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Occupational exposure and persistent headache

A 26 year old man presented complaining of persistent headaches for one month. He had a history of occasional headaches since adolescence, but, during the past four months, his symptoms had increased in intensity and frequency and were no longer relieved by over-the-counter medication. He had worked as a carpenter in a laminated product manufacturing company for the previous six months, where his duties included working with lacquer thinner to clean cabinet surfaces and spraying laminating materials over cabinet surfaces. Neither he nor any of the other workers used any type of personal protective equipment. The products he used included a spray contact cement which contained 70 methylene chloride, toluene and methyl ethyl ketone and a lacquer thinner which contained toluene, isopropanol, ethyl acetate, isobutyl alcohol and isobutyl acetate. Physical examination was unremarkable apart from his skin on both hands, which showed marked thickening and was very dry with fissures and...

Cerebral damage following a single high exposure to carbon disulphide

After a few asymptomatic days he then had progressive complaints of anxiety, nightmares, intermittent blurred vision lasting a few seconds, reduced memory and concentration, and headache, resulting in absences from work 2-3 times a week. Precordial pain and impotence occurred, symptoms which the patient had never previously experienced. As the symptoms progressed the patient was referred to an occupational medicine clinic. Neuropsychological examination established dementia in the form of reduced ability to learn and memorise, reduced rate in simple reaction time as well as in more complex tasks, and a reduction in abstract thinking. There were no focal neurological signs.

Accidental occupational exposure

A 36 year old boiler cleaner was working on the removal of sludge from a carbon tetrachloride tank. On the first day he acted as watchman for two other workers who were inside the tank, who were using full-face respirators. On the second day he entered the tank and washed it out several times with a high pressure hose. As the tank had been washed the previous day he did not anticipate any risk and did not wear a respirator. He worked in the tank for three hours, finishing at noon, and left to meet some friends. On the way he became nauseated and developed a severe headache, and decided, instead, to go home to bed. Over the next two days he became very drowsy, nauseated, vomited several times and passed very little urine. On the third day he was admitted to hospital where he complained of loin pain, nausea, vomiting and severe headache. On examination he was jaundiced, delirious and had extensive subconjunctival haemorrhages. He was anuric and laboratory investigations revealed high...

How Can Hccpd Affect My Health

Information on the health effects of HCCPD on people is limited to one incident involving short-term exposure to HCCPD vapors (0.04-19.2 ppm). Exposure occurred at a waste water treatment plant as a result of an industrial release of HCCPD into the sewage system. This incident showed that the breathing passageways (nose, throat, lungs) in people are very sensitive to HCCPD. You may get a sore throat or have shortness of breath and chest discomfort if you breathe HCCPD at high levels. Your eyes may burn and turn red, and your skin may be irritated. Some people get headaches when they breathe high levels of HCCPD.

Occupational exposure

A 40 year old man presented to hospital with abdominal pain, nausea and headache two weeks after starting work as a fabric coating machine operator. He stated that other workers suffered similar effects. Liver function tests showed an elevated AST. Alkaline phosphatase and bilirubin concentrations at this time were normal. Tests for hepatitis A IgM antibody and hepatitis B surface antigen were negative. An abdominal ultrasound was normal. He was thought to have toxic hepatitis and was removed from his work his symptoms resolved. The ALT was elevated at three times normal 3.5 months later. A liver biopsy showed changes consistent with resolving toxic injury, including evidence of diffuse regeneration, binucleated hepatocytes and variation in nuclear size. There was also spotty unicellular necrosis, enlarged Kupffer cells within the sinusoids and diffuse steatosis. There was no evidence of chronic disease. Transaminase concentrations returned to normal 6 months after removal from...

Air pollution and health

The two gases that particularly characterize photochemical smog, O3 and nitrogen oxides, caused particular concern because of their potential to induce respiratory problems. Ozone impairs lung function, while nitrogen oxides at high concentrations are particularly likely to affect asthmatics. Oxygen-containing compounds, such as aldehydes, cause eye, nose and throat irritation, as well as headaches, during periods of smog. Eye irritation is a frequent complaint in Los Angeles and other photochemically polluted cities. This eye irritation is particularly associated with a group of nitrogen-containing organic compounds. They are produced in reactions of nitrogen oxides with various organic compounds in the smog (Box 3.6). The best known of these nitrogen-containing eye irritants is peroxyacetylnitrate, often called PAN.

