Liquid Mosquito Repellent Ingestion in Children.

OBJECTIVES: Hydrocarbons are a common cause of accidental poisoning in children, with kerosene being the most implicated agent in rural parts of India. However, lately, liquid mosquito repellent ingestion is emerging as an important cause of hydrocarbon (kerosene) poisoning in urban households. METHODS: This is a retrospective case series over a 5-y period (January 2013 - December 2017) of children with accidental liquid mosquito repellent ingestion presenting to the pediatric emergency. Epidemiology, clinical profile, management and outcomes are discussed. RESULTS: Twenty-three children with median (IQR) age of 24 (18.8-32) mo presented after mean (SD) interval of 6 (3) h from ingestion. Majority (20, 87%) were seen during summer months (March-June) and all were from urban background. Sixteen (70%) had mild-moderate acute respiratory distress syndrome (ARDS) requiring supplemental oxygen with or without positive airway pressure for a mean (SD) duration of 3.3 (1.9) d. All except one survived. CONCLUSIONS: Children with accidental liquid mosquito repellent ingestion had predominant aspiration pneumonitis due to hydrocarbon content rather than neurological complications attributable to synthetic pyrethroids. Ensuring child-proof containers, appropriate storage, regulatory surveillance and parental awareness are must for prevention.

Hydrocarbon Enema: An Unusual Cause of Chemical Burn.

Hydrocarbons are a wide-ranging group of flammable chemicals and are often used in suicide attempts either by ingestion or as an accelerant in self-immolation. In this case study, we present a 37-year-old female who suffered 6% TBSA partial-thickness burns to her perineum and buttocks, which she claims resulted from diarrhea after ingesting a bottle of lighter fluid. The patient underwent decontamination and medical treatment for her burns and during her inpatient stay, it became apparent that the burns were more likely sustained from an intentional rectal administration of lighter fluid. To our knowledge, this is one of the first reported cases of hydrocarbon enema. We review hydrocarbon poisoning, including both ingestion and dermal exposure, and discuss medical management.

Evaluation and Monitoring of a Child With Hydrocarbon Pneumonitis Using Point-of-Care Lung Ultrasound in the Pediatric Emergency Department.

A well-appearing 3-year-old boy presented to the pediatric emergency department 2 hours after a presumed hydrocarbon ingestion. He was referred to the emergency department by his pediatrician after consultation with the local poison control center after possibly ingesting ylang ylang (Cananga odorata) fragrance oil. The child was asymptomatic with a normal physical examination. Point-of-care lung ultrasound identified focal hydrocarbon pneumonitis in the right lung and demonstrated resolution of these findings. Utilization of point-of-care ultrasound resulted in a shorter emergency department length of stay and the avoidance of radiation exposure from serial chest x-rays.

La exposición a las mareas negras y sus efectos en la salud / Health effects of exposure to oil spills

El naufragio del petrolero Prestige frente a las costas gallegas no sólo supuso el mayor desastre ecológico en la historia de nuestro país, sino que también propició la exposición de miles de personas que participaron en la limpieza de las zonas contaminadas a compuestos potencialmente tóxicos para la salud. Teniendo en cuenta que la vía respiratoria es una de las principales puertas de entrada de estos compuestos en el organismo, los posibles efectos de estos vertidos preocupan especialmente a los profesionales que nos dedicamos a las enfermedades respiratorias. Sin embargo, la información clínica que tenemos es manifiestamente insuficiente. Por tal motivo se ha elaborado esta revisión. En ella se analizan los estudios científicos realizados a propósito de otros naufragios de petroleros. Finalmente se exponen los datos clínicos y epidemiológicos de las investigaciones publicadas hasta la fecha con ocasión del hundimiento del buque Prestige

The sinking of the oil tanker Prestige off the coast of Galicia was not only the worst ecological disaster ever to affect Spain, it also led to thousands of people who participated in the cleanup of the contaminated areas being exposed to potentially dangerous toxic substances. As the airway is one of the principal routes of entry into the body of these toxic compounds, the possible effects of exposure to such spills is of particular interest and concern to respiratory specialists. The paucity of clinical information available on the subject was the motive for this paper, which reviews the scientific studies undertaken in the aftermath of other accidents involving oil tankers and concludes with a summary of the clinical and epidemiological data published to date on the Prestige oil spill

Effect of petroleum-containing wastewater irrigation on bacterial diversities and enzymatic activities in a paddy soil irrigation area.

