Skin and Mucous Membranes

Is there evidence of chemical burning (as opposed to thermal injury) Look for erythema and evidence of painful areas. 

If there is evidence of trauma from a vesicant agent, remember that decontamination of the eye must be immediate. 

Note that there is usually a latent period before the chemical agent affects the skin, 

A toxidrome is a grouping of signs and symptoms which are important in establishing the cause of toxic trauma both individual and collective. A toxidrome can be established only after careful examination of the presenting signs and symptoms as detailed above. Toxidromes can indicate whether the patient has been affected by the deliberate release of any of the six main classes of chemical warfare agents or by one of the five main classes of toxic industrial chemicals. 

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Maleic Anhydride. The ACGIH threshold limit value in air for maleic anhydride is 0.25 ppm and the OSHA permissible exposure level (PEL) is also 0.25 ppm (181). Maleic anhydride is a corrosive irritant to eyes, skin, and mucous membranes. Pulmonary edema (collection of fluid in the lungs) can result from airborne exposure. Skin contact should be avoided by the use of mbber gloves. Dust respirators should be used when maleic anhydride dust is present. Maleic anhydride is combustible when exposed to heat or flame and can react vigorously on contact with oxidizers. The material reacts exothermically with water or steam. Violent decompositions of maleic anhydride can be catalyzed at high temperature by strong bases (sodium hydroxide, potassium hydroxide, calcium hydroxide, alkaU metals, and amines). Precaution should be taken during the manufacture and use of maleic anhydride to minimize the presence of basic materials. 

Methanol is not classified as carcinogenic, but can be acutely toxic if ingested 100—250 mL may be fatal or result in blindness. The principal physiological effect is acidosis resulting from oxidation of methanol to formic acid. Methanol is a general irritant to the skin and mucous membranes. Prolonged skin contact with methanol vapor or Hquid can cause dermatitis. Methanol vapor can cause eye and respiratory tract irritation, nausea, headaches, and dizziness. 

Potassium hydrogen monoperoxosulfate monohydrate [14696-73-2] KHSO 20, related to the triple salt, is not made commercially. The crystal stmcture has been determined and some features of its Raman and ir spectra recorded (69). This compound is more stable under x-rays than the triple salt. The 0—0 distance is 0.1460 nm. The dihedral angle of the 0—0 moiety is about 90°, similar to that ia soHd hydrogea peroxide. This compouad is reported as toxic and irritating to eyes, skin, and mucous membranes (2). Although undoubtedly correct, this description probably better relates to the triple salt. 

Health and Safety Factors, Toxicology. Phosphoms oxychloride volatilises readily its vapors are extremely irritating to the eyes, skin, and mucous membranes (49). Direct contact with the Hquid can produce severe bums. Contaminated clothing must be removed immediately. Inhalation of POCl vapors can cause pulmonary edema and temporary eyesight problems. 

Monobasic aluminum acetate is dispensed as a 7% aqueous solution for the topical treatment of certain dermatological conditions, where a combination of detergent, antiseptic, astringent, and heat-dispersant effects are needed (12). The solution, diluted with 20—40 parts water, is appHed topically to the skin and mucous membranes as a wet dressing (13). Burrow s solution, prepared from aluminum subacetate solution by the addition of a specific amount of acetic acid, is also used as a topical wet dressing. Standards of purity and concentration have been estabHshed for both pharmaceutical aluminum acetate solutions (13). Each 100 mL of aluminum subacetate solution yields 2.30—2.60 g of aluminum oxide and 5.43—6.13 g of acetic acid upon hydrolysis. For the Burow s solution, each 100 mL yields 1.20—1.45 g of aluminum oxide and 4.25—5.12 g of acetic acid. Both solutions may be stabilized to hydrolysis by the addition of boric acid in amounts not to exceed 0.9% and 0.6% for the subacetate and Burow s solutions, respectively (13). 

Because of the high vapor pressure of the simple quinones and their penetrating odor, adequate ventilation must be provided in areas where these quinones are handled or stored. Quinone vapor can harm the eyes, and a limit of 0.1 ppm of 1,4-benzoquinone in air has been recommended. Quinone in either sohd or solution form can cause severe local damage to the skin and mucous membranes. Swallowing benzoquinones may be fatal the LD q in rat is 130 mg/kg orally and 0.25 mg/kg intravenously. There is insufficient data concerning quinones and cancer. The higher quinones are less of a problem because of their decreased volatihty (118—120). 

Uranium can enter the human body orally, by inhalation, and through the skin and mucous membranes. Uranium compounds, both soluble and insoluble, ate absorbed most readily from the lungs. In the blood of exposed animals, uranium occurs in two forms in equiUbrium with each other as a nondiffusible complex with plasma proteins and as a diffusible bicarbonate complex (242). 