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...

Chronic occupational exposure and memory impairment

A 44 year old man had worked from 1966 to 1982 as a chemical operator. He wore gloves and coveralls and was intermittently exposed to acetone 1,000 ppm, n-butyl acetone 100 ppm, isopropyl ether 500 ppm, isopropanol 400 ppm and MIBK 100 ppm. He had remained well during this period. From 1982 until 1987 he worked as a supervisor in a poorly ventilated area of a solvent extraction facility. He was exposed daily to concentrations of MIBK in excess of 100 ppm for 8 hours daily. Several times a day he also became soaked in the solvent when he climbed into a large chamber. He had daily headaches which cleared during the weekend. Following each period in the chamber he also experienced sedation and syncope. He also worked regular double shifts in 1985 and 1986.

Chronic occupational exposure

The second patient, a 45 year old male was admitted because of cough, shortness of breath, pyrexia, lethargy, staggering gait, blurred vision, slurred speech, poor memory, headache, confusion, anorexia, nausea, vomiting and nocturia. These effects had developed over the previous month after he had started working on the same operation as the first patient. Examination revealed only abnormal neurological signs with poor concentration, orientation, reasoning and recent memory. His haemoglobin and haemacrit were low. So was the white cell count at 5,100 with 30 neutrophils, 1 metamyelocytes, 58 lymphocytes, 8 monocytes and 2 eosinophils. A bone marrow aspirate showed marrow damage compatible with a marrow toxin. He recovered within a week without treatment (Ohi and Wegman, 1978).

Flavivirus Yellow Fever Dengue Japanese Encephalitis

The YF remains a serious endemic disease and a constant threat in Sub-Saharan Africa and South America (including Trinidad). It does not prevail in Asia, Oceania, nor the Indian Ocean. The incidence of YF varies greatly from one year to another in 1997, the WHO considered an annual incidence of YF of 200 000 cases, with 30 000 deaths per year. Many YF infections are mild, but the disease can cause severe, life-threatening illness. Symptoms can include high fever, chills, headache, muscle aches, vomiting, and backache. After a brief recovery period, the infection can lead to shock, bleeding, and kidney and liver failure with ''black vomit''. Liver failure causes jaundice (yellowing of the skin and the whites of the eyes), which gives YF its name. Symptoms start three to six days after being bitten by an infected mosquito. Yellow fever virus is diagnosed by a blood test. There is no specific treatment, but infected people should rest and drink plenty of fluids. Yellow fever virus can be...

Human Reproduction and Child Development

Chemical exposures in general can also have epigenetic transgenera-tional effects on future children. Eskenazi also described one scientific paper that explored the effect of oil spills on the health of pregnant women, finding only short-term eye irritation, headaches, and abdominal pain in pregnant women (Kim et al., 2009). However, maternal exposures to certain fungicides have been shown to cause low sperm counts in rats four generations removed (Anway et al., 2005). Paternal exposures to certain chemicals can also affect offspring, which is important because many of the Gulf oil disaster clean-up workers are fathers or future fathers, said Eskenazi. A growing body of evidence finds that paternal exposure to specific toxins can increase the risk of spontaneous abortion, birth defects, and aneuploidy syndromes (such as Down syndrome) in children. A 2010 study showed that fathers who had been exposed to workplace benzene had an increased risk of sperm hyperploidy, which could result...

List Of Contaminants And Their Mcls Epa 816F02013 July 2002

Turbidity is a measure of the cloudiness of water. It is used to indicate water quality and filtration effectiveness (e.g whether disease-causing organisms are present). Higher turbidity levels are often associated with higher levels of disease-causing microorganisms such as viruses, parasites and some bacteria. These organisms can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. 5 Fecal coliform and E. coli are bacteria whose presence indicates that the water may be contaminated with human or animal wastes. Disease-causing microbes (pathogens) in these wastes can cause diarrhea, cramps, nausea, headaches, or other symptoms. These pathogens may pose a special health risk for infants, young children, and people with severely compromised immune systems.

