Triebig G, Hallermann J
Institute and Policlinic of Occupational and Social Medicine, University Hospital Heidelberg, Hospitalstrasse 1, 69115 Heidelberg, Germany.
Occup Environ Med. 2001 Sep;58(9):575-81. doi: 10.1136/oem.58.9.575.
To obtain information about solvent related chronic encephalopathy (SRCE) in the countries of the European Union (EU).
A survey was conducted in 1998 and 1999 among medical experts, authorities for health and safety, and social security institutions.
SRCE is an acknowledged occupational disease in most of the participating countries. However, the numbers of compensated cases differ considerably. This is mainly a consequence of national social law rather than of differences in the criteria of diagnosis. In countries with relatively high reported incidences-such as Denmark, Finland, Norway, and Sweden-the number of acknowledged cases has declined over the past 5-10 years, although the most important criteria of diagnosis and causality, according to expert opinion, equivalent diagnostic procedures, and measures for prevention within the EU are not comparable.
There is a need for common guidelines for early diagnosis and the evaluation of causality. Actual figures of SRCE are not suitable to estimate prospective numbers of cases. For this reason a multicentre study in EU states is necessary after a consensus of diagnostic procedure. It is likely that the number of cases will decrease as a result of changes in legislation and preventive measures-such as substitution or reduction of solvents in the products, improvement of technical equipment, and regular health surveillance. Future research activities should focus on follow up studies of prognosis, randomised clinical trials of treatment, investigation of neurotoxic mechanisms, and of the interaction of solvent mixtures.
获取有关欧盟国家溶剂相关慢性脑病（SRCE）的信息。
1998年和1999年对医学专家、健康与安全部门以及社会保障机构进行了一项调查。
SRCE在大多数参与调查的国家中是一种公认的职业病。然而，获得赔偿的病例数量差异很大。这主要是国家社会法律的结果，而非诊断标准存在差异。在报告发病率相对较高的国家，如丹麦、芬兰、挪威和瑞典，尽管根据专家意见、等效诊断程序以及欧盟内部的预防措施，最重要的诊断和因果关系标准不可比，但在过去5至10年中，公认病例的数量有所下降。
需要制定早期诊断和因果关系评估的通用指南。SRCE的实际数字不适合估计未来病例数量。因此，在诊断程序达成共识后，有必要在欧盟国家开展多中心研究。由于立法和预防措施的变化，如产品中溶剂的替代或减少、技术设备的改进以及定期健康监测，病例数量可能会减少。未来的研究活动应侧重于预后的随访研究、治疗的随机临床试验、神经毒性机制的研究以及溶剂混合物相互作用的研究。
