A Planning Guide For The Management of Contaminated Patients

Managing
Hazardous
Materials
Incidents
A Planning
Guide for the
Management of
Contaminated
Patients
U.S. Department Of Health And Human Services
Public Health Service
Agency for Toxic Substances and Disease Registry
Volume I
Volume II
Volume III
Chemical Link Page
Includes
ToxFAQs
Click on PDF link below to open file
1,1,1-Trichloroethane
1,3-Butadiene
Acrolein
Acrylonitrile
Ammonia
Aniline
Arsenic Trioxide
Arsine
Benzene
Blister Agents (H, HD, HT)
Blister Agents (HL, L)
Blister Agents (HN-1, HN-2, HN-3)
Calcium-Sodium Hypochlorite
Carbon Disulfide
Chlordane
Chlorine
Crotonaldehyde
Diborane
Ethylene Dibromide
Ethylene Glycol
Ethylene Oxide
Formaldehyde
Gasoline
Hydrogen Chloride
Hydrogen Cyanide
Hydrogen Fluoride
Hydrogen Peroxide
Hydrogen Sulfide
Malathion
Mercury
Methyl Bromide
Methyl Isocyanate
Methyl Mercaptan
Methylene Chloride
Nerve Agents
Nitrogen Oxides
Parathion
Phenol
Phosgene Oxime
Phosgene
Phosphine
Selenium Hexafluoride
Sodium Hydroxide
Sulfur Dioxide
Tetrachloroethylene
Toluene Diisocyanate
Toluene
Trichloroethylene
Unidentified Chemical
Vinyl Chloride
Xylene
MANAGING HAZARDOUS
MATERIALS INCIDENTS
A Three Volume Series
March 2001
Under the authority of the Superfund Amendments and Reauthorization Act of 1986 (SARA), the Agency
for Toxic Substances and Disease Registry (ATSDR) works to prevent or mitigate adverse human health
effects and diminished quality of life resulting from exposure to hazardous substances in the environment.
In pursuit of this mission, Managing Hazardous Materials Incidents, Volume I , II, & III, and the training
video have been developed to provide emergency medical services (EMS) personnel and hospital emergency
departments (EDs) with the necessary guidance to plan for, and improve their ability to respond to, incidents
that involve human exposure to hazardous materials. The guidelines inform emergency personnel how to
appropriately decontaminate, treat, and recommend follow-up care to exposed persons, as well as take
measures to protect themselves.
HIGHLIGHTS: ATSDR's Managing Hazardous Materials Incidents is a three volume

set (with video) comprised of recommendations for on-scene (prehospital), and hospital
medical management of patients exposed during a hazardous materials incident. Volume
I - Emergency Medical Services: A Planning Guide for the Management of Contaminated
Patients and Volume II - Hospital Emergency Departments: A Planning Guide for the
Management of Contaminated Patients are planning guides to assist first responders and
hospital emergency department personnel in planning for incidents that involve hazardous
materials. Volume III - Medical Management Guidelines for Acute Chemical Exposures
is a guide for health care professionals who treat persons who have been exposed to
hazardous materials. Community Challenge: Hazardous Materials Response and the
Emergency Medical System - is a training video for Volumes I & II (50 minutes total; 25
minutes for each volume).
MANAGING HAZARDOUS MATERIALS INCIDENTS:
(a three-volume series plus a training video)
Volume I
Emergency Medical Services: A Planning Guide for the Management of

Contaminated Patients.
Volume II
Hospital Emergency Departments: A Planning Guide for the Management of

Contaminated Patients.
Volume III
Medical Management Guidelines for Acute Chemical Exposures.
Video
Community Challenge: Hazardous Materials Response and the Emergency Medical

System - a training video for Volumes I & II (50 minutes total; 25 minutes for each
volume).
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Public Health Service

MANAGING HAZARDOUS MATERIAL INCIDENTS

A Three Volume Series
Page 2
The ATSDR Internet address is < http://www.atsdr.cdc.gov >

Volume III of the Managing Hazardous Materials Incidents contains Medical Management Guidelines for
40 hazardous substances. Each Medical Management Guideline is divided into five easy to use sections:
C
C
C
C
C
General Information (synonyms, appearance, routes of exposure, potential for secondary

contamination, sources/uses, physical properties, and exposure standards).
Health effects (organ systems affected by acute exposure, potential sequelae, and chronic effects).
Pre-hospital management (personal protection, decontamination, support, triage, and
transportation, organized by hot zone, decontamination zone, and support zone).
Emergency department management (management and treatment)
Patient information sheet (information of exposure, potential effects, and follow-up instructions).
The general hazardous substances (35)

Acrylonitrile
Ammonia
Aniline
Arsenic Trioxide
Arsine
Benzene
Butadiene
Chlordane
Chlorine
Elemental Mercury
Ethylene Glycol
Ethylene Oxide
Formaldehyde
Gasoline
Hydrogen Chloride
Hydrogen Cyanide
Hydrogen Fluoride
Hydrogen Peroxide
Hydrogen Sulfide
Methyl Bromide
Methylene Chloride
Nitrogen Oxides
Parathion
Phenol
Phosgene
Phosphine
Sodium Hydroxide
Sulfur Dioxide
Tetrachloroethylene
Toluene
Trichloroethane
Trichloroethylene
Vinyl Chloride
Xylene
The DOD-related hazardous substances (5)

Phosgene Oxime
Blister Agents: Lewisite, Mustard - Lewisite Mixture (L, HL)
Nerve Agents (GA, GB, GD, VX) Blister Agents: Nitrogen Mustard (HN-1, HN-2, HN-3)
Blister Agents: Sulfur Mustard (H, HD, HT)
PEDIATRIC ISSUES: Children's unique
physiology and behavior can influence the extent
of their exposure, and they may differ in their
susceptibility to hazardous chemicals. As a result
of ATSDR's Childhood Health Initiative, the three
volume set has been updated to include any
pediatric specific information/data on each
substance listed above.
INTENDED AUDIENCE: HAZMAT Teams,

