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Benzene Poisoning

Benzene Toxicity

Benzene is a volatile aromatic hydrocarbon that is a component of gasoline and is used in many manufacturing processes. Thus, it is present in the general environment, but usually at low levels. The toxic effects of benzene are varied; acute exposure affects the central nervous system, whereas chronic exposure causes damage to the hematopoietic system.


Presentation

Since benzene is frequently used in industrial processes and is present in gasoline, workers employed in chemical plants and gas stations are most likely to be exposed to it; however, it is also present in the general environment, being released from paints, automobile exhausts, and cigarette smoke. Its concentration is higher indoors than outdoors, especially in homes where there are smokers.

Apart from workplace accidents, acute poisoning can follow unintentional consumption or inhalation of benzene or benzene-containing solutions at home, usually by children; exposure can also occur by intentional use of hydrocarbons, such as recreational abuse, or suicide attempts.

Acute ingestion or inhalation of benzene affects mainly the central nervous system (CNS) and is believed to be mediated by benzene itself, although there are claims [1] that benzene’s metabolites may also play a role. The signs are similar to alcohol intoxication and are the same irrespective of whether the chemical is inhaled or ingested, except for the irritation of the mucous membranes of the respiratory tract when the route is by inhalation. Also, according to some reports [2] the lethal dose (LD50) is higher by two orders of magnitude for hydrocarbons entering the body by ingestion than by inhalation. Therefore, aspiration of benzene-containing liquids, including vomitus is a major hazard. Mild exposure results in a headache, dizziness, euphoria, nausea, vomiting, tightness in the chest, and dyspnea. Higher concentrations may cause visual problems, ventricular fibrillation, paralysis, tremor, convulsions, or loss of consciousness [3]. Death can occur after large doses of benzene due to ventricular fibrillation.

In contrast to acute poisoning, the chronic effects of benzene on the cells of the hematopoietic system are mediated by its metabolic products [4]. All of these are oxidized derivatives (phenol, hydroquinone, catechol, benzenetriol, hydroquinone, and trans-Muconic acid). These are reactive chemical species and may contribute to benzene’s effects through different pathways, making the mechanism of toxicity a complex issue [5]. Patients suffering from chronic exposure present with general symptoms. These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising.

Chronic exposure to benzene may result in dysfunction of the hematopoietic system due to the chemical interfering with renewal and differentiation of stem cells; consequently, both anemic and leukemic diseases may develop [6].

Patients with chronic exposure may display signs of anemia and poor immunity. Sometimes, the condition of aplastic anemia caused by benzene exposure includes symptoms of hemolysis, such as mild bilirubinemia, shortened erythrocyte life-cycle and similar signs that are not present in idiopathic disease [7].

Leukemia may follow pancytopenia or aplastic anemia in about a quarter of the leukemia patients [7], often after a lag of several years [8]. Case reports and epidemiological studies demonstrate a variety of responses to chronic benzene exposure: both acute and chronic leukemias and other disorders are found. For example, among 74,828 people exposed to benzene, 82 were identified with hematopoietic diseases, with cases of acute leukemia, myelodysplastic syndrome, chronic granulocytic leukemia, malignant lymphoma and aplastic anemia [9]. In another study, among 28,460 people working in factories where they were exposed to benzene, 30 cases of leukemia were found, most of which were of the acute type [10]. The International Agency for Research on Cancer has determined that benzene is a carcinogen.

