Kidney failure apparently results from the … • Mentally, the symptoms range from inability to sleep properly to severe nightmares. Signs and symptoms occur 2 to 24 hours after exposure and result from massive hemolysis. Lower-dose chronic arsenic exposure can result in subacute toxicity that can include skin changes and skin cancer, peripheral sensorimotor neuropathy, diabetes mellitus, cardiovascular effects, peripheral vascular disease, hepatotoxicity, and other conditions []. Symptoms by organ system are as follows: General - … Tab Biol Per [1933]; 3:231 (in German). The extent of poisoning caused by arsine depends on how much arsine a person has been exposed to and how long the person was exposed. Arsine is a colourless, odourless, tasteless, nonirritating gas that causes a rapid and unique destruction of red blood cells and may result in kidney failure, which is uniformly fatal without proper therapy. In all cases of poisoning, it must be determined if this was an suicidal attempt. The clinical signs of hemolysis may not appear for up to 24 hours after acute exposure, thereby obscuring the relationship between exposure and effect. Inorganic arsenic may cause abdominal pains, destruction of red blood cells (hemolysis), shock, and death quickly. Arch Environ Health . Acute hemolytic anemia after occupational arsine exposure has been described in the smelting, refining, and chemical industries. Two fatal cases of arsine poisoning are reported. Arsine toxicity is different from arsenic toxicity. 19(1):133-43. With longer exposures, anemia is a prominent feature. Symptoms of poisoning appear after exposure to concentrations of 0.5 ppm. Hallucinations, delirium and severe anxiety are also quite common. Dermal exposures: An abnormal pigmentation of the skin may be seen. However, in subacute poisoning the onset of milder GI symptoms may be so insidious that the possibility of arsenic intoxification is overlooked. After arsine exposure, symptoms may be delayed for several hours. Symptoms can take several hours to become apparent. People exposed to a low or moderate dose of arsine by inhalation may experience some or all of the following symptoms within 24 hours of exposure: Confusion. Drowsiness. Fatigue. Headache. Muscle cramps. Nausea, vomiting, and/or abdominal pain. Rapid breathing. Depending on the intensity of exposure to arsine, symptoms are likely to occur within the first 24 hours after exposure. However, exposure to high doses of arsine can be fatal immediately. After arsine enters the bloodstream, it damages the red blood cells and can lead to signs and symptoms of hemolytic anemia as a direct result of this damage. The symptoms of blood agent poisoning depend on concentration and duration. [britannica.com] Ocular exposures: Red staining of the conjunctiva may be an early sign of arsine poisoning. A fifth worker also passed dark urine but had no other symptoms. The intensity and length of arsine exposure, and the premorbid condition of the person exposed, will contribute to the time of onset and the severity of illness. Oliguria and renal failure often occur 1-3 days after exposure. 2 Arsine is a powerful hemolytic poison in both acute and chronic exposures. The length of time between exposure and exhibition of symptoms depends on the concentration and duration of exposure. Arsine poisoning causes acute intravascular hemolysis, which may lead to renal failure. As the arsenic poisoning progresses, the patient may start experiencing convulsions, and their fingernail pigmentation may change. The processes in which the men were employed were in the handling of dross from molten lead alloy to which aluminium had been added; experiments to show the reactions resulting in the evolution of arsine are described, and a method is suggested for controlling the formation of arsine by altering the technique of the process. Twosubsequently died. Inhalation exposures: The signs and symptoms of acute poisoning are consistent with acute and massive hemolysis. ARSINE POISONING BY D. BLAIR MACAULAY and D. AUSTEN STANLEY From Bootle Hospital (RECEIVED FOR PUBLICATION MARCH 26, 1956) On June 20, 1952, at a tin smelting works in Bootle, six men were by mischance exposed to arsine gas ofvarying intensities. These symptoms usually occur within 30 to 60 minutes with heavy exposure, but can be delayed for 2 to 24 hours. Cardiac and Vascular System The clinical signs of hemolysis may not appear for up to 24 hours after acute exposure, thereby obscuring the relationship between exposure and effect. Arsine, the most toxic form of arsenic, is often produced from the reduction of inorganic arsenic salts with the use of acids and metal cofactors such as zinc. Five parts per million of arsine were found to be present in the atmosphere during slag washing, but