Emergency Medical Personnel, Hospital Emergency
Department Personnel, DHHS, DOD, DOE, FBI,
FEMA, U.S. Marine Corps Chemical and Biological
Incident Response Force (CBIRF), U.S. Uniformed
Services University, City and County Emergency
Management Agencies, International/Foreign
Agencies and Organizations.
Where can I get more information?
For more information about the Managaing Hazardous Mateerial Incidents

publications including the Medical Management Guidlines contact the Agency for Toxic Substances and Disease Registry,
Division of Toxicology, 1600 Clifton Road NE, Mailstop E-57, Atlanta, GA 30333. Phone: 1-888-422-8737, FAX: 404-6396359. The ATSDR Internet address is < http://www.atsdr.cdc.gov >.
Federal Recycling Program
Printed on Recycled Paper
Managing
Hazardous
Materials
Incidents
Volume I
(Revised)
Emergency Medical
Services:
A Planning Guide
for the Management of
Contaminated Patients
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume
series entitled Managing Hazardous Material Incidents. The series is designed to help emergency
response and health care professionals plan for and respond to hazardous material emergencies.
Volume I

Volume II

Volume III
Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department
personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to
hazardous materials.
Agency for Toxic Substances

and Disease Registry.........................................Jeffrey P. Koplan, Ph.D., M.P.H., Administrator
Henry Falk, M.D., M.P.H., Assistant Administrator
Division of Toxicology.........................................Christopher T. DeRosa, Ph.D., Director
Additional copies of this report are available from:

Agency for Toxic Substance and Disease Registry (ATSDR)
Division of Toxicology
Information Center (E57)
1600 Clifton Road, N.E.
Atlanta, Georgia 30333
(404) 639-6357
Internet address: www.atsdr.cdc.gov/prevent.html
2 Printed on recycled paper
DEPARTMENT OF
HEALTH & HUMAN SERVICES
Agency for Toxic Substances and Disease Registry (MS-E57)
Atlanta, GA 30333
Official Business
Penalty for Private Use $300
SPECIAL FOURTH-CLASS RATE

POSTAGE & FEES PAID
PHS/CDC
Permit No. G-284
Volume I - Table of Contents
Page
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
I.
Systems Approach to Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

The Role of EMS in a Systems Approach to Planning . . . . . . . . . . . . . . . . . . . . . . . . . 1
Prehospital Response Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
The Spectrum of Hazardous Materials Incidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SARA Title III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
The State Emergency Medical Services (EMS) Agency . . . . . . . . . . . . . . . . . . . . . . . . 4
Federal Emergency Response Activities
Hazard Analysis
Training
...................................6
.....................................................8
...........................................................9
Selected Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
II.
Emergency Medical Services Response to Hazardous Materials Incidents . . . . . . . . .13

Hazard Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Principles of Toxicology for Emergency Medical Service Personnel . . . . . . . . . . . . . 21
Personnel Protection and Safety Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Respiratory Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Site Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Decontamination of Emergency Medical Service Personnel . . . . . . . . . . . . . . . . . . . . 38

Communications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Selected Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
III.
Response and Patient Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

En Route to a Hazardous Materials Scene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Assessment, Decontamination, and Initial Treatment of Patients . . . . . . . . . . . . . . . . 49
Considerations for Patient Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Patient Transport to the Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Critique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 60
Patient Management Under Mass Casualty Conditions
Involving Hazardous Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60
Critical Incident Stress Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Appendix A
Hazardous Materials Classification Systems . . . . . . . . . . . . . . . . . . . . . . . . . A1
Appendix B
Types of Respiratory Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B1
Appendix C
Levels of Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C1
ii
Acknowledgments
This document was first published in 1992 and updated in 2000. ATSDR wishes to thank all those
who participated in making this a useful guidance document, including:
2000 Revision of Volume I
Emergency Medical Services:
A Planning Guide for the Management
of Contaminated Patients:
2000 Revision of Volume II

Hospital Emergency Departments:
Craig DeAtley, P.A.-C., C.C.T.
George C. Rodgers, Jr., M.D., Ph.D.
Associate Professor, Emergency Medicine

Professor of Pediatrics and Pharmacology/Toxicology
Disaster Medicine and Special Operations Section University of Louisville
George Washington University School of Medicine Louisville, KY
and Health Sciences
Washington, D.C.
Peer Review Panel for revised (2000) Volumes I and II:1

