Olfactory dysfunctions caused by inhalative toxins

Background: Both environmental and occupational pollutants can affect the f unctional integrity of the olfactory epithelium or even destroy olfactory t issue. However, occupational hyposmia and anosmia have not been included in to the list of occupational diseases. Therefore, compensation of occupation ally induced smell disorders is difficult. Objective: To evaluate patients with toxic hyposmia for the pollutants involved and to discuss consequences for occupational and environmental medicine. Methods: A total of 19 patien ts were evaluated in our departments between 1993 and 1997 for olfactory di sorders related to environmental or occupational pollutants. The charts of these patients were retrospectically analyzed and the causative pollutants compared with the literature. Results: A chronical exposure to mixtures of metal dusts and steam, volatile organic substances, and anorganic gases wer e the most common pollutants involved in occupational dysosmia. Only one ca se of acute development of an anosmia due to exposure to CO and combustion gases was documented. Conclusions: Olfactory disordes are underestimated in occupational and environmental medicine. Relevance of olfactotoxic substan ces for occupational medicine can be postulated in metal and chemical worke rs, in welding and desinfection. The list of occupational diseases should b e completed by olfactory hyposmia and anosmia.