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Clinical Detection of Exposure to Chemical Warfare Agents *
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Benedict R. Capacio, J. Richard Smith, Robert C. diTargiani, M. Ross Pennington, Richard K. Gordon, Julian R. Haigh, John R. Barr, Brian J. Lukey, Daniel Noort
At normal room temperatures (25°C), phosgene is a fuming liquid with a boiling point of 47°F and a vapor pressure of 1.6 atm at the boiling point. The gas is heavier than air with a relative density of 4.39 at 20°C. This density leads to collection of phosgene gas in low-lying areas. The odor of phosgene is somewhat sweet and resembles that of freshly cut grass or hay. At higher concentrations, the odor of phosgene becomes pungent or burning and causes rapid olfactory fatigue (Borak and Diller, 2001).
Formaldehyde
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
William J. Rea, Kalpana D. Patel
In some individuals, sensitivity to “low concentrations” can cause a reaction, resulting in an exacerbation of the symptoms of the chemically sensitive. The health effects of acute exposure to gaseous formaldehyde at low or moderate concentrations include eye, nose, and throat irritation; olfactory fatigue; thirst; headaches; dizziness; lethargy; inability to concentrate; paranoia; irritability; disturbed sleep, moodiness; crying without cause; a crawling sensation of the skin; and hemicorporeal elevation of body temperature. Chronic exposure to formaldehyde can cause chronic rhinitis, chronic pharyngitis, hypertrophic or subatrophic nasal mucosa, and subatrophic or atrophic pharynx.125 “Toxicity” was reported in the Wisconsin Epidemiology Bulletin in February 1979.126 Eighty-seven cases were reported in 56 houses where the mean formaldehyde level was 0.88 ppm, with a range of 0.02–4.15 ppm. Symptoms were reported as eye irritation (69%), upper respiratory irritation (53%), lower respiratory difficulty (26%), headache (25%), and fatigue (20%). Harris125 reported similar symptoms in 48 occupants of UF-insulated homes. They pointed out that allergic or sensitized individuals may have severe reactions to formaldehyde levels below odor threshold, which has been our experience at the EHC-Dallas in over 5000 inhaled challenges.
Intramuscular cobinamide versus saline for treatment of severe hydrogen sulfide toxicity in swine
Published in Clinical Toxicology, 2019
Patrick C. Ng, Tara B. Hendry-Hofer, Norma Garrett, Matthew Brenner, Sari B. Mahon, Joseph K. Maddry, Philippe Haouzi, Gerry R. Boss, Thomas F. Gibbons, Allyson A. Araña, Vikhyat S. Bebarta
As a byproduct of industrial processes, H2S occurs naturally in crude petroleum and natural gas. It has a rotten egg smell, but olfactory fatigue often occurs; hence, the smell is an unreliable tool for detecting the gas which can result in fatal exposure [6,7]. Exposure to H2S may rapidly produce dyspnea, confusion, nausea and vomiting, hypotension and loss of consciousness, seizures, and death [6,7]. The mechanism by which H2S causes toxicity is via inhibition of cytochrome C oxidase in complex IV of the electron transport chain; similar to cyanide [7–9]. Much like current FDA approved antidotes for cyanide poisoning, treatment recommendations for H2S exposure are aimed at binding H2S and accelerating elimination. To date, there are no FDA approved antidotes to H2S poisoning but research is ongoing.