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Limitations of periodical health examinations in detecting occupational chronic solvent encephalopathy
  1. Heidi M Furu1,
  2. Markku Sainio2,
  3. Hanna-Kaisa Hyvärinen2,
  4. Ari Kaukiainen1,3
  1. 1 University of Helsinki Faculty of Medicine, Helsinki, Finland
  2. 2 Finnish Institute of Occupational Health, Helsinki, Finland
  3. 3 University of Turku Faculty of Medicine, Turku, Finland
  1. Correspondence to Dr Heidi M Furu, University of Helsinki Faculty of Medicine, Helsinki 00014, Finland; heidi.furu{at}


Objectives Occupational diseases (ODs) are globally underdetected, and chronic solvent encephalopathy (CSE) is no exception. The aim was to study how the recommended policies and protocols were followed in occupational health services (OHS) periodical health examinations where symptomatic CSE cases have remained undetected.

Methods We retrospectively studied the medical records of occupational CSE cases (n=18) found in a screening project, which had not been detected in preceding OHS health examinations. We collected data from three sources: OHS units, the screening project and the Finnish Institute of Occupational Health. We analysed the health examinations conducted between symptom onset and the detection of CSE: regularity, content, use of recommended screening tools, exposure estimation and whether a physician was involved in the examinations, as recommended.

Results The mean duration of symptoms before OD identification was 7.3 years (range 3–13), and 36 health examinations had been conducted. Fifteen workers had attended these (1–9 times each) while suffering from CSE symptoms, and two before symptoms. Only one had not had access to OHS. The recommended symptom screening questionnaire, Euroquest, was used in five (14%) examinations, and previous solvent exposure inquired once. A physician was involved in 24 (67%) examinations, whereas the rest were carried out by a nurse.

Conclusions Although health examinations are conducted, guidelines are not followed. This may be due to a lack of awareness concerning CSE, and may apply to other ODs. In addition to legislation and policies, OH professionals must be continuously educated to improve awareness, prevention and detection of ODs.

  • solvents
  • chronic solvent encephalopathy
  • health surveillance
  • occupational disease
  • occupational health practice

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  • Contributors All the authors have approved the article text.

  • Funding This study was funded by The Finnish Work Environment Fund.

  • Competing interests None declared.

  • Ethics approval The study was approved by the ethical board of FIOH and the Scientific and Ethical Review Committee of the Hospital District Helsinki and Uusimaa.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.