Document xzkK9RvXKmw32b2o7Xv9mbwaJ

PMP : FE- 3 /& /4 6 SASOUME POISOUIKG G aso lin e i s o b ta in e d from cru d e p e tro le u m o i l -which i s th e s o u rc e o f a number o f commercial p ro d u c ts, in c lu d in g , in th e o rd e r o f t h e i r v o l a t i l i t y , p etro leu m e th e r , n a p th a , b e n z in e , k e ro se n e , f u e l o i l , lu b r ic a tin g o i l and a sp h a lt. G asoline is a m ixture of p a ra ffin hydro-carbons higher th an b u tan e, p a r t i c u l a r l y p e n ta n e , h ex an e, h e p ta n e and o c ta n e . The p re d o m in a tin g hydro carbons lib e ra te d by petroleum and i t s products from sto ra g e ta n k s, ta n k e rs , and s im ila r p la c e s , are b u ta n e and p ro p an e. W ith th e ex cep tio n o f h ig h -su lp h u r petro leu m and leaded g a s o lin e s , petroleum vapors are not very poisonous. P ercentages of g aso lin e vapor in a ir s u ffic ie n tly high to reduce th e oxygen content below th a t needed fo r re s p ira tio n w ill a c t as an asp h y x ian t. M orris B . Jaco b s: A n a ly tic a l C hem istry o f I n d u s tr ia l p o iso n s, H azards, and S o lv en ts, p p . 391-2 (1941). There a re wide v a r ia tio n s in th e com binations o f com m ercial g a s o lin e . H a p th a and b e n z in e may be c l a s s e d p h y s i o l o g i c a l l y w ith g a s o l i n e , b u t a r e l e s s v a rie d in co m p o sitio n . They are in h e re n tly more to x ic th a n th e lig h te r f r a c tio n s o f g a s o lin e b u t as th e y sr e le s s v o l a t i l e , th e y a re n o t so r e a d ily in h a le d . They a re la rg e ly used f o r d r y c le a n in g , g rease e x tr a c tio n and i n p a in t as a s u b s titu te fo r tu rp e n tin e . B enzine should not be confused w ith the cy c lic compound b en zen e. B esides benzene, o th er org an ic substances have been added to v ario u s g a s o li n e s as s n t i - d e t o n a n t s t o p r e v e n t s o - c a l l e d ''k n o c k in g " i n h ig h c o m p re s s io n m o to rs. Most im p o rta n t o f th e s e com ponents i s le a d t e t r a e t h y l . For m o to rists, poisoning by gasoline ra re ly c o n stitu te s a hazard, although, as a r e s u lt o f incom plete com bustion in th e engine, g aso lin e vapor may a p p e a r i n th e e x h a u s t g a s . T h is r e s u l t s fro m a to o r i c h m ix tu r e o f g a s o li n e w ith to o l i t t l e a i r because o f a fa u lty adjustm ent of th e c a rb u re to r o r from f a ilu r e o f th e g aso lin e vapor to ig n ite . I t is carbon monoxide, alm ost alo n e, w hich gives exhaust gas i t s poisonous c h a ra c te r. ^ 0004690 . Hen em ployed i n th e c a r e and r e p a i r o f au to m o b iles a re exposed t o g a s o lin e fumes to a g r e a te r e x te n t th a n a re th e d r iv e r s . G asoline s p ille d in co n fin e d q u a rte rs o r i n low p la c e s , such as th e p i t i n a r e p a ir shop f l o o r , during th e d rain in g of a gasoline tan k , occasio n ally reaches a to x ic co n cen tratio n . Toxic co n ce n tratio n s of g aso lin e vapors are o c c a sio n a lly encountered in confined q u a r t e r s , as 'hen g a s o lin e le a k s fro m s t o r a g e ta n k s and pum ping m a c h in e ry o r i s a c c id e n ta lly s p ill e d i n th e underground p ip e rooms o f g a s o lin e s to ra g e and d is p e n s in g s t a t i o n s . Men em ployed i n c l e a n in g t h e i n t e r i o r s o f ta n k c a r s o r s t o r a g e ta n k s -which have c o n ta in e d g a s o lin e a r e l i a b l e t o p o is o n in g , u n le s s p re c a u tio n s a re tak en to rem ove, as