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Purpose: Metronidazole, a widely used antimicrobial medication, has been linked to neurologic adverse drug reactions. This study investigates the association between metronidazole use and first-time neurologic events., Methods: We conducted a case-time-control study using data from the Danish National Patient Register and the National Prescription Register in years 2013 to 2021. Patients with a first-time diagnosis of encephalopathy, cerebellar dysfunction, or peripheral neuropathy were included. Conditional logistic regression analyses were performed to estimate the risk of neurologic events associated with metronidazole use., Findings: Out of 476,066 first-time metronidazole prescriptions, the 100-day cumulative incidence of peripheral neuropathy was 0.016%, and 0.002% for cerebellar dysfunction or encephalopathy. In the case-time control study, we identified 17,667 persons with a first-time neurologic event and were included for the analysis. The estimated odds ratio for the combined neurologic events was 0.98 (95% CI, 0.59-1.64, P = 0.95) with no statistically significant association across different subgroups and time windows., Implications: Our findings suggest that metronidazole-induced neurologic events may be rarer than previously described, and we did not find any consistent or statistically significant association between metronidazole exposure. Nonetheless, clinicians should remain vigilant to potential neurologic risks in patients receiving metronidazole, to ensure its safe and effective use., Competing Interests: Declaration of competing interest The authors declare no competing interests at the time of manuscript preparation and submission. Subsequent to manuscript finalization, author MAA has initiated employment with Novo Nordisk., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Exposure to industrial solvents has been associated with encephalopathy. Styrene is a neurotoxic industrial solvent, and we investigated the long-term risk of encephalopathy and unspecified dementia following styrene exposure. We followed 72,465 workers in the reinforced plastics industry in Denmark (1977-2011) and identified incident cases of encephalopathy (n = 228) and unspecified dementia (n = 565) in national registers. Individual styrene exposure levels were modeled from information on occupation, measurements of work place styrene levels, product, process, and years of employment. Adjusted analyses were performed using a discrete survival function. A positive trend for encephalopathy (P < 0.01) and a negative trend for unspecified dementia (P = 0.03) were seen with cumulative styrene exposure accrued during the recent period of up to 15 years. For unspecified dementia and the combination of unspecified dementia and encephalopathy, a positive trend was indicated when applying a 30-year exposure lag (P = 0.13 and P = 0.07). The risk patterns seen following recent exposure probably reflect diagnostic criteria for encephalopathy requiring recent industrial solvent exposure and referral bias rather than association with styrene exposure, while the increasing risk observed for unspecified dementia and the combination of encephalopathy and unspecified dementia following distant exposure indicates an increased risk of dementia following styrene exposure with a long latency period., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.)

The project concerned social and psychological treatment of patients with chronic health injuries of medium-severe character as a consequence of work with organic solvents. The treatment involved the spouse of the patient and their children, and took place in the family's home, often together with the family doctor, the children's teachers and other people. At a first step, the preliminary examinations have been carried out in the Clinic of Occupational Medicine, Aalborg Hospital, and a diagnosis has been made. In the light of the examinations, patients and their families were selected. The 19 patients and their families participated in the treatment for about 6 months. In other words, the project was divided into four phases, each dealing with 5 patients and their families. The treatment concerned the health status of the patients and the social, psychological and financial situation of their families as well. The results were better when the treatment followed immediately the diagnosis.

In an epidemiological study comprising 3,387 men aged 53 to 75 years, 3303 men with valid questionnaire answers to questions on occupational organic solvents exposure, four cerebral symptoms and current work status were examined. Two-hundred and ninety-five men had been occupationally exposed to mixed organic solvents for a period of 5 years or more. Among them 178 were retired, while 117 were still gainfully employed. The exposed men in both groups had highly significantly more complaints of decreased concentration ability and of memory difficulties. Of the exposed retired men a higher prevalence of headache was found. Among the exposed still employed a trend towards a higher prevalence of dizziness was found. This study was conducted within a cardiovascular study with no focus on the relationship between organic solvent exposure and cerebral symptoms, a design reducing the risk of overreporting. If overreporting was responsible for the differences found between solvent-exposed and unexposed cases a similar pattern for reporting of acute and chronic symptoms should be expected. This was not the case. Our results support the hypothesis, that occupational exposure to organic solvents for a period of 5 years or more increases the risk of developing persistent memory difficulties and a decrease in concentration ability.

On the basis of previous investigations from occupational medicine, neurology, and neuropyschology, a retrospective evaluation was made of 21 painters in whom chronic toxic encephalopathy following exposure to organic solvents had been diagnosed during a stay in the Neurology Department of Gentofte Hospital, Copenhagen, in the period 1976-1980. All the painters had given up their jobs for this reason. The assumption of a causal relationship between the exposure and the intellectual impairment was supported by a possible dose-effect relationship. The chronic toxic symptoms had considerable social consequences. Five years later, ten had not gotten other jobs. The lack of working ability was correlated to advancing age, increasing exposure, and increasing intellectual impairment. According to the results of the study, conditions at work places ought to be changed in such a way that harmful exposure can be prevented in the future.