higher levels would have occurred on the occasions when slag from the making of an aluminium copper alloy from copper with an arsenic content was similarly treated. If arsenic poisoning occurs over a brief period of time, symptoms may include vomiting, abdominal pain, encephalopathy, and watery diarrhea that contains blood. Facts About Arsine Overview of arsine, including signs, symptoms, & treatment. How arsine works . There is little information on the chronic toxicity of arsine, although it is reasonable to assume that, in common with other arsenic compounds, a long-term exposure could lead to arsenicosis . The symptoms of arsenic poisoning can be acute, or severe and immediate, or chronic, where damage to health is experienced over a longer period. This will often depend on the method of exposure. A person who has swallowed arsenic may show signs and symptoms within 30 minutes. Disease/Syndrome. Signs and symptoms associated with … Peripheral neuropathy was still present 6 months after exposure (Gosselin et al., 1982). Symptoms. Depending on the intensity of exposure to arsine, symptoms are likely to occur within the first 24 hours after exposure. Symptoms include nausea, headache, poor appetite, abdominal colic, palpitation on exertion, and blood-colored urine and jaundice. Common initial symptoms of exposure include malaise, headache, thirst, shivering, abdominal pain, and dyspnea. Physical characteristics of arsine and the symptoms and mechanisms of arsine poisoning are discussed. Depending on the intensity of exposure to arsine, symptoms may occur 2 to 24 hours after exposure. How arsine works • The extent of poisoning caused by arsine depends on the amount of arsine to which a person has been exposed and on the length of time of the exposure. Arsine is a powerful hemolytic poison in both acute and chronic exposures. Most cases of arsine poisoning have occurred with the use of … The primary route of exposure is inhalation, but poisoning due to skin contact is possible. The typical picture in subacute arsenic toxicity includes the onset of gastrointestinal symptoms—nausea, vomiting, and diarrhea—which may be intermittent but in retrospect are associated with ingestion of hot or cold beverages. However, exposure to high doses of arsine can be immediately fatal. Signs/Symptoms TIME COURSE: The first signs of arsine (SA) poisoning (nausea, vomiting [emesis], and crampy abdominal pain) may occur a few minutes to 24 hours after exposure. Arsine is one of the most potent haemolytic agents found in industry. Arsine is the most acutely toxic form of arsenic. However, exposure to high doses of arsine can be fatal immediately. Symptoms of arsenic poisoning vary with the type and concentration of the poison. Oliguria and renal failure often occur 1 to 3 days after exposure (1-3). Arsine (arsenic hydride) poisoning in the workplace. Symptoms of chronic poisoning are similar to those observed in acute poisoning. Fundam Appl Toxicol 5:499-505. The classic triad of symptoms in sublethal arsine exposures includes abdominal pain, hematuria, and jaundice. Phoon WH, Chan MO, Goh CH, Edmondson RP, Kwek YK, Gan SL, Ngui SJ, Kwok SF. Case Definition: Arsine or Stibine Poisoning Clinical description, laboratory criteria, case classification,and resources. Arsine is extremely toxic and is lethal at low concentrations. • Depending on the intensity of exposure to arsine, symptoms may occur 2 to 24 hours after exposure. Henderson and Haggard (1943) observed that the lethal dose of arsine for humans was 250 mg/m 3 for 30 minutes, and that symptoms of poisoning occur after a few hours of exposure to 3–10 mg/m 3. Hematological responses to arsine exposure: quantitation of exposure response in mice. Arsine causes massive hemolysis and results in anemia, jaundice, and hemoglobinuric renal failure. Signs and symptoms include generalized weakness, dark urine, jaundice, and dyspnea. Subacute poisoning resulting from exposure for a few days may cause reactive airways dysfunction syndrome (RADS) months later. However, exposure to high doses of arsine can be immediately fatal. industries. Hemoglobinuria usually occurs within hours, jaundice within 1 or 2 days. Difficulty in swallowing, abdominal pain, vomiting, diarrhea, and dehydration may result. Acute arsenic poisoning can occur through ingestion of contaminated water, occupational exposure and deliberate poisoning.