[Skin reaction after St Lucia holiday celebration]. / Hudreaksjon etter luciafeiring.

A 37-year-old man developed contact dermatitis on the front head after being exposed to dripping candles. The candles were placed in a crown on his head as he played St. Lucia in the traditional Lucia Day (13th December) pageant, trying to entertain the administrative staff of the University of Bergen where he was employed. Afterwards he washed his head with a soap he normally did not use. Probably the contact dermatitis is a skin reaction to the soap, but it is difficult to say whether the reaction was irritative or allergic. A similar case has not been reported earlier. It is of importance that noone stops celebrating the Lucia Day. However, proper precautions must be taken, with routines for avoiding exposure to stearine or unfamiliar soaps on the head of Lucia.

[Solvents and injuries of the nervous system]. / Løsemiddelskader i nervesystemet.

Currently, there is an ongoing debate on the extent of neurotoxic effects caused by organic solvents. A brief review of relevant scientific literature on human exposure to organic solvents and their effects on the nervous system therefore seems useful. Clinical studies of solvent abusers, pathological-anatomical studies, and epidemiological studies of workers exposed to organic solvents are summarized and discussed. The occurrence of acute and subacute effects on the nervous system caused by organic solvents is well documented. Evidence of the occurrence of chronic disease in the nervous system caused by organic solvents is rather limited, and reversibility has been described even in cases with serious dysfunction. Exposure to organic solvents ought to be prevented as far as possible, because of the reduced quality of life induced by acute and subacute effects. However, physicians are advised to exercise care in the diagnostic procedure of these patients and to search for differential diagnoses.

Exposure of the deck crew to carcinogenic agents on oil product tankers.

Work on deck on eight oil product tankers was examined. The purpose was to evaluate the need for improvement of the working environment to reduce the risk of occupational cancer. Benzene, polyaromatic hydrocarbons (PAHs) and organic lead compounds were sampled, and the crew answered a questionnaire on acute health effects. By area monitoring, benzene was generally found to be in the range from the detection limit, of 0.01 ppm, up to 1.15 ppm, but one tanker which loaded gasoline with the hatches open had levels up to 55 ppm. Personal monitoring showed exposure levels in the range 0.01-1.15 ppm. The PAH-levels and the levels of organic lead were low. No seamen were observed using respiratory protective equipment. Central nervous system symptoms were reported by the crew with the highest exposures to benzene although benzene may not be the only cause. The exposure to benzene and other hydrocarbons on the deck of oil product tankers ought to be reduced.

[Environmental poisons and the nervous system]. / Miljøgifter og nervesystemet.

The neurons are extremely vulnerable to changes in the local chemical environment, and the nervous system has therefore been given special priority and protection compared with other organ systems. Neurotoxic syndromes may occur when these biochemical conditions are disturbed. The brain is particularly vulnerable to hypoxia, and exposure to toxins that interfere with the intake, transport and utilization of oxygen provoke rapid and major neuronal damage. Compounds crossing the blood-brain barrier may induce both general and extremely localized neurotoxic effects. Today, dramatic and acute neurotoxic manifestations seldom occur in our part of the world. The focus of attention is now directed at the consequences of long-term and low-level exposure. This review presents a general description of some neurotoxic mechanisms, and the clinical effects of a few hazardous substances, ie metals, pesticides, organic solvents.

Occupational exposure of deck crews to carcinogenic agents on crude oil tankers.

Occupational exposure to carcinogenic agents on the decks on six Norwegian crude oil tankers was examined in five harbors. The purpose of the study was to evaluate the need for improving the working environment on deck on these tankers. Technical arrangements and the work itself on the deck were observed during loading or unloading. Occupational monitoring was performed by active sampling of benzene, polyaromatic hydrocarbons, and some aldehydes. The crew answered a questionnaire concerning their work, use of protective equipment, and occurrence of acute symptoms. The levels of air-borne carcinogenic agents were low, probably due to closed loading systems on all tankers. However, the seamen reported discomfort during the work that may be related to other chemical agents in the cargo. The seamen were frequently painting with lead chromate paint without using personal protective equipment. This type of chemical exposure should be evaluated.

