Presented in an easy-to-use double-page spread format, highly bulleted and concise, the Oxford Desk Reference: Toxicology is ideal for quick referral when an acute problem arises. [books.google.com]

Hydrogen sulfide can be present on oil and gas rigs, but it can also be present in locations where oil and gas are refined, such as industrial plants. The gas is present in mining and pulp and paper processing. [industrialinjuryattorney.com]

The patients with exposure to highly water-soluble gases like formaldehyde, hydrogen chloride, sulfur dioxide can also present with mucosal irritation and secretions; it is possible, although unproven, if glycopyrrolate can benefit these patients. [onlinejets.org]

Other risk factors may also be present in individual cases which may independently increase the risk of adverse pregnancy outcome. [medicinesinpregnancy.org]

Manifestations of ocular toxicity from ammonia include the following: Iritis Corneal edema Semi-dilated fixed pupil Eventual cataract formation See Clinical Presentation for more detail. [emedicine.medscape.com]

• Fatigue

  Ammonia's odor provides adequate early warning of its presence, but ammonia also causes olfactory fatigue or adaptation, reducing awareness of one's prolonged exposure at low concentrations. [health.ny.gov]

  However, ammonia causes olfactory fatigue or adaptation, making its presence difficult to detect when exposure is prolonged. [chemm.nlm.nih.gov]

  An olfactive fatigue occurs following repeated exposures, therefore the odor cannot be an adequate sign of warning to an exposure exceeding the VEMP or the VECD. However, the olfactive threshold is sufficiently low to prevent a situation of IDLH. [smart2000.pagesperso-orange.fr]

  However, ammonia causes olfactory fatigue (loss of sense of smell) or adaptation, making it difficult to detect its presence when exposure is prolonged. If the odor of ammonia is present, notify a person in authority immediately. [teamster.org]

• Fishing

  Fish Shellfish Immunol 29:623–629 CrossRef Google Scholar Cooper CE, Giulivi C (2007) Nitric oxide regulation of mitochondrial oxygen consumption II: molecular mechanism and tissue physiology. [link.springer.com]

  Anhydrous ammonia is widely used as refrigerant in industrial facilities such as meat, poultry, and fish processing facilities, seafood processing facilities aboard ships, dairy and ice cream plants, wineries and breweries, juice and soft drink processing [emedicine.medscape.com]

  "An accidental death due to Freon 22 (monochlorodifluoromethane) inhalation in a fishing vessel." Forensic science international 168, no. 2 (2007): 208-211. McGee, Michael B., Robert F. Meyer, and Subhash G. Jejurikar. [inspectapedia.com]

• Cough

  Exposure to high concentrations may cause irritation of the skin, damage to the cornea, cough, pain in the chest, respiratory problems (dyspnea i.e. shortness of breath) and suffocation. [smart2000.pagesperso-orange.fr]

  Even fairly low airborne concentrations (50 ppm) of ammonia produce rapid onset of eye, nose, and throat irritation; coughing; and narrowing of the bronchi. [chemm.nlm.nih.gov]

  Exposure to high levels of ammonia in air may be irritating to a person’s skin, eyes, throat, and lungs and cause coughing and burns. [chemicalsafetyfacts.org]

  This will be followed by tears running from your eyes, a runny nose and coughing. Exposure to ammonia can be fatal if the gas is inhaled deeply. [health24.com]

• Dyspnea

  Symptoms of anhydrous ammonia exposure include eye, nose, and throat irritation; dyspnea; wheezing; chest pain; pulmonary edema; pink frothy sputum; skin burns; vesiculation; and frostbite. [medical-dictionary.thefreedictionary.com]

  Our patient had stridor, dyspnea, excessive secretions, and altered mental state but we could avoid intubation in him by using a combination of steroids and anti-secretory agent like glycopyrrolate. [onlinejets.org]

  Vesicant toxicity severe enough to cause dyspnea typically causes airway necrosis often with upper airway obstruction. [chemm.nlm.nih.gov]

  Exposure to high concentrations may cause irritation of the skin, damage to the cornea, cough, pain in the chest, respiratory problems (dyspnea i.e. shortness of breath) and suffocation. [smart2000.pagesperso-orange.fr]

• Sneezing

  It is extremely irritating, you start coughing and sneezing, and the first thing you want to do is get the hell out of there.” The odor makes it fairly easy for Fire Department responders to monitor for presence of the gas, says Langerman. [healthland.time.com]

