Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Scand J Work Environ Health. 2024 Apr 1;50(3):135-141. doi: 10.5271/sjweh.4155. Epub 2024 Mar 14.
In this discussion paper, we describe the history of the science and societal action resulting in the mitigation of neurotoxic disorders from exposure to organic solvents at the workplaces in Sweden. When alkyd paints were introduced in large scale in construction painting in the 1960s and 1970s, Scandinavian unions voiced increasing concern as members reported symptoms like headache and vertigo, supported by participatory studies and case studies. Although acute and chronic neurotoxic effects were established for some specific solvents such as carbon disulphide, this was not the case for those used in the new paints. Union advocacy promoted formal epidemiological studies, providing increasing evidence for chronic neurotoxicity at levels far below current occupational exposure levels. The results were widely disseminated and accepted and led to concerted action with preventive measures, most importantly substitution of the organic solvents in paints for indoor use, but also drastic reductions in occupational exposure limits. The findings also resulted in funding of further research on solvent toxicity and the establishment of expert groups to advice authorities on occupational standards for exposure to chemicals. The substitution strategy was subsequently adopted in many other countries and occupational exposure limits were lowered, although several years or even decades later. While the societal context in Sweden was unique in many ways, we conclude that there are lessons to be learned from this preventive success when addressing current challenges.
在本讨论文件中，我们描述了瑞典在工作场所减少有机溶剂所致神经毒性疾病的科学和社会行动的历史。20 世纪 60 年代和 70 年代，醇酸树脂涂料在建筑涂料中大规模使用，斯堪的纳维亚工会对工人出现头痛和眩晕等症状表示越来越多的关注，这些症状得到了参与性研究和病例研究的支持。尽管某些特定溶剂（如二硫化碳）的急性和慢性神经毒性作用已经确立，但用于新型涂料中的溶剂并非如此。工会的倡导推动了正式的流行病学研究，为远低于当前职业暴露水平的慢性神经毒性提供了越来越多的证据。这些研究结果得到了广泛的传播和认可，并促使采取了协调一致的行动，包括采取预防措施，最重要的是在室内使用涂料中替代有机溶剂，以及大幅降低职业接触限值。研究结果还为进一步研究溶剂毒性提供了资金，并成立了专家组，就接触化学物质的职业标准向当局提供建议。随后，许多其他国家也采用了这一替代策略，并降低了职业接触限值，尽管这一过程需要数年甚至数十年的时间。虽然瑞典的社会背景在许多方面是独特的，但我们的结论是，在应对当前挑战时，可以从这一预防成功中吸取教训。
