Liver damage associated with occupational exposure to organic solvents in house painters

Among 156 patients admitted to hospital because of suspected solvent intoxication or dementia following long-term occupational exposure to organic solvents, twenty-three had elevated aminotransferases in serum. In thirteen of these no particular cause of this elevation could be found and the chronic exposure to aliphatic and aromatic organic solvents is therefore likely to have played a pathogenetic role and a liver biopsy was performed. Liver histology revealed significant steatosis in eleven patients and in six of these focal necroses were also observed. Moreover, six of the biopsies showed enlarged portal tracts with fibrosis. Necrosis was only observed in liver specimens from patients who recently had been exposed to solvents. A causal relation between occupational exposure to aliphatic and aromatic organic solvents such as white spirit, xylene, toluene and styrene, and toxic liver injury is suggested by this descriptive study but needs confirmation.