Neurotoxic diseases by workplace chemicals have been discussed a lot in Germany since 1880 (e.g., intoxications by benzene, xylol). After Nazis gained power in 1933, this tradition of occupational medicine was destroyed. After the war, in West-Germany, neurotoxic diseases by workplace-chemicals were initially no subject, except lead-poisoning. But the fact that Denmark recognized "painter´s disease" as an occupational disease in 1976, and a mini-epidemic of fatalities by glue-sniffing in the 1980s, started a discussion.
Acute effects of neurotoxic substances are, e.g., agitation, intoxication, confusion, fatigue, and unconsciousness. Chronic effects differ in regard to port of entry to the nervous system:
Neurotoxic effects of workplace-chemicals are variform, but often not specific for certain chemicals. Three degrees of severity are distinguished:
A spray painter worked for 25 years in different firms as semi-skilled worker. He was mostly painting metal parts that had previously been cleaned and degreased by solvents. Spray painting was done with a spray gun in a spray cabin, initially without air extraction. The employer only provided masks with cotton inserts, which were changed twice a day. For eleven years, the spray painter worked 8 to 10 hours per day in that spray cabin.
Because of increasing performance deficits, and several long illness periods, a disability-pension was requested. A neurologist certified a solvent-induced occupational disease, and sent an occupational disease report to the occupational disease insurance. The recognition procedure took seven years, during which the worker´s health deteriorated permanently. The appraiser for the occupational disease insuranance certified, after many tests, a solvent-induced encephalopathy without polyneuropathy, with a disability of 20 %. The insurance accepted.
Many animal and plant poisons, stimulants, intoxicants, and medical drugs are neurotoxic. Effect depends on dose.
Environmental chemicals and working materials may also be neurotoxic, e.g., benzene intoxication, lead poisoning. Neurotoxicity is often just one of several problematic effects of hazardous substances, e.g., the carcinogenic effect of benzene, the hypertensive effect of lead.
Neurotoxicity may be a feature of singular substances, like acrylamide or formaldehyde, but also of substance classes, like organic solvents, pesticides, wood preservatives, some metals. These effects are relevant for several occupatiional groups, like
Besides, consumers may be strongly exposed in certain cases, e.g., to formaldehyde, wood preservatives, pesticides, amalgam. Especially with a corresponding - innate or acquired - predisposition, this exposure may be a health risk.
Organic solvents are fluids that solve solids, fluids, or gases. They have a degreasing effect, e.g., on nerve tissue, which disturbs nervous functioning. Meanwhile, solvent syndrome is the predominant form of workplace neurotoxic disease. Acute and chronic effects may differ, according to substance, dose, effect phase, and duration of exposure.
To avoid and compensate for workplace neurotoxicity is expensive, which partially explains hesitant recognition. In addition, recognition is delayed for substantial and methodical reasons:
Consequences: either affected persons or doctors ignore neurotoxic effects, understand them merely as the usual "background noise" of health impairments. Or neurotoxic effects are analyzed, but with assumptions that do not take into account exposure to hazardous substances. Three hypotheses are especially popular:
Identical health-impairments may be diagnosed as solvent syndrome or multiple chemical sensitivity (MCS). But legal consequences of these diagnoses differ strongly. The solvent syndrome is, in principle, recognized as an occupational disease, MCS not. Workers with extensive exposure to solvents, polyneuropathy or encephalopathy symptoms have (rarely) a chance of getting this recognized, and maybe even compensated for, as Bk (occupational disease) 1317 by the occupational disease insurance. But not, when their diagnosis is MCS.
For a long time, solvent syndrome was only indirectly touched by occupational disease regulation, which effectively lowered number of recognized cases and compensations. After stubborn resistance by many occupational medicine doctors, the solvent syndrome has been recognized in 1997 as a new occupational disease in Germany (Bk 1317: polyneuropathy or encephalopathy by organic solvents or their mixture). This is 20 years late, compared to Denmark.
A compensation for solvent syndrome is often undermined