n e a rly as p o s s ib le , a l l th e v o l a t i l e m a tte r end to in s u r e a su p p ly o f u n co n tam in ated a i r to th e m en. The s t r i k i n g f e a t u r e o f a c u te g a s o lin e p o is o n in g i s t h e s e v e re m u sc u la r j a c t i t a t i o n o c c u r r in g d u r in g th e s ta g e o f e x c ite m e n t. In some c a se s t h e m u scu lar movements a re as v io l e n t as i n an e p i le p ti c c o n v u lsio n . They are p a r t i c u l a r l y marked d u rin g th e reco v ery in f r e s h a i r . W ith v ap o rs o f t h i s ty p e th e re is only a narrow m argin betw een th e c o n c e n tra tio n which produces a n e s th e sia and th a t which causes d e a th . However, i f r e s p ir a to r y f a ilu r e does ho t r e s u l t , th e chances fo r reco v ery w ith o u t any se rio u s a f te r - e f f e c ts are e x c e lle n t -- as w ith th e s u rg ic a l a n e s th e tic s . Henderson and H aggard, Noxious Gases (2d e d .) p p .169-192 (1943). T e tra e th y l le ad is w idely used as an a n ti-d e to n a n t fo r in te r n a l 0004691 com bustion en g in es. The danger o f p o isoning occurs d u rin g th e m anufacture of th e compounds and i n th e p ro c e ss o f b le n d in g i t w ith g a s o lin e . P o iso n in g may o c c u r, to a l e s s e r e x t e n t , among th o s e h a n d lin g t h e b le n d e d g a s o li n e . _ .o T e t r a e t h y l le a d may be a b so rb e d th r o u g h t h e s k i n , and t h e v a p o r s th r o u g h t h e lu n g s. Chronic p o isoning by te tr a e th y l lead resem bles th e ordinary and f a r m ore common c h r o n ic form o f le a d p o is o n in g fro m p a i n t and le a d d u s t s , and i3 c h a ra c te riz e d by n u tr itio n a l d istu rb a n c e s, p a ra ly sis of m otor nerves and in creased s u s c e p tib ility to such d iseases as pyorrhea and tu b e rc u lo sis, p p .239-40. As i s t r u e o f a l l t h e i n d u s t r i a l p o is o n s , th e s tu d y o f a c u te form s i s n o t n e a rly so im p o rtan t as th e study o f ch ro n ic forms and o f p o s sib le s e q u e la e o f th e a c u te . C hronic b en zin e p o iso n i s c o n s id e re d by some e x p e rie n c e d men as f a i r l y common among i n d u s t r i a l w o rk ers* b u t o t h e r s t h i n k i t i s -very r a r e . Since th e re are wide d iffe re n c e s in th e c o n d itio n s under w hich work is done, so th e r e s u l t s o f d i f f e r e n t su rv e y s may n o t be c o m p a ra b le . M achle, in an a r tic le in th e American M edical A sso c ia tio n Jo u rn al (1941) e n t i t l e d "G asoline I n to x ic a tio n " r e p o r ts t h a t he had some 2300 r e f in e r y w orkers under o b se rv a tio n fo r te n o r tw elve y ears and th a t he b e lie v e d chronic benzine po iso n in g is v ery r a r e . H am ilton and Johnstone, I n d u s tr ia l T oxicology, p . 663 ( 1 0 - 1 3 ) ,an O xford M ed ical P u b lic a ti o n (1 9 4 5 ). Only among t h e b a r r e l f i l l e r s , who a r e more h e a v i ly e x p o s e d , d id he f i n d s u g g e s tiv e sym ptom s. P a l l o r , low re d c e l l c o u n t, hem oglobin, n a u se a and n e rv o u s n e s s . These symptoms w ere c le a r ly connected w ith th e men's w ork. The h is to r y o f exposure i s of g re a t im portance in making a d ia g n o s is , fo r no la b o ra to ry t e s t s are s ig n if ic a n t. D r . Moorman a ls o c o n s id e rs th e d a n g e r o f c h ro n ic p o is o n in g s l i g h t . The v o l a t i l e p e tro le u m o i l s . -- n a p th a , b e n z in , p e tro le u m e t h e r . -- have a to x ic a c tio n on th e c e n tr a l nervous system (p .4 0 1 ). Acute p o iso n in g i n th e in d u s tr y i s c h a r a c te r iz e d by symptoms o f m ild i n t o x i c a t i o n o f th e c e n tr a l nervous sy ste m .