Sella Burchette (U.S. Environmental Protection Agency)
Keith Burkhart, M.D., F.A.C.E.P. (American College of Emergency Physicians)
Andrea Carlson (Physicians for Social Responsibility)
Linda Cochiarella, M.D. (American Medical Association)
Paul Cousins (The National Association of Emergency Medical Technicians)
Richard Duffy (International Association of Firefighters)
Philip Edelmen, M.D. (Association of Occupational and Environmental Clinics)
Robert McCunney, M.D. (American College of Occupational and Environmental Medicine)
Kent Olson, M.D. (American Association of Poison Control Centers)
Leslie Stein-Spencer, R.N. (Emergency Nurses Association)
Milton Tenenbein, M.D. (American Academy of Pediatrics)
John Turley (Emergency Management Institute)
1
The above reviewers were recommended by the organizations listed but do not necessarily represent them.
This project was directed by Scott V. Wright, ATSDR. For the 2000 revision, Linda Stein of Eastern
Research Group, Inc. (ERG) was the project manager, and Chris Reid of ERG was the editor (under
ATSDR Contract No. 205-93-0641).
The following panel of experts contributed to the original (1992) development of Volumes I and II:
Phillip Currance, EMT-P; Ralph B. Monty Leonard, Ph.D., M.D., F.A.C.E.P.; Mary Beth Michos,
R.N.; Eric Noji, M.D., M.P.H., F.A.C.E.P.; Martin J. ONeill; Paul Seidlitz, R.N.
The following experts served as peer reviewers for the original 1992 Volumes I and II:
Ben Blankeshire, Kenneth Bouvier, MacNeil Cross, Robert Daughdril, Craig DeAtley, Eileen Faries,
Steve Finefrock, John Friery, Niel Holtz, Winston E. Jones, William J. Keffer, Gus A. Koehler,
Kenneth Kuntz, Paul Manascalo, Kent Olson, Chappell D. Pierce, Alonzo Smith, Clark Staten, Dave
Tauber, Joe E. Taylor, Sandra L. Tirey, Wallace Weaver, Steve White
iii
iv
Introduction
The presence of hazardous materials or toxic chemicals at an incident location or other emergency
situation adds a new dimension of risk to those handling and treating casualties. The fundamental
difference between a hazardous materials incident and other emergencies is the potential for acute
risk from contamination to both patient and responder. In some cases, traditional practices must be
altered to avoid compounding a critical situation.
Emergency medical services (EMS) must protect their personnel on site and en route to the hospital,
and other people within the hospital, while providing the best care for the chemically contaminated
patient. This guide is intended to help emergency medical services plan for incidents that involve
hazardous chemicals and improve their ability to respond to these incidents.
To ensure appropriate and timely patient care, as well as optimal response protection, emergency
personnel must understand decontamination procedures and personal protective equipment, neither
of which are routinely covered in the course of their professional training. They should also be
aware of community resources that could be called upon to assist with an emergency response.
Current training curricula for emergency room physicians and nurses and emergency medical
technicians (EMTs) often do not adequately prepare these professionals to manage the contaminated
individual or to decontaminate patients exposed to toxic substances. Accurate, specific, and concise
guidance is needed to describe appropriate procedures to be followed by emergency medical personnel
to safely care for a patient(s), as well as to protect responders, equipment, hospital personnel, and
others from risk of secondary exposure. In response to this need, the Agency for Toxic Substances
and Disease Registry (ATSDR) contracted for the production of a three-volume series entitled
Managing Hazardous Materials Incidents: I. Emergency Medical Services: A Planning Guide for the
Management of Contaminated Patients; II. Hospital Emergency Departments: A Planning Guide for
the Management of Contaminated Patients; and III. Medical Management Guidelines for Acute
Chemical Exposures. The second document is designed for use by emergency department personnel
to minimize their risks of exposure within the emergency department, and to provide for the safe
and effective treatment of chemically contaminated patients.
This volume, written for emergency response personnel, is designed to familiarize readers with the
terminology, concepts, and key operational considerations that affect the proper management of incidents of chemical contamination. It is designed not only to present uniform guidance for the emergency
care of chemically contaminated patients, but also to provide basic information necessary to comprehensive planning and implementation of EMS strategies. It is intended to illustrate the characteristics
of hazardous materials (hazmat) incidents that compel emergency response personnel to modify their
preparations and response procedures.
Not all hospitals and community emergency response systems are prepared to respond to a hazardous
chemical incident to the same degree. This document may be used to assess the capabilities of
EMS with respect to potential community hazards and to develop response plans using national
and community-specific resources. Employee safety and training are also key factors in effective
management of medical emergencies. This document is intended to provide source material for
developing local training and safety protocols.
Section I, Systems Approach to Planning, introduces guidelines for emergency preparedness and
prehospital response planning. Government and private planning activities are outlined, including
those established under Title III of the Superfund Amendments and Reauthorization Act (SARA);
the National Response Team; the Community Awareness Emergency Response (CAER) program;
and the Chemical Emergency Preparedness Program (CEPP). This chapter discusses the need for
hazard identification and risk analysis pertaining to hazardous materials located in a community or
transported through it. Recommended training for EMS personnel is also included.
Section II, Emergency Medical Services Response to Hazardous Materials Incidents, outlines general
principles for hazard recognition, chemical exposure, and personal protective equipment. In addition, the hazard recognition section presents generalized guidance for determining whether a given situation constitutes a hazardous materials incident, and details various hazardous materials classification
systems. This section provides basic toxicological and chemical terminology that emergency personnel
need to understand to effectively conduct patient assessments. It also presents an outline of personal
protective equipment, such as respiratory devices and protective clothing.
Section III, Response and Patient Management, includes guidelines for EMS preparation and response
to a potential hazardous materials incident. This chapter also discusses patient assessment, clinical
management, and decontamination guidelines.
This guidance document is intended to improve the safety of responders as well as of patients. It is
not, however, all-encompassing, nor can it be regarded as a substitute for comprehensive instruction
and training for hazardous materials incidents. Supplemental material that is vital to successful
response to hazardous materials contamination is cited within the document. These materials should
be carefully reviewed before preparing any strategic plans or conducting training exercises on this
topic. Also, this document generally does not cover issues associated with weapons of mass destruction (WMD), although some of the information presented is pertinent to these situations as well.
Other ATSDR documents specifically address WMD concerns.
vi
vi
Section I.
Systems Approach To Planning
THE ROLE OF EMS IN A SYSTEMS APPROACH TO PLANNING

