Toxic Inhalation Injuries

Toxic inhalation injuries occur when individuals are harmed by breathing toxic materials, which may include gas, dust, mist, fumes, smoke, or aerosols.

What Are Toxic Inhalation Injuries?

Generally, toxic inhalations cause injury in several different ways:

What Are the Symptoms of Toxic Inhalation Injuries?

The symptoms of toxic inhalation injuries vary depending on the inhaled toxin and the duration of exposure. In general, these injuries have the following symptoms: coughing, shortness of breath, wheezing, a burning sensation, and increased phlegm or other respiratory secretions. Some examples of common inhaled toxins include the following:

Carbon monoxide

Carbon monoxide is one of the most common and dangerous of toxic materials. It is a chemical compound made of one carbon atom bonded to one oxygen atom. When individuals breathe in carbon monoxide with regular air, the carbon monoxide removes oxygen from the air so that the body takes in less oxygen with every breath. As a result, even though the person continues to breathe in and out, he or she becomes asphyxiated because less oxygen is available.

Carbon monoxide poisoning can be acute or chronic. Symptoms of acute carbon monoxide poisoning include flulike symptoms, such as headache, dizziness, and nausea * and/or vomiting; shortness of breath during activity; problems walking; memory loss, which may be mild or severe; confusion and sometimes hallucinations; chest pain; anxiety; depression; abdominal pain; fainting; a fast heartbeat; an increase in blood pressure; seizure *

Carbon monoxide poisoning is quite common. The Centers for Disease Control and Prevention (CDC) reports that more than 20,000 people visit the emergency room each year due to carbon monoxide poisoning. Of those 20,000, more than 4,000 are hospitalized and more than 400 Americans die from accidental carbon monoxide poisoning. The CDC also notes that fetuses, infants, and people 65 years old and older, as well as people with chronic heart disease, anemia * , or respiratory problems, are especially susceptible to the effects of carbon monoxide poisoning.

Individuals who are more likely to experience carbon monoxide exposure include firefighters because carbon monoxide is present in smoke; certain automotive workers because carbon monoxide is present in car exhaust; warehouse or factory employees who work in buildings where propane-powered forklifts or other equipment is used; and welders, who are exposed to shielding gas, which breaks down into carbon monoxide. Symptoms of chronic carbon monoxide poisoning include repeated and lasting headaches; lightheadedness; nausea and sometimes vomiting; depression; and confusion.

In addition, carbon monoxide is one of the compounds found in cigarette smoke. Both habitual cigarette smokers and those exposed to secondhand smoke can be affected by chronic carbon monoxide poisoning.

Chlorine gas

When a person mixes the commonly used cleaning products ammonia and chlorine bleach (or bleach-containing products), dangerous chlorine gas can result. Inhalation of this gas can cause choking and severe breathing problems. It can also be fatal.

Vinyl chloride Asbestos

Asbestos, which was once used in many building products, is one of several types of minerals that contain microscopic fibers. When asbestos is disturbed, such as during building renovations, these tiny fibers become airborne and are easily inhaled. Once breathed into the lungs, they can become lodged in the respiratory tract and produce health problems many years after the initial exposure. These health problems include lung cancer; mesothelioma (me-zoe-thee-lee-O-muh), which is a type of cancer of the lung and the lining surrounding the lungs; and asbestosis (az-bess-TOE-sis), which is a breathing disorder.

Cyanide

Cyanide is present in smoke from the burning of plastics, rubber, and other common household products. It is also present in certain plastic-manufacturing, metal-processing, and other industries. Workers in these industry factories are most at risk for cyanide poisoning. Symptoms from acute exposure include one or more of the following: headache, weakness and/or fatigue, confusion, vertigo (an unsettling dizzy feeling), anxiety, shortness of breath, nausea sometimes with vomiting, bluish skin, convulsions * , unconsciousness, and sometimes death. Symptoms from chronic exposure are similar to those for acute exposure, but may also include thyroid problems and itchy, irritated skin.

Hydrocarbons

Medical professionals have become alarmed by the practice—often among teenagers—of purposely breathing in toxins to become high. This practice is known as huffing, sniffing, or bagging, and involves a variety of dangerous substances, especially those containing hydrocarbons. These substances include petroleum products, numerous cleaning products, and many glues. Typical symptoms of acute poisoning include drowsiness, lightheadedness, dizziness, hallucinations, and impaired judgment. Chronic hydrocarbon abusers can suffer depression, weight loss, a decrease in motor skills, weakness, and changes in mood, often including irritability. In both acute and chronic poisoning, however, some individuals experience permanent damage to the brain, heart, or other organs, and some of them die, in some cases after trying it only once.

