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Gasoline Poisoning

Gasoline Exposure

Gasoline poisoning can be either acute, subacute or chronic and can be due to accidental or intentional inhalation of gasoline fumes or ingestion of gasoline. Adverse effects are caused by the hydrocarbons present in this compound and these can affect different organ systems. Children are more vulnerable to toxicity compared to adults. Diagnosis depends on history, findings on the clinical examination and organ-specific tests as gasoline levels cannot be detected in blood.


Presentation

Gasoline poisoning can lead to different symptoms depending on whether it is ingested, inhaled or is in contact and based on the duration of exposure. The toxic effects are mainly due to the hydrocarbon components in gasoline, although the chemical itself is a mild irritant.

Following sudden exposure to gasoline, patients can present with pneumonitis (if inhaled), and gastrointestinal irritation (if ingested). Lead, if present in gasoline, can cause lead poisoning, in addition, to gasoline poisoning. Hydrocarbons present in gasoline can cross the placenta and are potentially harmful to the fetus [1]. Inhalation of low concentrations results in facial flushing, imbalance, slurring of speech and confusion while higher concentrations can lead to dizziness, headaches, blurring of vision, seizures, coma, unconsciousness and eventually death due to respiratory failure. Children are more susceptible to the effects of gasoline poisoning as they have a relatively higher rate of minute ventilation per kilogram of body weight and often are not evacuated immediately following exposure.
Effects of gasoline toxicity on different organ systems are [2]:

Long-term exposure to gasoline as a fuel has not been associated with any specific health-related complications, however, chronic abuse e.g. sniffing [3] has been reported to cause changes in mood, increased irritability, drowsiness, confusion, tremors, seizures, visual dysfunction, hallucinations and even sudden death. Although, these adverse effects may be due to adulteration of gasoline with lead or other additives and not due to gasoline itself.

Gasoline has been designated as a possible 2B carcinogen by the International Agency for Research on Cancer [4].

Effects of gasoline on the human immune system were evaluated by White et al [5] although they could not provide any conclusive results.

