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Chemicals that affect the CNS often do so by interfering with neurotransmitters (the chemicals needed to transmit nerve impulses). Examples are metals like lead and mercury, organophosphate pesticides and organic solvents (Table 2). Lead and mercury do not just affect the nervous system, but also affect the kidney and gut. Mercury also affects the lungs and lead affects the reproductive system. These effects are important not only because of their nature, but also because so many workers are exposed to lead and organic solvents.

The type of effects, and whether they are likely to improve or persist, depend on the degree and duration of exposure to a chemical. In the case of organic solvents, the World Health Organisation divides the effects of exposure into three groups, according to their severity: Type 1, organic affective syndrome, leading to irritability, tiredness, difficulty in concentrating; Type 2, mild chronic toxic encephalopathy producing Type 1 effects, but more pronounced; and Type 3, severe chronic toxic encephalopathy, resulting in memory loss and dementia.

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