Disease Health Measurement

Other than observing whether someone is dead or alive, most health disease measurements are subject to some level of observer variation in diagnosis, assessment or reporting. This cannot be ironed out for the convenience of epidemiology. The important question is whether health disease are being measured consistently in exposed and unexposed people, or whether for any reason exposure status may affect the likelihood that people of equal health status are diagnosed as having a disease or not. If either the researcher, health assessor or the subject of the study knows that disease may be related to exposure at the time the health assessment is made, then they may be influenced in their assessment leading to bias in the results. For example, a study may send a questionnaire to all members of a community to study the health impact of an incinerator or landfill. If the questionnaire concerns health assessments on the more 'subjective' end of the spectrum, for example headaches and feelings...

The Recycling ofTires

Another consumer commodity that presents a waste-management headache is vehicle tires. In North America, about one 10-kg rubber tire per person per year on average is discarded thus about one-third of a billion tires are added to the supply of approximately 3 billion tires presently stored in mountainous piles, awaiting ultimate disposal Because the tires are made primarly from oil and consequently are flammable, tire fires in these huge piles are not uncommon and produce tremendous amounts of smoke, carbon monoxide, and toxins such as polynuclear aromatic hydrocarbons (PAHs) and dioxins (Chapters 11 and 12). The fires are difficult to extinguish because of air pockets in and between the tires.

Social Sustainability of Nuclear Energy

The health effect of the Chernobyl accident was short-term (deterministic) and long-term (stochastic). Out of 499 people that were admitted for observation right after the Chernobyl accident, 237 people suffered from acute radiation effects (Metivier 2007). Out of the 237, 28 died immediately. Ulcer, leukemia, and thyroid tumors were identified in some of them. The long term effects were different types of cancers, including thyroid cancer in children. The soil, water, vegetables, and other foods including milk were contaminated, which showed long-term implications for the health systems. Several patients were reported to have developed mental and physiological problems after the accidents. For a period of 12 years after the Chernobyl accident, thyroid carcinoma increased by 4,057 cases in Belarus, as compared to the same period of time before (Metivier 2007). Some studies linked several types of cancers, including leukemia in children, in Germany, Sweden, Greece, and other European...

Identification of Data Needs

Inhalation exposure to HCCPD for 3-15 days was associated with complaints of headaches in workers in a waste water treatment plant (Morse et al. 1979). High-concentration acute-duration inhalation exposures ( 41.6 ppm) in animals caused tremors (Treon et al. 1955), and longer-term exposures were associated with lethargy (NTP 1994). Diffuse degeneration of the brain was seen in animals following inhalation, oral, and dermal exposures (Treon et al. 1955). Accordingly, detailed investigation of the brain lesions that are observed with HCCPD exposure is justified. Additional neuro-toxicity studies evaluating functional end points after inhalation exposure that might be relevant to the occupational setting are needed. In addition, attention should be paid to the effects of HCCPD on unsaturated brain lipids and neurotransmitter derivatives of the aromatic amino acids. These molecules have the potential to react with this conjugated diene. There is no information to suggest...

Minor mycotoxins 221 Ergot alkaloids

Therapeutic properties of ergot, was the starting point, followed by the isolation of ergotamine, the first ergot alkaloid used in therapeutic, in 1918 by A. Stoll. With the determination of the basic chemical structure of the ergot alkaloids in the early 1930s, an era of intensive exploration of synthetic derivatives began. The ergot alkaloids are indole compounds that are biosynthetically derived from L-tryptophan and represent the largest group of nitrogenous fungal metabolites found in nature. Over 80 different ergot alkaloids have been isolated, mainly from various Claviceps species (over 70 alkaloids), but also from other fungi and higher plants. In addition to the naturally occurring ergonovine (used as an oxytocic) and ergotamine (an analgesic used to control migraine), synthetic derivatives of continuing importance today are the oxytocic methergine, the antimigraine drugs dihydroergotamine and methysergide, the anti-senility nootropic (smart drug) Hydergine and bromocriptine,...

Relevance To Public Health Overview

Some data pertaining to human exposures to HCCPD (100-200 people) come from an incident where waste water treatment plant workers and clean-up crews members were exposed after an industrial discharge. Irritation of the eyes, skin, and breathing passages were the primary complaints of those exposed. Less frequently, there were complaints of nausea and headaches. Issues relevant to children are explicitly discussed in Section 2.6, Children's Susceptibility, and Section 5.6, Exposures of Children.