Toxicity of Chlorine Sanitizers. Chlorine-based swimming-pool and spa and hot-tub sanitizers irritate eyes, skin, and mucous membranes and must be handled with extreme care. The toxicities are as follows for chlorine gas, TLV = 1 ppm acute inhalation LC q = 137 ppm for 1 h (mouse) (75). The acute oral LD q (rats) for the Hquid and soHd chlorine sanitizers are NaOCl (100% basis) 8.9 g/kg (76), 65% Ca(OCl)2 850 mg/kg, sodium dichloroisocyanurate dihydrate 735 mg/kg, and trichloroisocyanuric acid 490 mg/kg. Cyanuric acid is essentially nontoxic based on an oral LD q > 20 g/kg in rabbits. Although, it is mildly irritating to the eye, it is not a skin irritant. A review of the toxicological studies on cyanuric acid and its chlorinated derivatives is given in ref. 77. 

Chloroformates, especially those of low molecular weight, are lachrimators, vesicants, and produce effects similar to those of hydrogen chloride or carboxyhc acid chlorides. They can also irritate the skin and mucous membranes, producing severe bums and possible irreversible tissue damage. 

Unlike chloroformates, diethyl and dimethyl carbonates are only mildly irritating to the eyes, skin, and mucous membranes. Diethylene glycol bis(aHyl carbonate) may be irritating to the skin, but it is not classified as a toxic substance however, it is extremely irritating to the eyes. 

Health Hazards. AHyl chloride is a toxic, highly flammable compound that is severely irritating to the skin and mucous membranes. AHyl chloride is considered to be moderately to highly toxic (LD q = 275-700 mg/kg body weight) via oral exposure. Amounts incidental to industrial handling are unlikely to cause injury. Large amounts, however, can cause injury, even death (24,50). 

Health and Safety. Eree phenols may be present in phenoHc novolacs and resoles. Phenol [108-95-2] is poisonous and caustic, irritating the skin and mucous membranes. Eormaldehyde and ammonia [7764-41-7] are often emitted during the cure of novolacs and must be properly vented. Eormaldehyde is Hsted as a human carcinogen worker exposure and emissions are controUed by OSHA and the EPA. 

In all antiseptic testing, it is recognized that skin and mucous membranes to which products ate appHed cannot be disinfected or sterilized but it is possible to significantly reduce the population of transient and resident pathogenic bacterial flora. AH in vivo test methods requite a deterrnination of the bacteria on the skin before and after treatment. Because of the normal variation in bacterial population of the skin of different people, a number of people must be tested in order to make a statistical analysis of the results. Different parts of the body are used for different tests. In aH of the tests the details of the protocol ate extremely important and must be strictly adhered to in order to obtain reproducible results. 

Arnold Press 1966]. It can exists in five crystalline forms and is steam volatile. It is a strong IRRITANT to skin and mucous membranes and can become a chronic irritant— handle with CARE. 

Colourless, corrosive nonflammable gas with an acrid odour Highly irritating to eyes, skin and mucous membranes Attacks natural rubber Decomposed by light Extremely soluble in water Fumes in moist air... 

Methyl acrylate -3 CH2 CHC00CH3 2.8-25.0 1.0 3.0 80 Colourless liquid Acrid odour Extremely irritating to respiratory system, skin and mucous membranes... 

Health Hazards Information - Recommended Personal Protective Equipment Data not available Symptoms Following Exposure Irritating to skin and mucous membranes General Treatment for Exposure Data not available Toxicity by Inhalation (ThresholdLimit Value) Not pertinent Short-Term Exposure Limits Not pertinent Toxicity by Ingestion Grade 2 oral rat LDjq 3500 mg/kg Late Toxicity Not pertinent Vapor (Gas) Irritant Characteristics Not pertinent Liquid or Solid Irritant Characteristics Data not available Odor Threshold Not pertinent. 

Hydrofluoric acid is highly corrosive to skin and mucous membranes. Even in fairly low concentrations, it causes painful skin burns and severe damage to eyes and the respiratory system. Exposure at higher levels results in destruction of tissues and death. No one in l e.xas City was exposed to more than trace concentrations of hydrofluoric acid. The acid vessel had a capacity of about 850 barrels of which a small fraction was released. 

Elemental bromine is a readily evaporating liquid (pBr at 1 °C = 0.23 bar) with high reactivity. Because of the good solubility of Br2 in lipids, its aggressive and toxic properties affect skin and mucous membranes (bronchi). The MAK value of elemental Br2 is defined as 0.1 ppm (0.7 mg m 3), while the sense of smell is affected at a value of 0.01 ppm. The lethal concentration (around 100-200 ppm) is reached for example, by twice the MAK value, 5 min, eight times per working unit [91, 92]. 

Acute infection with Hetpes simplex viruses (HSV) results in painful rashes on skin and mucous membranes. HSV-1 mainly causes cold sores around the mouth (hetpes labialis) or eyes (keratitis), whereas infection by HSV-2 mostly results in sores in the genital or anal area. Less frequently, HSV also causes severe infections in newborns or potentially fatal encephalitis. HSV remains latent and can be reactivated by stress, suppression of the immune system or other infections. 

Metaldehyde is flammable and a dangerous fire risk. It is highly toxic and a strong irritant to skin and mucous membranes (Refs 3 4). 

NOC1 is intensely irritating to the eyes, skin and mucous membranes. Inhalation can cause pulmonary edema and hemorrhage (Ref 3) Refs 1) J.R. Morton H.W. Wilcox, Inorg-Synth 4 (1953), 48 2) Anon, C EN 35 (43),... 

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