… Acute Arsenic Poisoning: Read more about Symptoms, Diagnosis, Treatment, Complications, Causes and Prognosis. Five cases of arsine poisoning. Arsine is a powerful hemolytic poison both in acute and long-term exposure. Teitelbaum DT, Kier LC [1969]. occupational circumstances. Rapid hemolysis may lead to oliguric renal failure and death. Arsine attacks hemoglobin causing symptoms of headaches, vertigo, and nausea. Signs/Symptoms TIME COURSE: The first signs of arsine (SA) poisoning (nausea, vomiting [emesis], and crampy abdominal pain) may occur a few minutes to 24 hours after exposure. Serious arsine (SA) exposure may produce symptoms in 30 to 60 minutes, but they may be delayed for 2 to 24 hours. Arsenic poisoning is a medical condition that occurs due to elevated levels of arsenic in the body. Lower concentrations of inorganic arsenic and organic arsenic cause far less severe symptoms. Toxic Syndrome Description: Arsine or Stibine Poisoning Includes comprehensive signs & symptoms & differential diagnosis. Initial symptoms of arsine poisoning may include headache, nausea, abdominal pain, and hematuria. Blackwell M, Robbins A. The most serious problems tend to occur from exposure to … Circulatory collapse may occur and be followed by death within a few hours. Arsenic is a metalloid element. While the above list is far from exhaustive, it is a good starting point to recognize symptoms of arsenic poisoning. According to another hypothesis, arsine acts on sodium-potassium pomp mechanism, producing subsequent red blood cell swelling and hemolysis. The central mechanism of arsine poisoning is rapid intravascular hemolysis. Cyanide-based blood agents irritate the eyes and the respiratory tract, while arsine is nonirritating. When the individual presents with symptoms of arsine gas exposure, this is usually also related to an occupational accident. Symptoms may last for several days. Hydrogen cyanide has a faint, bitter, almond odor that only about half of all people can smell. 1969 Jul. How arsine works. [] Possible sources of occupational exposure are many, including microchip production in the semiconductor industry and other industries in which workers are involved in galvanizing, soldering, etching, and lead plating. A delay of 2-24 hours is typical before the onset of any symptoms. Symptoms of acute poisoning from swallowing arsenic include nausea, vomiting, burning of the mouth and throat, and severe abdominal pains. Arsine gas does not produce arsenic intoxication. The National Institute for Occupational Safety and Health (NIOSH) recommends that appropriate workpractices be implemented to reduce the risk of worker exposure to arsine (AsH3) gas. Four workers presented with abdominal pain, jaundice and passing tea-coloured urine. Initially, there is painless hemoglobinuria, dizziness, weakness, nausea, vomiting, abdominal cramping and tenderness. Acute high-dose exposure to arsenic can cause severe systemic toxicity and death. Late consequences of acute arsine poisoning include chronic renal damage, hematological changes, polyneuritis, and neuropsychological symptoms (e.g., irritation, confusion, memory losses, agitation, and disorientation). Clinical symptoms of poisoning occur after exposure for a few hours to 0.5–10 mg/m 3. Arsenic is highly toxic and can enter the body through the gastrointestinal tract, skin or lungs. Arsine poisoning: report of five cases in the petroleum industry and a discussion of the indications for exchange transfusion and hemodialysis. [10] Serious arsine (SA) exposure may produce symptoms in 30 to 60 minutes, but they may be delayed for 2 … These signs and symptoms include generalized weakness, dark urine, jaundice, and dyspnea. Short-term arsenic poisoning can cause unpleasant symptoms, but the outlook remains good overall. Initial symptoms of arsine poisoning include nausea, vomiting, headache, malaise, weakness, dizziness, abdominal pain, flank pain, and dyspnea. The main difference is a longer latency period. Inhalation of arsine gas produces headache, malaise, weakness, dizziness, dyspnea, and GI distress more rapidly. Report of five cases in the petroleum industry and a discussion of the indications for exchange transfusion and hemodialysis. Paresthesias and peripheral neuropathy are common symptoms of a work-related arsenic poisoning. Identified in 1775, arsine is a highly poisonous, colorless, nonirritating gas A case series documenting comprehensive descriptions of the symptoms and clinical course of arsine toxicity was published in 1975. The extent of poisoning caused by arsine depends on the amount of arsine to which a person has been exposed and on the length of time of the exposure. Arsine poisoning. Inhalation of arsine gas causes no immediate symptoms. Initial symptoms of arsine poisoning may include headache, nausea, abdominal pain, and hematuria. INTRODUCTION. Long-term exposure can result in thickening of the skin, darker skin, abdominal pain, diarrhea, heart disease, numbness, and cancer. In the reported cases, arsine was formed as a by-product of a chemical reaction between a base metal, an arsenic impurity, and an acid.
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