Fatigue
  • Symptoms of chronic gasoline poisoning occur during prolonged use under conditions of constant influence and manifest themselves: disorders of the nervous system with signs of hysteria or neurasthenia; complaints of constant fatigue, decreased performance[en.intoxication-stop.com]
  • If you are exposed to very low levels of carbon monoxide over a longer period (weeks or months), your symptoms can appear like the flu, with headache, fatigue, malaise (a general sick feeling) and sometimes nausea and vomiting.[drugs.com]
  • 'Often people are misdiagnosed as having chronic fatigue syndrome, seasonal affective disorder (SAD) or, worse, some doctors might wrongly suspect Parkinson's.' In March 2005, Alan's GP referred him to a neurologist - but only for his numb hand.[dailymail.co.uk]
  • Symptoms of gasoline poisoning may include: difficulty breathing throat pain or burning burning in the esophagus abdominal pain vision loss vomiting with or without blood bloody stools dizziness severe headaches extreme fatigue convulsions body weakness[healthline.com]
  • Some of the most common dangers include: * Respiratory problems * Permanent brain damage * Depressed immune system * Blood abnormalities * Heart damage * Liver and kidney damage * Chronic headaches * Chronic fatigue * Nose bleeds * Irregular heart beat[alcoholrehab.com]
Gastric Lavage
  • Tube through the mouth into the stomach to wash out the stomach ( gastric lavage ). Washing of the skin (irrigation). Perhaps every few hours for several days.[medlineplus.gov]
  • lavage for elimination of the substance from the stomach (irrigation using special solutions) Wash eyes or skin repeatedly and thoroughly (irrigation), to eliminate any remaining compound Surgical treatment for skin burns including removal of burnt skin[dovemed.com]
  • lavage may be performed Antibiotics Hydrocarbon Aspiration/Pneumonitis.[learningradiology.com]
  • Regarding gastric lavage, the risk and complications of aspiration generally outweigh the benefits. Lavage is useful in cases in which the hydrocarbon has an inherent systemic toxicity or contains additives with known toxicity.[emedicine.medscape.com]
Cough
  • This condition is manifested by symptoms: pain in the side of the affected lung and blueness of the skin; dyspnea on exertion, in severe case - at rest; cough accompanied by rusty sputum (presence of blood in the sputum); violation of the general condition[en.intoxication-stop.com]
  • They said that I would experience vomiting and coughing if it was serious. I havent really had any symptoms to tell you the truth, no vomitting or coughing or anything.[healthboards.com]
  • He coughed and vomited at the time. He called Poison Control the following day since he was belching a lot and could taste the gasoline.[poison.org]
  • If aspirated (or "goes down the wrong way") into the lungs may cause coughing, choking and difficulty breathing.[dpic.org]
Dyspnea
  • This can manifest as dyspnea. Cardiac: Due to sensitization of the myocardial fibers, patients may develop ventricular fibrillation which is usually fatal.[symptoma.com]
  • This condition is manifested by symptoms: pain in the side of the affected lung and blueness of the skin; dyspnea on exertion, in severe case - at rest; cough accompanied by rusty sputum (presence of blood in the sputum); violation of the general condition[en.intoxication-stop.com]
  • Initial symptoms may include chest pain and dyspnea. Over subsequent hours, pulmonary infiltrates may occur on the chest roentgenogram. Hypoxemia and pulmonary edema are common and requiring ventilatory support.[scialert.net]
Rales
  • While diagnosing these cases, clinical signs suggested of pulmonary and other systemic involvements like dyspnea, tachypnea, sweating, tachycardia, chest pain, cyanosis, rales, hemoptysis, seizure, phlebitis, vomiting, agitation, fever, pleuritis, cough[scialert.net]
Vomiting
  • (blood in vomit may be seen) Bloody stools Stomach and abdominal pain that may be cramping Sudden reduction in blood pressure (hypotension) Feeling dizzy or drowsy Low level of alertness or response Individuals act ‘drunk’ Unable to walk properly; lack[dovemed.com]
  • Symptoms of oral ingestion may also include dizziness, disorientation, seizures, and other neurological difficulties; gastric irritation and vomiting; rashes; and cardiac rhythm disturbances.[medical-dictionary.thefreedictionary.com]