- There is an in c re a s in g r e s tle s s n e s s and ex citem en t v e r y l i k e t h a t o f a l c o h o l i c i n t o x i c a t i o n . To some men i t i s p le a s u r e a b le and th ey become h i l a r i o u s , o th e rs a re i r r i t a b l e and u n reaso n ab le and prone to q u a rre l, (p.401-2) More s e r io u s form s o f p o is o n in g o c c u r when men a re o b lig e d t o go in to a ta n k or ta n k c a r w hich has h eld p etro leu m . Such p o iso n in g ending in d e a th has been re p o rte d from r e f in e r ie s , from o i l w e lls and from work in g a so lin e ta n k s and ta n k c a rs (p .4 0 2 ). K E 0004692 Acute cases o f b e n z in p o iso n in g are s tr ik i n g , b u t c h ro n ic cases w hich a t t r a c t le s s a tte n tio n are n o t only f a r more numerous b u t a re u s u a lly m ore l a s t i n g i n t h e i r e f f e c t s . C h ro n ic n a p th a p o is o n in g i s p ro b a b ly common, but i t is not easy to diagnose because i t does not produce c h a ra c te ris tic symptoms (p .4 0 4 ) - The pumping, re fin in g and d i s t i l l i n g o f lu b ric a tin g o ils has gone on f o r many decades i n th e U n ited S t a t e s , y e t th e r e i s s in g u la r ly l i t t l e in th e l i t e r a t u r e to show t h a t th e petroleum in d u s try , as such, has ev er given r i s e t o i n d u s t r i a l p o is o n in g (p 4 0 7 ). As a u s u a l t h i n g , w o rk e rs i n p e tro le u m r e f in i n g s u f f e r no im pairm ent o f h e a l t h . But i f a man were o b lig e d to e n te r a tan k he m ight lo se consciousness (p .4 0 7 ). H am ilton, In d u s tria l Poisons in th e U nited S ta te s (1929). KB 0004693 GASOLINE G aso lin e, sometimes c a lle d b e n z in , i s a petro leu m d i s t i l l a t e , a r e f in e d p etro leu m n a p h th a , and has no r e l a t i o n to benzene o r b e n z o l, w hich is a co al-tar d is tilla te . O c c u rre n c e . The c h i e f u s e o f g a s o lin e i s as a f u e l f o r i n t e r n a l com bustion e n g in e s . G aso lin e ex p o su re may o c c u r i n r e f i n e r i e s , i n t h e s to r a g e and tra n s p o rta tio n o f g a so lin e , in d isp en sin g s ta tio n s , ga j s , and to a s lig h t e x te n t in th e h an d lin g o f autom obiles and o th e r form s o f gaa. iin e e n g in e s. The second most im portant use fo r gasoline is because o f it s so lv en t a c tio n on many s u b s ta n c e s . I t i s u sed e x te n s iv e ly i n th e ru b b e r in d u s tr y i n m aking' ru b b er cem ent, in compounding ru b b e r, and i n th e m an u factu re o f ru b b e r t i r e s , t u b e s , s h e e t i n g , g lo v e s end w a te r p r o o f c l o t h . Ad a c l e a n in g f l u i d , i t i s u sed by dry c le a n e rs, in the degreasing of m etal p a rts , by p rin te rs in clean in g ty p e, lith o g ra p h sto n es and in k r o l l e r s . G asoline is also used by a r tg la s s w orkers, b ro n z e rs, e le c tr o p la te r s , ta n n e rs , enamel m akers, m o rd an ters, p a in te r s , v a rn ish e rs and. sho f i n i s h e r s , and i n t h e m a n u fa c tu re o f f u r n i t u r e p o l i s h , g l u e , ja p a n , la c q u e r, p a in t, p u tty , s h e lla c , v a rn is h , p y ro x y lin -p la s tic m a te ria ls and window shades* Symptoms * A cu te i n t o x i c a t i o n from th e i n h a l a t i o n o f an e x c e s s iv e amount o f g a s o lin e is v e ry