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The Critically Poisoned Worker

  • Michael G. Holland
Reference work entry

Abstract

Exposures to toxicants in the workplace can cause severe illness and death similar to intentional poisonings and overdoses. In some cases, without a careful occupational history, the relationship between the job and the illness may be missed. Prolonged exposure to an insoluble gas, such as nitrogen dioxide after arc welding in a confined space, can cause a delayed pulmonary injury and acute respiratory distress syndrome (ARDS) that occurs one day later, when the link may go unnoticed. Careful questioning about the particular sequence of events is important when an illness occurs after performance of a common task. An example is exposure to phosgene gas after torch-cutting or welding metal that had been recently degreased with a chlorinated hydrocarbon solvent. Alternatively, a worker may experience a delayed illness such as metal fume fever (MFF) if he or she is welding on galvanized metal or had been working in close proximity to someone doing so. It is important to ask not only about the job of the ill worker but also about the nature of the workplace and the other processes being performed there.

Keywords

Nitrogen dioxide Acute respiratory distress syndrome ARDS Metal fume fever Occupational asthma Work-Exacerbated Asthma Sensitizer-induced asthma Reactive airways dysfunction syndrome RADS Carbon monoxide Nitrogen oxides Chlorine Corticosteroids Inhalational fevers Extrinsic allergic alveolitis Hypersensitivity pneumonitis Polymer fume fever Humidifier fever Pontiac fever Legionella Legionaire’s disease Toxic encephalopathy Hemolysis Seizures Rhabdomyolysis Myocardial Infarction Carbon disulfide Organophosphates Carbamates Halogenated hydrocarbons Solvents Carbon tetrachloride Acute renal failure Trichloroethylene Cadmium Toluene Leukoencephalopathy Methylene chloride Cyanide Organochlorine insecticides DDT Cyclodienes Chlordecone Lindane Manganese Mercury Methylmercury Minamata disease Peripheral neuropathy Methemoglobinemia 

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Authors and Affiliations

  1. 1.Emergency MedicineState University of New York, Upstate Medical UniversitySyracuseUSA

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