  • In case of accidental ingestion of gasoline and its penetration into the stomach, reusable vomiting appears in copious amounts and loose stools, the victim complains of abdominal pain, liver damage is possible due to non-infectious hepatitis - the liver[en.intoxication-stop.com]
  • Gasoline poisoning can cause symptoms in various parts of the body: AIRWAYS AND LUNGS Breathing difficulty Throat swelling EYES, EARS, NOSE, AND THROAT Pain Vision loss STOMACH AND INTESTINES Abdominal pain Blood stools Burns of the esophagus (food pipe) Vomiting[medlineplus.gov]
  • They said that I would experience vomiting and coughing if it was serious. I havent really had any symptoms to tell you the truth, no vomitting or coughing or anything.[healthboards.com]
Nausea
  • Headaches and dizziness hemoglobin hydrogen Illinois illuminating gas industrial carbon-monoxide poisoning Industrial poisons instances Lead poisoning legs Lewin linotypists loss of memory Mechanic mental metal mining methane miners months motor muscular nausea[books.google.com]
  • […] gasoline vapors are observed, similar to alcohol intoxication: mental excitement of euphoria and unreasonable laughter; weakness and redness of the skin; dizziness and unsteady gait; irritation of the mucous membranes of the respiratory tract; possibly nausea[en.intoxication-stop.com]
  • […] food-pipe; this may affect the nose, ears, and eyes Respiratory difficulties, if the chemical is inhaled Throat inflammation may cause difficulty in swallowing, breathing Skin burns Vision abnormalities including loss of vision Headache and lethargy Nausea[dovemed.com]
  • It can cause headache and nausea and dizziness, those are the most common things, but as far as life threatening problems, usually not that big of a deal.[healthcare.utah.edu]
  • The gases may result in slurred speech, loss of coordination, increased heart rate, hallucinations or delusions, nausea, vomiting, and losing consciousness, according to the TeensHealth website.[livestrong.com]
Abdominal Pain
  • Gasoline poisoning can cause symptoms in various parts of the body: AIRWAYS AND LUNGS Breathing difficulty Throat swelling EYES, EARS, NOSE, AND THROAT Pain Vision loss STOMACH AND INTESTINES Abdominal pain Blood stools Burns of the esophagus (food pipe[medlineplus.gov]
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
  • In case of accidental ingestion of gasoline and its penetration into the stomach, reusable vomiting appears in copious amounts and loose stools, the victim complains of abdominal pain, liver damage is possible due to non-infectious hepatitis - the liver[en.intoxication-stop.com]
  • pain that may be cramping Sudden reduction in blood pressure (hypotension) Feeling dizzy or drowsy Low level of alertness or response Individuals act ‘drunk’ Unable to walk properly; lack of coordinated movements Seizures Collapse How is First Aid administered[dovemed.com]
  • Symptoms of gasoline poisoning may include: difficulty breathing throat pain or burning burning in the esophagus abdominal pain vision loss vomiting with or without blood bloody stools dizziness severe headaches extreme fatigue convulsions body weakness[healthline.com]
Diarrhea
  • Symptoms include burning in the mouth, throat or stomach; vomiting; or diarrhea. A person with paint thinner poisoning may become short of breath, or even appear blue around the lips and extremities.[sharecare.com]
  • Ingestion: Irritation to mouth and throat, possible upset stomach and diarrhea. If aspirated (or "goes down the wrong way") into the lungs may cause coughing, choking and difficulty breathing.[dpic.org]
  • What it may do is cause vomiting, vertigo, confusion, drowsiness, breathing difficulties, burning in the esophagus, sore throat, weakness, and diarrhea, even when ingested in small amounts; in larger portions, it can cause loss of consciousness, internal[todayifoundout.com]
Cyanosis
  • In statistical study, only hemoptysis, cyanosis and kerosene odor had significant differences between two groups with p-value of 0.024.[scialert.net]
  • […] ingestion Aspiration produces a direct toxic effect on lung parenchyma resulting in a pneumonitis Hemorrhagic alveolitis can peak 3 days after ingestion Clinical Findings Respiratory symptoms can be delayed several hours after ingestion Cough and hypoxia Cyanosis[learningradiology.com]
  • Young children may have cyanosis, hold their breath, and cough persistently. Older children and adults may report burning in the stomach. Aspiration pneumonitis causes hypoxia and respiratory distress.[msdmanuals.com]