  Symptoms of Exposure to Ammonia or Ammonia Gas High concentrations produce violent, burning pain in the eyes and nose, lacrimation, sneezing, pain in the chest, cough, spasm of the glottis, and pulmonary edema. [inspectapedia.com]

• Rhinorrhea

  Signs and symptoms Symptoms of exposure to gaseous ammonia include the following: Rhinorrhea Scratchy throat Chest tightness Cough Dyspnea Eye irritation Symptoms usually subside within 24-48 hours. [emedicine.medscape.com]

• Rhinitis

  Rhinitis, pharyngitis, laryngitis, and bronchitis may occur. Pulmonary edema may result. [inspectapedia.com]

• Nausea

  Inhalation leads to nervous system damage, headache, dizziness, nausea and other symptoms. Skin exposure leads to the same symptoms with the added risk of dermatitis. [industrialinjuryattorney.com]

  Exposure to chloramine gases can cause coughing, shortness of breath, chest pain, nausea, irritation to the throat, nose and eyes or pneumonia and fluid in the lungs. [chemicalsafetyfacts.org]

  Gastrointestinal - nausea, vomiting, and abdominal pain are common symptoms following ingestion of ammonia. Ingestion of household ammonia (5-10%) has resulted in severe esophageal burns. [chemm.nlm.nih.gov]

  Exposure to a low concentration of ammonia vapor can: Irritate the nose, mouth, and throat; Irritate the lungs, causing coughing and or shortness of breath; Irritate the eyes and skin, causing a burning sensation; Cause headache, nausea and vomiting; [teamster.org]

  When ammonia is ingested, nausea and vomiting may result; oral, esophageal, and stomach burns are common. If ammonia has contacted the eyes, irritation, pain, conjunctivitis (red, inflamed eyes), lacrimation (tearing), and corneal erosion may occur. [cameochemicals.noaa.gov]

• Vomiting

  DO NOT give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow. If the poison was inhaled, immediately move the person to fresh air. [medlineplus.gov]

  DO NOT induce vomiting or attempt to neutralize! 3. Obtain authorization and/or further instructions from the local hospital for administration of an antidote or performance of other invasive procedures. 4. [cameochemicals.noaa.gov]

  Gastrointestinal - nausea, vomiting, and abdominal pain are common symptoms following ingestion of ammonia. Ingestion of household ammonia (5-10%) has resulted in severe esophageal burns. [chemm.nlm.nih.gov]

  In the last 3 weeks an odor has appeared in the house that causes headaches and vomiting. Can this detect if I am being poisoned? Reply: Kay: You first need to take this concern to your doctor. [inspectapedia.com]

  Exposure to a low concentration of ammonia vapor can: Irritate the nose, mouth, and throat; Irritate the lungs, causing coughing and or shortness of breath; Irritate the eyes and skin, causing a burning sensation; Cause headache, nausea and vomiting; [teamster.org]

• Abdominal Pain

  Esophageal pain with swallowing, drooling and refusal of food suggest a more significant injury. Substernal chest pain, abdominal pain and rigidity suggest profound injury and potential perforation of the esophagus and/ or stomach. [chemm.nlm.nih.gov]

  Swallowing a cleaning product that contains ammonia can burn the mouth, throat, and stomach and cause severe abdominal pain. [chemicalsafetyfacts.org]

  Ingestion of ammonia can produce the following symptoms: Oropharyngeal, epigastric, and retrosternal pain Abdominal pain and other GI symptoms, with viscus perforation (perforation may occur up to 24-72 hours post ingestion) Respiratory symptoms, if aspiration [emedicine.medscape.com]

  Prolonged overexposure to bromine can cause dizziness, headache, and cough followed by abdominal pain and, later, lung edema and pneumonia if the exposure is severe enough. [inspectapedia.com]

• Choking

  Internationally, the UK is a signatory to the international UNECE Convention on Long-Range Transboundary Air Pollutants (LRTAP); and the Gothenburg UN/ECE Protocol to abate acidification, eutrophication (where over-fertilisation causes water bodies to become "choked [apps.sepa.org.uk]

  Medical Management Guidelines Respiratory Agents, such as Choking, Lung, or Pulmonary ones, cause severe irritation/swelling to the respiratory tract. Background Information Synonyms include ammonia gas, anhydrous ammonia, and liquid ammonia. [sccgov.org]