The potential for hazardous materials incidents exists almost everywhere. While infrequent, chemical incidents are capable of endangering the health of the individuals involved and the emergency
personnel directed to assist them. People who have been seriously injured by a hazardous material
have a greater chance of recovery without complications when appropriate emergency treatment is
provided by trained prehospital Emergency Medical Service (EMS) personnel at the scene, and
when the patient is transported to a facility having the most appropriate personnel and technical
resources to manage his or her care. This requires an integrated emergency medical response.
However, many local governments, private businesses, and hospitals do not have a tested hazardous
materials response plan in place that integrates all of the responding agencies and personnel. This
has resulted in several problems:
l
Incidents have been poorly managed on site by first responders.
Communication channels between the private and public sectors, or among public responders,
have not been clearly identified and formalized.
The medical community has not been firmly integrated into many response systems and may not
be prepared to treat multiple casualties resulting from a serious hazardous materials incident.
EMS agencies are a crucial link in the community response system for emergency preparedness
planning. EMS personnel are often the first to arrive at an incident scene and must assess the nature
and extent of the hazard as well as attend to the immediate needs of victims, including initial treatment
of people who may have been chemically contaminated. For effective coordination and communication, hospitals, EMS agencies, and other response agencies must participate jointly in local meetings
involving hazmat planning, incident management, and protocol review.
EMS agencies must acknowledge their role and responsibility as a component of the communitywide
emergency response system. Administrators should familiarize themselves with the contingency plans
of other participants, such as fire, police, and health departments and area hospitals, and understand
what services are expected from each participant. Optimally, EMS staff should be represented on
planning committees that develop and periodically review these contingency plans.
A common characteristic of the successful management of chemical incidents is adequate contingency planning. Local emergency planning committees are mandated under federal law to identify
high-risk locations and ensure adequate response planning and training. Planning requires the
involvement of an array of community institutions, including fire, EMS and police departments,
community hospitals, other health facilities, and the regional Poison Control Center.
PREHOSPITAL RESPONSE PLANNING

To ensure an effective and safe response to a hazardous materials accident, an EMS agency must
develop a written response plan which becomes an integral part of the local community response
plan. This agency plan should include important definitions, incident command practices to follow,
operational policies and procedures, safety practices, medical practices, and transportation guidelines.
The plan should be developed in collaboration with other response agencies and hospitals, and
reviewed annually. Training sessions based on the plan should be given on a regular basis to all
agency personnel. Various types of disaster drills should be held each year to evaluate the effectiveness of the plan, as well as of the training sessions. The plan should be revised, and further training
offered, based on feedback from its use.
THE SPECTRUM OF HAZARDOUS MATERIALS INCIDENTS

Local and state EMS agencies should be able to participate in the response to a range of hazmat
incidents from the individual level, through the multi-casualty, to the mass-casualty level. The hospital(s) and emergency medical responders are key components of the local response system. Planning
should integrate hospital(s) and EMS personnel, equipment, and supply needs into state and local
hazmat plans. In turn, the hospital must be familiar with these plans and know how to use them if it
is involved in an incident that overwhelms its capabilities.
l
Individual patient: A single individual is contaminated and must be transported to an emergency

department:
;
May pose a problem in rural areas with small hospitals, or where there are low levels
of hazmat skills and experience among EMTs.
Multi-casualty: This situation is usually limited to a single location:

;
Can occur in the workplace, in a public place, or at home.
Involves normal systems of transportation.

Patients are usually treated at the same level facility as a single emergency response, but the
demand on all systems is much greater.
Mass-casualty: Disrupts a large segment of the community:

;
Involves several locations.

Involves additional units to the normal responders (mutual aid); such units may not be part of
the local EMS system, and these units may not know how the system works.
Involves long-range mutual aid; normal systems of transportation (ambulances) are inadequate or disrupted.
Patients may be treated locally at different facilities that provide various levels of care, or
even outside of the area altogether.
May be an intentional criminal act with secondary harmful devices present.
While transportation incidents attract larger media attention, statistics show that almost 75 percent of
acute hazardous materials events, excluding fuel spills, occur in the fixed locations where the chemicals
are used or stored. In addition, events resulting in death and injury occur almost 1.5 times as often in
fixed locations as in transit.
Hazardous material incidents range from small releases at a factory site to rapidly expanding events
that may endanger a community. Regardless of the size or location of an incident, its successful management depends on preplanning. This preplanning often requires coordination among local, state,
and federal agencies; industries; medical personnel; military hospitals; the Health Department; the
regional Poison Control Center, as well as those in the community who use and maintain stocks of
potentially hazardous materials. Contributions to hazardous materials planning come from a variety
of sources. These include regulations from the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO), state and local planning committees established under Title III of the
Superfund Amendments and Reauthorization Act (SARA), state EMS agencies, and federal agencies.
SARA TITLE III