Neurological Effects

An industrial waste worker who accidentally splashed pure 2,4-DCP on portions of his right arm and leg, experienced a seizure within 20 minutes of the exposure, and died shortly thereafter (Kintz et al. 1992). Lumber mill workers exposed to a mixture of tetrachlorophenols (specific isomers not stated) and pentachlorophenol reported headaches more frequently than unexposed workers (Kleinman et al. 1986). Industrial hygiene observations of inadequate use of protective equipment to prevent skin exposure led the investigators to suggest that exposure was principally through the skin, with some possibility of oral ingestion.

Bunyavirus Bunyamwera La Crosse Phlebovirus (Rift Valley Fever). Rift Valley fever virus (RVF) is at the origin of epidemics in Africa, Kenya (1930, 1997), Chad and Cameroon (1967), Egypt (1977), Mauritania (1987), Malagasy (1991), the Arabian Peninsula (2000). Its vector is Culex pipiens. In 2001, two strains of RVF virus were isolated on 50 French soldiers in Chad. Symptoms range from asymptomatic forms and mild forms with fever, muscle pain, joint pain and headache, to serious forms with ocular disorder, meningo-encephalitis or haemorrhagic fever. Reservoir hosts livestock (RVF is a disease of herders, farmers, slaughterhouse workers and veterinarians) vectors Aedes, Mansonia

Toxic reaction to white spirit fumes

He got up for a short while 19 hours later but returned to bed because he was unsteady on his feet. His cough continued and he was still restless, often shouting in his sleep. After a further six hours he got up again, but was very uncoordinated and complained of a headache. He subsequently fell down stairs and was unrousable for about five minutes, then became aggressive and confused.


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...

Chronic exposure

As methanol is eliminated from the body relatively slowly, there is a possibility of cumulative toxicity with repeated exposures. However, there is limited information in the literature on chronic methanol exposure. Workers exposed to an average methanol concentration of 459 ppm complained of eye and nose irritation, headache, forgetfulness at work and increased sensitivity of the skin (Kawai et al., 1991).

State Responses

At the time of the workshop, only Alabama had detected an increase in illness through syndromic surveillance (29 exposure-related emergency room visits, mostly inhalation related). Additionally, Alabama had detected 66 exposure-related illnesses through reporting surveillance, with most being inhalation related. Louisiana had detected a total of 143 exposure-related illnesses through reporting surveillance. Most illnesses were inhalation-related illnesses among rig workers or clean-up workers, with the most commonly reported symptoms being headache, nausea, and throat irritation.


(3) rash, and (4) other (nausea, vomiting, headache). The inland hospitals serve as controls. The data are reported on a daily basis as a percentage of all non-trauma patients seen in a 24-hour period. Mary Currier emphasized the importance of gathering baseline data to get a sense of normal and routine, so that spikes can be readily identified and investigated. She showed a few examples of the types of spikes in data that prompted further investigation (see Figure 5-1).

Case Reports

A 23 year old female laboratory technician was employed as an atomic spectrophotometer operator. She was normally fit and well, did not smoke, drink alcohol or use caffeine, although she was taking prenatal vitamins daily including 4000 IU of vitamin A (UK adult recommended daily amount 2500 IU). Working without personal protective equipment, she was exposed daily to NMP and small quantities of methanol and or acetone. Ultrasound examination revealed a healthy fetus at 14 weeks gestation. After raising concerns with an occupational medicine consultant about an NMP material safety data sheet listing reports of fetotoxicity and teratogenicity in rats, she was given a respirator and protective clothing including latex gloves, a lab coat and goggles. The latex gloves dissolved and extensive dermal exposure to the hands occurred at 16 weeks gestation, when she cleaned up a spillage of NMP. Over the following four days she experienced malaise, headache, nausea and vomiting. Staining of the...