much lik e th a t of a c u te a lc o h o l in to x ic a tio n . I t i s commonly c a l le d a "n a p h th a ja g " w hich c le a r s up p ro m p tly on g e t t i n g in to th e fr e s h a i r , le av in g no a f t e r e f f e c t ex ce p t a few hours o f n au se a , headache o r d iz z in e s s . I n some in d u s t r i e s where th e w orkers b re a th e c o n c e n tra te d g a so lin e fumes day a f t e r d ay , i t has been n o te d t h a t i n th e f o r e p a r t o f th e day th e y a re q u ite h il a r io u s , b u t tow ards evening th ey become m orose, d ep ressed a n d , i n some i n s t a n c e s , q u i t e q u a rre ls o m e , symptoms common t o h a b i t u a l a l c o h o l i c s . An o v erw h elm in g d o se o f g a s o li n e may p ro d u c e a p ro fo u n d d e g r e e o f in to x ic a tio n to the p o in t o f ren d erin g th e p a tie n t unconscious, such a c irc u m sta n c e i s g e n e r a lly c o n s id e re d an an a c c id e n t and may o c c u r u n d er th e fo llo w in g circ u m stan c es* From a le a k in a g a s o lin e ta n k o r p ip e , from fumes of g aso lin e accum ulating in an enclosed sp ace, from w orking in an enclosed space w ith p a in t, v a rn is h o r o th e r m a te ria l in which g a so lin e is used as a so lv e n t, from clean in g o r re p a irin g ta n k s i a w hich th e vapor o f g asoline rem ains, and from a b s o r p tio n th ro u g h th e s k in i n p e rs o n s who have f a l l e n i n t o a ta n k o f g a s o l i n e , o r who hav e s p i l l e d a l a r g e q u a n t i t y on t h e i r c l o t h i n g w ith o u t prom ptly removing them . CHRONIC GASOLINE POISONING h as b e e n d e s c r ib e d a s o c c u r r i n g i n men who h a v e b e e n ex p o se d t o t h e i n h a l a t i o n o f t h e v a p o r f o r many m o n th s, o r who hav e o v e r a lo n g p e r io d o f tim e w orked w ith t h e i r h a n d s o r arms immersed i n a g a so lin e s o lu tio n . C hronic g a so lin e p o iso n in g does n o t produce a d e f i n i t e c l i n i c a l p i c t u r e , and th e symptoms o f w hich th e s e w orkers com plain are q u ite v a ria b le . M oreover, the number of such p a tie n ts is q u ite sm all compared w ith th e la rg e number o f p erso n s w orking in in d u s tr ie s u sin g g a so lin e K 0004694 e x t e n s i v e l y . H ow ever. we m u st c o n s id e r th e p o s s i b i l i t y o f a f u n c t i o n a l d i s tu r b a n c e i n some i n s t a n c e s b e c a u s e t h e r e a r e enough workmen who a re ex p o sed t o t h e v a p o rs o f g a i o l i n e -who, o v e r a p e r io d o f m onths o r y e a r s , show a lo s s o f energy, a re d u ll m e n tally , com plain o f headache, d iz z in e s s , lo ss o f a p p e t ite and g a s t r i c d i s t r e s s . I th ile th e s e symptoms may n o t in d i c a te a di s t i n c t o c c u p a tio n a l d is e a s e , th e y do show t h a t c e r t a in p erso n s have a s u s c e p t i b i l i t y to th e in flu e n c e o f g a s o lin e v ap o rs w hich c a u ses in them u n p le a s a n t symptoms and a low ering o f t h e i r e ffic ie n c y . (A uthor's i t a l i c s ) B .3 . H ayhurst (P oisoning by P etroleum D i s t i l l a t e s , J . In d u s t. M ed., F e b ., 1 9 3 6 ), who h as s tu d ie d s e v e r a l su c h c a s e s m o st c a r e f u l l y , c o n c lu d e s i n t h e m ain as f o llo w s : The p e rs o n s s tu d ie d had b een exposed t o g a s o lin e f o r p e r io d s ra n g in g from f iv e weeks to fo u r y e a rs b e fo re d i s a b i l i t y b eg an . They com plained o f headache, d iz zin ess, loss of a p p e tite , dyspepsie, itc