Addressing neurological health outcomes from low exposure to volatile organic compound mixtures in workplaces:...

Numerous workplaces handle solvent-based products, exposing workers to complex and changing mixtures of volatile organic compounds (VOCs), many of which are neurotoxic. In this commentary, we highlight key findings from research on VOC exposures in the workplace and their consequences for the central nervous system (CNS). We also provide a case study of nail salons as exposure sites. A few nail salon studies have suggested adverse health effects at low-level complex mixture VOC exposures, including significant neurological symptoms such as headaches, dizziness, difficulty concentrating, and memory loss, even when VOC exposures are below occupational exposure limits. Limited evidence specific to the health effects on nail salon workers relies on self-reported health outcomes or broad tests of mental abilities, using self-reported exposure surrogates that can lead to exposure misclassification. Unfortunately, assessing risk one chemical at a time with its respective threshold limit-or even using the traditional industrial hygiene mixtures approach-has not been sufficient to identify key VOCs or groups of VOCs most strongly linked to CNS health outcomes in nail salon workers. Scientific methodology used to understand low-level VOC mixture health effects in this population must evolve to measure chemical mixtures more easily and accurately, employ sensitive and culturally appropriate methods to assess neurological health effects, use advanced statistical methods, and develop strategies to prevent these debilitating health outcomes. Research evaluating possible health consequences at low exposure levels is still critical for guaranteeing the health of workers exposed to VOC, even with ongoing safer alternative substitution efforts.