Acute inhalational and dermal methanol toxicity

Two volunteer fire-fighters developed toxicity from inhalation and dermal exposure to vapourised methanol. The incident happened following derailment and overturning of at least five railroad cars used for transporting chemicals. Two of these contained methanol, two contained sodium hydroxide and one contained isobutane. A HAZMAT (hazardous materials) station was established adjacent to the scene of the accident and police began evacuating the area. The two fire-fighters arrived late at the scene, on the opposite side of the tracks to the HAZMAT station. They reported running approximately 150 yards from where they had parked their vehicle between the non-involved railroad cars to reach the station. They were wearing short-sleeved shirts and shorts, shoes but no socks. The total estimated time spent crossing the potential hazard area was less than two minutes. They did not notice an odour at the time of exposure but on questioning later, they remembered a small cloud developing over the wreckage. On reaching the station they disrobed and donned standard fire-fighting gear. However, after 10 minutes of work, both men began to feel dizzy and nauseated and one of them vomited. They appeared to be confused and were removed from the scene for treatment for suspected heat exhaustion. On arrival at the health facility, patient one appeared well but complained of headache; patient two complained of headache and light-headedness. Although the initial diagnosis was of heat exhaustion, the methanol concentrations were determined and found to be 190 mg/l and 130 mg/l, respectively. Both men received IV ethanol and folic acid for the following 48 hours. The peak methanol concentrations were 230 mg/l and 160 mg/l at approximately 2 hours post exposure. Both patients were discharged well after 48 hours, with no ocular or CNS sequelae (Aufderheide et al., 1993).

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