• Clinical science

Organic solvent toxicity

Abstract

Organic solvents are used in detergents, insecticides, and a number of industrial settings. Most of these substances are highly lipid-soluble and therefore capable of causing CNS disorders and polyneuropathy. Some organic solvents break down into metabolites that are carcinogenic. While the metabolites may be found in urine or blood, the diagnosis is usually established based on clinical features and a history of exposure. Most organic solvents do not have an antidote; therefore, treatment is generally supportive.

For an overview of other types of substance toxicity (e.g., with organophosphates), see the learning card on poisoning.

Overview

Overview of some organic solvents

Effects
Aromatic amines
Lindane
Polyvinyl chloride
Hydrocarbons

High lipid solubility

Chronic toxic encephalopathy

  • Etiology: chronic or repeated high-dose exposure (e.g,, inhalation) to organic solvents or heavy metals → cerebral, cerebellar, and brain stem atrophy
  • Presentation
    • Mental conditions (e.g., personality changes)
    • Multifocal neurologic deficits (e.g., memory impairment)
  • Grading
Clinical features Diagnosis Prognosis
Stage I
  • Difficulty concentrating
  • Poor memory
  • Mood changes
  • History
  • Psychopathological findings
Complete recovery within 2 years if no further exposure occurs.
Stage II A
  • Symptoms: same as above
  • Personality changes
  • Same as above
  • Psychological evaluation to detect psychomotor retardation
Reduced healing tendency
B
  • Symptoms: same as above
  • Psychomotor deficits (e.g., ataxia)
  • Same as above
  • Neurological evaluation to detect sensorimotor disturbances
Stage III
  • Dementia associated with pronounced memory problems and mental retardation
  • Detection of cerebral atrophy on cranial imaging
Improvement of symptoms rarely occurs

References:[1][1][1][1][2]

Aromatic amines

References:[1][3]

Quinone (benzoquinone)

  • Sources of exposure: inhalation, skin contact, or ingestion of oxidizing agents, bactericides, analytical reagents, or paint
  • Effects
    • Eye Pain
    • Blurry vision
    • Brownish discoloration of the conjunctiva and the cornea
    • Nausea, vomiting, abdominal pain
    • Irritation of skin, mucous membranes, and respiratory tract
  • Diagnosis: clinical
  • Treatment: supportive

Dimethylformamide (DMF)

  • Sources of exposure: inhalation of or skin contact with solvent used to produce fibers, films, and coatings
  • Effects
    • Nausea and vomiting
    • Toxic hepatopathy (i.e., jaundice, alcohol intolerance, abdominal pain)
    • Rashes
  • Diagnosis: clinical
  • Treatment: supportive

Formaldehyde

  • Sources of exposure: inhalation, skin/eye contact, and ingestion of disinfectants, tobacco smoke, or embalming fluid (an aqueous solution stabilized with methanol; formalin)
  • Effects
    • Irritation of the skin (contact dermatitis), mucous membranes, eyes, and respiratory tract
    • Headache, vertigo, sleeping disturbances, impaired cognition (memory, concentration)
    • Metabolic acidosis
    • Chronic exposure in high doses has a carcinogenic effects (especially in the nasopharynx).
  • Diagnosis: clinical
  • Treatment: supportive

Methyl n-butyl ketone

Lindane

  • Sources of exposure: skin contact, ingestion, or inhalation of hexachlorocyclohexane found in insecticides or topical creams for scabies
  • Effects
    • CNS: dizziness, vertigo, headache
    • Carcinogenic effects are currently being investigated.
  • Diagnosis: HCH isomer detection in blood, urine, or semen

References:[6904;681]

Polyvinyl chloride

References:[1]

Hydrocarbons

References:[2][4]

Pyrethroid

  • Sources of exposure: skin contact with, ingestion of, or inhalation of insecticides (e.g., malaria control); permethrin treatment of scabies, head and pubic lice
  • Effects
    • Headaches, dizziness, fatigue, coma
    • Nausea
    • Irritation of the skin and mucous membranes
  • Diagnosis: detection of pyrethroid metabolites in serum and urine
  • Treatment: supportive

Para-tertiary butylphenol formaldehyde resin

  • Sources of exposure: skin/eye contact with, ingestion of, or inhalation of adhesives, varnish, mineral oil, plastics, motor oil, fiberglass, or rubber processing fumes
  • Effects
  • Diagnosis: clinical or patch testing
  • Treatment: supportive

Carbon disulfide

Styrene

  • Sources of exposure: skin contact with, ingestion of, or inhalation of styrene released from disposed packaging materials, cigarette smoke, automobile emissions, or manufacturing of automobile parts, fiberglass, plastic pipes, and insulation for wiring and appliances
  • Effects (mainly due to inhalation)
  • Diagnosis
  • Treatment: supportive
  • 1. Marquardt H, Schäfer SG, McClellan R, Welsch F . Toxicology. Cambridge, MA: Academic Press; 1999.
  • 2. Levine MD. Hydrocarbon Toxicity. In: Miller MA. Hydrocarbon Toxicity. New York, NY: WebMD. http://emedicine.medscape.com/article/821143. Updated June 6, 2017. Accessed September 26, 2017.
  • 3. Roberts SM, James RC, Williams PL. Principles of Toxicology: Environmental and Industrial Applications. Hoboken, NJ: John Wiley & Sons; 2014.
  • 4. Lewander WJ, Aleguas A Jr, Burns MM, Wiley JF II. Hydrocarbon Poisoning. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/hydrocarbon-poisoning. Last updated April 25, 2017. Accessed September 26, 2017.
last updated 12/13/2018
{{uncollapseSections(['xfYEoo', 'hsXcuz', '3sXSuz', 'jsX_uz', 'PsXWEz', 'ksXmEz', 'QsXuuz', 'OsXIEz', '5sXivz', 'Bpcz7W0', 'nsX7vz', 'LsXwvz', 'NsX-Ez', 'msXVvz'])}}