Effects of petroleum contamination on bacterial diversities and enzymatic activities in paddy soils were investigated in the Shenfu irrigation area, the largest area irrigated by oil-containing wastewater for more than 50 yr in northeastern China. Bacterial diversities were determined by conventional colony morphology typing techniques and 16S rDNA polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE). Dehydrogenase, hydrogen peroxidase, polyphenol oxidase, urease, and substrate-induced respiration (SIR) were measured to evaluate the effects of petroleum-containing wastewater irrigation on soil biochemical characteristics. Results showed that paddy soil total petroleum hydrocarbon (TPH) concentration in the irrigation area varied from 277.11 to 5213.37 mg kg(-1) dry soil. Soil TPH concentration declined along the gradient of the irrigation channel from up- to downstream. At the current pollution level, the paddy soil TPH concentration was positively correlated with the colony forming units (CFU) of aerobic heterotrophic bacteria (AHB) (r = 0.928, p < 0.001) and the genetic diversity based on DGGE profiles (r = 0.655, p < 0.05). The bacterial diversities in the soils based on colony morphotypes of AHB also increased with TPH concentration (r = 0.598), but not significant statistically (p = 0.052). Analysis of soil enzyme activities indicated a significant positive correlation between soil TPH concentration and activities of dehydrogenases (r = 0.974, p < 0.001), hydrogen peroxidases (r = 0.957, p < 0.001), polyphenol oxidases (r = 0.886, p < 0.001), and SIR (r = 0.916, p < 0.001). On the contrary, the urease activity showed a negative correlation with paddy soil TPH concentration (r = -0.814, p = 0.002), and could be used as a sensitive indicator of petroleum contamination.

Hepatic CYP1A levels and EROD activity in English sole: biomonitoring of marine contaminants in Vancouver Harbour.

To assess chemical contaminant stress in the marine environment, ethoxyresorufin-O-deethylase (EROD) activity and cytochrome P450 1A (CYP1A) expression were measured in 88 English Sole (Pleuronectes vetulus) collected during May and June 1999 from four sites in Vancouver Harbour and at an expected reference site outside the harbour. Hepatic microsomes were prepared from the fish and analyzed for total CYP content, EROD activity, and CYP1A protein levels. Hepatic EROD activity and CYP1A protein levels were elevated in fish from two sites in the inner harbour. A comparison with sediment chemistry data showed that fish with increased EROD activity and CYP1A levels came from sites containing relatively high levels of polycyclic aromatic hydrocarbons and polychlorinated biphenyls. Unexpectedly high levels of EROD activity and CYP1A protein were also found in fish from a reference site near Gibsons, in Howe Sound. The elevated EROD activity and CYP1A expression in fish from this site cannot be explained by the chemical analysis data collected.

Indirect effects of contaminants in aquatic ecosystems.

