Juntunen J
LEL Employment Pension Fund, Helsinki, Finland.
Environ Res. 1993 Jan;60(1):98-111. doi: 10.1006/enrs.1993.1019.
Neurotoxic syndromes due to occupational solvent exposure present a worldwide health problem, the magnitude of which varies from country to country. Apart from the relatively clear-cut exposure-effect relationships in acute solvent intoxications, those caused by long-term, low-level occupational exposure to solvents are more difficult to detect. Controversial opinions and even debate are frequently encountered in literature on this matter. This is partly due to differences in neurobehavioral methods used, partly to difficulties in obtaining accurate information about exposure. These effects can be studied in humans using biochemical, clinical, and epidemiological methods. It is thus quite conceivable that direct comparison of the results obtained by different methods is not always possible. Moreover, exposure to a variable mixture of solvents is frequent in an occupational setting which is problematic from the toxicological point of view. The clinical pictures of "chronic" occupational solvent intoxications are, with few exceptions, quite nonspecific in nature and share several common features regardless of the underlying chemical exposure. The development of manifest disease is insidious and high interindividual variation of symptoms and signs exists. Some solvents cause primarily peripheral neuropathy. Deterioration in many psychological and neurophysiological functions can be seen. The most common subjective symptoms of solvent intoxication are headache, tiredness, memory disturbances, and dizziness. Clinical findings comprise signs of the central nervous system depression (psychoorganic syndrome, tiredness), dizziness, disturbances in coordination, and general neurasthenic signs. From the clinical point of view, it is important to define the criteria for a diagnosis. In different countries the diagnostic criteria for solvent intoxication may vary considerably, which provides additional difficulties in interpreting the results of studies in this field.
职业性接触溶剂所致的神经毒性综合征是一个全球性的健康问题，其严重程度因国家而异。除了急性溶剂中毒中相对明确的接触-效应关系外，长期、低水平职业性接触溶剂所导致的情况更难察觉。关于此事的文献中经常出现有争议的观点甚至争论。这部分是由于所使用的神经行为方法存在差异，部分是由于难以获取关于接触的准确信息。这些影响可以通过生化、临床和流行病学方法在人体中进行研究。因此，完全可以想象不同方法所获得的结果并非总是能够直接比较。此外，在职业环境中经常接触多种不同的溶剂混合物，这从毒理学角度来看是个问题。“慢性”职业性溶剂中毒的临床表现，除少数例外，本质上相当不具特异性，无论潜在的化学接触如何，都有几个共同特征。明显疾病的发展较为隐匿，症状和体征存在很大的个体差异。一些溶剂主要导致周围神经病变。许多心理和神经生理功能会出现恶化。溶剂中毒最常见的主观症状是头痛、疲劳、记忆障碍和头晕。临床发现包括中枢神经系统抑制的体征（精神器质性综合征、疲劳）、头晕、协调障碍和一般神经衰弱体征。从临床角度来看，定义诊断标准很重要。在不同国家，溶剂中毒的诊断标准可能有很大差异，这给解释该领域的研究结果带来了额外困难。
