The unsuspected killer: Liquefied petroleum gas overexposure in South Africa.

A 21-year-old woman with no past medical history of note was found unconscious together with five of her family members after prolonged exposure to liquefied petroleum gas. She was admitted to the intensive care unit at Victoria Hospital, Wynberg, Cape Town, South Africa, following resuscitation for pulseless electrical activity. On examination the following was found: coma without focal neurology; shock requiring fluid resuscitation and adrenaline; probable pneumonitis or aspiration pneumonia; acute rhabdomyolysis with severe metabolic acidosis; and raised serum K+. A carboxyhaemoglobin test was unable to confirm or exclude carbon monoxide poisoning.

Deaths involving natural gas inhalation.

Death due to gas inhalation is accidental or suicidal. Natural gas can be a cause of death as a result of oxygen replacement in the atmosphere. Three male victims who were killed from gas inhalation are described in this study. One 19-year-old man attempted suicide using a combination of plastic bag suffocation and natural gas tube in his mouth. The other victim (24 years old man) attempted suicide by natural gas inhalation, and the cause of death of the third victim was inhalation of the vapor from a furnace that contained crude oil or gasoline. Methanol was detected in blood and liver samples by headspace gas chromatography (HSGC) and headspace gas chromatography-mass spectrometry (HSGCMS). Carboxyhemoglobin (CO-Hb) and other drugs and poisons were not detected in blood and liver samples.

[A literature review on health effects of exposure to oil spill].

OBJECTIVES: Our objective is to review and summarize the previous studies on the health effects of exposure to oil spills in order to make suggestions for mid- and long-term study plans regarding the health effects of the Hebei Spirit oil spill occurred in Korea. METHODS: We searched PubMed to systemically retrieve reports on the human health effects related to oil spill accidents. The papers' reference lists and reviews on the topic were searched as well. RESULTS: We found 24 articles that examined seven oil spill accidents worldwide over the period from 1989 to August 2008, including the Exxon Valdes, Braer, Sea Empress, Erika, Nakhodka, Prestige and Tasman Spirit oil spills. Most of the studies applied cross-sectional and short-term follow-up study designs. The exposure level was measured by assessing the place of residence, using a questionnaire and environmental and personal monitoring. Studies on the acute or immediate health effects mainly focused on the subjective physical symptoms related to clean-up work or residential exposure. Late or mid-term follow-up studies were performed to investigate a range of health effects such as pulmonary function and endocrine, immunologic and genetic toxicity. The economic and social impact of the accidents resulted in the socio-psychological exposure and the psychosocial health effects. CONCLUSIONS: Studies of the health effects of exposure to oil spills should consider a range of health outcomes, including the physical and psychological effects, and the studies should be extended for a considerable period of time to study the long-term chronic health effects.

[Inquiries to the Norwegian Poisons Information Centre on acute exposures to chemicals and chemical products]. / Henvendelser til Giftinformasjonen om akutte eksponeringer for kjemiske produkter.

BACKGROUND: The Poisons Information Centre receives many inquiries about acute exposures to chemical products. Our aim was to characterise the frequency and severity of such exposures and to raise awareness of chemicals that rarely cause poisoning, but may lead to serious systemic toxicity even in small amounts. MATERIAL AND METHODS: Data were collected from inquiries to the Poisons Information Centre in the period 2004-2006 and from the Product Register on the use of selected chemicals. RESULTS: In 2004-2006, the Poisons Information Centre received 35,802 inquiries regarding acute exposures to chemicals or chemical products. Most of the exposures (72%) were assessed as non-toxic or involving risk of minor poisoning, while only 7.8% were assessed as involving risk of severe poisoning. The substances most frequently involved were cleaning agents, cosmetics/personal care products and hydrocarbon fuels, whereas risk of severe poisoning is related to alkali and hydrocarbon exposures. Poisonings with hydrofluoric acid and glycols/glycol ethers are rare, but the outcome is often severe. As many as 84% of the hydrofluoric acid exposures and 36% of the ingestions of ethylene glycol by children were assessed as involving risk of moderate or severe poisoning. INTERPRETATION: Exposure to chemicals or chemical products is frequent, but rarely leads to severe poisonings. Data from inquiries to the Poisons Information Centre are representative of the chemical exposure conditions. It is important to have detailed product information readily available to assure correct treatment after exposure incidents.

