
Source
Neurotoxicology. 2012 Aug;33(4):734-41
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Air Pollutants, Occupational - adverse effects
Attention - drug effects
Brain - drug effects - physiopathology
Chi-Square Distribution
Chronic Disease
Cognition - drug effects
Female
Finland
Health Surveys
Humans
Male
Mass Screening - methods
Memory - drug effects
Middle Aged
Neurologic Examination
Neuropsychological Tests
Neurotoxicity Syndromes - diagnosis - etiology - physiopathology - prevention & control - psychology
Occupational Diseases - chemically induced - diagnosis - physiopathology - psychology
Occupational Exposure - adverse effects - prevention & control
Occupational Health
Predictive value of tests
Prognosis
Questionnaires
Risk assessment
Risk factors
Severity of Illness Index
Solvents - adverse effects
Time Factors
Abstract
Chronic solvent encephalopathy (CSE) is under-reported worldwide due to difficulties in recognition and differences in national legislation. Although its occurrence in developed countries has declined, new cases continue to be detected. Our aim was to determine whether CSE can be detected in risk trades, using a stepwise screening procedure. Another aim was to evaluate if this method detects more cases than present occupational health service (OHS) practices do in Finland, a country with decreasing exposures, high OHS coverage and an annual rate of around forty cases of suspected CSE and seven cases of occupational CSE. The studied fields, based on the national occurrence of CSE, were industrial and construction painting, floor layering, the printing press industry, boat construction, reinforced plastic laminating and the metal industry. We obtained contact information from trade union registers and municipal OHS. A postal survey including the Euroquest (EQ) neurotoxic symptom questionnaire, Beck's Depression Inventory (BDI) and the Alcohol Use Disorders Identification Test-Consumption (Audit-C), and questions on exposure and medical conditions, was sent to 3,640 workers in the age range of 30-65 years in two Finnish provinces. The survey resulted in 1,730 responses (48%). This was followed by a clinical examination, with methods applicable to OHS, of subjects fulfilling the criteria: three or more EQ memory and concentration symptoms and sufficient exposure, a BDI score=18, an AUDIT-C score=8, and no evident medical condition explaining their symptoms. Of 338 respondents with memory and concentration symptoms, 129 subjects fulfilled all the criteria, of which 83 participated in clinical examinations. We found 38 CSE compatible cases. The study shows that more CSE compatible cases can be detected when the screening is directed towards the occupational fields at greatest risk. This stepwise method is more effective for finding CSE compatible cases than regular OHS activity. The number of cases was similar to the total annual occurrence, of new CSE-suspected cases, although the sample represented approximately 18% of the abundantly exposed workforce in Finland. Combining of exposure and medical differential diagnostics to neurotoxic symptom questionnaire, decreases the amount of cases needing clinical examinations. This two-step procedure can be carried out with methods suitable for OHS and other primary health care, both in industrialized and developed countries.
PubMed ID
22560996 View in PubMed
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Multimodal event-related potentials in occupational chronic solvent encephalopathy.