  If the nose or throat is exposed, flood the area repeatedly for 15 minutes, being careful not to choke the victim. Even a brief or mild exposure to the eyes requires irrigation for a minimum of 15 minutes. Remember to flush underneath eyelids. [nasdonline.org]

  Throat pain,choking sensation, & the feeling of someone sitting on her. She was getting rashes & finally a doctor tested her for pneumonia. It came back positive. The day of her last dose her symptoms came back with a vengeance. [inspectapedia.com]

• Chest Pain

  Symptoms of anhydrous ammonia exposure include eye, nose, and throat irritation; dyspnea; wheezing; chest pain; pulmonary edema; pink frothy sputum; skin burns; vesiculation; and frostbite. [medical-dictionary.thefreedictionary.com]

  AIRWAYS, LUNGS, AND CHEST Cough Chest pain (severe) Chest tightness Difficulty breathing Rapid breathing Wheezing BODY-WIDE SYMPTOMS Fever EYES, EARS, NOSE, MOUTH, AND THROAT Tearing and burning of eyes Temporary blindness Throat pain (severe) Mouth pain [medlineplus.gov]

  Exposure to chloramine gases can cause coughing, shortness of breath, chest pain, nausea, irritation to the throat, nose and eyes or pneumonia and fluid in the lungs. [chemicalsafetyfacts.org]

  Esophageal pain with swallowing, drooling and refusal of food suggest a more significant injury. Substernal chest pain, abdominal pain and rigidity suggest profound injury and potential perforation of the esophagus and/ or stomach. [chemm.nlm.nih.gov]

  Signs and Symptoms of Acute Ammonia Exposure: Inhalation of ammonia may cause irritation and burns of the respiratory tract, laryngitis, dyspnea (shortness of breath), stridor (high-pitched respirations), and chest pain. [cameochemicals.noaa.gov]

• Weak Pulse

  Most household cleaners are relatively weak and cause little or mild damage. Industrial strength cleaners can cause severe burns and injury. Survival past 48 hours most often indicates recovery will occur. [medlineplus.gov]

• Blurred Vision

  It has been used for its antimuscarinic actions in organophosphate poisoning. [7] Glycopyrrolate, in high dose, can produce xerostomia (dry mouth), blurred vision, photophobia due to mydriasis, and cycloplegia. [onlinejets.org]

• Flushing

  Ammonia on the skin: If irritation occurs, gently blot or brush away any excess chemicals and flush contaminated skin with water. If the chemicals penetrate clothing, promptly remove clothing and flush the skin with water. [safetyandhealthmagazine.com]

  The rain will flush it out of the air and very quickly dilute it out and into the soil where it will actually act as fertilizer. [healthland.time.com]

  Clothing must be removed and the skin must be flushed with water for at least 5 minutes. Irritated eyes must also be flushed with plain or saline water for 5 minutes. Remove contact lenses if they are being worn by affected persons. [health24.com]

  Remember to flush underneath eyelids. Always begin flushing immediately. This reduces injuries, caused as soon as anhydrous ammonia contacts skin or clothes. If water is not immediately available, use any non-toxic liquid such as cold coffee. [nasdonline.org]

  Immediately and briefly flush with lukewarm, gently flowing water. DO NOT attempt to rewarm. Cover both eyes with a sterile dressing. DO NOT allow victim to drink alcohol or smoke. Ingestion: Not applicable (gas). [ccohs.ca]

• Blister

  Exposure to concentrated vapor or solution can cause pain, inflammation, blisters, necrosis and deep penetrating burns, especially on moist skin areas. [chemm.nlm.nih.gov]

  Blistering, tissue death and infection may develop in severe cases. Eye Contact: CORROSIVE. The gas irritates or burns the eyes. Permanent damage including blindness can result. Direct contact with the liquefied gas can freeze the eye. [ccohs.ca]

  Blistering, tissue death and gangrene may also develop in severe cases. Available studies have not shown significant health effects in people with long-term occupational exposure to ammonia. [teamster.org]

• Euphoria

  A person suffering from carbon monoxide (CO) intoxication may first experience euphoria (similar to the effect of a martini or two), then headache, followed by nausea and possibly vomiting as the concentration of carboxyhemoglobin in the blood increases [inspectapedia.com]

• Headache

  Inhalation leads to nervous system damage, headache, dizziness, nausea and other symptoms. Skin exposure leads to the same symptoms with the added risk of dermatitis. [industrialinjuryattorney.com]