Exposure to Benzene
  • Assessment of exposure to benzene was carried out in 672 factories in 12 cities in China. Historical exposure data were collected for 3179 unique job titles.[ncbi.nlm.nih.gov]
  • Patient history may reveal current or past occupational or environmental exposure to benzene. Further tests may be needed to exclude other forms of anemia.[symptoma.com]
  • Effects of Benzene Exposure Exposure to benzene can have several harmful effects on individuals.[seegerweiss.com]
  • Benzene Poisoning Long-term exposure to benzene can result in the development of several conditions and diseases including: Anemia - a condition in which the number of red blood cells is diminished.[impactlaw.com]
Anemia
  • Patients with chronic exposure may display signs of anemia and poor immunity.[symptoma.com]
  • CBP could give the appearance of different types of disorders such as leukopenia, agranulocytosis, anemia, pancytopenia, aplastic anemia (AA), myelodysplastic syndrome (MDS), and leukemia.[ncbi.nlm.nih.gov]
  • Benzene has been identified as a carcinogen, and long-term exposure can lead to benzene poisoning , which can cause anemia, lymphoma, and leukemia, a form of cancer.[impactlaw.com]
  • Chronic occupational benzene exposure is associated with an increased risk of hematological malignancies such as aplastic anemia and leukemia. The new biomarker and action mechanisms of chronic benzene poisoning are still required to be explored.[ncbi.nlm.nih.gov]
  • Year History of Benzene Toxicity: Aplastic Anemia and Leukemia 1897 Santeson - aplastic anemia; established benzene as powerful bone marrow poison 1903 LeNoir - leukemia in benzene workers 1911 Setting - benzene a bone marrow poison in rabbit bioassays[digitalsynergy.com]
Gastric Lavage
  • lavage ) Washing of the skin (irrigation) -- perhaps every few hours for several days You may be admitted to the hospital if the poisoning is severe.[indiatoday.in]
Vomiting
  • If someone has swallowed benzene, do not try to make them vomit or give them fluids to drink. Also, if you are sure the person has swallowed benzene, do not attempt CPR. Performing CPR on someone who has swallowed benzene may cause them to vomit.[rxwiki.com]
  • Typical signs of poisoning include rashes, vomiting, redness around the mouth and nose, chemical odors and burns. Empty pill bottles, unresponsiveness and difficulty breathing are also signs.[sharecare.com]
  • Gastric upsets and vomiting. Dizziness. Headache. Sense of constriction about the head and chest.[jamanetwork.com]
  • Followed, may have nausea, vomiting, palpitations, instability of walking, trance, just like drunkenness 9.[slideshare.net]
  • , which can lead to breathing problems if the benzene-contaminated vomit enters the victim’s lungs Drowsiness Convulsions and Death Serious Health Problems Due to Long-Term Benzene Exposure If the victim has been exposed to benzene for one year or more[napolilaw.com]
Nausea
  • Toxic effect caused by exposure to benzene through contact , inhalation, or ingestion, characterized by disorientation, dizziness, headache, and/or nausea. In severe cases it can cause death through respiratory failure .[businessdictionary.com]
  • Yet, some of the more common symptoms caused by benzene are: pallor tremors euphoria dizziness petechiae headache weakness staggering tachypnea drowsiness palpitations convulsions nervousness appetite loss blurred vision chest tightness nausea, vomiting[healthblurbs.com]
  • Mild exposure results in a headache, dizziness, euphoria, nausea, vomiting, tightness in the chest, and dyspnea. Higher concentrations may cause visual problems, ventricular fibrillation, paralysis, tremor, convulsions, or loss of consciousness.[symptoma.com]
  • Among other symptoms are vomiting, loss of appetite and nausea. It may also cause irregular heartbeat and rapid, shallow breathing or even experience a tight chest.[ukaccidentatwork.co.uk]
  • Clinical presentation Acute exposure may cause immediate CNS effects, including headache, nausea, dizziness, tremor, convulsions, and coma.[mhmedical.com]
Blurred Vision
  • Yet, some of the more common symptoms caused by benzene are: pallor tremors euphoria dizziness petechiae headache weakness staggering tachypnea drowsiness palpitations convulsions nervousness appetite loss blurred vision chest tightness nausea, vomiting[healthblurbs.com]
  • One may experience blurred vision and inflammation of nose and throat. Among other symptoms are vomiting, loss of appetite and nausea. It may also cause irregular heartbeat and rapid, shallow breathing or even experience a tight chest.[ukaccidentatwork.co.uk]
  • […] benzene poisoning a toxic condition caused by ingestion of benzene, inhalation of benzene fumes, or exposure to benzene-related products such as toluene or xylene, characterized by blurred vision, nausea, headache, dizziness, and incoordination.[medical-dictionary.thefreedictionary.com]
  • EYES, EARS, NOSE, AND THROAT Blurred vision Burning sensation in the nose and throat STOMACH AND INTESTINES Loss of appetite Nausea and vomiting HEART AND BLOOD Irregular heartbeat Rapid heartbeat Shock and collapse LUNGS AND CHEST Rapid, shallow breathing[stlukes-stl.com]
  • Symptoms Eyes, ears, nose, and throat: Blurred vision Burning sensation in the nose and throat Gastrointestinal: Loss of appetite Nausea Vomiting Heart and blood: Irregular heartbeat Rapid heartbeat Lungs and chest: Rapid, shallow breathing Tight chest[indiatoday.in]