https://arctichealth.org/en/permalink/ahliterature126689
Source
Neurotoxicology. 2012 Aug;33(4):703-9
Publication Type
Article
Date
Aug-2012
Author
Petra Keski-Säntti
Kirsi Palmu
Miia Pitkonen
Sara Liljander
Juhani V Partanen
Ritva Akila
Markku Sainio
Anu Holm
Author Affiliation
Finnish Institute of Occupational Health, Department of Occupational Medicine, Brain and Work Research Centre, Topeliuksenkatu 41 a A, FI-00250, Helsinki, Finland. petra.keski-santti@hus.fi
Source
Neurotoxicology. 2012 Aug;33(4):703-9
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Acoustic Stimulation
Aged
Air Pollutants, Occupational - adverse effects
Analysis of Variance
Attention - drug effects
Auditory Perception - drug effects
Brain - drug effects - physiopathology
Case-Control Studies
Chronic Disease
Cognition - drug effects
Electroencephalography
Event-Related Potentials, P300 - drug effects
Female
Finland
Humans
Male
Middle Aged
Neuropsychological Tests
Neurotoxicity Syndromes - diagnosis - etiology - physiopathology - psychology
Occupational Diseases - chemically induced - diagnosis - physiopathology - psychology
Occupational Exposure - adverse effects
Occupational Health
Photic Stimulation
Predictive value of tests
Reaction Time - drug effects
Recognition (Psychology) - drug effects
Solvents - adverse effects
Time Factors
Visual Perception - drug effects
Abstract
The aim of this study was to test a multimodal event-related potential (ERP) paradigm in chronic solvent encephalopathy (CSE) to develop a sensitive method for the clinical diagnostics to CSE. The study comprised 11 CSE patients and 13 healthy controls. We used three tasks: an auditory odd-ball (AUD), a visual detection (VIS), and a recognition memory (MEM) task. The auditory and visual stimuli were presented in single- and dual-task conditions. The auditory P300 amplitude in single-task condition was smaller in the patient group than in the control group at the parietal (Pz) but not at the frontal midline electrode location. The auditory P300 response in the dual task condition AUD+VIS was unrecognizable in 8 of 11 patients and in 1 of 13 controls and in the AUD+MEM condition in 10 of 11 patients and in 4 of 13 controls. In the AUD+MEM condition, the auditory P300 amplitude at Pz was smaller in the patient group than in the control group. Reaction time for auditory stimuli in both dual conditions as well as for visual stimuli in AUD+VIS condition were in the patient group prolonged. The ERP results indicate that CSE patients present with slowed performance speed and difficulties in allocation of attention. Based on ERP results, the disturbance in brain activity in CSE seems to affect posterior aspects of the frontoparietal continuity. The multimodal paradigm seems promising as a tool for the clinical diagnostics of CSE.
PubMed ID
22366255 View in PubMed
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P300 of auditory event related potentials in occupational chronic solvent encephalopathy.

https://arctichealth.org/en/permalink/ahliterature161354
Source
Neurotoxicology. 2007 Nov;28(6):1230-6
Publication Type
Article
Date
Nov-2007
Author
Petra Keski-Säntti
Anu Holm
Ritva Akila
Katinka Tuisku
Tero Kovala
Markku Sainio
Author Affiliation
Helsinki University Central Hospital, Jorvi Hospital, Department of Neurology, Turuntie 150, FIN-02740, Espoo, Finland. petra.keski-santti@pp.inet.fi
Source
Neurotoxicology. 2007 Nov;28(6):1230-6
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects
Attention - drug effects
Case-Control Studies
Central Nervous System Agents - adverse effects
Depressive Disorder, Major - physiopathology
Event-Related Potentials, P300 - drug effects
Evoked Potentials, Auditory - drug effects
Finland
Humans
Memory - drug effects
Middle Aged
Neuropsychological Tests
Neurotoxicity Syndromes - diagnosis - etiology - physiopathology - psychology
Occupational Diseases - chemically induced - diagnosis - physiopathology - psychology
Occupational Exposure
Predictive value of tests
Reaction Time - drug effects
Retrospective Studies
Solvents - adverse effects
Time Factors
Abstract
This retrospective study characterized the P300 component of the auditory event related potential (ERP) and assessed its diagnostic value in occupational chronic solvent encephalopathy (CSE). The P300 was recorded on 86 CSE patients by the classical oddball paradigm. In addition to the laboratory's reference values, we used an age and education matched control group that consisted of 104 blue-collar workers with no known occupational solvent exposure. The association of P300 values with solvent exposure indices, major depression, alcohol consumption, and neuropsychological parameters was studied. The P300 amplitude was lower in CSE patients (mean 7.5 microV; S.D. 3.6) compared to laboratory controls (mean 11.8 microV; S.D. 4.1; F(1,167)=24.4; p
PubMed ID
17869344 View in PubMed
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Solvent-related health effects among construction painters with decreasing exposure.