Retinal Damage
  • Ophthalmological effects: Acute exposure is associated with irritation and corneal injury while prolonged exposure presents as corneal, ciliary body and retinal damage with vision abnormalities.[symptoma.com]
Eczema
  • Prolonged contact of gasoline with the skin causes the development of eczema or acute inflammation occurs. Gasoline substance abuse refers to a dangerous phenomenon among adolescents.[en.intoxication-stop.com]
Dermatitis
  • Dermatological effects: Gasoline exposure over a long period of time results in contact dermatitis, burns, and blisters.[symptoma.com]
Hysteria
  • Symptoms of chronic gasoline poisoning occur during prolonged use under conditions of constant influence and manifest themselves: disorders of the nervous system with signs of hysteria or neurasthenia; complaints of constant fatigue, decreased performance[en.intoxication-stop.com]
Oliguria
  • Gastrointestinal: Ingestion of gasoline causes oral mucosal ulceration and esophagitis with severe gastritis Renal toxicity: While inhalation of excessive gasoline leads to proximal tubule and glomerular degeneration with subsequent renal failure, ingestion causes oliguria[symptoma.com]
Hematuria
  • Ingestion of gasoline causes oral mucosal ulceration and esophagitis with severe gastritis Renal toxicity: While inhalation of excessive gasoline leads to proximal tubule and glomerular degeneration with subsequent renal failure, ingestion causes oliguria, hematuria[symptoma.com]
Oliguria
  • Gastrointestinal: Ingestion of gasoline causes oral mucosal ulceration and esophagitis with severe gastritis Renal toxicity: While inhalation of excessive gasoline leads to proximal tubule and glomerular degeneration with subsequent renal failure, ingestion causes oliguria[symptoma.com]
Headache
  • […] consciousness danger death doors Doubtful test dynamite effect employed engines especially examination exhaust gases explosion exposure fatal fires fumes furnace gas containing gas poisoning gassing accidents Glaister headache Headaches and dizziness[books.google.com]
  • Inhalation of low concentrations results in facial flushing, imbalance, slurring of speech and confusion while higher concentrations can lead to dizziness, headaches, blurring of vision, seizures, coma, unconsciousness and eventually death due to respiratory[symptoma.com]
  • He had a mild headache throughout the day. Then last night his glands became extremely swollen such that he is having a hard time swallowing and sometimes gags even though there is nothing in there. His eyes are watering a lot and they are swollen.[mothering.com]
  • Abdominal pain Blood stools Burns of the esophagus (food pipe) Vomiting, possibly with blood HEART AND BLOOD Collapse Low blood pressure -- develops rapidly NERVOUS SYSTEM Convulsions Depression Dizziness Drowsiness Feeling of being drunk (euphoria) Headache[medlineplus.gov]
  • […] the mouth, throat, and food-pipe; this may affect the nose, ears, and eyes Respiratory difficulties, if the chemical is inhaled Throat inflammation may cause difficulty in swallowing, breathing Skin burns Vision abnormalities including loss of vision Headache[dovemed.com]
Confusion
  • Inhalation of low concentrations results in facial flushing, imbalance, slurring of speech and confusion while higher concentrations can lead to dizziness, headaches, blurring of vision, seizures, coma, unconsciousness and eventually death due to respiratory[symptoma.com]
  • Ultimately, both of these nasty gases affect the amount of oxygen getting to your brain and heart, so the symptoms are similar: drowsiness, headache, nausea, dizziness, and shortness of breath in lower exposures; and vomiting, confusion, coma, seizures[ipcblog.org]
  • The ongoing trouble with lead exposure is not to be confused with lead poisoning, which has dropped significantly in developed countries, including the U.S.[scientificamerican.com]
  • What it may do is cause vomiting, vertigo, confusion, drowsiness, breathing difficulties, burning in the esophagus, sore throat, weakness, and diarrhea, even when ingested in small amounts; in larger portions, it can cause loss of consciousness, internal[todayifoundout.com]
  • […] poorly ventilated room, you can develop: Headache Shortness of breath Personality changes Unusually emotional behavior or extreme swings in emotions Fatigue Malaise (a generally sick feeling) Dizziness Clumsiness or difficulty walking Vision problems Confusion[drugs.com]

