Annoyance and performance of three environmentally intolerant groups during experimental challenge with chemical odors

OBJECTIVES: This study investigated exposure- and subject-related determinants of annoyance and performance during the chemical odor provocation of healthy persons with self-reported environmental annoyance. METHODS: Persons with self-reported annoyance attributed to (i) chemicals or smells (smell-annoyed, SA, N=29), (ii) electrical equipment (electrically annoyed, EA, N= 16), and (iii) both smells and electricity (generally annoyed, GA, N=39) were, together with referents (N=54), challenged with n-butyl acetate in an exposure chamber at levels far below the threshold values for neurotoxic effects and trigeminal irritation. A sequence of three air concentrations, 0.37, 1.5, and 6 ppm (1.8, 7.1, and 28 mg/m3) was used, counterbalanced within groups, together with intermittent periods of room air between each exposure level. The response measures comprised ratings of annoyance and smell intensity and reaction-time tests. RESULTS: Only the GA group showed clearly elevated ratings of smell annoyance, mucous membrane irritation, and fatigue, as well as longer reaction times, compared with the referents, in response to the challenge. No group difference was found for the smell-intensity ratings. During intermittent periods without exposure, only the GA group maintained higher ratings for mucous membrane irritation and fatigue. Reaction time and all the rating dimensions showed a positive relationship with momentary n-butyl acetate concentration, while cumulative exposure had a more limited impact on the ratings and reaction time. A suggestion effect by the chamber environment before exposure could not be demonstrated. CONCLUSIONS: The results suggest that self-reported annoyance generalized to both electrical equipment and smells is a better predictor of chemical intolerance than self-reported annoyance to smells only.     

Psychological reactions related to chemosensory irritation

OBJECTIVES: For risk assessments of solvents the knowledge on chemosensory irritation effects is important, but the methodological base for that is incomplete. The psychological approach measuring chemosensory irritations leans on perceived symptoms and self-reported changes of well being. Characteristics assessing the validity of such psychological approaches are presented. METHODS: The article is based on 14 experimental inhalation studies with (mostly) 4-h exposures to acetone, 2-butanone, ethanol, ethyl acetate, ethyl benzene, iso-propanol, 1-octanol, and styrene. The profiles of exposure include constant and changing concentrations using the range of the German maximum concentrations at the workplace (MAK) list. Irritations (eyes and nose), olfactory symptoms (odour), and annoyance are the dependent variables measured by ratings. Young and healthy subjects ( n=160), - partially, subjects with self-reported odour sensitivity (measured by items from the questionnaire on chemical and general environmental sensitivity) - were investigated. RESULTS: The reliability of ratings is sufficient. Dose-response relationships for perceived odour and annoyance are stronger than those for irritations. A ranked order of the size of effect (related to the values before exposure) for the substances investigated shows correspondence between odour and annoyance; that for irritation differs. Within the limits of the MAK list, perceived irritations are not correlated to annoyance, whereas perceived bad smell correlates significantly to annoyance. Reversibility of the self-reported effects to approximately the pre-exposure level can be shown 1 h after cessation of the experimental exposure for the "normal" subjects. Influences of trait anxiety and chemical sensitivity on reports of annoyance, bad odour or irritation are only weak. CONCLUSION: The psychological approach of repeated measurements for self-reported irritation includes distinctive advantages compared with other methods, the simple and repeated availability during exposure, the sufficient reliability and dose-response relationship, and the comparability between substances by means of effect size. The extension of the concept of "chemosensory irritations" on reports for annoyance and bad smell can be recommended.     

Psychological test performance during experimental challenge to toluene and n-butyl acetate in cases of solvent-induced toxic encephalopathy

