Respiratory Irritation Symptoms Research Articles

Case report: Mixed hydrofluoric and nitric acid mist inhalation poisoning

IntroductionHydrofluoric and nitric acids are strongly acidic substances with strong oxidation and are widely used in industrial production. Chemical pneumonia caused by the inhalation of strong acids has occasionally been reported. Severe chemical pneumonia can lead to acute pulmonary edema and life-threatening acute respiratory distress syndrome. The treatment of chemical pneumonia mainly relies on symptomatic and supportive treatment such as anti-inflammatory and anti-infection.Case descriptionThis study reports three cases of chemical pneumonia caused by the inhalation of a mixed hydrofluoric and nitric acid mist during an occupational exposure accident. After appropriate emergency symptomatic treatment, such as oxygenation and excretion promotion, cough, and difficulty in breathing were alleviated but not completely cleared.DiscussionMost of the literature reports damage caused by hydrogen fluoride on the skin and mucosal burns, and reports on lung damage caused by the inhalation of large amounts of hydrogen fluoride gas are relatively rare. Usually in the early stage of this kind of patients can have elevated blood picture, hypoxemia, pulmonary CT inflammatory plaque changes, so as to have obvious respiratory irritation symptoms. When inhaling a large amount of hydrofluorine mixed nitric acid mist, in addition to considering the occurrence of severe pneumonia, we should also be alert to the occurrence of other organ damage and electrolyte disorder.ConclusionAs occupational hydrogen fluoride gas inhalation poisoning often occurs in groups, improving the safety facilities and standard operations of small- and medium-sized enterprises is necessary. For medical workers, it is necessary to be alert to the occurrence of severe toxic pneumonia and severe fluorosis.

Analysis of health risk and respiratory complaints on footwear craftsman exposed to Toluene vapour.

Background: The primary effect of toluene on the respiratory tract following inhalation is irritation. This study was conducted to analyze the level of health risks and respiratory complaints due to toluene exposure by footwear craftsmen, in order to get scientific reference for Maximum Contaminant Level and working tenure restriction.Design and Methods: A total of 51 footwear craftsmen from eight factories participated in this study. The toluene concentration in the work environment was measured according to National Institute of Occupational Safety and Health 1501. Moreover, data were collected using an American Thoracic Society standardized questionnaire to assess respiratory health effects. A characterization of risk model was to analyze the toluene exposure risk and suggest improvements.Results: The results showed toluene levels were over the Threshold Limit Value 20 ppm (138.88 ppm). The most commonly observed respiratory symptoms included coughing by 81.3% and cold by 85.7%, Symptoms of respiratory irritation by 72.7%, higher among workers who were highly exposed to toluene above the median. This is observed from the opportunity value (P-value) of toluene exposure with the characteristics the workers of each variable which was less than 0.05 work station and working tenure. Maximum Contaminant Level of toluene is 4.59 ppm, a safe working tenure restriction for toluene exposure is maximum 25 years.Conclusions: The recommended risk control measures include ventilation improvements, personal hygiene and protection of workers through periodic physical examinations.Significance for public healthToluene levels over the Threshold Limit Value can cause irritative respiratory tract diseases. Therefore, it is recommended that workplaces are separated from domestic activities whenever possible and the workers are protected from unnecessary exposure. This study describes the level of health risks and respiratory complaints due to toluene exposure by footwear craftsmen in footwear industry.

Exposure Assessment For Air-To-Skin Uptake of Semivolatile Organic Compounds (SVOCs) Indoors.