Muscle Weakness
  • weakness, hyperkeratosis and hyperpigmentation of the skin, as well as paresthesia in hands and feet 48.[slideshare.net]
Suggestibility
  • Our findings suggest that benzene exposure duration, BMI, and GSTT1 genotype may impact prognosis of the CBP workers.[ncbi.nlm.nih.gov]
  • Our findings suggest that these differential proteins may help elucidate the mechanism of CBP and provide potential biomarkers for diagnosis. Copyright 2018 Elsevier B.V. All rights reserved.[ncbi.nlm.nih.gov]
  • These data suggest that antibodies against Hsps can potentially be useful biomonitors to assess if workers are experiencing or have experienced abnormal xenobiotic-induced stress within their living and working environment.[ncbi.nlm.nih.gov]
  • Neutrophil and Mean Corpuscular Volume (MCV) showed a significant difference between the two study groups, and neutrophil has the greatest impact on the alterations suggestive of BP.[ncbi.nlm.nih.gov]
  • Our results suggest that genetic polymorphisms in EPHX1 may contribute to risk of CBP in a Chinese occupational population.[ncbi.nlm.nih.gov]
Headache
  • These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising.[symptoma.com]
  • Toxic effect caused by exposure to benzene through contact , inhalation, or ingestion, characterized by disorientation, dizziness, headache, and/or nausea. In severe cases it can cause death through respiratory failure .[businessdictionary.com]
  • Headache. Sense of constriction about the head and chest.[jamanetwork.com]
  • Acute Effects of Lead Poisoning • Fatigue • Headache • Irritability • Metallic taste in mouth • Poor appetite • Reproductive problems • Sleeplessness • Stomach upset 32.[slideshare.net]
  • […] benzene poisoning a toxic condition caused by ingestion of benzene, inhalation of benzene fumes, or exposure to benzene-related products such as toluene or xylene, characterized by blurred vision, nausea, headache, dizziness, and incoordination.[medical-dictionary.thefreedictionary.com]
Dizziness
  • These can include fatigue, weight loss, headaches, dizziness, weakness, pale skin, bleeding gums, nosebleeds, and bruising.[symptoma.com]
  • Toxic effect caused by exposure to benzene through contact , inhalation, or ingestion, characterized by disorientation, dizziness, headache, and/or nausea. In severe cases it can cause death through respiratory failure .[businessdictionary.com]
  • Dizziness. Headache. Sense of constriction about the head and chest.[jamanetwork.com]
  • These signs of benzene poisoning include: Confusion Irregular or rapid heartbeat Headache Unconsciousness Tremors Dizziness and Death Consuming benzene can also cause sudden health problems that develop in minutes or hours, which include the following[napolilaw.com]
  • Some symptoms of inhalation may include: dizziness, increased/rapid heart rate, chronic headaches, muscle twitching or tremors, drowsiness, and unconsciousness.[legalinfo.com]
Confusion
  • How Benzene Poisoning Causes Damage to the Body When benzene is inhaled, it confuses the body’s cells into working improperly.[napolilaw.com]
  • Toxic tort and injury laws are complex and confusing. The Metzger Law Group is here to help you. Call us today for a FREE evaluation to find out if you have a case or fill out our free evaluation forms to consult with a member of our caring staff.[digitalsynergy.com]
  • Individuals who inhale or ingest high levels of benzene may go on to develop the following symptoms: confusion drowsiness dizziness irregular heartbeat irritation of the stomach headaches tremors unconsciousness vomiting Impact on long-term health Unfortunately[limepersonalinjury.co.uk]
  • Dizziness, drowsiness, headaches, confusion, tremors, a feeling of intoxication, and loss of consciousness may occur. If ingested, individuals may experience vomiting, convulsions, and a dangerously increased heart rate.[benzeneweb.com]
  • While low-level exposure to benzene may cause drowsiness, dizziness, rapid heart rate, headaches, tremors, confusion, and unconsciousness, eating or drinking foods containing high levels of benzene can cause vomiting, irritation of the stomach, dizziness[charcoalremedies.com]
Seizure
  • Signs & Symptoms of Overexposure Severe stages: • Constant vomiting • Periods of stupor • Delirium • Seizures • Coma 30.[slideshare.net]
  • Blurred vision Burning sensation in the nose and throat HEART AND BLOOD Irregular heartbeat Rapid heartbeat Shock and collapse LUNGS AND CHEST Rapid, shallow breathing Tightness in the chest NERVOUS SYSTEM Dizziness Drowsiness Nervousness Convulsions (seizures[arh.adam.com]
  • Seizures may begin without any prodromal signs or symptoms. If the patient is paralyzed after intubation, electroencephalographic monitoring is warranted.[emedicine.medscape.com]
  • Stupor, delirium, and drowsiness give way to seizures and coma. Fluid accumulates in the lungs compromising breathing; there is poor oxygen absorption from the air. Intensive treatment is necessary to prevent death.[livestrong.com]
Asthenia
  • Anxiety, dizziness, cramps, asthenia and normal menstrual cycle were reported. No physical examination alteration and no family history of cancer were observed.[ncbi.nlm.nih.gov]

