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Agency for Toxic Substances and Disease Registry
Stoddard Solvent Toxicity
Clinical Evaluation
Exposure to Stoddard solvent produces clinical signs and symptoms similar to those caused by other aliphatic solvents. Medical evaluation of a patient with Stoddard solvent exposure should initially consist of a complete history and physical examination. The medical history should include the following:
- Temporal associations between exposure and health effects
- Occupational and environmental history of the patient and relevant household members
- Hobbies or household projects; solvent use in such activities as painting, paint removal, refinishing, and automotive repair
- Residence or worksite proximity to industries and hazardous waste sites
- Dose estimates, taking into account the amount of solvent used, routes of exposure, duration of exposure, and personal protection such as gloves and respiratory apparatus
- Accentuators of effects such as social habits (e.g., cigarette smoking; drug or ethanol use), intercurrent diseases, and other exposures. Persons also exposed to other CNS depressants, such as solvent "huffing" or inhalant abuse, might be at increased risk.
(See Case Studies in Environmental Medicine: Taking an Exposure History.)
The physical examination should include evaluation of the skin, eyes, and mucous membranes for signs of irritation, and the CNS for signs of excitation or depression. Other organ systems that should be evaluated include the ophthalmologic (e.g., color vision testing), hematologic, hepatic, renal, and respiratory systems.
- The most serious effects of acute exposure to Stoddard solvent involve the CNS and the respiratory tract.
After aspiration of even small amounts, pulmonary aspiration of Stoddard solvent may result in serious chemical pneumonitis and pulmonary edema. Because of its aspiration hazard, Stoddard solvent is in Class 3 (may cause irreversible effects that can be life-threatening). Reported symptoms of acute exposure to Stoddard solvent include lightheadedness, dizziness, visual disturbances, and drowsiness. Although Stoddard solvent has not been reported to cause respiratory depression or coma, it is chemically similar to other agents that can produce such effects with prolonged high-level exposure, such as gasoline. Irritation of the respiratory tract, mucous membranes, and skin can occur.
- Neurologic effects associated with chronic workplace exposure are generally reversible.
Chronic exposure to Stoddard solvent has been associated with headaches, fatigue, intermittent episodes of inebriation, and memory deficits that generally resolve upon discontinuation of exposure. High-dose, chronic exposures to other volatile hydrocarbons, mainly through deliberate inhalant abuse, have been associated with memory, cognitive, and emotional disturbances.
- There are no biomarkers for exposure to Stoddard solvent.
Because Stoddard solvent contains hydrocarbons of varying concentrations and volatility, and because formulations may vary, no specific hydrocarbon in the plasma or tissues is a reproducible index of exposure.
- Medical surveillance for workers exposed to Stoddard solvent should include a complete blood count, urinalysis, and tests to evaluate liver, kidney, and CNS functions.
Depending on route, exposure to Stoddard solvent has been associated with neuropsychiatric disorders, hepatotoxicity, kidney damage, and changes in blood-forming capacity. NIOSH has recommended that preplacement and medical surveillance examinations for workers exposed to refined petroleum products include a complete blood count and a urinalysis, and appropriate tests for function of the liver, nervous system, and kidneys. If neurobehavioral abnormalities are suspected, consider referring the patient for neuropsychologic tests that evaluate cognitive and emotional functioning.
| You have educated your patient about the health effects of Stoddard solvent. A short time later, your patient calls to say that a neighbor who races cars and uses the vehicle maintenance shop on a regular basis is complaining of chronic fatigue, headaches, and recent memory impairment. |
| 4. | Your patient asks you if there is a test to determine whether his neighbor's condition might be due to Stoddard solvent. What is your answer? |
| 5. | What would you recommend for the neighbor? |
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