Case Report: Hexachloroethane Smoke Inhalation: A Rare Cause of Severe Hepatic Injuries
| Autor: | Saou Hsing Liou, Yaw-Wen Chang, Jun Hei Chang, Ching Hui Loh, Hong I. Chen |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male hepatotoxicity medicine.medical_specialty Health Toxicology and Mutagenesis Smoke inhalation Environmental Medicine chemistry.chemical_compound Chemical pneumonitis Smoke Hydrocarbons Chlorinated medicine Humans Aspartate Aminotransferases Hexachloroethane Inhalation exposure Ethane Inhalation Exposure white smoke Inhalation Research Public Health Environmental and Occupational Health zinc oxide Alanine Transaminase gamma-Glutamyltransferase medicine.disease Surgery Liver chemistry Anesthesia Toxicity Chemical and Drug Induced Liver Injury Phosgene hexachloroethane |
| Zdroj: | Environmental Health Perspectives |
| ISSN: | 1552-9924 0091-6765 |
| DOI: | 10.1289/ehp.8635 |
| Popis: | Hexachloroethane/zinc oxide (HC/ZnO) smoke, also known as white smoke, has many military and civilian applications, such as in training exercises and on the battlefield [Agency for Toxic Substances and Disease Registry (ATSDR) 1997; Holmes 1999; Zerahn et al. 1999]. Inhalation is the most common route of injury. Documented injuries are predominately pulmonary and range from cough and dyspnea to chemical pneumonitis, pulmonary edema, adult respiratory distress syndrome, and death (Cullumbine 1957; Greenfield et al. 2002; Hjortso et al. 1988). The toxicity of HC/ZnO smoke results from both the chemical and physical properties of the smoke. The primary component of white smoke is HC/ZnO combined with granular aluminum. Upon burning, several compounds are produced: zinc chloride, 62.5%; ZnO, 9.6%; iron oxide, 10.7%; aluminum oxide, 5.4%; lead oxide, 1%; and chlorinated vapors, 10.8% (DeVaull et al. 1989). The reaction equation is as follows (Cichowicz 1983): The reaction is exothermic and self-perpetuating to the right, liberating large amounts of ZnCl2 as a hot vapor. Upon cooling, it nucleates to form an aerosol that rapidly absorbs water from the surrounding atmosphere. Hydrated ZnCl2 particles then scatter light, thereby creating the desired obscurant effect (ATSDR 1997; Holmes 1999; Katz et al. 1980). When a smoke grenade is used, the heat causes other chemicals to form, including carbon tetrachloride, tetrachlorethylene, hexachlorobenzene, and phosgene (ATSDR 1997). Medical personnel, military and civilian alike, may be called upon to recognize and treat patients with HC/ZnO smoke injuries. Almost all studies have focused on the pulmonary effects, and little if any information exists on hepatic toxicity. In this article we report two cases of acute hepatic injuries associated with HC/ZnO smoke inhalation. |
| Databáze: | OpenAIRE |
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