OBJECTIVES: This study determined whether performance in neurobehavioral tests deteriorates during subjectively annoying chemical challenge below known neurotoxic thresholds among persons with toxic encephalopathy with subjective hypersensitivity to chemicals. METHODS: Subjects with symptoms and previous neuropsychological test results compatible with toxic encephalopathy (TE) of either type 2A (N=12) or 2B (N=12) and unexposed referents (N=12) were challenged in an exposure chamber. In a counterbalanced design, the subjects were exposed on 2 occasions to increasing air concentrations of n-butyl acetate and toluene at levels well below the thresholds for neurotoxic effects. Attention and motor speed tests were given (i) in room air outside the chamber before the challenge, (ii) in room air inside the chamber before the exposure, (iii) at 12 ppm (44 or 56 mg/m3), and (iv) at 48 ppm (at 180 or 228 mg/m3). RESULTS: For both substances the TE groups showed a slight increase (deterioration) in the simple reaction-time task during chemical exposure, but not in the complex reaction-time task or in the digit symbol test of the Wechsler Adult Intelligence Scale. Contrary to reference subjects, the TE subjects did not show any improvement or learning effect in the digit symbol test over the chamber phases. n-Butyl acetate tended to affect cognitive functioning more obviously than toluene did. Suggestion or expectancy effects were not observed in any group in the clean-air baseline conditions. CONCLUSIONS: The results do not support the notion that men with subjective hypersensitivity to chemicals would be more affected than healthy men regarding cognitive functioning during annoying solvent exposure below thresholds for acute neurotoxic effects.     

Neurobehavioral effects during experimental exposure to 1-octanol and isopropanol

OBJECTIVES: The study examined acute neurobehavioral effects provoked by controlled exposure to 1-octanol and isopropanol among male volunteers. METHODS: In a 29-m3 exposure laboratory, 24 male students (mean age 25.8 years) were exposed to 1-octanol and isopropanol. Each substance was used in two concentrations (0.1 and 6.4 ppm for 1-octanol; 34.9 and 189.9 ppm for isopropanol:). In a crossover design, each subject was exposed for 4 hours to the conditions. Twelve subjects reported enhanced chemical sensitivity; the other 12 were age-matched controls. At the onset and end of the exposures neurobehavioral tests were administered and symptoms were rated. RESULTS: At the end of the high and low isopropanol exposures the tiredness ratings were elevated, but no dose-dependence could be confirmed. For both substances and concentrations, the annoyance ratings increased during the exposure, but only for isopropanol did the increase show a dose-response relation. The subjects reported olfactory symptoms during the exposure to the high isopropanol and both 1-octanol concentrations. Isopropanol provoked no sensory irritation, whereas high 1-octanol exposure slightly enhanced it. Only among the subjects with enhanced chemical sensitivity were both 1-octanol concentrations associated with a stronger increase in annoyance, and lower detection rates were observed in a divided attention task. CONCLUSIONS: Previous studies reporting no neurobehavioral effects for isopropanol (up to 400 ppm) were confirmed. The results obtained for 1-octanol lacked dose-dependency, and their evaluation, is difficult. The annoying odor of 1-octanol may mask sensory irritation and prevent subjects with enhanced chemical sensitivity from concentrating on performance in a demanding task.     

Olfactory function in painters exposed to organic solvents

The olfactory receptor cells are in direct contact with the exterior environment, and some chemical agents can impair olfactory function. The olfactory function of 54 painters exposed to organic solvents was compared with that of 42 unexposed referents. A new clinical test validated for the sense of smell was used, the University of Pennsylvania Smell Identification Test. Age, smoking habits, exposure to organic solvents, and medical disorders of importance for the sense of smell were recorded. The painters had a somewhat lower test score than the referents. However, the influence of the exposure variable was not statistically significant in a multiple regression analysis including age and smoking habits. The exposure to organic solvents was low, and therefore an effect of high exposure on olfactory function cannot be ruled out. Since some of the painters had earlier been highly exposed, the effects of high exposure are likely to be reversible.     

Multiple chemical sensitivity in male painters; a controlled provocation study

The purpose of the present study was to examine whether male painters reporting multiple chemical sensitivity (MCS) differ from their matched controls (male painters without such sensitivity) during controlled chamber challenges to singular and mixtures of odorous chemicals with respect to: (1) Subjective rating of symptoms (i.e., symptoms related to central nervous system (CNS) and symptoms related to irritation) and sensations of smell elicited by low-level chemical exposures. (2) Changes in serum prolactin and cortisol levels, changes in nasal cavity and eye redness as a result of the various exposures. Moreover, background assessments were made regarding mental well-being, sense of coherence (SOC) as well as state of anxiety and depression in both groups. The MCS and control group consisted of 14 and 15 male painters respectively. Regarding background assessments of mental well-being, anxiety, depression and SOC, statistically significant differences were obtained between painters with MCS and their controls. During the controlled chamber challenges, neither difference regarding sensations of smell nor development of CNS related symptoms were seen between MCS and control group. In contrast, subjective rating of symptoms related to irritation (i.e., eyes, nose, throat, skin, and breathing difficulties) was significant higher in subjects with MCS. No differences between the groups as a result of the different exposures were seen concerning nasal cavity, eye redness and serum cortisol levels. However, a trend (P=0.056) between the groups was measured regarding a decline of serum prolactin levels in the MCS group. This is a relatively small study with a limited number of volunteers; and no definitive conclusions can be drawn concerning the above findings. But it is the first controlled challenge study that incorporates similarly exposed groups (painters) recruited from a community rather than from a clinical population.     