Title III of the 1986 Superfund Amendments and Reauthorization Act (SARA) provides for an infrastructure in states and local communities to plan for effective response to hazardous materials emergencies. The legislation also provides for public access to information on the presence and releases
of specified hazardous chemicals in communities.
Title III, The Emergency Planning and Community Right-to-Know Act of 1986, requires that
each state establish a State Emergency Response Commission (SERC), consisting of members with
technical expertise in emergency response, environmental and natural resources, public health, occupational safety, media, and transportation. The SERC is responsible for establishing local emergency
planning districts (usually on a county level), appointing and overseeing local emergency planning
committees (LEPCs), establishing procedures for handling public requests for information, and
reviewing LEPC emergency plans.
SARA Title III requires that the local committees include, at a minimum, representatives from the
following groups: state and local officials, law enforcement, civil defense, firefighters, environmental, hospital, media, first aid, health, transportation, and facility owners or operators subject to the
emergency planning requirements. LEPCs were primarily responsible for preparing a comprehensive
emergency response plan for their districts by October 1988, using information about the presence
of potentially hazardous chemicals reported by businesses and other facilities under Title III. LEPCs
were also charged with making information on hazardous chemicals available to the public.
As part of the planning process, each LEPC must evaluate available resources for developing,
implementing, and exercising its plan. The plan must include:
l
Identification of facilities subject to planning provisions under Title III
Identification of transportation routes for extremely hazardous substances
Identification of risk-related facilities
Methods and procedures for response
Designated community and facility coordinators
Procedures for public notification
Methods for determining release occurrence and the area affected
Description of emergency equipment and facilities, and those responsible for them
Evacuation plans and training programs
Under Title III s planning provisions, EPA was mandated by Congress to establish a list of chemicals
to help focus local emergency planning activities. In April 1987, EPA listed 406 Extremely
Hazardous Substances (EHSs) and established a Threshold Planning Quantity (TPQ) for each. Any
business or facility that contains one or more of these EHSs in an amount equal to or greater than
its respective TPQ is required to notify the SERC and LEPC. These facilities must also appoint a
coordinator to work with the LEPC for specific inclusion of that facility in the local plan.
Representative facilities covered under the planning provisions include not only major chemical
manufacturing facilities but a wide variety of chemical users, such as farmers, dry cleaners, and
other service-related businesses. Exemptions under this provision apply only to vessels (ship/boat),
federal facilities, and transportation operations. Storage incidental to transportation is exempt provided that the EHSs are still moving under active shipping papers and have not reached the final
consignee.
Accidental releases of EHSs and other hazardous substances identified in the Comprehensive
Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) must be reported to
the LEPC and SERC. This requirement ensures immediate notification of local response personnel.
Other provisions of Title III provide further information on the presence, storage, and emissions of
hazardous and toxic chemicals. These data further assist the LEPC in obtaining a comprehensive
picture of chemical risk in the local district.
Emergency medical personnel can be better prepared to respond to incidents that involve contaminated victims by actively participating in the LEPC planning process. Title III provides for the submission of information on hazardous and toxic chemicals as presented above. In addition, Title III
contains a specific provision requiring facility owners or operators to disclose the chemical identity
of substances for which companies have made trade secret claims. Access to chemical identities
assists health professionals, physicians, and nurses in obtaining further information for diagnostic
and treatment recommendations during emergencies, and for prevention and treatment measures
during nonemergencies.
THE STATE EMERGENCY MEDICAL SERVICES (EMS) AGENCY

Planning for hazardous materials incidents should include the appropriate linkage to the state EMS
agency. The state agencies are responsible for overseeing a network of local EMS units, and thus are
an essential part of the planning process. This body is often part of the SERC.
The duties of these agencies vary from state to state. However, EMS agencies are usually responsible
for medical management of civilians and injured first responders. EMS agencies must develop medical mutual aid agreements between counties and establish procedures for distribution of casualties
between hospitals. In addition, EMS agencies should maintain an inventory of disaster medical supplies.
EMS agencies should also develop and maintain communications protocols for onsite activities
(e.g., between receiving hospitals and the base hospital, between base hospitals and ambulances,
between all hospitals and the regional Poison Control Center). Further, EMS agencies must work
with local and state officials in designating field casualty decontamination and collection points
for a major disaster, and in arranging for the acquisition and distribution of additional equipment,
supplies, and pharmaceuticals.
Suggested planning activities include:
l
Incident Management: Establish with fire and police departments a unified command approach
to mitigating a hazmat or Weapons of Mass Destruction (WMD) incident.
Triage: Outline triage procedures to be utilized in prioritizing decontamination and transport of

multiple patients.
Decontamination: Institute a regional standard for performing decontamination of ambulatory and

nonambulatory patients, in coordination with the fire department, hazmat team(s), and hospitals.
Planning should also address how to handle children, pregnant women, the elderly and the
infirm, as well as large numbers of patients (mass decontamination).
Medical Management Protocols: The literature on the clinical management of hazardous materials
exposures is sometimes inconsistent in its recommendations. Provisions should be made in the plan
for obtaining field and hospital medical management information from experienced physicians.
For example, the regional Poison Control Center can provide decontamination and medical
management protocols via fax, e-mail, or telephone to all receiving hospitals, and through the base
hospital or via cellular telephone to EMTs in the field. Planning should address antidote utilization
and the rapid acquisition of additional supplies and pharmaceuticals, if needed. Volume III in this
series, Medical Management Guidelines for Acute Chemical Exposures, contains useful emergency
care recommendations for prehospital and hospital personnel.
Patient Destination: Hospital emergency departments are able to provide supportive care. In
some cases, however, it may be more appropriate to take the patient to a hospital that has expertise
in handling certain kinds of poison exposures or injuries. The plan should include directions for
obtaining this information. One option is to contact the regional Poison Control Center or the
base hospital. The Poison Center will often know which hospitals are best prepared to handle
exposures to which substances.
Coordination with Burn Centers, Trauma Centers, Hyperbaric Chamber Facilities, Health
Department(s), and Other Specialty Centers: Provisions should be made to alert and coordinate
patient destination with various specialty care centers.
Mental Health: Identify mental health resources, such as critical incident stress debriefing
teams, to assist with meeting the mental health needs of patients, response personnel, and the
general public.
Documentation: Identify the required incident documentation that must be completed during and
after the hazardous materials incident.
Media Relations: Appoint an individual who will handle all media requests for information.
FEDERAL EMERGENCY RESPONSE ACTIVITIES