Contaminants such as petroleum hydrocarbons, heavy metals and pesticides can cause direct toxic effects when released into aquatic environments. Sensitive species may be impaired by sublethal effects or decimated by lethality, and this ecological alteration may initiate a trophic cascade or a release from competition that secondarily leads to responses in tolerant species. Contaminants may exert direct effects on keystone facilitator and foundation species, and contaminant-induced changes in nutrient and oxygen dynamics may alter ecosystem function. Thus, populations and communities in nature may be directly and/or indirectly affected by exposure to pollutants. While the direct effects of toxicants usually reduce organism abundance, indirect effects may lead to increased or decreased abundance. Here we review 150 papers that reference indirect toxicant effects in aquatic environments. Studies of accidental contaminant release, chronic contamination and experimental manipulations have identified indirect contaminant effects in pelagic and benthic communities caused by many types of pollutants. Contaminant-induced changes in behavior, competition and predation/grazing rate can alter species abundances or community composition, and enhance, mask or spuriously indicate direct contaminant effects. Trophic cascades were found in 60% of the manipulative studies and, most commonly, primary producers increased in abundance when grazers were selectively eliminated by contaminants. Competitive release may also be common, but is difficult to distinguish from trophic cascades because few experiments are designed to isolate the mechanism(s) causing indirect effects. Indirect contaminant effects may have profound implications in environments with strong trophic cascades such as the freshwater pelagic. In spite of their undesirable environmental influence, contaminants can be useful manipulative tools for the study of trophic and competitive interactions in natural communities.

Water pollution and habitat degradation in the Gulf of Thailand.

The Gulf of Thailand has been a major marine resource for Thai people for a long time. However, recent industrialization and community development have exerted considerable stress on the marine environments and provoked habitat degradation. The following pollution problems in the Gulf have been prioritized and are discussed in details: (1) Untreated municipal and industrial waste water are considered to be the most serious problems of the country due to limited waste water treatment facilities in the area. (2) Eutrophication is an emerging problem in the gulf of Thailand. Fortunately, the major species of phytoplankton that have been reported as the cause of red tide phenomena were non-toxic species such as Noctiluca sp. and Trichodesmium sp. (3) Few problems have been documented from trace metals contamination in the Gulf of Thailand and public health threat from seafood contamination does not appear to be significant yet. (4) Petroleum hydrocarbon residue contamination is not a problem, although a few spills from small oil tankers have been recorded. A rapid decrease in mangrove forest, coral reefs, and fisheries resources due to mismanagement is also discussed.

The impact of the 1993 Braer oil spill on grey seals in Shetland.

Signs of acute respiratory distress were reported in moulting grey seals (Halichoerus grypus) hauled out on Lady's Holm, Shetland, following the Braer oil spill in January, 1993. Behavioural observations carried out between 16 January and 13 February 1993 showed that the proportion of animals exhibiting a discharge of nasal mucus was significantly higher than the proportion at a control site in the north (Papa Stour). The proportion of animals affected on Lady's Holm increased for up to one month following the spill. However, the time lag between exposure and peak response was approximately 30 days, longer than may be expected for an acute effect. The proportion of non-specific signs of respiratory distress in unexposed Shetland seals was assessed from observations made between 16 January and 25 January 1994. Symptoms similar to those seen in 1993 were also reported during this period, but the proportion of affected animals was higher in 1993. Symptoms were not observed at a grey seal moult site on the east coast of England in March 1993 and 1994. Grey seals moulting in Shetland during the time of the oil spill may have been acutely affected by exposure to hydrocarbons, but without sufficient baseline data on the occurrence of respiratory distress in grey seals it is difficult to determine the proportion attributable to other causes.

Retrospective benzene and total hydrocarbon exposure assessment for a petroleum marketing and distribution worker epidemiology study.

A quantitative exposure-estimating algorithm for benzene and total hydrocarbons was developed for a case control study of petroleum marketing and distribution workers. The algorithm used a multiplicative model to adjust recently measured quantitative exposure data to past scenarios for which representative exposure measurement data did not exist. This was accomplished through the development of exposure modifiers to account for differences in the workplace, the materials handled, the environmental conditions, and the tasks performed. Values for exposure modifiers were obtained empirically and through physical/chemical relationships. Dates for changes that altered exposure potential were obtained from archive records, retired employee interviews, and from current operations personnel. Exposure modifiers were used multiplicatively, adjusting available measured data to represent the relevant exposure scenario and time period. Changes in exposure modifiers translated to step changes in exposure estimates. Though limited by availability of data, a validation exercise suggested that the algorithm provided accurate exposure estimates for benzene (compared with measured data in industrial hygiene survey reports); the estimates generally differed by an average of less than 20% from the measured values. This approach is proposed to quantify exposures retrospectively where there are sufficient data to develop reliable current era estimates and where a historical accounting of key exposure modifiers can be developed, but where there are insufficient historic exposure measurements to directly assess historic exposures.

