However, if the victim survives the first two weeks, the prognosis is good for complete recovery, or for only mildly compromised liver and kidney function (ATSDR, 1992a).

Carbon tetrachloride toxicity has been reported after accidental inhalation (Alswang, 1979), occupational inhalation (Barnes and Jones, 1967; Folland et al., 1976), accidental ingestion (Alston, 1970), intentional ingestion (Bagnasco et al., 1978; Fogel et al., 1983; Mathieson et al., 1985) and dermal exposure (Javier Perez et al., 1987). In a case series of nineteen carbon tetrachloride poisoned patients (age range 3-79 years) 4 cases of inhalation and 15 cases by ingestion symptoms evident on presentation to hospital included nausea, vomiting, diarrhoea, abdominal pain, headache, hypotonia, confusion, agitation, drowsiness and coma. Initial liver function changes included raised AST, bilirubin, and prothrombin time ratios. The length of stay in hospital ranged from 2 to 28 days, in some cases haemodialysis was required and some patients received acetylcysteine. One patient was lost to follow-up and one died; 17 patients recovered completely, however one of these had residual abnormal LFTs (Ruprah et al., 1985).

There is a marked variation in individual susceptibility to carbon tetrachloride (Mathieson et al., 1985). Fatal cases of carbon tetrachloride ingestion have occurred from as little as 1.5 ml (Bagnasco et al., 1978), and the fatal dose from inhalation or ingestion is often quoted as 3-5 ml (Mathieson et al., 1985, Ruprah et al., 1985; Driesbach and Robertson, 1987). However, much larger doses have been survived (Mathieson et al., 1985). Survival depends, to a large extent, on the victim's nutritional status and underlying hepatorenal function. Although, there are numerous reports of injury and death from both acute and chronic exposure to carbon tetrachloride in humans, there are few epidemiological studies on occupational exposure. There are no laboratory studies of long-term exposure (IPCS, 1999).

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