Contingency planning is essential to the successful implementation of any system designed to manage chemically contaminated patients and to promptly contain the hazard itself. Contingency plans
require a coordinated community response that may also involve state and federal agencies.
Preplanning and coordination of services are equally critical at the national level. The federal government established a National Contingency Plan (NCP) to promote coordination of resources and
services of federal and state response systems. To oversee this plan, a National Response Team
(NRT) and a National Response Center, a network of Regional Response Teams (RRTs), and a group
of On-Scene Coordinators (OSCs) have been established. In addition, with passage of the NunnLugar-Domenici Anti-Terrorism Bill in 1996, the U.S. Public Health Service developed a series of
strategically placed Metropolitan Medical Response Teams (NMRTs) to respond in the event of
Nuclear, Biological, or Chemical (NBC) terrorism. These multidisciplinary teams, consisting of
police, hazmat, EMS, and hospital personnel, are specially trained and equipped to respond to serious
hazmat incidents as well as to NBC-related situations.
The Hazardous Materials Emergency Planning Guide, referred to as NRT-1, provides guidance to
help local communities prepare for potential hazardous materials incidents. NRT-1 can be used by
local communities developing their own plans, as well as by LEPCs formed in accordance with the
Emergency Planning and Community Right-to-Know Act of 1986 (SARA Title III).
The objectives of the Hazardous Materials Emergency Planning Guide are to:
l
Focus communities on emergency preparedness and response.
Provide communities with information that can be used to organize the emergency planning task.
Furnish criteria for risk and hazard assessments, and to assist communities in determining
whether a hazardous materials incident plan is needed in addition to the districtwide plan developed
by the LEPC.
Help LEPCs and individual communities prepare a plan that is appropriate for their needs and
consistent with their capabilities.
Provide a method for revising, testing, and maintaining community emergency plans.
NRT-1 is published by the National Response Team, and was developed cooperatively by its federal
member agencies, including the Department of Defense, Department of the Interior, Department of
Transportation, U.S. Coast Guard, Environmental Protection Agency (EPA), Department of
Commerce (National Oceanic and Atmospheric Administration [NOAA]), Federal Emergency
Management Agency (FEMA), Department of State, Department of Agriculture, Department of
Health and Human Services (Agency for Toxic Substances and Disease Registry [ATSDR]),
Department of Justice, General Services Administration (GSA), Department of the Treasury,
Department of Labor (Occupational Safety and Health Administration [OSHA]), Nuclear Regulatory
Commission (NRC), and the Department of Energy (DOE). NRT-1 represents a concerted effort by
federal agencies to consolidate their general hazardous materials planning guidance into an integrated
federal document.
NRT-1 states that an emergency plan must include response procedures of facilities and local emergency and medical personnel, as well as a description of emergency equipment and facilities in the
community. It also recommends that hospital, emergency medical service, and health department
personnel be included as members of an emergency planning team. As previously mentioned, SARA
Title III requires medical, hospital, and first aid personnel to be members of the local emergency
planning committee. NRT-1 describes relevant publications that provide specific operational guidance
to emergency responders, such as the DOT s North American Emergency Response Guidebook
(NAERG), which provides guidance for firefighters, police, and other emergency services personnel
to help them protect themselves and the public during the initial minutes immediately following a
hazardous materials incident.
In addition, the document provides information on the Chemical Manufacturers Association s (CMA)
Community Awareness Emergency Response (CAER) and Chemical Transportation Emergency
Center (CHEMTREC) programs. The CAER program encourages local chemical manufacturing
facilities to inform area residents, public officials, and emergency response organizations about
industry operations and to integrate their onsite emergency response plans with the planning efforts
of the local community. In some areas of the country, the chemical industry has established physician
networks to encourage better dialogue between company physicians and local health authorities.
CAER has outlined specific steps for industrial plants:
l
Review the plant s emergency plan
Improve employee awareness and training
Prepare a community relations plan
Inventory the status of local emergency planning
Develop a briefing paper
Prepare a list of initial contacts
Meet with initial contacts and identify key officials
Establish a coordinating group
Begin implementation steps
On the federal level, EPA and FEMA provide technical assistance and guidance to local and state
planners through the SARA Title III program.
The NRT-1 document also recommends that contingency plans include standard operating procedures
for entering and leaving sites, accountability for personnel entering and leaving sites, decontamination
procedures, recommended safety and health equipment, and personal safety precautions. The document
suggests that emergency plans include a list of emergency response equipment appropriate to the various
degrees of hazard based on EPA s four levels of protection (Levels A through D; see Section II).
Further, it recommends that the list include the type of respirator (i.e., self-contained breathing apparatus, supplied-air respirator, or air-purifying respirator) that should be used, the type of clothing that
must be worn, and the equipment needed to protect the head, eyes, face, ears, hands, arms, and feet.
In addition, NRT-1 recommends that medical personnel be made aware of significant chemical hazards
in the community to prepare for possible hazardous materials incidents. It also states that emergency
medical teams and hospital personnel must be trained in the proper methods for decontaminating
and treating individuals exposed to hazardous chemicals.
HAZARD ANALYSIS
Hazard analysis is a necessary component of comprehensive emergency planning for a community.
It is a three-step decisionmaking process comprised of hazard identification, vulnerability analysis,
and risk analysis. This section focuses primarily on hazard identification. Hazard analysis is usually
the task of an agency (e.g., the fire department), the Disaster Committee, or the LEPC. EMS personnel
should consult with the LEPC or their agency head to review the hazard analysis information for
their area.
The first task in conducting such an analysis is to complete an inventory of the hazardous materials
present in the community and to determine the nature of the hazard. This is a key step because it
permits planners to describe and evaluate risks, and to allocate resources accordingly. However,
the task of analyzing all relevant hazards may not prove cost effective for many communities. The
planning committee should, therefore, assign priorities to the hazards found in its community and
establish affordable limits for analysis. It should be noted that several federal agencies (e.g., DOT,
FEMA, EPA) report that frequently encountered substances often pose the most prevalent dangers.
These materials include fuels and chemicals, such as chlorine, ammonia, and hydrochloric and sulfuric
acids. Such materials should be given special attention (vulnerability analysis) by the LEPC in the
planning process.
In this context, a hazard is any situation that is capable of causing injury or impairing an individual s
health. During the process of identifying hazards, facilities or transportation routes will be pinpointed