[Pathomorphological changes of the macroglia in chronic intoxication produced by gas containing hydrogen sulfide]. / Patomorfologicheskie izmeneniia makroglii pri khronicheskoi intoksikatsii serovodorodsoderzhashchim gazom.

Changes in the rat brain macroglia produced by a natural gas from Astrakhan source containing hydrogen sulphide were studied immunocytochemically (glial fibrillar acid protein). Primary response was from oligodendroglia, dose increase followed by reaction from the astroglia.

Burning charcoal: an indigenous method of committing suicide in Hong Kong.

BACKGROUND: Carbon monoxide (CO) poisoning by burning charcoal has become one of the most common ways of committing suicide in Hong Kong since late 1998. The evolution of the phenomenon was explored in the current study. METHOD: Information about completed suicides between January 1996 and December 1999 was obtained from the Hong Kong death registry and hospital authority, and information about ambient temperature and humidity was obtained from the Hong Kong Observatory. News on completed suicides by burning charcoal was collected by computer search using the data bank of 6 major Hong Kong newspapers. The data were analyzed. RESULTS: CO poisoning by burning charcoal rose from 0% of all Hong Kong suicides in 1996 and 1997 to 1.7% in 1998 and 10.1% in 1999. The monthly incidence rate bore a reciprocal relationship with the ambient temperature. Suicidal pacts were overrepresented, and past history of mental illness was uncommon. Both demographic and clinical features of suicides by burning charcoal resembled those of suicides by domestic gas poisoning. The overall suicide rate remained unchanged in the above period. CONCLUSION: Suicide by burning charcoal is a new variant of domestic gas poisoning. A host of biopsychosocial and ethnological factors are responsible for the birth and indigenization of the method.

Health hazards among workers in power stations. Comparative study between natural gas and mazout stations.

This study was done on 65 workers working in power station I (Shoubra El-Kheima) where they are exposed to natural gas and mazout, 74 workers in power station II (El-Gharb) where there is mazout exposure only and 74 individuals acting as controls. All these individuals were admitted to a questionnaire, examined clinically and they were investigated to assess their respiratory, liver and kidney function tests. This is in addition to a complete blood picture. Air pollution inside these stations was assessed. The study aimed at determining the pollutants inside and outside the stations and to investigate the health hazards of the workers exposed to these pollutants. It aimed also to see if it is important and urgent to replace the mazout by natural gas as a fuel in these power stations. The results showed that by-products of mazout have bad effect on the environment. When mazout is used alone as a fuel, it has an adverse effect on the respiratory system and the liver. There is a need for a prospective study to assess the causal relationship between mazout by-products and health hazards before taking the decision of replacing mazout by natural gas.

Acute renal toxicity after ingestion of Lava light liquid.

A 65-year-old man with a history of alcohol abuse and seizure disorder presented to the emergency department with altered mental status, increased anion gap acidosis, phenytoin toxicity, and acute kidney failure. The patient had ingested the liquid contents of a Lava light, which contained chlorinated paraffin, polyethylene glycol (molecular weight 200), kerosene, and micro-crystalline wax. Gas chromatography-mass spectrophotometry of the patient's blood produced results consistent with the same analysis of the Lava light contents. After 3 days of declining mental status and worsening kidney function, the patient required hemodialysis. After a prolonged hospitalization, the patient was discharged home with residual renal insufficiency. Although multifactorial, the associated renal toxicity was most probably related to the low molecular weight polyethylene glycol content of the lamp's liquid contents.

[Several aspects of clinical signs and pathogenesis of pneumopathies in acute poisoning caused by sulfur-containing natural gas]. / Nekotorye aspekty kliniki i patogeneza pnevmopatii pri ostrykh otravleniiakh serovodorodsoderzhashchim prirodnym gazom.