Semivolatile organic compounds (SVOCs) are ubiquitous in the indoor environment and a priority for exposure assessment because of the environmental health concerns that they pose. Direct air-to-skin dermal uptake has been shown to be comparable to the inhalation intake for compounds with certain chemical properties. In this study, we aim to further understand the transport of these types of chemicals through the skin, specifically through the stratum corneum (SC). Our assessment is based on collecting three sequential forehead skin wipes, each hypothesized to remove pollutants from successively deeper skin layers, and using these wipe analyses to determine the skin concentration profiles. The removal of SVOCs with repeated wipes reveals the concentration profiles with depth and provides a way to characterize penetration efficiency and potential transfer to blood circulation. We used a diffusion model applied to surface skin to simulate concentration profiles of SVOCs and compared them with the measured values. We found that two phthalates, dimethyl and diethyl phthalates, penetrate deeper into skin with similar exposure compared to other phthalates and targeted SVOCs, an observation supported by the model results as well. We also report the presence of statistically significant declining patterns with skin depth for most SVOCs, indicating that their diffusion through the SC is relevant and eventually can reach the blood vessels in the vascularized dermis. Finally, using a nontarget approach, we identified skin oxidation products, linked to respiratory irritation symptoms, formed from the reaction between ozone and squalene.

Tropical Storm Harvey causes disruptions, emissions, and explosions in Houston area

As flood waters continue to rise, Storage facilities holding highly flammable organic peroxides at an Arkema plant in Crosby, Texas, began to explode early this morning, sending black smoke into the air. The facility and area around it had been evacuated and no serious injuries were reported. However, several first responders were treated for symptoms of respiratory irritation. The explosion was another setback for the storm-ravaged region of the Texas Gulf coast. By Aug. 30, Houston residents finally caught a glimpse of sunlight after nearly five days of record-breaking rain from Tropical Storm Harvey. But dangers still lurk in areas that remain underwater, as the Crosby explosion shows. Tens of millions of people in the Houston area have moved from their flooded homes to shelters. As the water recedes, state and federal officials, as well as refinery and chemical plant managers, will assess the damage. Many refineries and petrochemical facilities

Respiratory Symptoms due to Occupational Exposure to Formaldehyde and MDF Dust in a MDF Furniture Factory in Eastern Thailand.

The study aimed to investigate factors associated with respiratory symptoms in workers in a medium-density fiberboard (MDF) furniture factory in Eastern Thailand. Data were collected from 439 employees exposed to formaldehyde and MDF dust using questionnaire and personal sampler (Institute of Occupational Medicine; IOM). The average concentration of formaldehyde from MDF dust was 2.62 ppm (SD 367), whereas the average concentration of MDF dust itself was 7.67 mg/m3 (SD 3.63). Atopic allergic history was a factor associated with respiratory irritation symptoms and allergic symptoms among the workers exposed to formaldehyde and were associated with respiratory irritation symptoms and allergic symptoms among those exposed to MDF dust. Exposure to MDF dust at high level (>5 mg/m3) was associated with respiratory irritation symptoms and allergic symptoms. Excluding allergic workers from the study population produced the same kind of results in the analysis as in all workers. The symptoms were associated with the high concentrations of formaldehyde and MDF dust in this factory. If the concentration of MDF dust was >5 mg/m3, the risk of irritation and allergic symptoms in the respiratory system increased. The respiratory health of the employees with atopic allergic history exposed to formaldehyde and MDF dust should be monitored closely.

An examination of injuries and respiratory irritation symptoms among a sample of undergraduate chemistry students from a Public Northeastern University

Injuries have become an important indicator of safety and risks to health in the laboratory, but few studies have examined injuries among undergraduate chemistry students. Respiratory and mucous membrane irritation due to exposures were also important potential outcomes of present concern, because they were potentially related to factors such as physician-diagnosed asthma and smoking. The present study, with a cross-sectional design, implemented an anonymous online survey among a sample of students enrolled in general chemistry and first semester organic chemistry laboratory courses from a single northeastern university. Survey questions were assimilated from existing validated national surveys or developed (and approved by Institutional Review Boards) to obtain demographic information, acute injury status, respiratory irritation and mucous membrane irritation symptoms due to exposures in academic chemistry laboratories, physician-diagnosed asthma, primary active smoking, and secondary passive smoking. A Likert-scale was created to assess behavioral risk factors (BRF). A prepared recruitment email was sent to 1,704 undergraduate students enrolled in either general chemistry laboratory or organic chemistry laboratory in the winter–spring semester, 2012; 319 participants completed the online survey during the 27-day data collection period (response rate 18.7%). Two hundred and sixty-five valid records were analyzed. Prevalence of current semester injury (11%) and also current semester respiratory irritation (22%) in the winter–spring, 2012 semester were elevated. Analysis of variance models suggested gender, course of enrollment, birth year, and class standing were significantly related to BRF scores. Current semester injury and also current semester respiratory irritation during laboratory courses were not significantly related to BRF scores. Current semester respiratory irritation during laboratory courses was not significantly related to asthma after controlling for primary active and secondary passive smoking. Further applied research into undergraduate sciences laboratory safety and health evaluations are warranted.

