Severity of exposure

Nickel carbonyl should be used in totally enclosed systems or under good local exhaust. Plants and laboratories where nickel carbonyl is used should make use of air-monitoring devices, alarms should be present in case of accidental leakage, and appropriate personal respiratory protective devices should be readily available for emergency uses. Monitoring of urinary nickel levels is useful to help determine the severity of exposure and identify appropriate treatment measures. Some large-scale users of nickel carbonyl maintain a supply of sodium diethyldithiocarbamate, or Antabuse, a therapeutic agent, on hand for use in case of overexposure. 

Natural weathering (see Section 5.2.5) can be accelerated directly by exposure in a climate more severe than that expected in service. There are established test sites for this purpose in Australia and in the hotter states of the USA. The severity of exposure can also be maximised by arranging for the plane of the test pieces to automatically follow the sun. Another approach is to use a Fresnel mirror concentrating device that increases the intensity of sunlight falling on the test piece. These procedures are standardised in ISO 877 [25]. 

Central nervous system effects predominate in acute exposures at massive doses, whereas peripheral neuropathy is more common with lower doses.After cessation of exposure to acrylamide, most cases recover, although the course of improvement can extend over months to years and depends on the severity of exposure. Because peripheral neurons can regenerate and central axons cannot, severely affected individuals may still experience residual ataxia, distal weakness, reflex loss, or sensory disturbance. 

In an epidemiological study of 1345 workers potentially exposed to acrylonitrile and followed for 10 or more years there was a greater than expected incidence of lung cancer (8 obs. vs. 4.4 exp.)." A trend toward increased risks of cancer of all sites was also observed with increased duration of exposure and with higher severity of exposure. However, in a follow-up of this cohort through 1983 the only statisti-... 

In eight cases of corneal injury reported from industrial exposure to crotonaldehyde, healing was complete in 48 hours the severity of exposure was not specified. ... 

Although inhalation is usually of secondary importance, the effects from the dust or mist will vary ftom mild irritation to severe pneumonitis, depending on the severity of exposure. Ingestion produces severe abdominal pain, corrosion of the lips, mouth, tongue, and pharynx, and the vomiting of large pieces of mucosa. In severe cases, circulatory failure, esophageal perforation, and peritonitis may occur. 

Mercury interacts with sulfhydryl groups in vivo, inhibiting enzymes and altering cell membranes. The pattern of clinical intoxication from mercury depends to a great extent on the chemical form of the metal and the route and severity of exposure. 

Like other carbamates, propoxur can inhibit the action of cholinesterase and disrupt nervous system function. Depending on the severity of exposure, this effect may be short-term and reversible. 

It may be postulated that the severity of exposure to Al determines the pattern of morbidity. Normally, Al in plasma is bound and transported by transferrin. However, when plasma Al levels exceed 500 to 600 pg/L, transferrrin s capacity for binding Al is exceeded, and Al probably exists in plasma in combination with citrate or as a hydroxide in association with phosphate. Thus, acute severe exposure may be more likely to produce the neurological disorder and increased sensitivity to flicker, whereas chronic moderate exposure may manifest primarily as bone disease and the other less dramatic symptoms [27, 125-128]. In any case, considering the fact that there have been only two reports of outbreaks of acute Al encephalopathy in dialysis centers [17, 43-45], and s-Al levels of 1200 pg/L [44] to 1700 pg/L (Table 1) have been reported (Table 6), acute Al encephalopathy due to water contamination probably only develops when the Al level in the tap water is well above 1000 pg/L. 

Nerve agent exposures must be handled quickly and efficiently. When children are exposed, it is important to remember that antidote dosing will be determined by the patient s weight and the severity of exposure. Progress has been made to provide pediatric-specific autoinjectors however, since 2-PAM Cl is not yet available in a pediatric autoinjector form, it is possible to carefiilly use adult autoinjectors to manage pediatric patients. 

Lewisite Shock Pulmonary injury Blisters Decontamination soap, water, no bleach Antidote BAL-dimercaprol may decrease systemic effects of lewisite Pulmonary management BAL 3-5 mg/kg deep IM q4 h X 4 doses (dose depends on severity of exposure and symptoms) Skin management BAL ointment Eye management BAL ophthalmic ointment... 