A cohort study of disability pensioning among Norwegian painters, construction workers, and workers in food processing.

The debate on the potentially adverse effects of long-term occupational exposure to organic solvents has mainly been based on observations in cross-sectional studies. We present results from a retrospective cohort study of three cohorts: 11,542 industrial and house painters, 36,899 construction workers, and 9,314 workers in food processing, all identified by the 1970 Norwegian census. The cohorts were followed to the end of 1987 for registration of disability pensioning by linkage of the census files to the files of the National Insurance Administration. The analysis revealed an increased risk for disability pensioning due to neurosis among the painters, compared with construction workers (rate ratio = 1.62; 95% confidence interval = 1.36-1.93) and compared with the workers in food processing (rate ratio = 1.84; 95% confidence interval = 1.42-2.38). The painters were also at increased risk of disability pensioning due to alcoholism. We found no major differences in ischemic heart diseases, disability pensioning due to all causes, or overall mortality. These results support the hypothesis that occupational exposure to organic solvents is a risk factor for disabling effects on the central nervous system.

[Practical teaching in occupational medicine. A good angle of approach in preventive medicine]. / Praktisk undervisning i arbeidsmedisin. En god innfallsvinkel for engasjement i forebyggende helsearbeid.

A new teaching programme in occupational medicine was established in Bergen in 1991, as a joint project between the Institute of Occupational Medicine and several doctors engaged in occupational medicine in the Bergen area. The medical students, in groups of five, visit one of these company doctors for one day. During this day, they learn about the Occupational Health Care Unit, visit a company together with the doctor, and interview one employee. The education was evaluated by the students in 1992 and 1993. The comments from the students led to some changes in the programme. Student satisfaction was high, with a slight increase from 1992 to 1993. The programme led to increased enthusiasm for occupational medicine among the students.

Organic Solvents Activate Human Platelets Through the Inositol Lipid-linked Signal Transduction System.

It has recently been proposed that occupational exposure to organic solvents in vivo may lead to platelet activation and this has been substantiated by exposure of platelets to solvents in vitro. The present work was undertaken to study the effects of organic solvents on the platelet inositol lipid signal transduction system. Human platelets that had been prelabelled with [(32)P] P, were exposed to a saturated atmosphere of the organic solvents toluene, xylene or hexane. Extracts were analyzed for metabolites of the polyphosphoinositide cycle and ATP. All solvents studied induced a decrease in radioactivity in phosphatidylinositol 4,5-bisphosphate together with an increase in radioactivities in phosphatidylinositol 4-phosphate and phosphatidic acid. This is compatible with solvent-induced activation of the cells through the inositol lipid pathway. In cells exposed to toluene or xylene we could detect an increased level in inositol trisphosphates at 3 min of exposure. The solvent-induced changes in metabolic ATP could not explain the solvent-induced effects on the inositol lipid metabolism. It is concluded that the organic solvents toluene, xylene and hexane can activate human platelets through the inositol lipid-linked transmembrane signal system.

Hydrophobic organic solvents activate human platelets in vitro.

The purpose of this study was to investigate blood platelet function during exposure to the hydrophobic organic solvents toluene, p-xylene and n-hexane. Human blood platelets were exposed for 30 min at 37°C to a saturated atmosphere of p-xylene, toluene or n-hexane. All three solvents, and the aromatics in particular, induced a decrease in the number of single platelets (61-88%) together with an increase in the extracellular levels of ATP plus ADP (45-65% of total) and serotonin (67-100% of total). Passive leakage of [(14)C] adenine-labelled nucleotides from the metabolic pool, due to platelet lysis, was minor or delayed. Electron microscopy of platelets exposed to p-xylene revealed aggregation. The platelets were spherical without pseudopods. Our results indicate that the hydrophobic solvents n-hexane, p-xylene and toluene induce platelet aggregation and dense granule secretion.