Application of warming humidification oxygen therapy in patients with tracheotomy

Objective To investigate the application value of warming humidification oxygen therapy in patients after tracheotomy.Methods Forty-one patients after tracheotomy were collected consecutively for this study.All patients were randomly assigned into the treatment group (21 cases)and the control group (20 cases).The treatment group adopted warming humidification oxygen therapy,and the control group adopted common airway moistening method.Moist effect judgment,viscosity of sputum,phlegm scab formation,respiratory irritation symptoms,airway mucosal bleeding,air way resistance,lung infection cases,average days in the ICU were investigated.Results There were statistically significant differences in moist effect judgment,viscosity of sputum,phlegm scab formation,respiratory irritation symptoms,airway mucosal bleeding,air way resistance,lung infection cases,average days in the ICU between the two groups.Conclusions Warming humidification oxygen therapy is more suitable to patients with tracheotomy than common airway moistening method. Key words: Ttracheotomy; Warming humidification; Intensive care; Airway nursing

Ocular and Respiratory Symptoms Among Lifeguards at a Hotel Indoor Waterpark Resort

To determine the cause of eye and respiratory irritation symptoms among lifeguards at an indoor waterpark. Investigators 1) performed environmental sampling for chloramine, endotoxin, and microbials; 2) administered symptom questionnaires; 3) reviewed ventilation system designs; and 4) reviewed water chemistry. Airborne trichloramine concentrations were found at levels reported to cause irritation symptoms in other studies. Some endotoxin concentrations were found at levels associated with cough and fever in previous studies. Exposed lifeguards were significantly more likely to report work-related irritation symptoms than unexposed individuals. The ventilation system may not have provided sufficient air movement and distribution to adequately capture and remove air contaminants at deck level. No water microbes were detected, and water chemistry met state standards. Indoor waterparks need to control water chemistry and ensure adequate air movement and distribution to control air contaminants and reduce health symptoms.

Health impacts of exposure to second hand smoke (SHS) amongst a highly exposed workforce: survey of London casino workers

BackgroundCasino workers are exposed to high levels of secondhand smoke (SHS) at work, yet remain at risk of being excluded from smoke-free legislation around the world. If the prime motivation for smoke-free legislation is the protection of workers, then a workforce experiencing ill-health associated with SHS exposure should not be excluded from legislation. This study aimed to determine the prevalence of respiratory and sensory irritation symptoms among a sample of casino workers, to identify any association between the reporting of symptoms and exposure to SHS at work, and to compare the prevalence of symptoms with that in other workers exposed to SHS.MethodsA postal questionnaire survey of 1568 casino workers in London. Using multivariate analysis we identified predictors of respiratory and sensory irritation symptoms.Results559 workers responded to the questionnaire (response of 36%). 91% of casino workers reported the presence of one or more sensory irritation symptoms in the previous four weeks, while the figure was 84% for respiratory symptoms. The presence of one or more sensory irritation symptoms was most strongly associated with reporting the highest exposure to SHS at work (OR 3.26; 1.72, 6.16). This was also true for reporting the presence of one or more respiratory irritation symptoms (OR 2.24; 1.34, 3.74). Prevalence of irritation symptoms in the casino workers was in general appreciably higher than that reported in studies of bar workers.ConclusionOur research supports the need for comprehensive smoke-free legislation around the world, covering all indoor workplaces including casinos.