Occupational exposure to mixtures of organic solvents increases the risk of neurological symptoms among printing workers in Hong Kong

LEARNING OBJECTIVES: Summarize the nature and extent of exposure to organic solvents to which printing workers in this study were subjected. Compare the numbers of neurological symptoms in exposed and non-exposed workers and how they related to level of exposure, as defined by specific job title or by air sampling. Clarify the relationship between exposure to organic solvents and individual psychoneurological and other symptoms. ABSTRACT: The health effects of low-dose occupational exposure to organic solvents remains unclear. A cross-sectional survey was conducted among 762 male printing workers to assess the impacts of exposure to mixtures of n-hexane, toluene, isopropyl alcohol, and benzene on neurological and other symptoms. After controlling for age, smoking, alcohol drinking, past exposure history, working hours and shift work, current exposure to solvent mixtures was significantly associated with the total number of neurological symptoms and with the prevalence of specific symptoms of the nervous system and mucous membrane irritation. The adjusted odds ratio of neurovegetative lability (1.7-5.9), abnormal or reduced smell (1.6-4.1), memory loss (1.8), and mucous membrane irritation symptoms (1.5-4.6) significantly increased in the exposed group, especially when the summation index of exposure exceeded one.     

Acute sensory irritation from exposure to isopropanol (2-propanol) at TLV in workers and controls: objective versus subjective effects

OBJECTIVES: Phlebotomists occupationally exposed to isopropanol (IPA) (2-propanol) and na?ve controls (n = 12 per group) were exposed to the time-weighted average threshold limit value of 400 p.p.m. IPA for 4 h in an environmental chamber to investigate: (i) acute effects of sensory irritation using subjective health symptom reports and objective, physiological end-points; and (ii) differences in measured effects in relation to exposure history. METHODS: Before, during and after exposure subjects gave self-reports of health complaints. During exposure subjects rated the intensity of the odor, sensory irritation and annoyance. Objective end-points of ocular hyperemia, nasal congestion, nasal secretion and respiration were obtained at various times before, during and after exposure. Results were compared with exposure to phenylethyl alcohol (PEA), a negative control for irritation, and to clean air (CA), a negative control for odor and irritation, using a within-subjects design. RESULTS: Significantly higher intensity ratings of odor, irritation and annoyance were reported during the exposure to IPA, when compared with exposure to CA or PEA. Nevertheless, the overall level of reported sensory irritation to IPA was low and perceived as 'weak' on average. Health symptom ratings were not significantly elevated for IPA as compared with PEA or CA exposure. The only physiological end-point that showed a change exclusively in the IPA condition was respiration frequency: relative to baseline, respiration frequency increased in response to IPA in both groups. No differences were encountered between the occupationally exposed and the control groups. CONCLUSIONS: The increase in respiration frequency in response to IPA may reflect either a reflexive change due to sensory irritation (an autonomic event) or a voluntary change in breathing in response to perception of an unpleasant, solvent-like odor (a physiological event caused by cognitive mediation). Our findings on objective end-points, including nasal and ocular sensory irritation, did not confirm subjective irritation reports. Irritation reports and odor intensity decreased, rather than increased, over time, lending credence to the cognitive argument and suggesting that the elevated subjective responses to IPA may be mediated by responses to its odor.     