Impact and Toxicity

Example Fertility Diet

Phenolic toxicity has been studied on selected microbes (e.g. protozoa, yeast and bacteria), algae, duckweed and numerous invertebrates and vertebrates. Human consumption of phenol contaminated water can cause severe pain, blood changes, liver injury and muscular effects, and even death (Flocco et al., 2002 Aksu, 2005). In addition, chronic toxic effects on human include vomiting, difficulty in swallowing, anorexia, liver and kidney damage, headache and other mental disturbances (Srivastava et al., 2006). A probable oral lethal dose to humans is 50-500 mg kg-1. Similarly, chronic effects on animals include shortened lifespan, reproductive problems, lower fertility and changes in behaviour (Flocco et al., 2002).

Tin and Lead

Anorexia Organ Damage

The toxicity of lead in the environment has caused extensive concern in recent years. The current U.S. limit for lead in water is 0.015 mg liter. Like mercury, Pb(II) forms comparatively covalent bonds with appropriate donor groups in complexes, generally favoring sulfur and nitrogen over oxygen donors, and it may owe some of its physiological action to replacement of other metals in some enzymes. Low levels have subtle effects on the nervous system, while higher levels can lead to many symptoms, such as severe effects on the nervous system, including loss of sight and hearing, as well as symptoms of gout, headache, insomnia, anemia, kidney damage, diarrhea, stomach pains, intestinal paralysis, and eventually death.


Toxicity, acute condition Adverse effects occurring shortly after the administration or intake of a single or multiple dose of a substance (oral rat LD50). Conditions classified as acute include viruses, colds, flu, and other respiratory conditions headaches, gastrointestinal disorders, and other digestive conditions accidental injuries genitourinary disorders diseases of the skin and other acute conditions. A condition that has lasted less than three months and has involved either a physician visit (medical attention) or restricted activity.

Yessotoxins Ytxs

Ammonia Adduct

Brevetoxins are depolarizing substances that open voltage gated sodium ion channels in cell membranes, leading to uncontrolled sodium ion influx into the cell. The main route of human intoxication is from the consumption of shellfish 9,125 . The effects of NSP are felt within 30-60 min and include chills, headache, diarrhoea, muscle weakness, muscle and joint pain, nausea and vomiting. In extreme cases, altered perception of hot and cold, difficulty in breathing, double vision and difficulty in swallowing. These toxins also cause respiratory distress by inhalation of sea spray 126 . NSP has not been known to be fatal, with symptoms generally resolving within a few days. Many brevetoxins have been identified as being products of the red tide dinoflagellate, Karenia brevis (formerly Ptychodiscus brevis) 127,128 . Studies into the metabolic products produced in shellfish, especially mussels, have revealed multiple brevetoxin analogues 129,130 .


At the time of the workshop, there had been a total of 143 reported exposure-related illnesses (108 workers, 35 general public), including 20 hospitalizations (17 workers, 3 general public). Poison control centers reported most of the data (73 reports), followed by physician clinics (33 reports), and the hotline (3 reports). The most commonly reported route of exposure was odor or inhalation, followed by skin contact. Again, most of the illnesses were among rig workers or clean-up workers, with the most commonly reported symptoms being headache, nausea, and throat irritation. An important limitation of the surveillance data being collected (at the time of the workshop) is that no attempts were made to confirm exact exposure. Confirming self-reported exposures is challenging. People's perception of reality is often very different from reality, and people may perceive that they are exposed to things when they are not, said Guidry. For example, after receiving multiple reports of nausea,...

Systemic Effects

Exposure to HCCPD vapors was associated with headaches in 45 of 145 individuals who responded to a questionnaire after being exposed at a waste water treatment plant (Morse et al. 1979). As much as 6 weeks later, 18 of 177 respondents were still experiencing headaches. Tremors were noted in animals acutely exposed to HCCPD vapor concentrations of 41.6 ppm or greater (Treon et al. 1955). Rats exposed to concentrations of 0.4-2 ppm were described as listless after 1-3 weeks of exposure (NTP 1994). The higher the dose, the sooner the listlessness was noted. It must be remembered that these same doses were also lethal. Thus, the listless behavior could well have been a symptom of impending death rather than HCCPD neurotoxicity. Scattered degenerative brain lesions were seen following acute- and intermediate-duration doses of 0.13 ppm or more, or acute oral doses of 579 mg kg day or more. With dermal exposure, the doses associated with effects on the brain were not...