Current Concepts: Acute Chemical Emergencies

Details

• Personal Author:
  Christiani, David C. ; Kales SN
• Description:
  Acute chemical emergencies can occur as a result of an industrial disaster, occupational exposure, recreational mishap, natural catastrophe, chemical warfare, and acts of terrorism. This article reviews the health effects most commonly associated with the short-term release of industrial and environmental substances and with the use of chemical weapons. We emphasize the application of empirical principles and the recognition of four clinical syndromes, or "toxidromes," that are applicable to most scenarios of accidental release of chemicals and deliberate release as in acts of chemical terrorism. The classes of substances that correspond to these clinical syndromes are asphyxiants (e.g., cyanide), cholinesterase inhibitors (e.g., organophosphorus nerve agents), respiratory tract irritants (e.g., chlorine), and vesicants (e.g., mustard). The agents that cause each clinical syndrome require similar treatment. In accidental industrial releases, information about the presence of specific chemicals may be available from the personnel of the facility, safety officials, and other sources. In contrast, an act of terrorism is more likely to involve substances that cannot be immediately identified. Owing to the rapidity of the onset of similar symptoms in a group of persons or the close proximity of a group of persons to a release of hazardous materials, chemical exposures are more quickly recognizable than are exposures to biologic agents. However, in contrast to the period of latency that is associated with the effects of biologic agents, when serious chemical intoxication occurs, the window for effective therapy is often narrow. Furthermore, real-time identification of specific chemicals by means of environmental or clinical laboratory testing is difficult. [Description provided by NIOSH]
• Subjects:
  Accidents, Occupational Chemistry Environmental Exposure Hazardous Substances Manufacturing And Industrial Facilities Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Accidents Asphyxiants Biological Agents Chemical Agents Chemical Hazards Chemical Properties Chemicals Chemical Warfare Agents Cholinesterase Inhibitors Environmental Exposure Exposure Levels Hazardous Materials Hazards Health Effects Industrial Environment Organophosphorus Compounds Risk Factors Terrorism

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• ISSN:
  0028-4793
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  350
• Issue:
  8
• NIOSHTIC Number:
  nn:20057093
• Citation:
  N Engl J Med 2004 Feb; 350(8):800-808
• Contact Point Address:
  Dr. Kales at the Cambridge Health Alliance, Department of Medicine, Occupational and Environmental Health, 1493 Cambridge St., Cambridge, MA 02139
• Email:
  skales@challiance.org
• Federal Fiscal Year:
  2004
• Performing Organization:
  Harvard School of Public Health
• Peer Reviewed:
  True
• Start Date:
  20030701
• Source Full Name:
  New England Journal of Medicine
• End Date:
  20050630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:10edf09fd2623cb73e84fb2a98e3c37143f8c162f56bea15e8275c095ad5e724691bcd8e55f934e3c38ee4fca03d56f3f39664cf803b4178d1ef7922e8f3f9d9
• Download URL:
  https://stacks.cdc.gov/view/cdc/214551/cdc_214551_DS1.pdf
• File Type:
  [PDF - 93.52 KB ]