Renal toxicity, phenol

No MRLs were derived for inhalation exposure to phenol. Human inhalation studies of phenol alone were not identified. Inhaled phenol is a respiratory irritant in animals and decreased respiration rate in mice by 50% during a 5-minute exposure at 166 ppm (De Ceaurriz et al. 1981). Based on their studies in mice, De Ceaurriz et al. (1981) estimated that a level of 2 ppm would be aNOAEL for respiratory effects in humans. A study in rhesus monkeys, rats, and mice did not find significant effects following a 90-day continuous exposure at 5 ppm (Sandage 1961). Intermittent exposure of guinea pigs and rabbits to 26-52 ppm phenol resulted in severe respiratory, cardiovascular, hepatic, and renal toxicity (Deichmann et al. 1944). Similar effects were not observed in rats exposed in a similar manner. 

When intoxication has been severe and death narrowly avoided, jaundice and oliganuria follow - a sign of the hepatic and renal toxicity of phenol. These cases do not fall... 

Some cases of hepatic and renal toxicity after severe poisoning with phenol derivatives have been reported in the literature, but I have not been able to find any such record in medical publications dealing with phenol peels. 

Acute oral and percutaneous toxicity of pyrocatechol is greater than that of phenol inhalation toxicity is less than that of phenol. The toxic symptoms include weakness, muscular pain, dark urine, tremor, dyspnea, and convulsions. Large amounts can produce degenerative changes in renal tubules. Large doses can cause death due to respiratory failure. Skin contact can cause eczematous dermatitis. 

Phenols are carcinogenic [39-42] and mutagenic thus affect the central nervous system. Long term contact to phenol may even paralyze the body and damage liver, kidneys [41] and heart [43]. Phenol and its vapour are corrosive to the eyes, skin and respiratory tract [44], Renal failure and pulmonary toxicity has been reported with overdose of 89% injectable phenol solution [45]. According to Central Pollution Control Board (CPCB) the discharge limit of phenol in inland water should be lower than 1 mg/1 [46],... 

The present paper deals with a relation between toxicity and accumulation of chlorophenols in goldfish, Carassius auratus, PCP metabolites and their amounts excreted by the three major routes (branchial, renal and biliary) in the fish, and also with effects of pre-exposure to PCP on PCP-tolerance and on sulfate conjugation with phenol by the liver soluble fraction of the fish. 

Systemic adverse effects can occur through absorption from intact skin or wounds, by ingestion, or by absorption of vapor through the skin or via the lungs. They include central nervous stimulation followed by depression, seizures, coma, tachycardia, hypotension, dysrhjdhmias, pulmonary edema, metabolic acidosis, and hepatic and renal injury. Serious adverse reactions due to percutaneous absorption can occur and death has been described several times. The signs and symptoms of phenol toxicity have been reviewed (3-7) and are listed in Table 1. 

Intravenous access should always be set up to help diuresis by infusing 11 of physiological saline or glucose solution throughout the procedure and for 1 hour afterwards. Proper diuresis is usually considered to be an effective way of reducing the toxic effects of phenol by helping renal elimination. 

Clinical manifestation. It includes several syndromes a) pulmotoxic and irritative syndrome - expressed by catarrhal changes on the contact mucosa and respiratory tract, toxic pulmonary oedema b) hemotoxic syndrome - expressed by severe hemolysis of different degrees, in the severe forms - hemolytic shock and anaemia c) hepatal syndrome - characterised by subicterus or icterus, increased liver and bilirubinaemia d) renal syndrome - by oliguria or anuria, pathological deviations in the urine and acute kidney insufficiency. In the extremely severe forms consciousness is disordered. Laboratory blood and urine chemical tests show evidence of phenol metabolites, data for blood damage (increased values of free hemoglobin, reduced number of erythrocytes), positive liver tests etc. 

Catechol (1,2-benzenediol [CAS 120-80-9]) Highly Irritating upon direct contact severe eye and deep skin burns result. Well absorbed by skin. Systemic toxicity similar to that of phenol (see p 302) however, catechol may be more likely to cause convulsions and hypertension. At high doses, renal and liver injury may occur. 5 ppm, S, A3 Colorless solid crystals. 

Phenol peels are categorized as deep peels. Similar to TCA, phenol works through protein denaturation and coagulation. However, phenol differs from TCA in that it penetrates quickly to the level of the reticular dermis. Phenol is partially detoxified by the liver and excreted through the kidneys. Percutaneous absorption of phenol can lead to rapid elevation of serum phenol levels, resulting in systemic toxicity and cardiac arrhythmias. Therefore, all patients should be cleared from a cardiac, hepatic, and renal standpoint preoperatively. In addition, intraoperative cardiac monitoring is imperative. 

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