h in g of the sk in , cough, sh o rtn e s s o f b r e a th , mouth and th r o a t in f e c tio n s , n e u ro a sth e n ic and p sy ch o asth en ic sym ptom s. ' The o b je c tiv e fin d in g s in t h i s group o f p a tie n ts are lo s s o f w eig h t, i n c r e a s e d p u ls e r a t e , s e c o n d a ry a n em ia, i n some c a s e s an e o s i n o p h i l i a , s k i n ra s h e s , f u ru n c u lo s is , mouth and th r o a t in f e c tio n s , p e r s is te n t d ia rr h e a , at tim e s , a lte rn a tin g w ith c o n s tip a tio n , m uscle tw itc h in g and trem o rs, s lig h t a ta x ia , and, in severe ca ses, sem istupor and d is o rie n ta tio n . When one a n a ly z e s t h e above sym ptom s, i t i s q u i t e e v i d e n t t h a t t h e s e same symptoms, b o th s u b je c tiv e and o b je c tiv e , a r e f r e q u e n tly e n co u n tered i n p a t i e n t s i n a l l w alks o f l i f e and a r e i n no way c o n fin e d t o w o rk ers i n g a s o lin e . The above s tu d ie s are very com plete and d eserv e our c o n s id e ra tio n . N e v e rth e le ss, when c o n fro n te d w ith a p a t ie n t p r e s e n tin g th e above named symptoms, even when he i s a w orker in g a s o lin e , he should be examined c a re fu lly to exclude o th e r form s o f d i s e a s e o r d e g e n e r a tiv e p r o c e s s e s . On th e o t h e r h a n d , a p e r s o n who 0004695 - 6- d o es p r e s e n t t h e s e symptoms an d i n whom no o th e r c a u s e f o r h i s c o m p la in ts aan be fou n d , sh o u ld be g iv en th e b e n e f it o f th e d o u b t, and h is c o n d itio n should be considered to be due to th e e ffe c ts of g aso lin e absorption* J e w e tt V* Reed and A. K. E a r c o u r t : The E s s e n t i a l s o f O c c u p a tio n a l D i s e a s e s , pp. 45-47 (1941). D r. W illard M achle, K e tte rin g L ab o rato ry o f A pplied P hy sio lo g y , U n iv e rsity o f C in c in n ati C ollege o f M edicine p u b lish ed (1941) an a r t i c l e e n t i t l e d " G a so lin e I n t o x i c a t i o n 'fi n 117 Am* Med. A ss` n . Jo u rn * 1S65, from which th e f o llo w in g i s sum m arized : In v e s tig a tio n s and re p o rts ov er a span o f y ears have dem onstrated th a t lead p o iso n in g w ill not r e s u lt from th e use o f lead ed g aso lin e as i t is u s u a lly handled in commerce. The hazard i s lim ite d ' to th e m anufacture o f th e te tr a e th y l lead and th e antiknox m ix tu res, th e m ixing of these m a te ria ls w ith g aso lin e and th e cle a n in g o f ta n k s in which lead ed g a so lin e has been s to re d (p .1 9 6 6 ). The u s u a l mode o f a b s o r p tio n o f g a s o lin e i s th r o u g h th e r e s p i r a t o r y t r a c t . In C hronic p o iso n in g th e anatom ic changes are n e ith e r pronounced n o r sp ecific. The te rm "ch ro n ic in to x ic a tio n " i s a p p lie d to p o iso n in g w hich r e s u lts from exposure to low c o n c e n tra tio n s o f g a so lin e vapor f o r long p e rio d s o f tim e (p .1 9 6 8 ). W hile H am ilton ( in d u s tr ia l P oisons in U .S .,1 9 2 5 ) s ta te s (p p .400-409) to t h a t c h r o n ic n a p th a p o is o n in g i s p ro b a b ly common, M achle* s e x p e r ie n c e i n d i c a t e s t h a t i t i s r a r e . He h a s h ad more th a n 2 ,3 0 0 r e f i n e r y w o rk e rs u n d e r o b s e r v a t i o n , i n some in s ta n c e s f o r t e n t o tw elv e y e a r s , and found no s ig n s o f c h ro n ic g a s o lin e poisoning in any c a se . N egative r e s u lts , in re sp e c t to sig n s o f chronic g asoline in to x ic a tio n , were a lso o b ta in e d in