Toxicology of Hazardous Materials

UHHS BMH Paramedic Training Program

Lt. Ronald Pristera EMTP, EMSI

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Todays Objectives!
Explain the relationship between concentration and exposure to HM and onset of symptoms. Define Chronic & Acute Exposure List 7 categories of toxic substances Cite some of the effects of each type of substance on organs.

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Objectives (cont.)
Define relevant terms
LD/LC 50 TLV, PEL, STEL IDLH Ppm, ppb,

Describe routes of entry of HM Describe one hazard for each class

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Why study toxicology?

Everyday application Not all calls to industry involve HM, but many involve chemicals Drug research

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Hazardous Chemical?

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What is a Hazardous Material?

Gasoline Drain cleaner water

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Toxic; Defined
Have either physical or chemical properties that are HARMFUL Present in sufficient amounts Present for sufficient time Have a route into the body Reach a susceptible organ or tissue

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H2SO4 (Sulfuric Acid)

Can destroy human tissue on contact The greater the concentration or the longer the contact= more damage PPE exists that prevent contact ? Is sulfuric acid HM
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What are the likely effects

It depends on:
The potential toxic effects The amount present The route and conditions of exposure Characteristics of the exposed person

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Import Factors
Concentration Duration of exposure Dose= the amount of an agent reaching a target organ.

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Concentration
Measurement in vapors/gasses is amount of material per parts of gas.
ppm
Really small 1 can of pop in an Olympic size pool.

ppb
Way small 1ft2 in 36miles2

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Concentrations
Solids suspended in air are measured in mg/M3
Dusts Mists Fumes

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Sample Concentrations
Exposure limits
HCN Cl2 NH3 CO2 4-10 ppm 0.5-1ppm 25-50ppm 5000 ppm

Pentaborane 0.005 ppm or 50 ppb

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Duration
How long the substance remains in contact
Influences total amount absorbed Chronic repeated exposure also increases duration.

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Types of Exposure
Acute
Short term usually very high levels Can have
Immediate effects Delayed effects

Chronic
Long term (days weeks, years) Repeated contact Relatively low amounts. In many cases chronic effects are much different than acute.

Full effect may not be known for years

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Relative Toxicity LD 50
Minimum lethal dose to of test animals. Is not absolute; other factors are involved
Overall victim health

LD100 is the minimum dose lethal to all test animals. LC is lethal concentration

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Chronic exposure measures

Threshold Limit Value (TLV) Average airborne concentrations over a normal workweek
Guidelines established by ACGIH Exposure levels below the TLV does NOT guarantee absence of toxic effects. TLV-C is a max. level that never be exceeded!

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Chronic Exposure Measures

Permissible Exposure Limit (PEL)
Average airborne concentration that an employee can be exposed to for an 8hr period Legal limit allowed in the workplace Most were adopted from TLVs

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Chronic Exposure Measures

Short Term Exposure Level (STEL)
Also a legal limit Maximum exposure duration
Usually 15 minutes 4 times through the day

It is believed that this level of exposure causes no permanent damage NO margin of error and susceptible people may experience toxic affects at lower levels!

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IDLH

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Immediately Dangerous to Life & Health (IDLH)

Misnomer is only a respirator selection guide Maximum concentration from which a person could escape:
Within 30 minutes of BA failure Without experiencing impairing effects Without causing permanent health problems.

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Clarifications
The guidelines and standards are not absolute Some individuals may experience problems at lower levels. Does not consider
Adulterations Commingling of chemicals Underlying medical history

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Categories of Toxic material

7 Categories
Asphyxiants Corrosives Irritants Sensitizers Carcinogens Mutagens Teratogens

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Asphyxiants
Deprive the body of oxygen Two types
Simple Chemical

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Simple Asphyxiants
Displace Oxygen thereby causing suffocation Not necessarily hazardous
CO2 N, Helium Argon, Neon Methane

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Chemical Asphyxiants
Interfere with the cellular transit of oxygen Are, intrinsically hazardous
CO Cyanide

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Corrosives
Cause irreversible tissue death Can affect
Skin Eyes Mucous membranes

Examples include
Alkalis Acids

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Irritants
Cause temporary (maybe severe) inflammation of the
Eyes, Skin and respiratory tract.

Symptoms may result from chronic or acute exposure Examples include;

Ammonia Chlorine

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Sensitizers
Cause allergic reactions after repeated exposure. Tend to become worse over time and more frequent exposures. Examples include;
Formaldehyde Mercury Nickel;

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Carcinogens
Cause cancer Some have been definitely linked with cancer in humans. Some are only suspected. Examples include:
Coal Tar Asbestos

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Mutagens
Toxins that cause genetic changes Material in both sperm & egg may be affected Examples include;
ETO Ionizing radiation HO Benzene

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Teratogens
Cause malformations in unborn children Examples include
Anesthetic gasses Organic mercury compounds Ionizing radiation

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General
Chemicals may belong to more than one hazard class. Information is constantly evolving regard the hazardous properties of chemicals.

