Chronic solvent-induced encephalopathy - painters syndrome

Chronic solvent-induced encephalopathy is popularly known as 'painter's disease' and is a disease of the nervous system. It is also called chronic toxic encephalopathy (CTE). We will use this name in the remainder of this page.
This neurological disorder mainly occurs in professional groups where volatile solvents are used in the work environment. Examples are car painter, paint sprayer, painter, printer, concrete repairer, upholsterer (carpet layer), laboratory technician, and cleaner. But also people who work in the metal industry,
agricultural sector, shipbuilding, leather goods industry, polyester processing industry, graphic industry, wood and furniture industry may be affected.
Inhaling solvents is toxic. The toxins can also penetrate the skin.
Examples of these solvents are acetone, benzene, turpentine, thinner, toluene, gasoline or xylene. A short-term peak exposure to
solvent may cause a feeling of dizziness or drowsiness. Long-term exposure can lead to chronic toxic encephalopathy (CTE).
Gradually more attention is being paid to painter's disease, because it is becoming clear how serious its consequences can be for the central nervous system, with physical and psychological complaints.


Sneaky start

Painter's disease (CTE) often starts insidiously with concentration problems, forgetfulness, (severe) fatigue, loss of sense of smell, (severe) headache, slowness, difficulty absorbing new information and being more easily irritated.



Painter's disease (CTE) has different stages according to the World Health Organization (WHO):

  • Stage 1: Neurasthenic syndrome. Non-specific complaints such as fatigue, irritability, behavior, headache, reduced concentration and
    forgetfulness. The term neurasthenia is not really specific and occurs in many conditions.
  • Stage 2a: Moderately severe chronic toxic encephalopathy (CTE). Personality changes. Mood swings and depression.
    An MRI scan can show changes in the brain at this stage.
  • Stage 2b: Moderately severe chronic toxic encephalopathy (CTE). Difficulty thinking logically, absorbing new information and difficulty with memory and psychomotor skills. People can become disoriented in time and space.
  • Stage 3: Severe CTE. Demential image.

People with Painter's Disease (CTE) have more psychological problems than control groups.
Research shows that psychological complaints generally do not worsen if the person is no longer exposed to the substances.



Research shows that cognitive complaints generally do not worsen if a person is no longer exposed to the substances. Cognitive complaints even seem to improve somewhat over time.
Even though research generally shows an improvement in cognitive functioning, this does not mean that this is always immediately noticeable for the person who has Painter's disease (CTE). It is also true that the improvement does not have to apply to every person. The course can be slightly different for everyone. Many people no longer return to their previous level before the disease and some remain incapacitated for work.
The dementia picture of painter's disease (CTE) probably does not occur or is very rare in the Netherlands.


Diagnosis and guidance

In the Netherlands, diagnosis and guidance is provided by a Solvent team. Patients come in for assessment by a solvent team
qualify if they meet the following four conditions:

  • the complaint pattern contains at least two of the following symptoms in addition to memory problems: fatigue, mood disorder,
    attention problems
  • occupational exposure to solvents (in principle 5 years)
  • there is a relationship over time between the complaints and exposure
  • there is no other clear explanation for the complaints



Using personal protective equipment, good ventilation, adjusting the working environment or using other types of paint and glue is very important to prevent painter's disease (CTE).

Relevant information can be found here and here.


Arlien-Søborg P, Bruhn P, Gyldenstedt C, MelgaardB. Chronic painters' syndrome. Chronic toxic encephalopathy in housepainters. Acta Neurol Scand 1979;60:149-56. Amsterdam AMC Beroepsziekten 12-02-2024 15:55

Schildersziekte Chronische Toxische Encefalopathie (CTE) / Vergiftiging en Middelengebruik / Soorten hersenletsel hersena…… 

Hageman G, Hout MSE van, Laan G van der. Toxischeencefalopathie; beroepsziekte als gevolg van organische oplosmiddelen.Ned Tijdschr Geneeskd1996;140:289-91. Hoek JAF van der, Verberk MM, Hageman G. Criteria forsolvent-induced chronic toxic encephalopathy: a systematic review. Int ArchOccup Environ Health 2000;73:362-8. van Valen, E., Wekking, E., van Hout, M., van der Laan, G., Hageman, G., van Dijk, F., & Sprangers, M. (2018). Chronic solvent-induced encephalopathy: course and prognostic factors of neuropsychological functioning. International archives of occupational and environmental health, 91(7), 843-858. Nederlands Centrum Beroepsziekten Coronel Instituut, Academisch Medisch Centrum Amsterdam J.A.F. van der Hoek, M.M. Verberk, G. van der Laan en G. Hageman. Chronische encefalopathie door oplosmiddelen; het