chemical pneumonitis

Etiology: 1) acid fumes: H2SO₄, HNO3 a) acute toxicity - mucous membrane irritation followed by chemical pneumonitis in 2-3 days b) chronic exposure: no data c) epidemiology: - manufacture of fertilizers, chlorinated organic compounds, dyes, explosives, rubber products, metal etching, plastics 2) ammonia a) acute toxicity - mucous membrane irritation followed by chemical pneumonitis in 2-3 days b) chronic exposure: chronic bronchitis c) epidemiology: - refrigeration, petroleum refining, manufacture of fertilizers, explosives, plastics & other chemicals 3) cyanides a) acute toxicity - tachypnea followed by respiratory arrest - lactic acidosis - pulmonary edema - death b) chronic exposure: no data c) epidemiology: - electroplating - extraction of gold or silver - manufacture of mirrors, fumgigants, photo supplies 4) diazomethane a) acute toxicity - violent coughing, dyspnea, wheezing, pulmonary edema b) chronic exposure: no data c) epidemiology: laboratory workers, methylating agent 5) halogens (fluorine, chlorine, bromine) 1) acute toxicity - mucous membrane irritation, pulmonary edema possible reduced FVC 1-2 years after exposure 2) chronic exposure: - dryness of mucous membranes, epistaxis, dental fluorosis, tracheobronchitis 3) epidemiology: - bleaching in pulp, paper or textile industry, manufacture of chemical compounds, synthetic rubber, plastics, disinfectant, rocket fuel, gasoline 6) formaldehyde a) acute toxicity - mucous membrane irritation followed by chemical pneumonitis in 2-3 days b) chronic exposure: cancer in laboratory animals c) epidemiology: - manufacture of resins, leathers, rubber, metals & wood, laboratory workers (fixative), embalmers, emission from urethane foam insulation 7) hydrogen sulfide a) acute toxicity: - low level exposure: conjunctival irritation - high level exposure: respiratory paralysis b) chronic exposure: chronic bronchitis, recurrent pneumonitis c) epidemiology: - by-product of many industrial processes, petroleum processes & storage 8) isocyanates a) acute toxicity: - mucous membrane irritation, dyspnea, cough, wheezing, pulmonary edema b) chronic exposure: - upper respiratory tract irritation, cough, asthma, allergic alveolitis c) epidemiology: - production of polyurethane foams, plastics, adhesives, surface coatings 9) nitrogen dioxide a) acute toxicity: - cough, dyspnea, pulmonary edema may be delayed 4-12 hours, bronchiolitis obliterans in 2-6 weeks (possible) b) chronic exposure: emphysema in animal models c) epidemiology: - silage, metal etching, explosives, racket fuels, welding, by-product of burning fossil fuels 10) ozone a) acute toxicity: - mucous membrane irritation, pulmonary hemorrhage & edema, diminished pulmonary function (transient) in individuals exposed to summer smog b) chronic exposure: chronic eye irritation c) epidemiology: - arc welding, flour bleaching, deodorizing, emissions from copying equipment, photochemical air pollutant 11) phosgene a) acute toxicity: - delayed onset of bronchiolitis & pulmonary edema b) chronic exposure: chronic bronchitis c) epidemiology: - metallurgy, chemical workers (volatile chlorine-containing compounds) 12) phthalic anhydride a) acute toxicity: - nasal irritation, cough b) chronic exposure: asthma, chronic bronchitis c) epidemiology: - manufacture of resin esters, polyester resins, thermoactivated adhesives 13) sulfur dioxide a) acute toxicity: - mucous membrane irritant, epistaxis b) chronic exposure: chronic bronchitis (possible) c) epidemiology: - manufacture of sulfuric acid, bleaches, coating of metals (non-ferrous), food processing, refrigerant, burning of fossil fuels, wood pulp industry

References

Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1182