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Routes of entry
Integuementary system Respiratory system Digestive system Vectoring agents

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Integumentary System

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Integumentary system
Substances pass via
Traveling through the dermis Entering hair follicles

The integrity of the integumentary system is dependant upon

Condition of skin Contact site Toxic properties of the material.

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Integumentary system
The property of the chemical has a profound affect on absorption
Solvents are the most rapidly absorbed

Other factors that affect absorption

Temperature of the skin Blood flow

Examples of skin penetrating chems

Phenols organophosphate

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Integumentary System
Skin permeability differs by body area Areas that are rich in hair follicles allow for greater absorption
Scalp Forehead Jaw Axial Scrotum/perineal

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Integumentary System
Bodys first line of defense Can be damaged by
Trauma Temp extremes Humidity Prior exposure

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Integumentary System
The contaminant absorbed depends
Amount Concentration Length of contact Exposed surface area

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Integumentary System
Other factors that affect absorption
Sweat Presence of other chemicals
Solvents surfactants

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Integumentary System
Four main types of reactions
Irritation
Dermatitis

Sensitization Photosensitization Carcinogenesis

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Respiratory System

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Inhalation
Many chemicals are absorbed through the respiratory system after inhalation. Alveoli is when this occurs Size of the inhaled particles are key Respiration is the prime determining factor
MV=TV x RR

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EXPOSURE SURFACE
Route Ingestion / parenteral Ocular Percutaneous Respiratory Surface Area --0.0002 m2 2 m2 50-150 m2

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Anatomy
Upper Airway
Naso/oropharynx to VC

Central Airways
conducting VC to terminal bronchiole

Peripheral Airways
gas exchange respiratory bronchiole to alveoli
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Ingestion

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Ingestion
Most ingested chemicals only produce systemic affects after GI tract absorption. Stomach is usually the first site. Ingestion is least common occupational exposure route. Can be vectored in
Lead, Cadmium, Arsenic

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Central Nervous System

Chemicals that are fat soluble are more likely to affect the CNS Many chemicals easily reach brain cells after absorption. Not all CNS tissues responds the same. Incomplete CNS systems are more susceptible to toxins.

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Central Nervous System

Potential neurotoxin affects
Euphoria ALOC & awareness Behavioral disturbances Subtle effects

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Eyes
Affected by the same chemicals as skin but more sensitive. Extent of damage is influenced by
Concentration/Duration pH Defense mechanisms

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Eyes
Acid Burns
Can cause
Lid scarring Conjunctiva Damage to tearing ability

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Eyes
Alkali burns Appear mild at first but can get progressively worse Can cause
Ulceration Perforation Clouding of cornea/lens deep eye damage

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Toxicity by hazard class

Class 1 (Explosives) Generally Nitrates Known to cause vasodilatation & decreases RBCs ability to carry O2 Severe exposure can cause
Dysrhymia Dyspnea

Some explosives emit fumes extremely toxic to the lungs.

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Toxicity by hazard class

Class 2 (Gasses) Class 2.3 materials are extremely toxic
Cyanogen gas (immediate effects) Phosgene (delayed effects) Organic phosphates in compressed gas

Inhalation is the entry routes C-2 materials are more dangerous than C-6, as they are already gasses.
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Toxicity by hazard class

Class 2.1 Flammable Gasses Combustion is primary hazard, but some are toxic Acetylene; asphyxiant & narcotic ETO; carcinogen & mutagen
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Toxicity by hazard class

Class 2.2 non flammable gasses CO2 is a simple asphyxiant Ammonia is an irritant Halogens are highly irritating (lungs) they also react with water
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Toxicity by hazard class

Class 3 Halogenated hydrocarbons toxic to liver & kidneys. Some hydrocarbons are known carcinogens

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Toxicity by hazard class

Class 4 Flam. /H2O reactive solids Very diverse class Lithium compounds are irritants N compounds can produce NO, N2O
Liver Kidneys Heart CNS
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Toxicity by hazard class

Class 5 Oxidizers & Per Oxides Class includes inorganic peroxides
Irritants PE or laryngeal edema

Also includes halogens & nitrates

Irritants/Caustic Carcinogens

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Toxics by Hazard Class

Class 6 (Toxic)

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Toxicity by hazard class

Class 7 Radioactive Long term exposure is a problem High exposure levels are usually rare Some body self repair is possible

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Toxicity by hazard class

Class 8 Corrosives Acids & Bases Effects include;
Severe tissue damage Lung damage GI damage

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Toxicity by hazard class

Class 9 ORM Diverse group of material that might be dangerous ORM-A includes anesthetic, irritating or otherwise toxic
CO2 Carbon tetrachloride Chloroform

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Toxicity by hazard class

ORM-B are materials that can damage the transport vehicle
Lime

ORM-C/D do not have common health effects ORM-E includes hazardous waste and other material not specified elsewhere
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Where does the data come from?

Msd Reference material Labels Pre-plan

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MSDS Sheet

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Summary
Toxicology is the basis for understanding the effects of exposure Protect yourself! Dont forget the basics

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Questions

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