Those involved in individual health assessment are concerned with the early detection of specific organ kidney injury. With regard to acute kidney injury (AKI), biomarkers may serve several additional purposes. That is, they may determine AKI subtypes (prerenal, intrinisic renal, or postrenal), identify the etiology of AKI (ischemia, toxins, sepsis, or a combination), differentiate AKI from other forms of acute kidney disease (urinary tract infections, glomerulonephrihs, intershtial nephritis), predict the AKI severity (risk stratification for prognostication as well as guide to therapy), monitor the course of AKI, and monitor the response to AKI interventions. For chronic kidney disease (CKD), they provide both evidence and severity of exposure and may be used to assess response to removal of offend-... 

Exposure to environmental agents may be through the skin, lungs, or digestive system. Effects from environmental exposures to harmful agents depend upon duration, frequency, and severity of exposure, as well as susceptibility of the individual. Susceptibility may depend upon age, nutritional status, sex, or genetic makeup (heredity). The duration, frequency, and severity or exposure depend upon many factors including locality, occupation, behavior, socioeconomic status, and population density. 

Sulfur mustards are vesicants and alkylating agents however, the biochemical mechanisms of action are not clearly understood. They are highly reactive and combine rapidly with proteins, DNA, or other molecules. Therefore, within minutes following exposure, intact mustard or its reactive metabolites are not found in tissue or biological fluids. Sulfur mustards also have cholinergic activity, stimulating both muscarinic and nicotinic receptors. The onset of clinical symptoms and their time of onset depend on the severity of exposure. The death rate... 

Carcinogenesis. Surviving victims of mustard exposure during the Iran-haq War are exhibiting carcinoma of the nasopharynx, bronchogenic carcinoma, adenocarcinoma of the stomach, as well as acute myeloblastic and lymphoblastic leukemia (Balali-Mood and Hefazi, 2006). Definitive studies of the nature and types of cancers seen in this patient population and correlations with severity of exposure have yet to be published. 

However, our findings show that the level of plasma cholinesterase and the degree of miosis did not always correlate with severity of exposure. We believe that level of plasma cholinesterase and pupil diameter should only be used as approximate guides to the level of poisoning and that severity and the need for treatment should be based on clinical findings. 

Route of exposure Severity of exposure Signs and symptoms atropine dose11,6 ... 

The outcome depends on the form of mercury compormd which is the toxicant and on the severity of exposure. Mild exposure to elemental, inorganic and organic mercury can be followed by a complete recovery. Death may result from a severe exposure while neurological complications such as mood and behaviour alteration, memory loss and fine tremors often remain even when patients with moderately high exposure have been removed from the source of contamination. 

Chronic exposure to MBK via inhalation or skin absorption can cause disorders of the peripheral nervous system and neuropathic diseases. The symptoms in humans, depending on the severity of exposure, were parasthesias in the hands or feet, muscle weaknesses, weakness in ankles and hand, and difficulty in grasping... 

Sophisticated laboratory studies are of limited value in the immediate care of an exposed, injured individual. The following studies are of some predictive value in determining the severity of exposure and the likely outcome. 

Primary failure of respiration after exposure to toxicants other than nerve agents suggests a severity of exposure that requires intensive medical support at this point, a triage decision may be needed. The presence of wheezing indicates severe bronchospasm, which requires immediate therapy. The presence of dyspnea necessitates careful observation of the patient for at least 4 to 6 hours, until severe, potentially lethal respiratory damage can be reasonably excluded. 

The use of foot protection minimizes the potential for occupational foot injuries. Terms such as safety shoes and protective footwear refer to shoes which are specifically designed and tested to withstand stimuli defined in ASTM-F 2413 March 2005. Managers and employees must review their tasks to determine the potential for exposure to foot hazards and the severity of exposure and assure that foot protection is worn when necessary. 

Administrative Controls. A sound overall ergonomics program includes administrative controls that reduce the duration, frequency, and severity of exposure to ergonomic hazards. 

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