  The patient also complained of mild headache and discomfort behind his eyes for which he was taking aspirin. The discomfort behind his left eye was worse than on the right. [mdedge.com]

  Prolonged overexposure to bromine can cause dizziness, headache, and cough followed by abdominal pain and, later, lung edema and pneumonia if the exposure is severe enough. [inspectapedia.com]

  Exposure to a low concentration of ammonia vapor can: Irritate the nose, mouth, and throat; Irritate the lungs, causing coughing and or shortness of breath; Irritate the eyes and skin, causing a burning sensation; Cause headache, nausea and vomiting; [teamster.org]

• Altered Mental Status

  This may result in low blood oxygen levels and an altered mental status. Mucosal burns to the tracheobronchial tree can also occur. Immediate onset of laryngospasm with respiratory arrest can occur. [chemm.nlm.nih.gov]

• Stroke

  Lightning strokes are another natural source of ozone and the characteristic odor of that material can often be noted during and after a thunderstorm. [inspectapedia.com]

• Insomnia

  Dangerous To Life or Health Concentration (IDLH): 100 ppm Potential symptoms: Apnea; coma; convulsions; irritated eyes, conjunctivitis pain, lacrimation, photophobia, corneal vesiculation; respiratory system irritation; dizziness; headaches; fatigue; insomnia [inspectapedia.com]

[…] capillary wedge pressure (PCWP) monitoring – In cases of severe acute lung injury (ALI) or ARDS Pulmonary function tests Ventilation/perfusion (V/Q) scan Bronchoscopy – In severe acute inhalation injury Endoscopy – In significant ingestion exposures See Workup [emedicine.medscape.com]

• Hypercapnia

  Indications for intubation include severe respiratory distress (hypoxemia, hypercapnia), stridor, hoarseness, deep facial burns, burns, and depressed mental status. [onlinejets.org]

  […] supportive, as follows: Decontaminate the patient (if that was not done at the site of exposure) Support the ABCs as necessary Provide warmed humidified oxygen Indications for tracheal intubation include the following: Severe respiratory distress (hypoxemia, hypercapnia [emedicine.medscape.com]

The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. [medicinesinpregnancy.org]

Treatment: Skin Exposure If ammonia gas or solution was in contact with the skin, chemical burns may result. Treat as thermal burns. [sccgov.org]

Each chapter includes key clinical features and potential treatment options to help physicians to assess the potential severity of the poisoned patient and provide the optimum clinical care. [books.google.com]

The best first aid treatment for anhydrous ammonia exposure is water -- large amounts of it. Flush all exposed areas with water for at least 15 minutes. [nasdonline.org]

Physical (aeration), chemical (reduce or increase manure pH by manure additives) and biological (biofilteration) treatment of stored manure. [www1.agric.gov.ab.ca]

Ammonia Gas Properties, Exposure Pathology, Symptoms, Treatment, Prognosis The following information about exposure to ammonia gas hazards is based on information from U.S. [inspectapedia.com]

[…] medical care, 32 required hospitalization, and 4 were placed in intensive care. [7] In March 2011, equipment and operator error in a poultry plant in Alabama released 32,000 pounds of anhydrous ammonia, resulting in the hospitalization of 150 people. [3] Prognosis [emedicine.medscape.com]

In turn, hypochlorous acid reacts with water to form hydrochloric acid and nascent oxygen, a strong oxidizing agent with corrosive effects. [17] Etiology Agriculture-related ammonia injury most often results from either ammonia leaks in fertilizer tanks [emedicine.medscape.com]

Epidemiology The 2017 Annual Report of the American Association of Poison Control Centers' National Poison Data System (AAPCC-NPDS) reported 1846 single exposures of ammonia, but no deaths. [emedicine.medscape.com]

Pathophysiology Ammonia most commonly causes damage when anhydrous ammonia (liquid or gas) reacts with tissue water to form the strongly alkaline solution, ammonium hydroxide. [emedicine.medscape.com]

These systems are designed and built to strict standards and codes developed to prevent accidental releases. [teamster.org]

Employers are required to minimize exposure to benzene to prevent its detrimental effects, even in high-risk industries. [industrialinjuryattorney.com]

It may be necessary to use stringent control measures such as process enclosure to prevent product release into the workplace. [ccohs.ca]

In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. A breathing machine (ventilator) would then be needed. [medlineplus.gov]