Environmental Medicine Integrating a Missing Element into Medical Education (1995) / Chapter Skim
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Case Study 16: Gasoline Toxicity
Case Study 16: Gasoline Toxicity
Pages 374-394
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From page 374... ...
Of the estimated 1.4 million underground gasoline storage tanks in the United States, about 85% have no protection against corrosion. Gasoline inhalation exposures to the general public during self-serve automobile refueling probably are not a significant healik risk.
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From page 375... ...
She tells you that she has also been irritable and that several of their neighbors have been complaining of a variety of nonspecific symptoms, including headaches and forgetfulness. The wife also says that a nearby gas station was recently fined for having a leaking underground storage tank, and she feels that her family and her neighbors are being poisoned by contaminated drinking water.
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From page 376... ...
In addition to hydrocarbons, gasoline contains additives to improve its performance as a motor fuel and to enhance its stability. These additives include antioxidants, metal deactivators, antirust agents, anti-icing agents, detergents, dyes, and antiknock agents (which prevent detonation during combustion in internal-combustion engines and ensure smooth, even burning within the combustion cylinder)
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From page 377... ...
Branched Chain ~C' H 3 CH H C C H H C C H C H ortho-Xylene C- CH3 11 3 ENVIRONMENTAL MEDICINE 377
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From page 378... ...
Exposure to Gasoline Vapor Gasoline exposureto the general population occurs primarilythrough inhalation of the vapor during automobile refueling. Of the more than 300 million gallons of gasoline used in the United States annually, the Environmental Protection Agency (EPA)
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From page 379... ...
By one estimate, as many as 100,000 tanks leak millions of gallons of gasoline to groundwater each year; approximately 2,000 leaks are reported each year in New Jersey alone. The state of Maine estimates that leaking underground storage tanks are responsible for the release to groundwater of about 11 million gallons of gasoline each year in that state alone.
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From page 380... ...
Although numerous cases of leaking underground storage tanks have been documented, contaminated water supplies have rarely contained the individual components of gasoline at concentrations that exceed the EPA maximum contaminant levels. Persons susceptible to gasoline toxicity include the very young, the very old, pregnant women, and persons suffering from malnutrition.
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From page 381... ...
The increased metabolism of antipyrine in humans and experimental animals exposed to gasoline vapors suggests that mixed-function oxygenase activity is accelerated by gasoline. Some gasoline hydrocarbons are oxidized by liver microsomal-enzyme systems to products that are readily excreted in the urine.
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From page 382... ...
Contact with liquid gasoline can cause an acute burning sensation in the skin, eyes, and mucous membranes. Prolonged contact with liquid gasoline can defat the skin and cause irritation and dermatitis.
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From page 383... ...
O Relatively little is known about the potential neurotoxicity of gasoline vapors after prolonged exposures to low concentrations. O Chemical pneumonitis from aspiration of gastric contents after gasoline ingestion is a concern.
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From page 384... ...
O Lifetime exposure to gasoline vapor causes cancer in experimental animals, but extensive studies do not generally support a similar cancer hazard in humans. O Epidemiologic studies suggest that certain cohorts of refinery workers employed before 1940 may have had an elevated risk of leukemia due to relatively large exposures to benzene.
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From page 385... ...
A person would have to ingest or inhale large amounts of hydrocarbons to receive sufficient ethanol exposure from gasohol, and the hydrocarbons themselves would cause acute toxicity. There is evidence that methanol, toluene, benzene, xylene, 1,3butadiene, and methyl-t-butyl ether can cause reproductive or developmental effects in experimental animals under various exposure situations.
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From page 386... ...
12 When patients have acute symptoms from gasoline overexposure, it is usually apparent where and how the exposure occurred. Persons who are inadequately protected have been overcome by gasoline vapors while cleaning or working in gasoline storage tanks, although this occurrence is rare.
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From page 387... ...
Signs and Symptoms Acute Exposure Acute gasoline toxicity occurs only rarely today and is most often associated with emergencies involving the cleaning or maintenance of storage tanks, exposures related to large spills or leaks, intentional inhalation of gasoline vapors to obtain euphoric effects, deliberate ingestion in suicide attempts, or unintentional ingestion during siphoning, or misuse of gasoline as a solvent. The signs and symptoms that develop after acute exposure depend on the route of exposure and the dose absorbed.
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From page 388... ...
Prolonged ingestion of drinking water contaminated with relatively high levels of gasoline may pose a small risk related to benzene exposure. Although no definitive evidence exists to indicate that such exposures are associated with any increased risk of hematologic disorders, in some limited circumstances, periodic hematologic monitoring has been suggested.
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From page 389... ...
Activated charcoal is of limited use; spontaneous vomiting and diarrhea are likely to occur if a massive dose of gasoline has been ingested. O Treatment of a patient with acute gasoline exposure is supportive.
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From page 390... ...
mandates permissible limits for occupational exposures. The permissible exposure limit (PEL)
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From page 391... ...
= highest concentration of a contaminant allowed in public drinking water supplies. Environment Air The Clean Air Act Amendments of 1990 mandate that gasoline be reformulated in the nine airquality control regions in the United States with the worst pollution (specifically those that have not attained mandated ozone levels)
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From page 392... ...
Evaluation of the health effects from exposure to gasoline and gasoline vapors. Final Report.
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From page 393... ...
The patient has potential gasoline exposure from the following sources: · automobile refueling · consuming contaminated drinking water · working on old cars (2) Exposure of the general public to gasoline vapor through automobile refueling is low and does not pose an identifiable health risk to consumers.
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From page 394... ...
Prolonged and repeated misuse of gasoline as a solvent or cleaning agent can, however, cause significant toxicity. If the patient has frequent extensive skin contact with liquid gasoline or is frequently exposed to high concentrations of gasoline vapors via open containers of gasoline in a confined space, his headaches, confusion, and forgetfulness could be from gasoline overexposure.
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