Case report: hydroquinone and/or glutaraldehyde induced acute myeloid leukaemia?

BackgroundExposures to high doses of irradiation, to chemotherapy, benzene, petroleum products, paints, embalming fluids, ethylene oxide, herbicides, pesticides, and smoking have been associated with an increased risk of acute myelogenous leukemia (AML). Although there in no epidemiological evidence of relation between X-ray developer, fixer and replenisher liquids and AML, these included glutaraldehyde which has weakly associated with lymphocytic leukemia in rats and hydroquinone has been increasingly implicated in producing leukemia, causing DNA and chromosomal damage, inhibits topo-isomerase II, alter hematopoiesis and inhibit apoptosis of neoplastic cells.Case presentationTwo white females (A and B) hired in 1985 as medical radiation technologists in a primary care center, in Greece. In July 2001, woman A, 38-years-old, was diagnosed as having acute monocytic leukaemia (FAB M5). The patient did not respond to therapy and died threeweeks later. In August 2001, woman B, 35-year-old, was diagnosed with acute promyelocytic leukaemia (FAB M3). Since discharge, she is in continuous complete remission. Both women were non smokers without any medical history. Shortly after these incidents official inspectors and experts inspected workplace, examined equipment, archives of repairs, notes, interviewed and monitored employees. They concluded that shielding was inadequate for balcony's door but personal monitoring did not show any exceeding of TLV of 20 mSv yearly and cytogenetics analysis did not reveal findings considered to be characteristics of ionizing exposure. Equipment for developing photos had a long list of repairs, mainly leakages of liquids and increases of temperature. On several occasions the floor has been flooded especially during 1987–1993 and 1997–2001. Inspection confirmed a complete lack of ventilation and many spoiled medical x-ray films. Employees reported that an "osmic" level was continuously evident and frequently developed symptoms of respiratory irritation and dizziness.ConclusionThe findings support the hypothesis that the specific AML cases might have originated from exposure to chemicals, especially hydroquinone and/or glutaraldehyde. The report also emphasises the crucial role of inspection of facilities and enforcement of compliance with regulations in order to prevent similar incidents.

Respiratory symptoms, subjective annoyance and asthma in a moisture damaged central hospital

Rationale Moisture damage and associated microbial growth cause annoyance and impaired health in residential buildings and work places. This study describes consequences of moisture damage in a large hospital building. Methods A questionnaire was sent to the personnel of a central hospital (n=2258). Information of moisture damage and associated microbial exposure was obtained from the occupational health care system and construction authorities of the hospital. The mental hospital (n=202) and the pediatric hospital (n=135) with severe moisture damage were compared to less damaged parts of the hospital. Results Respiratory irritation symptoms, such as cough, chest tightness and hoarseness were reported in the damaged areas. The prevalence of doctor diagnosed asthma was significantly higher (9.0%) in the moisture damaged parts of the hospital (p<0.05). No differences were found in reported prevalence of allergic rhinitis or atopic eczema. Subjective annoyance due to indoor air factors was highest in the pediatric hospital, and also visible signs of moisture damage were common (26%). Visible mold growth was reported by 11% of the respondents and 72% were not satisfied with the ventilation system in the mental hospital. Nurses and assistant nurses had highest prevalence of respiratory allergies compared to physicians and blue-collar workers. Conclusions Exposure to moisture damage was associated with asthmatic symptoms and asthma in hospital personnel. Insufficient ventilation and subjective annoyance due to poor indoor air quality reduced work satisfaction. Improvement of indoor air quality by remediation of moisture damage is important in reducing the health risk for workers and patients.