s tu d ie s o f la rg e numbers o f f i l l i n g s ta tio n a tte n d a n ts , ta n k wagon d riv e rs and garage m echanics (p .1 9 6 9 ). -7- 000469 The c l i n i c a l m a n ife s ta tio n s in c h ro n ic g a so lin e in to x ic a tio n are u s u a ll y vague and n o t c h a r a c t e r i s t i c . The f i r s t symptoms a r e o f a g e n e r a l n atu re o r p sy ch asth en ic and n e u ra sth e n ic m a n ife s ta tio n s , follow ed by m uscular weakness and cram ps, lis tle s s n e s s and a fe e lin g o f d u lln ess, fa tig u e and lo ss o f w eig h t. U sually th e i r r i t a t i v e p ro p e rtie s o f th e vapor cause c o n ju n c tiv itis w ith la c rim a tio n and cough w ith e x p e c to ra tio n . N ervous symptoms may o c c u r in w ide v a r i e t y and d e g re e . I n d ig e s tio n i s u s u a l, sme n a u s e a . G e n e ra liz e d abdom inal p a in is a f r e q u e n t c o m p la in t. Changes in th e c ir c u la to r y system a re n o t c o n s id e ra b le , b u t u s u a lly th e p u lse ra te is in c re a se d . Nor are changes in th e blood chem istry s ig n if ic a n t. D ia g n o s is : Any one o f th e g a s t r o - e n t e r i c , c e r e b r a l o r p e r ip h e r a l n e u r i t i c m a n ife s ta tio n s o f c h ro n ic g a s o lin e in t o x ic a t io n may occur i n i n f e c t i o n s , m etabolic or degenerative d ise a se : and, fo r th is reaso n , g reat dependence must b e p la ced on th e h is to r y o f exposure to g a s o lin e . Knowledge o f w orking c o n d itio n s may b e n e c e s s a r y t o e s t a b l i s h th e m a g n itu d e o f e x p o s u r e . O th e r c a s e s w ith s i m i l a r symptoms i n workmen h av in g s i m i l a r e x p o su re w i l l b e o f c o n s id e ra b le a i d . A m e lio ra tio n of symptoms may b e e x p e c te d t o fo llo w c e s s a ti o n o f ex p o su re i n c h ro n ic c a s e s , and t h i s may be th e b e s t e x p e d ie n t i n e s ta b l is h in g th e d ia g n o s is . P s y c h o n e u ro tic symptoms i n a p e rs o n w ith c h ro n ic ex p o su re t o g a s o lin e sh o u ld s u g g e s t th e p o s s i b i l i t y o f i n t o x i c a t i o n , and r e l i e f from th e s e symptoms sh o u ld fo llo w soon a f te r removal from exposure. C hronic in to x ic a tio n from g aso lin e is ra re (p .1 9 7 1 ). P u b lic H e a lth B u l l e t i n No. 163 e n t i t l e d f^The Use o f T e t r a e t h y l Lead G aso lin e in i t s R e la tio n to P u b lic H e a lth " , w hich was p rep ared by d ir e c tio n o f th e jSurgeon G eneral and p u b lish e d by th e Government P r in tin g O ffic e in June 1926, contains th e fo llo w in g : HE 00046 T e traeth y l lead is u n iv e rsa lly ap p reciated to be very dangerous in i t s u n d ilu te d form . However, C ity and S ta te H ealth a u th o ritie s and la b o r l e a d e r s , who a re i n a p o s i t i o n t o know, gave a b s o l u t e l y n e g a tiv e e v id e n c e as to any such h arm fu ln ess when d ilu te d in g a s o lin e ( p .3 9 ) . One f i l l i n g s t a t i o n a t t e n d a n t was s a id t o have s u f f e r e d fro m h a n d lin g e t h y l g a s o l i n e . "When v i s i t e d he s a i d t h a t he had had a b a d ly e n la r g e d h e a r t f o r many y e a r s ; t h a t he had sto p p ed w ork b ecau se he became s h o r t o f b r e a t h . He had t o re m a in u p r i g h t t o b r e a t h e w ith any c o m fo rt ( p . 4 0 ) . The. i n v e s t i g a t i o n c o n c lu d e d ( p .4 0 ) t h a t "i n no c a s e was any e v id e n c e o b ta in e d as t o h a rm fu l e f f e c t s o f e t h y l g a s o l i n e 1' . 0004698