Airway irritation

In humans, four clinical syndromes (three of which are associated with immunologic reactions) are induced by inhalation of TMAN dust and furne. The first is a direct irritant syndrome characterized by cough and upper airway irritation related to the irritant properties of the anhydride at high-dose exposures. 

Limited information is available on the human health effects of exposure to VDC. Upper airway irritation consisting of inflammation of mucous membranes has been reported after acute exposure, whereas CNS toxicity has been associated with levels of 4000ppm. ... 

Desflurane 3-5 Yes Some Some Decrease Decrease Bad odor airway irritation, t... 

In theory, induction should be rapid, but in practice the inspired vapour concentration must be increased slowly to avoid airway irritation. MAC is 1.15% in 100% oxygen and 0.56% in 30% oxygen, making it less potent than halothane (0.75% and 0.29% at these oxygen concentrations). Isoflurane is the most potent of all the currently available anaesthetic ethers. Recovery from isoflurane anaesthesia is rapid and clear and the drug is suitable for use in day surgery. Cardiovascular system... 

Its low solubility, lack of airway irritability, and moderate potency make it particularly useful for gas induction in children. Other physical characteristics are shown in Table 3.2. 

Desflurane does not have a marked bronchodilator effect and in cigarette smokers it is associated with significant bronchoconstriction. In clinical practice, both humidification of inspired gases and opioids are thought to reduce airway irritability but even at moderate concentrations (2 MAC), desflurane is more likely to cause coughing than sevoflurane. In common with other volatile agents, desflurane causes dose-related respiratory depression. Tidal volume is reduced and respiratory rate increases, initially. As inspired concentrations of desflurane increase, the trend is to hypoventilation and hypercardia and apnoea is to be expected at concentrations of 1.5 MAC or greater. 

Rhinitis, lower airway irritation and corneal oedema have been reported in workers exposed to morpholine (IARC, 1989). 

The irritative effects of 1,5-naphthalene diisocyanate were confirmed in a further study of rubber production workers, in which exposure over the range of 0.002-0.007 mg/m was associated with increased frequency of eye irritation, cough and exertion dyspnoea. Also, an increase in the closing volmne, especially among the older workers, was observed, suggesting airway irritation (Alexandersson et al., 1986)... 

Clausen, P.A., Wilkins, C.K., Wolkoff, P. and Nielsen, G.D. (2001) Chemical and biological evaluation of a reaction mixture of r-(+)-limonene/ozone-formation of strong airway irritants. Environment International,... 

Upper airway irritation of terpene/ozone oxidation products (TOPS). Dependence on reaction time, relative humidity and initial ozone concentration. Toxicology Letters, 143 (2), 109-14. 

Vanadium Upper airway irritation and mucous production... 

Upper and lower airway irritation a respiratory tract carcinogen Inflammation of upper and lower airway Nasal inflaimnation and ulceration, rhinitis, pneumonitis with massive exposure... 

Chronic bronchitis, pneumoconiosis, obstructive lung disease, focal emphysema, progressive massive fibrosis (PMF), coal workers pneumoconiosis (CWP), siUcosis Acute bronchospasm, pneumonitis, chronic exposure leads to Itmg fibrosis, progressive massive fibrosis (PMF), coal workers pneumoconiosis (CWP), silicosis Ocular and upper airway irritation, bronchospasm in severe exposure, contact dermatitis... 

Severe ocular and upper airway irritation, transient renal damage Upper and lower airway inflammation asflimatics are highly susceptible Pulmonary fibrosis... 

Upper and lower airway injury, bronchospasm, pneumonitis Ocular, upper and lower airway symptoms Upper and lower airway irritation, fever, delayed onset pneumonitis... 

Dalton, P. (2003). Upper airway irritation, odor perception and health risk due to airborne chemicals. Toxicol. Lett. 140-1 239 8. 

Hg acts as airway irritant, and cellular poison can affect central nervous system due to ability to pass blood-brain barrier. 

Desflurane has the lowest blood/gas partition coefficient of any inhaled anaesthetic agent and thus gives particularly rapid onset and offset of effect. As it undergoes negligible metabolism (0.03%), any release of free inorganic fluoride is minimised this characteristic favours its use for prolonged anaesthesia. Desflurane is extremely volatile and caimot be administered with conventional vaporisers. It has a very pimgent odour and causes airway irritation to an extent that limits its rate of induction of anaesthesia. 

Bunting HE, Kelly MC, Milligan KR. Effect of nebulized lignocaine on airway irritation and haemodynamic changes during induction of anaesthesia with desflurane. Br J Anaesth 1995 75(5) 631-3. 

Strong upper airway irritants can be found in reaction mixtures of limonene, other terpenes, and ozone. The identified products included aldehydes, ketones, and carboxylic acids. These identified chemicals and some unidentified reaction products have been studied in upper airway irritation studies in mice, with reduction of the respiratory rate as a key end point. 

Rapid-onset ocular, nasal, and airway irritations from high levels of phosgene are caused by... 

Titanium dioxide appears to be relatively nontoxic. Ti has been used extensively in food products without apparent adverse effects. Upper airway irritation is the principle sign of acute overexposure. Increased pulmonary dust disposition may lead to alveolar cell hyperplasis and fibrosis. 

The respiratory effects of irritant mixtures are not limited to complex ones such as those just described. Volunteers who were exposed to formaldehyde at concentrations as high as 2.0 pg/m3 (greater than the PEL of 1.2 pg/m3) did not experience lower airway irritation, 8 yet those exposed to mixtures of formaldehyde (Kqw = 0.35) and terpenes (Kqw = 2.42 to 4.83) did exhibit symptoms of lower airway irritation. 9 Additional examples of the effects of respiratory irritant mixtures are presented later in the case study Section (17.7) of this chapter. 

---