The influence of cognitive bias on the perceived odor, irritation and health symptoms from chemical exposure

 Objective: Responses to volatile chemicals are often subjective and variable, both over time and across individuals. Although variability can derive from differences in individual olfactory sensitivity, the response to a chemical stimulus is also influenced by the complex environment surrounding the exposure, which can include the perceiver’s cognitive state. To explore the role of cognitive bias in chemical exposures, we evaluated whether information about the consequences of exposure to acetone could influence ratings of odor and irritation during exposure and/or the frequency or intensity of reported health symptoms following exposure. Methods: Ninety adults (mean age 33.7, range 25–64) with no history of occupational exposure to solvents, were exposed to 800 ppm acetone in a chamber for 20 min. To control for non-specific responses to the odor of acetone, the subjects were also exposed for 20 min to 200 ppm phenylethyl alcohol (PEA), a nonirritant volatile chemical that produces a distinct odor but does not elicit irritation in the vapor phase. Subjects were assigned to one of three groups (n=30/group); each group was given either a positive, negative or neutral bias towards the consequences of exposure to the chemicals in the study. During exposure, subjects rated the intensity of odor and irritation; following exposure, they completed symptom questionnaires. Results: During the 20-min exposure to acetone, the positive bias group exhibited the most adaptation to its odor and the lowest perceived irritation; following exposure they reported the fewest health symptoms. In contrast, the negative bias group rated higher levels of odor intensity and, on average, reported the most overall irritation; following exposure they reported significantly more health symptoms than the other groups. None of the demographic variables studied (e.g., age, gender, race, smoking status) were predictive of the response to odor or irritation. The perceived irritancy of acetone was well predicted by a linear combination of the perceived odor of acetone and the perceived irritation from PEA (the nonirritant), r ²=0.73. Conclusions: The results provide strong evidence that both the perceived odor and cognitive expectations about a chemical can significantly affect how individuals respond to it. Moreover, because naive control subjects appear to exhibit extreme variation in their cognitive evaluations of chemical effects, there may be limited value in using non-exposed controls to assess the irritancy of chemicals for worker populations. Received: 7 May 1996/Accepted: 20 September 1996     

1998 equivalence of sensory responses to single and mixed volatile organic compounds at equimolar concentrations.

Exposure to low levels of chemicals indoors is often to a mixture of volatile organic compounds (VOCs). It is of interest to determine if the symptomatic and sensory responses can be attributed to a single chemical or to a mixture of chemicals. To determine if sensory or symptomatic responses differ with exposure to single or mixed VOCs, 100 female subjects participated in a 6-hr exposure study. Subjects were exposed to one of six equimolar concentrations equivalent to 24 mg/m3 toluene, control, m-xylene, n-butyl acetate, m-xylene plus n-butyl acetate, a mixture of 21 chemicals including n-butyl acetate and m-xylene, and to the same mixture of chemicals without n-butyl acetate and m-xylene (19 chemicals). The results indicated that there was no difference in reporting of symptoms or sensory responses between the exposures. When the control group was added, some variables, primarily odor intensity and nasal irritation, attained significance.     

Perceived odor and irritation of isopropanol: a comparison between naïve controls and occupationally exposed workers

OBJECTIVES: To assess sensory irritation levels from isopropanol (IPA) unconfounded by subjective evaluations of odor for comparison against the recommended exposure limits (400 ppm threshold limit value (TLV); American Conference of Governmental Industrial Hygienists). METHOD: The lateralization method was used to assess intra-nasal irritation thresholds for IPA, while odor detection thresholds were also measured. Thresholds for 1-butanol and phenyl ethyl alcohol (PEA) were obtained as positive and negative irritant controls. To compare potency and hedonic characteristics, subjects provided subjective ratings of odor, irritation and annoyance intensity for three concentrations of each chemical. Workers occupationally exposed to IPA ( n=26) were compared with previously unexposed controls ( n=26). RESULTS: The (geometric) mean odor detection threshold for IPA was slightly higher among exposed workers than controls (39 ppm vs. 11 ppm). Lateralization thresholds measuring intra-nasal irritation were elevated when compared with controls (6,083 ppm in exposed workers vs. 3,361 ppm in na?ve controls), with a significantly higher proportion of phlebotomists being unable to lateralize the maximum concentration regarded as safe, than controls. Calculations of the 6th percentile for lateralization thresholds revealed that 95% of the sample did not experience sensory irritation below 512 ppm. Thus, while odor detection thresholds were well below the current recommended exposure limits, the irritation thresholds were well above these values. The odor, irritation and annoyance from IPA was perceived, on average, as between weak and almost strong, from lowest to highest concentration. CONCLUSIONS: The results indicate that current exposure guidelines would be adequately protective of the acute adverse effect of nasal sensory irritation, as operationally defined by the intra-nasal lateralization threshold. Exposures to higher concentrations should perhaps be evaluated on the basis of existing knowledge about systemic, rather than local (e.g., irritation), toxic effects. IPA appears to be a weak sensory irritant and occupational exposure to IPA appears to elicit small changes in sensitivity that do not generalize to other odorants (e.g., PEA and 1-butanol) and are likely to be reversible.     

Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure

Multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms occur with low-level chemical exposure; whether it is an organic disease initiated by environmental exposure or a psychological disorder is still controversial. We report a 38-year-old male worker with chronic toluene exposure who developed symptoms such as palpitation, insomnia, dizziness with headache, memory impairment, euphoria while working, and depression during the weekend. Upon cessation of exposure, follow-up neurobehavioural tests, including the cognitive ability screening instrument and the mini-mental state examination, gradually improved and eventually became normal. Although no further toluene exposure was noted, non-specific symptoms reappeared whenever the subject smelled automotive exhaust fumes or paint, or visited a petrol station, followed by anxiety with sleep disturbance. During hospitalization for a toluene provocation test, there was no difference between pre-challenge and post-challenge PaCO(2), PaO(2), SaO(2) or pulmonary function tests, except some elevation of pulse rate. The clinical manifestations suggested that MCS was more relevant to psychophysiological than pathophysiological factors.     

Time courses of sensory irritations due to 2-butanone and ethyl benzene exposure: influences of self-reported multiple chemical sensitivity (sMCS)

The individually different effects of exposure to comparable levels of chemicals might be partly explained by dissimilar response sensitivity towards chemicals. Multiple chemical sensitivity (MCS) might be the clinical endpoint of this altered sensitivity. Concerning a subclinical range of chemical sensitivity, 'challenge studies' with people reporting chemical sensitivity are needed to improve the knowledge about such differences. The chemical and general environmental sensitivity questionnaire (CGES) is a standardized screening tool for the selection of this group. In the present study 24 healthy male volunteers, half of them classified as sMCS-subjects, were experimentally exposed to 2-butanone and ethyl benzene at different levels (TLV-level vs. odor threshold). The strength of self-reported sensory irritations (nasal and ocular) and symptoms of bad smell were assessed, prior, during, and after the 4 hours of exposure. The time courses of sensory irritations were affected by sMCS. Across all exposure periods sMCS-subjects showed increasing symptom scores while control-subjects did not. Symptoms of bad smell were affected by three exposure-related factors (substance, level, duration) without any additional influence from the sMCS factor. Starting from these results it could be concluded that the time-depending influence of reported chemical sensitivity is most prominent for subjective data of sensory irritations.     

Trait anxiety and modeled exposure as determinants of self-reported annoyance to sound, air pollution and other environmental factors in the home

Objectives We examined to what degree annoyance ratings to noise, air pollution and other common environmental factors in the home environment could be considered to mirror personality disposition in terms of habitual anxiety level and, when appropriate, objectively modeled noise and nitrogen emission (NOx). Methods A trait anxiety scale was introduced in a cross-sectional public health survey with 2,856 respondents. Of these, 705 had self-reported asthma and the rest constituted gender-matched referents. Annoyance to ten specific factors in the residential environment, mainly focusing on source-specific noise and air pollution, was assessed on a six-point likert scale. A-weighted energy equivalent continuous sound pressure level during a full day (24 h; L _Aeq,24) as well as annual average NOx levels (μg/m³) at the residential address were modeled with high resolution, using a road data base and a detailed emission data base for NOx. Results The two most prevalent complaints were annoyance to traffic noise and sounds from neighbors, which was reported by about 8% of the participants. Unadjusted logistic regression analyses using the continuous trait anxiety score as a predictor showed positive associations with ratings of annoyance from total traffic noise, sounds from neighbors, sound from ventilation, exhaust fumes from traffic, sounds from other installations, and vibrations from traffic (ORs between 1.37 and 2.14). Modeled noise and NOx exposure were positively related with annoyance to traffic noise and exhaust fumes, respectively. Adjustment of the trait anxiety scores for other individual characteristics and potential determinants did not change the overall pattern of results. Conclusion Trait anxiety scores were often mirrored in ratings of annoyance, which suggests caution when using annoyance reports either as a surrogate measure for environmental exposure on the individual-level in epidemiologic studies or when studying the moderating effects of annoyance on health outcomes.     

