Air bags: Lifesaving with toxic potential?

Abstract

Federal Motor Vehicle Safety Standard No. 208, “Occupant Crash Protection”, requires that all passanger cars manufactured after September 1, 1989 be equipped with automatic crash protection. Car manufacturers met this requirement by installing automatic safety belts or air bags. No chemical injuries have been reported as a result of airbag deployment in motor vehicle accidents (MVA). A 6-month retrospective study was conducted to evaluate the toxic effects of the white powdery residue from air bags, a combination of talc and sodium hydroxide, found in the driver compartment after an MVA. The study reviewed time to onset of symptoms, symptomatology, and treatment. The study included seven patients exposed to deployed air bags after an MVA. Four cases resulted in dermal burns and three patients were diagnosed with unrelated injuries. Three patients presented to an emergency department within 48 hours of the exposure complaining of burns to the skin. Two patients attempted home therapy but became concerned when the symptoms did not subside. One patient was discharged with the diagnosis of first degree burns of the chin and left hand. Another patient experienced bilateral hand erythema and blisters. Standard burn therapy was instituted in both instances. A third patient arrived 1 hour post-exposure to the emergency department complaining of a burning sensation to the hands, but the skin appeared normal. Thorough irrigation was initiated and Silvadene (Marion, Kansas City, MO) applied. One patient notified the poison center 1 hour post-exposure complaining of erythema and burning to his hands after an MVA. Vehicle air bag restraint systems are a new phenomenon that can result in dermal injury due to the presence of sodium hydroxide. All cases were treated symptomatically and recovered without significant effect. Although automobile safety air bags are a reliable, proven method of occupant protection against severe injury in an MVA, they are associated with at least minor corrosive toxicity. We recommend that all patients exposed to deployed air bags have thorough skin irrigation to decrease the potential for dermal irritation or burns.