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Survey of solvent related chronic encephalopathy as an occupational disease in European countries
1Institute and Policlinic of Occupational and Social Medicine, University Hospital Heidelberg, Hospitalstrasse 1, 69115 Heidelberg, Germany. gerhard_triebig@med.uni-heidelberg.de
Objectives:
To obtain information about solvent related chronic encephalopathy (SRCE) in the countries of the European Union (EU).
Method:
A survey was conducted in 1998 and 1999 among medical experts, authorities for health and safety, and social security institutions.
Results:
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.
Conclusions:
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.