Particulate Air Pollution and Hospital Emergency Room Visits for Asthma in Seattle

Recent studies have associated short-term exposure to respirable particulate matter (PM10) exposure with peak flow decrements, increased symptoms of respiratory irritation, increased use of asthma medications, and increased hospitalization for asthma. Increased mortality from chronic respiratory disease has also been reported. To help confirm whether PM10 exposure is a risk factor for the exacerbation of asthma, we compiled daily records of asthma emergency room visits from eight hospitals in the Seattle area. In Poisson regressions controlling for weather, season, time trends, age, hospital, and day of the week, the daily counts of emergency room visits for persons under age 65 were significantly associated with PM10 exposure on the previous day. The mean of the previous 4 days' PM10 was a better predictor (p < 0.005). The relative risk for a 30 micrograms/m3 increase in PM10 was 1.12 (95% confidence interval 1.20 to 1.04). Daily PM10 concentrations never exceeded 70% of the current ambient air quality standards during the period. The consistency of investigations of the health effects of PM10 suggest that increased attention should be given to the control of particulate matter air pollution.

Prospective study of respiratory effects of formaldehyde among healthy and asthmatic medical students.

We conducted a prospective evaluation of pulmonary function and respiratory symptoms among 103 medical students exposed to formaldehyde over a 7-month period to determine the incidence of bronchoconstriction and respiratory symptoms in response to exposure. Time-weighted average formaldehyde exposures were generally less than 1 part per million (ppm) and peak exposures were less than 5 ppm. Acute symptoms of eye and upper respiratory irritation were significantly associated with exposure. There was no pattern of bronchoconstriction in response to exposure after either 2 weeks or 7 months. Twelve subjects had a history of asthma; they were no more likely to have symptoms of respiratory irritation or changes in pulmonary function than those without such a history. These findings are consistent with previous case reports that indicate exposure to formaldehyde vapor at levels that are commonly encountered in occupational and residential settings do not commonly cause significant bronchoconstriction, even among subjects with preexisting asthma.

Potential nephrotoxic effects of exposure to silver.

A cross sectional study was conducted on workers engaged in manufacturing precious metal powder. Of the 27 workers, 96% had raised urine silver concentrations (range 0.5-52.0 micrograms/l, mean 11.3 micrograms/l) and 92% had raised blood silver concentrations (range 0.05-6.2 micrograms/100 ml, mean 1.0 microgram/100 ml). Nineteen per cent also had raised urine cadmium concentrations (range 1.9-76.0 micrograms/l, mean 11.8 micrograms/l). Most workers had symptoms of respiratory irritation and nose bleeds were reported in eight (30%) of the 27 workers. Deposition of silver in the cornea of the eye was detected in five of eight (63%) of the long term workers. Although not statistically significant, corneal deposition was associated with complaints of decreased night vision. The urinary enzyme N-acetyl-B-D glucosaminidase (NAG) was significantly raised in four individuals and was correlated with blood silver concentrations and age. In addition, the group's average NAG concentration was significantly higher than that found in a control population. No association between age and urinary NAG was found in the control group. Estimated creatinine clearance was also significantly lower in the group exposed to silver than in the control group. Kidney function appears to have been adversely affected by exposures at work but because of the exposure to cadmium the role of silver in causing the decrement in kidney function could not be definitely determined.

Federal epidemiologists link ills to environs

ABSTRACT Scientists at the Centers for Disease Control (CDC), Atlanta, understand the complexities of environment-health interactions. The CDC's Center for Environmental Health has investigated outbreaks of illness in which the causes ranged from rug shampoo to volcanic eruptions.In 1980, for example, symptoms of respiratory irritation among inhabitants of a city office building and a day-care center were traced to underdilution of commercial carpet cleaners. The dry residue, sodium dodecyl sulfate, turned out to be a potent respiratory irritant (Environ Int 1982;8:337-341). Henry Falk, MD, of the Center for Environmental Health, says the group has conducted a dozen such indoor air quality investigations.Indoor studies have more recently been taken over by the CDC's National Institute for Occupational Safety and Health. Its records indicate that the tally of indoor air quality complaints investigated now exceeds 200.Also in 1980, the Center for Environmental Health had the opportunity to study an outdoor