Survey of solvent related chronic encephalopathy as an occupational disease in European countries

Objectives-To obtain information about solvent related chronic encephalopat hy (SRCE) in the countries of the European Union (EU). Method-A survey was conducted in 1998 and 1999 among medical experts, autho rities for health and safety, and social security institutions. Results-SRCE is an acknowledged occupational disease in most of the partici pating countries. However, the numbers of compensated cases differ consider ably. This is mainly a consequence of national social law rather than of di fferences in the criteria of diagnosis. In countries with relatively high r eported incidences-such as Denmark, Finland, Norway, and Sweden-the number of acknowledged cases has declined over the past 5-10 years, although the m ost important criteria of diagnosis and causality, according to expert opin ion, equivalent diagnostic procedures, and measures for prevention within t he EU are not comparable. Conclusions-There is a need for common guidelines for early diagnosis and t he evaluation of causality. Actual figures of SRCE are not suitable to esti mate prospective numbers of cases. For this reason a multicentre study in E U states is necessary after a consensus of diagnostic procedure. It is like ly that the number of cases will decrease as a result of changes in legisla tion and preventive measures-such as substitution or reduction of solvents in the products, improvement of technical equipment, and regular health sur veillance. Future research activities should focus on follow up studies of prognosis, randomised clinical trials of treatment, investigation of neurot oxic mechanisms, and of the interaction of solvent mixtures.