Chemical exposure of deck crew on product tankers loading the cargo with the hatches open.

Exposure of the deck crew to volatile hydrocarbon compounds and polycyclic aromatic hydrocarbon PAH compounds was observed and monitored on two Norwegian product tankers. The tankers were loading their cargo with the hatches open during the monitoring period. One of the tankers loaded gas oil. This type of cargo is not volatile, and very low concentrations of the monitored chemical PAH compounds were found on this tanker. The second tanker loaded gasoline. On this tanker high concentrations of hydrocarbon compounds were found; benzene was as high as 55 ppm, toluene was as high as 34 ppm, hydrocarbon compounds in the C5-C7 range were as high as 570 ppm, n-hexane was as high as 25 ppm. The levels of PAH-compounds were low. None of the seamen working on the deck did use respiratory protective equipment during the work. The exposure of the deck crew to volatile hydrocarbon compounds ought to be reduced on product tankers. Better routines concerning the use of respiratory protective equipment is an immediate action which ought to take place. Loading volatile cargo like gasoline with the hatches open should be avoided.

Activation of blood platelets in workers exposed to organic solvents.

Organic solvents probably exert their clinical effects through distortion of cellular membrane structure and function. Blood platelets represent an easily available membrane system. This study describes an evaluation of mean platelet volume (MPV) and total platelet count (TPC) in a group of workers exposed to a mixture of organic solvents in paint factories. We have found a correlation between decreased MPV and present exposure. The reduction was reversed within an exposure-free interval of 3 weeks. The intracellular adenosine triphosphate/adenosine diphosphate (ATP/ADP) ratio was significantly increased in exposed workers, compatible with dense granule secretion. A quantitative study of the phosphoinositide cycle in the platelets revealed an increased concentration of the phosphatidic acid, indicating an increased turnover. These findings are consistent with a solvent-induced activation of circulating platelets.

[Prognosis of patients with nervous system lesions caused by organic solvents]. / Prognose for pasienter med løsemiddelskade i nervesystemet.

19 patients with chronic organic solvent intoxication of the nervous system were interviewed and examined three years after the diagnosis was set. The study shows a significant reduction of subjective symptoms, especially among the youngest patients. Clinical neurological examination was almost unchanged. 18 of the patients were no longer occupationally exposed to organic solvents. Six patients were still working, and three other patients were being re-educated. Most of the patients were followed by general practitioners.

[Nervous system impairment caused by solvents]. / Løsemiddelskade i nervesystemet.

Exposure to organic solvents may impair the function of the peripheral and the central nervous system. This paper describes the results of neurological and neuropsychological examinations of 19 patients with a chronic organic solvent intoxication syndrome. During examination they presented clinical findings diagnosed as polyneuropathy, encephalopathy or both. The syndromes have no specific characteristics, and a qualified evaluation of alternative etiologies is compulsory. Experience from occupational medicine is essential for appraising exposure to solvents.

Cerebrospinal fluid proteins and free amino acids in patients with solvent induced chronic toxic encephalopathy and healthy controls.

The concentrations of protein, albumin, IgG, and free amino acids in the cerebrospinal fluid of 16 patients with chronic toxic encephalopathy due to organic solvents were measured. The patient group consisted of all patients with this diagnosis in a neurological department in 1985. The diagnosis was based on neuraesthenic symptoms, pathological psychometric performance, and verified exposure to neurotoxic organic solvents. A control group of 16 patients with myalgias or backache, or both, and no signs of disease was used for comparison. The purpose was to study possible changes in the cerebrospinal fluid that might contribute to understanding the aetiology of solvent induced chronic toxic encephalopathy. A rise in protein, albumin, and IgG was found in the patient group compared with the control group, as well as reduced concentrations of phosphoethanolamine, taurine, homocarnosine, ethanolamine, alpha-aminobutyric acid, and leucine. Using a stepwise multiple regression analysis, taurine was negatively correlated to exposure to solvents. These findings may indicate membrane alterations in the central nervous system related to exposure to organic solvents.