Workup

In acute cases, people displaying neurological symptoms of benzene poisoning should be monitored for inadequate oxygenation. Even if only small amounts have been inhaled or ingested, patients should be transferred to a healthcare facility for evaluation. For severely affected patients, toxicologists, and poison centers should be consulted.

Exposure to benzene can be detected by measuring the concentration in blood, exhaled breath, and urine; this – or routine blood work - can also be used to monitor workers in hazardous occupations. There is a linear relationship between benzene levels in the patients’ environment and in their biological samples [11]. However, measuring benzene itself may not be completely reliable when there has been exposure to only a low level. Urinary benzene metabolites (trans-Muconic acid and S-phenyl mercapturic acid) are more suited for the measurements of low exposures [12], and thus, for monitoring general populations [13]. Albumin adducts of benzene derivatives can be used to measure longer term exposure [14].

Since benzene is a hematopoietic toxin, detection of hematologic abnormalities by a complete blood count with differential, erythrocyte indices, and thrombocyte counts is the most basic examination. Patient history may reveal current or past occupational or environmental exposure to benzene. Further tests may be needed to exclude other forms of anemia. Examination of bone marrow can produce highly variable results in that patients can have hypoplastic or hyperplastic bone marrow [7] [15].

Treatment

  • In general, prognosis of CBP cases is optimistic when appropriate treatment is given.[ncbi.nlm.nih.gov]
  • Since poisons work in different ways depending on the amount and type ingested, it is important to consult with a doctor or a poison control center to seek advice for treatment. More[sharecare.com]
  • Though it is potentially curable with extensive chemotherapy, without any treatment, AML is generally fatal within weeks or months. I also lost two uncles to similar bone marrow cancers about the same time.[labovick.com]
  • The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.[arh.adam.com]
  • The most important thing is for victims to seek medical treatment as soon as possible. If someone has swallowed benzene, do not try to make them vomit or give them fluids to drink.[rxwiki.com]

Prognosis

  • With methods of logistic regression, a risk model was set up to predict the prognosis of CBP workers.[ncbi.nlm.nih.gov]
  • In general, prognosis of CBP cases is optimistic when appropriate treatment is given.[ncbi.nlm.nih.gov]
  • The results are discussed from the point of view of prognosis.[oem.bmj.com]
  • Outlook (Prognosis) How well someone does depends on how much benzene they swallowed and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery. Benzene is very poisonous.[stlukes-stl.com]
  • Outlook (Prognosis) How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Benzene is very poisonous. Poisoning can cause rapid death.[indiatoday.in]

Epidemiology

  • The epidemiologic literature shows that benzene is the chemical most strongly associated with CML.[amlbenzene.net]
  • Clinical and epidemiologic variables were collected from medical records and from a detailed questionnaire. The average age was similar in the two groups (51.1 and 50.7, respectively).[ncbi.nlm.nih.gov]
  • Author information 1 Division of Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA. dosemecm@epndce.nci.nih.gov Abstract We present a validation study of a quantitative retrospective exposure assessment method used in a follow-up[ncbi.nlm.nih.gov]
  • Case reports and epidemiological studies demonstrate a variety of responses to chronic benzene exposure: both acute and chronic leukemias and other disorders are found.[symptoma.com]
Sex distribution
Age distribution