that contain materials that are potentially dangerous to humans. The identification of hazards also
should provide information on: (1) the types, quantities, and location(s) of hazardous materials in
the community, or transported through a community; and (2) the nature of the hazard that would accompany incidents, such as explosions, spills, fires, and venting to the atmosphere.
Hazards should be identified at as many facilities in the community as possible. These include the
obvious ones such as chemical plants, refineries, petroleum plants, storage facilities, and warehouses.
In requesting information directly from facilities, remember that the planning provisions under
SARA Title III require certain facilities to provide the LEPC with any information on the facility
that the committee needs to develop and implement its plan. The LEPCs may provide assistance
here, particularly if the committee includes industry representatives. It is essential that these industries
or businesses understand the role this information plays in ensuring a sound emergency response
plan. As previously stated, placing airport, business, or industrial representatives on the communitywide planning committee, as required under SARA Title III, should facilitate their cooperation. The
assistance and cooperation of a facility that regularly deals with hazardous materials also presents
the local planning unit with a wide array of services. For example, such a facility can provide technical
experts, Spill Prevention Control and Countermeasure (SPCC) plans, training and safe handling
instructions, and cleanup capabilities.
In identifying hazards, hospitals and educational and governmental facilities should not be overlooked
since they all contain a variety of chemicals. Major transportation routes and transfer points, such was
airports, vessels in port, railroad yards, and trucking terminals, should also be included in the overall
hazards identification plan. SARA Title III planning provisions address many of these potential transportation risk areas by requiring facility cooperation in plan preparation and by including specific risk
areas as well as a wide range of chemical handlers, from manufacturers to service-related businesses.
Risk analysis includes the probable damage that may occur if a chemical incident occurs.
Information that is necessary for risk analysis includes:
l
The type of risk to humans, such as an acute, chronic, or delayed reaction.
The groups that are most at risk.
The type of risk to the environment, such as permanent damage or a recoverable condition.
Many documents can be of assistance in conducting a risk analysis. Risk analysis in transportation
settings is outlined in the DOT s Community Teamwork: Working Together To Promote Hazardous
Materials Safety, A Guide for Local Officials. In conjunction with FEMA and DOT, EPA published a
supplement to NRT-1 in December 1987. This document, entitled Technical Guidance for Hazardous
Analysis and often referred to as the Green Book, provides technical assistance to LEPCs in assessing
the lethal hazards associated with potential airborne releases of extremely hazardous substances.
TRAINING
Each member of an EMS agency (career, volunteer, or combined service) is mandated to receive
8 hours of hazmat awareness training each year. This training provides an introduction to basic
response principles: the importance of incident recognition, assessment, and taking defensive strategies until more qualified assistance arrives. The National Fire Protection Association (NFPA) has
published several standards for fire departments regarding hazardous materials response. In 1997 it
released Standards for Professional Competence of EMS Responders to Hazardous Materials
Incidents (NFPA 473), which outlines desired levels of competence for EMS personnel responding
to hazmat incidents. Level I EMS/HM-trained responders are prepared with the knowledge and
skills to safely deliver emergency medical care in the Support (Cold) Zone, whereas Level II
EMS/HM responders are prepared to provide care to individuals who still may pose a risk of secondary contamination (i.e., working in the Contamination Reduction (Warm) Zone). Personnel at
this level are also able to coordinate EMS activities at a hazardous materials incident and provide
medical
support for hazmat response personnel. All EMS agency administrators should familiarize themselves
with this standard, as well as with NFPA 472, Standards for Professional Competence of Responders
to Hazardous Materials Incidents. These two courses and other instructional programs, such as the
Domestic Preparedness: Weapons of Mass Destruction Training program, are recommended for all
EMS personnel who will be responding to hazardous materials calls.
A growing number of commercially available audiovisual and computer-based training programs are
becoming available which provide accurate, timely, and cost-effective instruction. In addition, numerous
sites on the Internet offer free access to educational materials pertaining to hazardous materials (e.g.,
www.NLM.NIH.gov/pubs/FactSheets/toxnctfs.html; www.ATSDR.cdc.gov/hazdat.html).
SELECTED BIBLIOGRAPHY
Auf der Heide, E. 1989. Disaster Response: Principles of Preparation and Coordination. St. Louis,
MO: Mosby.
Auf der Heide, E. (ed.). 1995. Community Medical Disaster Planning and Evaluation Guide. Dallas,
TX: American College of Emergency Physicians.
Brunancini, A.V. 1985. Fire Command. Quincy, MA: National Fire Protection Association.
Fire Protection Publications. 1983. Incident Command System. Stillwater, OK: Oklahoma State
University Press.
National Emergency Training Center. 1998. Guidelines for Public Sector Hazardous Materials
Training. Emmitsburg, MD: HEMP Curriculum Guidelines.
National Fire Protection Association. 1992. Recommended Practice for Responding to Hazardous
Materials Incidents, NFPA 471. Quincy, MA: National Fire Protection Association.
National Fire Protection Association. 1992. Standards for Professional Competence of Responders to
Hazardous Materials Incidents, NFPA 472. Quincy, MA: National Fire Protection Association.
National Fire Protection Association. 1997. Standards for Professional Competence of EMS
Responders to Hazardous Materials Incidents, NFPA 473. Quincy, MA: National Fire Protection
Association.
National Response Team. 1987. Hazardous Materials Emergency Planning Guide. Washington, DC:
Government Printing Office.
Noll, G.G., M.S. Hildebrand, and J.G. Yvonna. 1995. Hazardous Materials: Managing the Incident.
2nd ed. Stillwater, OK: Fire Protection Publications.
SARA Title III Compliance Guidebook. 1988. Government Institutes, Inc. ISBN: 0-86587-749-1.
Sullivan, J.B. and G.R. Krieger. 1992. Hazardous Materials Toxicology: Clinical Principles of
Environmental Health. Baltimore, MD: Williams & Wilkins.
U.S. Department of Defense, U.S. Army, USAMRICD Chemical Casualty Division. 1998. Medical
Response to Chemical Warfare and Terrorism. 3rd ed. Edgewood, MD.
U.S. Department of Transportation. 1983. Community Teamwork: Working Together To Promote
Hazardous Materials Safety, A Guide for Local Officials. Washington, DC: Government Printing
Office.
U.S. Department of Transportation. 1996. 1996 North American Emergency Response Guidebook.
Washington, DC: Government Printing Office. [available in English, Spanish and French][http://hazmat.dot.gov/gydebook.htm]
10
10
U.S. Environmental Protection Agency. 1992. EPA Standard Safety Operating Guidelines.
Washington, DC: Government Printing Office.
U.S. Environmental Protection Agency and U.S. Federal Emergency Management Agency. 1987.
Technical Guidance for Hazardous Analysis: Emergency Planning for Extremely Hazardous
Substances. Washington, DC: Environmental Protection Agency.
U.S. Federal Emergency Management Agency. 1996. Guide for all Hazard Emergency Operations
Planning. Washington, DC: Government Printing Office.
11
12
12
Section II.
Emergency Medical Services Response