How Are Toxic Inhalation Injuries Treated?

Treatment of acute exposures depends on the specific toxin but always includes removing the victim from the area of exposure, giving the victim oxygen, and decontaminating the area as needed. Victims often spend time in a hospital or other clinical setting where they are monitored for 24 hours to keep watch for the development of a severe lung condition called acute respiratory distress syndrome (ARDS), which can be fatal without immediate treatment.

Diagnosing chronic exposures to toxins is often much more difficult. In many cases, medical professionals are able to treat the symptoms but cannot determine the exact cause of the patient's health problems.

Major Disasters and Their Prevention

Accidental exposures sometimes happen in industrial settings, and such accidents may be devastating. An example is the release of the deadly gas methylisocyanate from a chemical plant in Bhopal, India, in 1984. More than 500,000 people were exposed to the gas, and at least 3,000 of them died shortly thereafter.

In the United States, strict rules are in place to protect workers and the general public from exposure to airborne and other toxic chemicals. Two groups that create the rules and monitor workplace safety are the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health.

Weapons of Mass Destruction

Several toxic gases have been developed as weapons of mass destruction. In World War I, for instance, soldiers on all sides used different toxins, including a yellow substance known as mustard gas. Shortly after exposure to mustard gas, victims experienced intense blistering and itching of the skin, and those who inhaled a substantial amount of the gas had severe breathing problems. In addition, exposed individuals who survived exposure faced an increased risk of cancer later in life.

Whereas most developed nations have signed the Geneva Protocol that bans the use of chemical weapons, many countries have developed and stockpiled chemical weapons and chemical responses to the possible use of those weapons.

See also Bioterrorism Agents: Overview • Carbon Monoxide Poisoning • Liver and Biliary Tract Cancers • Lung Cancer • Mesothelioma • Poisoning

Resources

Books and Articles

Lafferty, Keith A. “Smoke Inhalation Injury.” Medscape, August 22, 2014. http://emedicine.medscape.com/article/771194-overview (accessed November 17, 2015).

Websites

National Fire Protection Association. “The Consequences of Fire.” http://www.nfpa.org/press-room/reporters-guide-to-fire-and-nfpa/ consequences-of-fire (accessed November 17, 2015).

New York State Department of Health. “What You Know Can Help You: An Introduction to Toxic Substances.” https://www.health.ny.gov/environmental/chemicals/toxic_substances.htm (accessed November 17, 2015).

Organizations

Agency for Toxic Substances and Disease Registry. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 888-674-6854. Website: http://www.atsdr.cdc.gov (accessed November 17, 2015).

American Cancer Society. 250 Williams St. NW, Atlanta, GA 30303. Toll-free: 800-227-2345. Website: http://www.cancer.org (accessed November 17, 2015).

Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 888-674-6854. Website: http://www.cdc.gov (accessed November 17, 2015).

National Institute for Occupational Safety and Health. 1600 Clifton Rd., Atlanta, GA 30329-4027. Toll-free: 888-674-6854. Website: http://www.cdc.gov/niosh (accessed November 17, 2015).

Occupational Safety and Health Administration. 200 Constitution Ave. NW, Washington, DC 20210. Toll-free: 800-321-6742. Website: http://www.osha.gov (accessed November 17, 2015).

U.S. Environmental Protection Agency. Policy, Analysis, and Communications Staff, Mail Drop C404-03, U.S. EPA, Research Triangle Park, NC 27711. Toll-free: 800-424-8802. Website: http://www.epa.gov (accessed November 17, 2015).

* nausea (NAW-zha) a feeling of being sick to one's stomach or needing to vomit.

* seizure (SEE-zhur) is sudden bursts of disorganized electrical activity that interrupt the normal functioning of the brain, often leading to uncontrolled movements in the body and sometimes a temporary change in consciousness. Also called convulsions.

* anemia (uh-NEE-me-uh) is a blood condition in which there is decreased hemoglobin in the blood and, usually, fewer than normal numbers of red blood cells.

* convulsions (kon-VUL-shuns), also called seizures, are involuntary muscle contractions caused by electrical discharges within the brain and are usually accompanied by changes in consciousness.

  This information is not a tool for self-diagnosis or a substitute for professional care.