Prevention

  • Foundation, Rio de Janeiro 21041-210, Brazil 2 Medical Ambulatory, Center for Studies of Worker’s Health and Human Ecology, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil 3 Technical Unit of Occupational Exposure, Environmental and Cancer, Prevention[mdpi.com]
  • In rabbits immunized by one to three intracutaneous injections with living culture of streptococci, an exposure to benzene with the following leucopenia did not consistently prevent the fixation of streptococci in an intracutaneous focus, as it is the[jimmunol.org]
  • Duty of care Employers have a duty to prevent, or where this is not possible, to control the level of exposure to benzene that employees face. Following risk assessments employers are required to implement and maintain effective control measures.[limepersonalinjury.co.uk]
  • Under the Control of Substances Hazardous to Health Regulations 2002 (COSHH), employers are required to assess the risk of employees being exposed to benzene at work – and take measures to prevent the risks of benzene poisoning.[duncanlewis.co.uk]
  • Benzene poisoning was diagnosed from 1980 to 1998 by the local authorized Occupational Disease Diagnostic Team, and patients were registered in the hospitals of prevention and treatment for occupational diseases, which cooperated with us.[medical-dictionary.thefreedictionary.com]

References

Article

  1. Dempster AM, Evans HL, Snyder CA. The temporal relationship between behavioral and hematological effects of inhaled benzene. Toxicol Appl Pharmacol. 1984 Oct;76(1):195-203.
  2. Gerarde HW. Toxicological studies on hydrocarbons. IX. The aspiration hazard and toxicity of hydrocarbons and hydrocarbon mixtures. Arch Environ Health. 1963 Mar;6:329-41.
  3. Reese E, Kimbrough RD. Acute toxicity of gasoline and some additives. Environ Health Perspect. 1993 Dec;101 Suppl 6:115-31.
  4. Snyder R. Xenobiotic metabolism and the mechanism(s) of benzene 
toxicity, Drug Metab. Rev. 2004; 36:531–547.
  5. Yardley-Jones A, Anderson D, Parke DV. The toxicity of benzene and its metabolism and molecular pathology in human risk assessment. Br J Ind Med. 1991 Jul;48(7):437-444.
  6. Dexter TM, Heyworth CM, and Whetton AD. The role of haemopoietic cell growth factor (interleukin3) in the development of haemopoietic cells. In: Evered D, Nugent J, Ivhelm J, Eds. Growth Factor in Biology and Medicine. Ciba Foundation Symposium, Vol. 116 London, England: Pitman. 1985;129-142.
  7. Aksoy M. Hematotoxicity and carcinogenicity of benzene. Environ Health Perspect. 1989 Jul;82:193-197.
  8. Vigliani EC, Forni A. Benzene and leukemia. Environ Res. 1976 Feb;11(1):122-127.
  9. Travis LB, Li CY, Zhang ZN, et al. Hematopoietic malignancies and related disorders among benzene-exposed workers in China. Leuk Lymphoma. 1994 Jun;14(1-2):91-102.
  10. Yin SN, Li GL, Tain FD, et al. Leukaemia in benzene workers: a retrospective cohort study. Br J Ind Med. 1987 Feb;44(2):124-128.
  11. Brugnone F, Perbellini L, Faccini GB, et al. Breath and blood levels of benzene, toluene, cumene and styrene in non-occupational exposure. Int Arch Occup Environ Health. 1989;61:303–311.
  12. Boogaard PJ, van Sittert N. Biological monitoring of exposure to benzene: a comparison between S-phenylmercapturic acid, trans, trans-muconic acid, and phenol. Occup Environ Med. 1995;52: 611–620.
  13. Weaver VM, Davoli CT, Heller PJ, et al. Benzene exposure, assessed by urinary trans,trans-muconic acid, in urban children with elevated blood lead levels. Environ Health Perspect. 1996;104:318–323.
  14. Rappaport SM, Waidyanatha S, Qu Q, et al. Albumin adducts of benzene oxide and 1,4-benzoquinone as measures of human benzene metabolism. Cancer Res 2002 Mar;62 (5):1330–1337.
  15. Mallory TB, Gall EA, Bickley WJ. Chronic exposure 
to benzene. J. Ind. Hyg. Toxicol. 1939;21:355-393

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Last updated: 2018-06-22 07:01