Subjective and objective signs of organic solvent toxicity among occupationally exposed workers. An experimental evaluation

A questionnaire consisting of 55 items concerning acute and long-term symptoms associated with exposure to organic solvents, as well as questions about type and duration of exposure, was distributed to 225 male spray painters in the Stockholm region. From the 152 respondents, two extreme groups were selected on the basis of frequency of solvent-related symptoms. Subjects for the experimental study (N = 26) were chosen from these groups and matched with respect to age and number of years employed as a painter. The subjects were experimentally exposed for 4 h to 3.2 mmol/m3 (300 mg/m3) of toluene and a control condition in an exposure chamber. Effects on performance were assessed with a computerized battery of four tests. Ratings of acute symptoms were also studied, and toluene exposure was found to affect them. However, there were no indications of toluene effects on performance, nor was there any correlation between symptom frequencies and performance levels. The only difference found between the two groups was a higher frequency of symptoms of local irritation in the group which had reported high symptom frequencies on the questionnaire.     

Neurobehavioral and respiratory symptoms of formaldehyde and xylene exposure in histology technicians

Disturbances of memory, mood, equilibrium, and sleep that occurred simultaneously with headache and indigestion, were experienced more frequently among women working in histology who had daily exposure to formaldehyde, xylene, and toluene than in unexposed female clerical workers working in the same hospitals. Neurobehavioral symptoms were accompanied by irritation of eyes, upper airways, and trachea. Formaldehyde exposure correlated better with neurobehavioral symptoms and with respiratory and mucous membrane symptoms than did exposure to xylene/toluene or to other agents.     

Passive smoking: Irritating effects of the total smoke and the gas phase

Summary In a ventilated climatic chamber 32 subjects (in groups of two or three) were exposed in one experiment to the total sidestream smoke of cigarettes and in another experiment to the gas phase of cigarette smoke, which was obtained by filtering out the particulate matter. The degree of air pollution corresponded to 10 ppm CO in both experiments. The concentrations of the particulate matter, CO, NO, NO₂ and HCHO were recorded. With a questionnaire, we determined the degree of annoyance and of subjective irritations of the eyes, nose and throat; eye blink rate was measured, as an objective indicator of eye irritation.Both exposures of air pollution produced nearly the same degree of annoyance, which indicates that the gas phase is to a large extent responsible for the annoyance due to cigarette smoke. On the other hand the objective and subjective eye irritation was very much lower with the gas phase than with the total smoke. This indicates that the particulate phase is to a very large extent responsible for the irritating effects.     

Human response to varying concentrations of toluene

Thirty two males and 39 females aged 31-50 were exposed for 7 h to one of the three following conditions: (1) Clean air, (2) constant exposure to 100 ppm toluene, or (3) a varying exposure with the same time-weighted average, but with peaks of 300 ppm every 30 min. During exposure the subjects exercised in three 15-min periods with a load of 50 to 100 W. Exposure to toluene caused significant (P less than 0.05) complaints about poor air quality, altered temperature and noise perception, increased irritation in the nose and the lower airways, feeling of intoxication, and there were tendencies (P less than 0.1) towards irritation in the throat, headache and dizziness. In the four performance tests there was a tendency towards a lower score in a vigilance test while no effect of toluene exposure was seen in a peg board test, a five choice serial reaction test, or a colour test, indicating only minimal if any effect on the psychomotor or visual performance. There was no difference in the acute effects caused by the exposure containing peak concentrations and by the constant exposure.     

Response of solvent-exposed printers and unexposed controls to six-hour toluene exposure

The acute effects of toluene were studied in 43 male printers and 43 control subjects matched according to sex, age, educational level, and smoking habits. The mean age of the subjects was 36 (range 29-50) years. The printers had been exposed to solvents for 9 to 25 years during employment at flexo and rotogravure printing plants, while the controls had no history of solvent exposure. Each subject was exposed once in a climate chamber to either 100 ppm of toluene or clean air for 6.5 h preceded by a 1-h acclimatization period. The effects of toluene were measured from subjective votes with linear analogue rating scales on 16 items, and on the performance of 10 different tests measuring psychomotor skills, perceptual skills, and vigilance. Exposure to 100 ppm of toluene compared with exposure to clean air caused discomfort with complaints of low air quality, strong odor, fatigue, sleepiness, a feeling of intoxication, and irritation of the eyes, nose and throat. Furthermore, the subjects exposed to toluene showed decreased manual dexterity, decreased color discrimination, and decreased accuracy in visual perception. There was no significant difference in the effects of toluene on printers compared to those of toluene on controls, but tendencies toward a greater sensitivity were seen for the printers in two tests.