The article summarizes and analyzes data on 32 cases of acute intoxication varying in severity and caused by inhalation of sulfur-containing natural gas of Astrakhan gas deposit (SCNGAGD). The data were obtained in experimental poisoning of 120 Wistar rats with the gas. Pneumopathies (toxic pulmonary edema, pneumonitis, asthmatic bronchitis, alveolitis) appeared to play the central role among other syndromes of the intoxication by SCNGAGD. Mechanisms of the pneumopathies were traced to morphologic disorders of blood-lung barrier, compromised functions of lung surfactant, disturbances in lipid peroxidation and anaerobic glycolysis.

Fatal respiration of liquefied petroleum gas.

We have found that an efficient method of providing evidence of lethal solvent abuse is to sample headspace above lung tissue and then perform cryogenically focused gas-liquid chromatography. In the case presented, the level of lethal agent in lung tissue was low, but the solvent was present in abundance in the pleural cavity. We conclude that the pleural cavity acts as an efficient trap for aspirated substances.

Toxicosis in sheep following ingestion of natural gas condensate.

Thirty of 200 ewes died or were euthanatized during a 21-day period following a 1-day accidental exposure to natural gas condensate, a complex mixture of hydrocarbons obtained during collection of natural gas from wells. Despite access to potable well water, the poisoned ewes willingly consumed toxic doses of condensate that contaminated surface water. Eight animals died without premonitory signs; the remainder became ill over the course of a few days to 3 weeks. The principal cause of mortality was aspiration pneumonia, but myocardial degeneration and necrosis, renal tubular damage, gastritis, enteritis, and meningeal edema and hyperemia were also observed. Gas chromatographic analysis identified chemical traces of the hydrocarbons in the tissues, and "fingerprinting," the process of matching chromatographic tracings, provided forensic proof of the contamination source. Atomic absorption spectroscopy and cholinesterase analyses were performed to eliminate the possibility of toxicosis by heavy metal contaminants or other constituents. This appears to be the first reported incidence of natural gas condensate toxicity involving sheep or other ruminants. Although the available literature presents a suggestive pattern of clinical signs and pathologic lesions of petroleum product poisoning, diagnostic investigations should employ detailed analytic examination because each source of petroleum hydrocarbons contains unique sets of components that may produce different toxic effects.

The effect of the detoxification of domestic gas in Switzerland on the suicide rate.

An examination of suicide rates in Switzerland during the period when domestic gas was detoxified indicated that, not only did the use of domestic gas for suicide decline, but so did the overall suicide rate, indicating that people did not switch to alternative methods for suicide, contrary to a claim made by the late Erwin Stengel.

[Acute carbon monoxide poisoning]. / Ossicarbonismo acuto.

Carbon monoxide is one of the most common cause of poisoning both in industry and in homes. About 75-80% of cases of acute oxicarbonism occur in homes. The chief domestic source of poisoning was in the past the escape of illuminating gas, today the incomplete combustion of methane or GPL. On the basis of personal experience the authors illustrate the kinetics of absorption and the mechanism of action of CO, the clinical pattern of acute poisoning and the elements of prognostic value. A careful distinction must be done between acute oxicarbonism and acute intoxication from fire-smoke at the physiopathological, clinical and therapeutic level.

Recent changes in suicide among adolescents in England and Wales.

This paper examines suicide statistics in the 15-19 years group in England and Wales between 1950 and 1984. There was an increase in suicide rate for both sexes between 1950 and the mid 1960's, largely due to suicide using domestic gas. The rate then decreased as domestic gas was detoxified, and this was followed by a further increase in suicide associated with poisoning with solids and liquids until the late 1970's. More recently there has been an increase, particularly for males, in suicide by hanging, strangulation and suffocation, poisoning with vehicle exhaust gas and firearms and explosives.

[Natural gas in forensic medicine]. / Zemní plyn v soudne lékarské praxi.

In the experiment in rats the effect of earth gas on the living organism was followed. In comparison with nitrogen representing the largest portion of atmospheric gases, the earth gas did not manifest an increased toxicity. The results of the experiment were compared with case reports from practice, where the persons and died in connection with using the earth gas, most frequently due to the carbon monoxide content of insufficiently combusted gas. In some cases the detected relatively low levels of COHb in blood indicate that in addition to the carbon monoxide poisoning the suffocation was also caused by lack of oxygen. The authors refer to the possibility of methane demonstration in blood, indicating the exposure of persons to the environment containing the earth gas.