Organic solvent toxicity: health effects of solvents at work

Solvents, often known as volatile organic compounds, are used to dissolve or dilute other substances. The HSE says they are found in many construction products such as paints, paint strippers, thinners and glues, and names dichloromethane (DCM, also called methylene chloride), toluene, xylene, white spirit, acetone and ethyl acetate among potentially harmful ones. In woodworking the HSE lists solvent-based stains, varnishes, paints, adhesives and wood preservatives.

Organic solvent toxicity is a broad term for the harm that these substances can do. It is not one disease: effects range from a headache after a morning of painting in a closed room, to dermatitis in someone whose hands are repeatedly wet with thinners, to more serious long-term problems with the liver, kidneys or nervous system, depending on the solvent, the dose and the duration.

The HSE stresses that different solvents affect health in different ways and that exposure from more than one solvent may be additive or, in some cases, greater than the sum of the individual effects. That is why product labels and safety data sheets matter.

The HSE groups the effects by timescale and route. The table summarises what its pages say.

The NHS says that poisoning can happen if you swallow, touch or breathe in harmful substances, and lists chemicals found in some workplaces among the causes. It says to call 999 or go to A&E if you think you or someone else has swallowed, touched or breathed in something harmful, if someone has lost consciousness or stopped breathing, has severe difficulty breathing or has a seizure, and to call NHS 111 if you are not sure whether something is harmful.

The NHS lists symptoms of poisoning such as feeling sick or being sick, diarrhoea, feeling sleepy, blurred vision, high temperature, confusion, difficulty breathing, seizures and loss of consciousness, and notes that symptoms may take a few hours or days to start. While waiting for help it advises starting CPR if the person is unresponsive and not breathing, using the recovery position if unconscious but breathing, and showing doctors the substance or its packaging if possible. It says not to try to make someone sick or to give them anything to eat or drink.

For skin symptoms the NHS says to see a GP if contact dermatitis is persistent, recurrent or severe; it names solvents among the common irritants. The NHS also says the GP may refer you to a dermatologist if the substance cannot be identified or symptoms are not responding to treatment.

There is no single test for solvent toxicity. A doctor will usually ask about the products you use, how long you have worked with them, whether symptoms improve away from work and what protection you use. Your product labels and safety data sheets give the doctor a precise list of the substances, which the HSE says you should check or request from the supplier.

The HSE explains that health surveillance collects information to protect employees' health through early detection of adverse effects, and that it is not a substitute for preventing or adequately controlling exposure. It lists skin soreness, blotches, cracking, itching and blisters as effects of solvent-based products such as stains, varnishes and paints.

Treatment depends on the effect. For acute poisoning, the NHS says treatment is needed in hospital and may include antidotes, a charcoal drink for some poisons, treatments for symptoms such as fluids into a vein, and removing the substance from the body, and that people without symptoms may still need monitoring for several hours.

For dermatitis, the NHS says the condition usually improves or clears up completely if the substance is identified and avoided, and treatments such as emollients and topical corticosteroids can ease symptoms. For long-term organ effects, reducing exposure is the central measure, with specialist assessment of any liver, kidney or neurological problem.

The HSE says the COSHH Regulations require protection against the risks of hazardous solvents, following an assess, control and review approach. The first question is whether the solvent can be eliminated, for instance by using water-based paint. Spraying puts more solvent into the air than brush or roller work, and enclosed spaces with little air movement are higher risk. Ventilation is always required and mechanical ventilation or local exhaust ventilation may be needed for more hazardous tasks.

The HSE also advises keeping lids on containers, using sealed containers for contaminated waste, not leaving solvent-soaked rags lying around and not using solvents to remove paint or grease from the skin. DCM-based paint strippers are singled out: the HSE says the vapour can cause drowsiness and headaches, can lead to unconsciousness and death at high concentrations and is classed as a carcinogen, and that it can currently only be used for paint, varnish or lacquer stripping in industrial premises with appropriate safety measures.

Your GP is the NHS starting point for symptoms you think are work-related, and can refer you to a dermatologist or other specialist. Many employers also provide occupational health, which can assess whether your symptoms relate to your work and advise on adjustments. Private occupational physicians are an option for an independent opinion. Keep the product names and safety data sheets, as they speed up any assessment.