https://arctichealth.org/en/permalink/ahliterature177359
Source
Am J Ind Med. 2004 Dec;46(6):627-36
Publication Type
Article
Date
Dec-2004
Author
Ari Kaukiainen
Riitta Riala
Rami Martikainen
Ritva Akila
Kari Reijula
Markku Sainio
Author Affiliation
Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland. ari.kaukiainen@ttl.fi
Source
Am J Ind Med. 2004 Dec;46(6):627-36
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Cardiovascular Diseases - epidemiology - etiology
Construction Materials
Cross-Sectional Studies
Environmental monitoring
Epidemiological Monitoring
Finland - epidemiology
Humans
Incidence
Logistic Models
Male
Mental Disorders - epidemiology - etiology
Middle Aged
Occupational Diseases - epidemiology - etiology
Occupational Exposure - adverse effects
Paint - toxicity
Probability
Questionnaires
Respiratory Tract Diseases - epidemiology - etiology
Risk assessment
Solvents - toxicity
Abstract
The prevalence of solvent-related symptoms among construction painters is unclear due to their declining exposure.
A questionnaire study was conducted on 1000 male Finnish construction painters and 1000 carpenters. Symptom questions were combined with exposure parameters, medical history, and health behavior.
Highly significant associations were found between cumulative intensity of long-term solvent exposure (CE-LT) and symptoms of memory and concentration, and mood. CE-LT was a better measure of solvent exposure than the number of years as a painter. Exposure was also associated with diagnosed psychiatric disorders, hypertension and arrhythmia. Recent exposure in the 1990s had no major effect on symptoms.
The results strengthen the dose-response relationship of exposure and long-term neurotoxic effects. No clear association was found between recent exposure and symptoms. Cardiovascular effects in solvent-exposed construction painters is further suggested.
PubMed ID
15551367 View in PubMed
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Symptoms of chronic solvent encephalopathy: Euroquest questionnaire study.

https://arctichealth.org/en/permalink/ahliterature146914
Source
Neurotoxicology. 2009 Nov;30(6):1187-94
Publication Type
Article
Date
Nov-2009
Author
Ari Kaukiainen
Hanna Kaisa Hyvärinen
Ritva Akila
Markku Sainio
Author Affiliation
Finnish Institute of Occupational Health, Occupational Medicine, Topeliuksenkatu 41 aA, FI-00250 Helsinki, Finland. ari.kaukiainen@ttl.fi
Source
Neurotoxicology. 2009 Nov;30(6):1187-94
Date
Nov-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Area Under Curve
Brain Damage, Chronic - chemically induced - diagnosis
Finland
Humans
Middle Aged
Neuropsychological Tests
Neurotoxicity Syndromes - diagnosis - etiology
Occupational Diseases - diagnosis
Psychometrics
Questionnaires
Solvents - toxicity
Abstract
The aim was to study the symptomatology of chronic solvent encephalopathy (CSE), and the persistence of the symptoms. We examined how Euroquest, a neurotoxic symptom questionnaire, distinguished workers with verified CSE from unexposed employees, and evaluated symptom cut-off for CSE. Another aim was to study the effect of age on the responses. CSE cases confirmed at the Finnish Institute of Occupational Health had completed Euroquest either before their first investigation procedure (CSE-1 group, n=33), or before attending a routine control for previously diagnosed CSE (CSE-2, n=43). Non-exposed carpenters served as referents (n=292). We studied responses to single questions and to symptom domains. The domain with the highest AUC (area under the ROC: Receiver Operating Characteristic Curve) value was chosen to study cut-off points. CSE groups reported nearly all 59 symptoms more frequently than the carpenters. There was only little difference between younger and older carpenters. CSE-1 reported 12 symptoms more often than CSE-2, but no significant differences were found in the memory and concentration domain, which had the highest AUC, above 0.9. Using a three out of 10 symptoms cut-off point, 97% of the CSE-1 cases and 80% of the carpenters were classified correctly. At a four-symptom cut-off, the sensitivity was 93% and specificity 87%. The memory and concentration as core symptoms distinguished CSE cases from unexposed workers and remain, even after cessation of exposure. The effect of age on Euroquest was minor. Euroquest is recommended for the screening of CSE in solvent-exposed work-force and in the diagnostic process of CSE. We propose three memory and concentration symptoms as cut-off to minimize under-detection.
PubMed ID
19963103 View in PubMed
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