Toxicopathology of oilfield poisoning in cattle: a review.

The toxicologic pathology of petroleum and oilfield-related chemicals is reviewed, and a field guide for toxicopathologic evaluation of cattle is given. Cattle will voluntarily ingest petroleum and chemicals used in the exploration, production and transportation of crude petroleum. Variability in chemical composition of petroleum from different fields will alter the type and severity of lesions observed. When airborne pollutants are present, cattle are continually exposed and make excellent sentinel animals. The lung, kidney, liver, gastrointestinal tract, heart and brain are target organs for petroleum hydrocarbons. Exposure to elemental sulfur can produce pulmonary pathology. Sulfur-containing gases are irritating to the mucosa of the eye and respiratory tract. Arsenic and lead cause lesions in the gastrointestinal tract, brain, liver and kidney. Glycols are hepato-, nephro- and neurotoxic, and oral exposure to diethylene glycol produces corneal lesions. Invert drilling fluids are fetotoxic. Nonpesticide organophosphate esters target the peripheral and central nervous systems. Toxicopathy is a strategic tool in the diagnosis of intoxications occurring in cattle after exposure to oilfield chemicals. Cattle are sensitive to oilfield pollutants and are a useful biomonitoring species.

Benefits of extracorporeal membrane oxygenation for hydrocarbon pneumonitis.

OBJECTIVE: To review the therapeutic benefits of extracorporeal membrane oxygenation for the management of hydrocarbon pneumonitis. METHODS: A search of the medical literature was conducted through Medline and the bibliographies of relevant articles and a search of patient databases maintained by the Extracorporeal Life Support Organization and the American Association of Poison Control Centers was performed. All articles and case reports on the use of extracorporeal membrane oxygenation in patients with hydrocarbon pneumonitis were selected. The data were abstracted without judgments about study design. RESULTS: There is some evidence that pulmonary parenchymal tissue can recover from hydrocarbon pneumonitis, but the degree of injury and recovery are variable. In the Extracorporeal Life Support Organization Registry 19 children with hydrocarbon pneumonitis were treated with extracorporeal membrane oxygenation during 1985 to 1994 and 68% survived compared to the 52% overall survival of 883 pediatric cases who had a diagnosis of a respiratory condition. A review of the American Association of Poison Control Centers data for 1993 and 1994 identified five cases of hydrocarbon pneumonitis in which extracorporeal membrane oxygenation was used and two survived. There are two full case descriptions in the literature with both children surviving, but one child developed persistent moderate left hemiparesis and seizure activity. CONCLUSIONS: The need for extracorporeal membrane oxygenation is rare owing to the generally good outcome of most cases of hydrocarbon ingestions and pneumonitis. Only with further research on the nature and clinical course of severe hydrocarbon pneumonitis, refinement of extracorporeal membrane oxygenation criteria, and evaluation of alternative therapies, will the benefits of extracorporeal membrane oxygenation be better defined.

[Poisoning with petroleum preparations--again!]. / Forgiftning med petroleumspraeparater--igen!

Accidentally occurring hydrocarbon poisoning during early childhood is a frequent and in most cases benign event. Nevertheless there is a potential risk of more serious consequences. We describe such a case. Respiratory symptoms are of the greatest concern. They include cough, tachypnoea, and in the more serious cases cyanosis and respiratory failure. Moreover, symptoms from the gastrointestinal tract are common. Treatment includes prevention of aspiration, symptomatic treatment and in more serious cases respiratory support.