Workup

It is difficult to detect gasoline poisoning in blood samples. Therefore the clinician has to rely on a detailed history, and physical examination findings to arrive at a diagnosis. In acute and severe cases, blood and urine toxicology, as well as specific laboratory tests, to diagnose organ dysfunction may be needed.

A thorough physical examination is performed recording vital parameters like heart rate, temperature, respiratory rate, and blood pressure. In case, of ingestion or inhalation, the throat is examined and flexible pharyngolaryngoscopy with bronchoscopy [2] may be required.

In addition, imaging studies like a plain X-ray chest to exclude aspiration pneumonitis, and an electrocardiogram to rule out cardiac arrhythmias are also performed [2].

Treatment

  • Treatment with gasoline poisoning In the case of severe gasoline poisoning treatment is recommended in the hospital, which includes: bed rest; a diet enriched with vitamins - C, PP, B1, and minerals - calcium, iron preparations; detoxification therapy[en.intoxication-stop.com]
  • How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.[medlineplus.gov]
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
  • Carbon Monoxide Poisoning Treatment The treatment for carbon monoxide poisoning is high-dose oxygen, usually using a facemask attached to an oxygen reserve bag.[emedicinehealth.com]

Prognosis

  • This is mostly the case with mild poisoning Since, gasoline is a poisonous substance, the severity of damage to the body, and consequently the prognosis, is dependent on the amount of chemical ingested and promptness with which treatment is provided In[dovemed.com]
  • Carbon Monoxide Poisoning Prognosis The prognosis for a person with carbon monoxide poisoning is difficult to predict. Death can result from severe cases.[emedicinehealth.com]
  • Prognosis The prognosis depends on the severity of carbon monoxide poisoning. Among people with severe symptoms, as many as two out of three people may have long-term complications, especially neurological problems.[drugs.com]

Epidemiology

  • […] design and statistical analysis of toxicological investigations The book is conveniently divided into four sections covering general medical toxicology, environmental toxicology, industrial and occupational toxicology, and epidemiology and statistics[books.google.com]
  • Alavanja, “Influence of Medical Conditions and Life Style Factors on the Menstrual Cycle,” Epidemiology, Vol. 13, No. 6, 2002, pp. 668-674. doi:10.1097/00001648-200211000-00011 [ 19 ] M.[scirp.org]
  • Epidemiologic assessment of the impact of four hurricanes- Florida, 2004. MMWR 2005;54:693-7. National Institute of Occupational Safety and Health. Preventing carbon monoxide poisoning from small gasoline-powered engines and tools.[imic.or.jp]
  • Adult Blood Lead Epidemiology and Surveillance --- United States, 2002. CDC MMWR [On-line information]. Available online at . Harold E. Hoffman, MD, FRCPC, FACOEM. Occupational & Environmental Medicine. Edmonton, Alberta, Canada. Thomas P.[labtestsonline.it]
Sex distribution
Age distribution

Pathophysiology

  • Clinical characteristics, pathophysiology, and management of hydrocarbon ingestion: case report and review of the literature. Pediatr Emerg Care. 1987 ;3(3):187–193. PubMed CrossRef Google Scholar 8. Shotar AM.[link.springer.com]

Prevention

  • Prevention Preventive measures are aimed at compliance with safety regulations: ensuring effective ventilation (ventilation) both at the enterprises and in everyday life; use of personal protective equipment (gas masks, gloves); conducting regular medical[en.intoxication-stop.com]
  • You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. Take the container with you to the hospital, if possible.[medlineplus.gov]
  • CDC Childhood Lead Poisoning Prevention Program, CDC Recommendations for Lead Poisoning Prevention in Newly Arrived Refugee Children.[labtestsonline.it]
  • Carbon monoxide detectors that meet the UL standard 2034, when used properly, may provide early detection and warning and may prevent unintentional carbon monoxide related deaths.[healthychildren.org]

References

Article

  1. GAO report to the Chairman, Committee on Government Affairs, US Senate. Reproductive and Developmental toxicants. Regulatory actions provide uncertain protection. 1991; October. http://www.gao.gov/assets/160/151187.pdf Accessed 2nd May 2017.
  2. Lee DC. Hydrocarbons. In: Marx JA, Hockberger RS, Walls RM, et al. Eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2014; chap 158.
  3. Clark CR, Schreiner CA, Parker CM, Gray TM, Hoffman GM. Health assessment of gasoline and fuel oxygenate vapors: subchronic inhalation toxicity. Regul. Toxicol. Pharmacol. 2014;70 (2S): S18–S28.
  4. IARC Monographs. Diesel and gasoline engine exhausts and some nitroarenes. 2012; 105.https://www.iarc.fr/en/media-centre/iarcnews/pdf/BackgrounderMono-105.pdf Accessed 2nd May 2017.
  5. White KL, Peachee VL, Armstrong SR, Twerdok LE, Clark CR, Schreiner CA. Health assessment of gasoline and fuel oxygenate vapors: immunotoxicity evaluation. Regul. Toxicol. Pharmacol. 2014;70 (2S): S43–S47.

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Last updated: 2019-07-11 21:21