The aim was to study the symptomatology of chronic solvent encephalopathy (CSE), and the persistence
of the symptoms. We examined how Euroquest, a neurotoxic symptom questionnaire, distinguished
workers with verified CSE from unexposed employees, and evaluated symptom cut-off for CSE. Another
aim was to study the effect of age on the responses.
CSE cases confirmed at the Finnish Institute of Occupational Health had completed Euroquest either
before their first investigation procedure (CSE-1 group, n = 33), or before attending a routine control for
previously diagnosed CSE (CSE-2, n = 43). Non-exposed carpenters served as referents (n = 292). We
studied responses to single questions and to symptom domains. The domain with the highest AUC (area
under the ROC: Receiver Operating Characteristic Curve) value was chosen to study cut-off points.
CSE groups reported nearly all 59 symptoms more frequently than the carpenters. There was only
little difference between younger and older carpenters. CSE-1 reported 12 symptoms more often than
CSE-2, but no significant differences were found in the memory and concentration domain, which had
the highest AUC, above 0.9. Using a three out of 10 symptoms cut-off point, 97% of the CSE-1 cases and
80% of the carpenters were classified correctly. At a four-symptom cut-off, the sensitivity was 93% and
specificity 87%.
The memory and concentration as core symptoms distinguished CSE cases from unexposed workers
and remain, even after cessation of exposure. The effect of age on Euroquest was minor. Euroquest is
recommended for the screening of CSE in solvent-exposed work-force and in the diagnostic process of
CSE. We propose three memory and concentration symptoms as cut-off to minimize under-detection.
The aim was to study the symptomatology of chronic solvent encephalopathy (CSE), and the persistenceof the symptoms. We examined how Euroquest, a neurotoxic symptom questionnaire, distinguishedworkers with verified CSE from unexposed employees, and evaluated symptom cut-off for CSE. Anotheraim was to study the effect of age on the responses.CSE cases confirmed at the Finnish Institute of Occupational Health had completed Euroquest eitherbefore their first investigation procedure (CSE-1 group, n = 33), or before attending a routine control forpreviously diagnosed CSE (CSE-2, n = 43). Non-exposed carpenters served as referents (n = 292). Westudied responses to single questions and to symptom domains. The domain with the highest AUC (areaunder the ROC: Receiver Operating Characteristic Curve) value was chosen to study cut-off points.CSE groups reported nearly all 59 symptoms more frequently than the carpenters. There was onlylittle difference between younger and older carpenters. CSE-1 reported 12 symptoms more often thanCSE-2, but no significant differences were found in the memory and concentration domain, which hadthe highest AUC, above 0.9. Using a three out of 10 symptoms cut-off point, 97% of the CSE-1 cases and80% of the carpenters were classified correctly. At a four-symptom cut-off, the sensitivity was 93% andspecificity 87%.The memory and concentration as core symptoms distinguished CSE cases from unexposed workersand remain, even after cessation of exposure. The effect of age on Euroquest was minor. Euroquest isrecommended for the screening of CSE in solvent-exposed work-force and in the diagnostic process ofCSE. We propose three memory and concentration symptoms as cut-off to minimize under-detection.
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