[Effect of pollen extract (Cernitin) on the course of poisoning with organic solvents (biochemical analysis)]. / Wplyw wyciagów z pylków kwiatowych (preparat Cernitin) na przebieg zatrucia rozpuszczalnikami organicznymi (analiza biochemiczna).

The aim of the study has been to experimentally estimate the chronic exposure of selected biochemical parameters of serum and microsomal level fraction in animals to a mixture of organic solvents. An attempt was made to alleviate the eventual changes by applying Cernitin preparation. The experiment was performed on male rats, Wistar strain. The rats were exposed to the organic solvents in a toxicological chamber with controlled parameters. Cernitin preparation was added to standard diet, being given to the animals in the form of balls. The biochemical investigations were carried out after a lapse of 3 and 6 month exposition. The range of the accomplished studies included: activity of enzymes (AspAT, AlAT, AP, ChE) bilirubin level and lipids content in blood serum. Lipids content was determined in liver homogenate. The content of protein, cholesterol, phospholipids and free fatty acids, was studied in liver microsomes. It has been shown that protracted exposure to the mixture of organic solvents elicits an increase in the activity of the studied aminotransferases and alkaline++ phosphatase, as well as a decrease in the activity of cholesterase. The changes in activity are accompanied by a rise in the content of lipids. Cernitin preparation used prophylactically normalizes impairments affecting the studied enzymatic and lipid parameters.

Death following crude oil aspiration.

This is a report on three deaths following oil aspiration by workers in petrol tankers. Lung aspiration was demonstrated by the presence of a yellowish-brown material in the alveolar spaces, which was difficult to identify by optic microscopy. Volatile hydrocarbons from petroleum were identified in lung samples by gas chromatography/mass spectrometry.

Toxicology of selected pesticides, drugs, and chemicals. Petroleum distillates and turpentine.

Companion animal exposures to volatile hydrocarbons and turpentine accounted for 2% of all calls received by the IAPIC in 1987. Volatile hydrocarbons are also used as vehicle solvents (e.g., pesticides), and both vehicle and active ingredients pose a significant hazard to companion animals. The most significant clinical effects of the hydrocarbons are related to aspiration pneumonia. The likelihood of aspiration is generally related to the compound's viscosity, with more volatile and most widely available compounds posing the greatest risk. Treatment generally is conservative. Gastrointestinal decontamination methods (e.g., emetics and activated charcoal administration) are used only in massive ingestions or when other toxicants are present in conjunction with the hydrocarbons. Oxygen therapy and cage rest are recommended for the dyspneic animal. Close monitoring of an exposed animal and symptomatic care as needed are also recommended for at least 12 hours after exposure.

[Effect of essential phospholipids (EPL) on the course of chronic poisoning with organic solvents in rats]. / Wplyw niezbednych fosfolipidów (EPL) na przebieg przewleklego zatrucia rozpuszczalnikami organicznymi u szczurów.

Male Wistar rats were exposed in toxicological camera to the mixture of organic solvents. Composition and concentrations of the mixture were similar to the conditions in the production hall. The influence of essential phospholipids (EPL) on changes in the liver caused by the organic solvents were studied. Animals were exposed for 6 months. Histochemical and histological evaluation was performed after 2 and 6 months. In the liver of intoxicated animals marked vacuolar degeneration and diminution of glycogen contents were observed. Simultaneously, the protective effect of EPL was noted. It was expressed by distinctly decreased vacuolar degeneration, probably corresponding to neutral fat in hepatocytes as well as by normalization of glycogen contents.

Health implications of petroleum distillate ingestion.

The authors discuss the clinical approach to the management of hydrocarbon ingestions, including the role, implementation, and type of gastric decontamination utilized; the extent of medical evaluation, observation or hospitalization required; and the appropriate therapy for hydrocarbon pneumonitis. An appendix covers myocardial sensitization following inhalation abuse of hydrocarbons.