to Hazardous Materials Incidents
HAZARD RECOGNITION
When dispatched to the scene of an incident, emergency response personnel may not be aware that
the situation involves hazardous materials. As a result, emergency medical services personnel should
always be alert to the possibility that they may be dealing with a chemically contaminated individual, and should ask the dispatch personnel and victims about the nature of the event. An injury at a
hazardous materials incident need not invariably involve chemical exposure: it could have resulted
from a physical accident, such as slipping off a ladder. But as a routine precaution, the involvement
of hazardous materials should be considered a possibility on every call. The manual Recognizing
and Identifying Hazardous Materials (produced by the National Fire Academy and the National
Emergency Training Center) states that there are six primary clues that may signify the presence
of hazardous materials. These clues are included below to facilitate and expedite the prompt and
correct identification of any hazardous materials at the scene of an incident. Dispatch protocols should
seek to obtain information about these clues and relay the information to field personnel as soon as
possible. Certain combinations of patient symptoms such as nausea, dizziness, burning eyes or
skin, or cyanosis should also suggest to the dispatch staff the presence of hazardous materials.
The six principle clues to hazardous materials incidents are:
l
Occupancy and Location. Community preplanning should identify the specific sites that contain
hazardous materials. In addition, emergency personnel should be alert to the obvious locations in
their communities that use and/or store hazardous materials (e.g., laboratories, factories, farm and
paint supply outlets, construction sites). The Department of Labor s Material Safety Data Sheets
(MSDSs) should also be available, especially for any particularly dangerous chemicals kept on
site. It should be kept in mind, however, that these data sheets may have incomplete information
and that the medical information provided is generally at a basic first aid level.
Container Shape. Department of Transportation (DOT) regulations delineate container specifications for the transport of hazardous materials. There are three categories of packaging: stationary
bulk storage containers at fixed facilities that come in a variety of sizes and shapes; bulk transport
vehicles, such as rail and truck tank cars, that vary in shape depending upon the cargo; and labeled
fiberboard boxes, drums, or cylinders for smaller quantities of hazardous materials. The shape
and configuration of the container can often be a useful clue to the presence of hazardous materials.
Markings/Colors. Certain transportation vehicles must use DOT markings, including identification (ID) numbers. Identification numbers, located on both ends and both sides, are required on
all cargo tanks, portable tanks, rail tank cars, and other packages that carry hazardous materials.
Railcars may have the names of certain substances stenciled on the side of the car. A marking
scheme designed by the National Fire Protection Association (NFPA 704M System) identifies
hazard characteristics of materials at terminals and industrial sites, but does not provide productspecific information. This system uses a diamond divided into four quadrants. Each quadrant
represents a different characteristic: the left, blue section refers to health; the top, red quarter
pertains to flammability; the right, yellow area is for reactivity; and the bottom, white quadrant
highlights special information (e.g., W indicates dangerous when wet, Oxy stands for oxidizer).
13
A number from zero through four in each quadrant indicates the relative risk of the hazard, with
zero representing the minimum risk. This system does not indicate what the product is, the quantity,
or its exact location. In addition, it does not reveal the compound s reactivity with other chemicals.
The military also uses distinctly shaped markings and signs to designate certain hazards. These
markings may be found on vehicles, on the products themselves, or on shipping papers.
l
Placards/Labels. These convey information through use of colors, symbols, Hazard Communication
Standards, American National Standard Institute (ANSI) Standards for Precautionary Labeling of
Hazardous Industrial Chemicals, United Nations Hazard Class Numbers, and either hazard class
wording or four-digit identification numbers. Placards are used when hazardous materials are
being stored in bulk (usually over 1,001 lb), such as in cargo tanks. Labels designate hazardous
materials kept in smaller packages. Caution must be exercised, however, because the container or
vehicle holding a hazardous material may be improperly labeled or recorded, or it may not have
any exterior warning.
Shipping Papers. Shipping papers can clarify what is labeled as dangerous on placards. They
should provide the shipping name, hazard class, ID number, and quantity, and may indicate whether
the material is waste or poison. Shipping papers, which must accompany all hazardous material
shipments, are now required to list a 24-hour emergency information telephone number. The
location where the shipping papers are stored can be problematical; often they are found in close
proximity to the hazardous material(s) or in other locations not easily accessible during an emergency. Shipping papers should remain at the incident scene for use by all response personnel.
Senses. Odor, vapor clouds, dead animals or fish, fire, and skin or eye irritation can signal the
presence of hazardous materials. Generally, if one detects an odor of hazardous materials, it should
be assumed that exposure has occurred and the individual is still in the danger area, although
some chemicals have a detectable odor at levels below their toxic concentrations. Some chemicals,
however, can impair an individual s sense of smell (e.g., hydrogen sulfide), and others have no
odor, color, or taste at all (e.g., carbon monoxide). Binoculars are helpful to ascertain visible
information from a safe distance.
Appendix A provides greater detail on NFPA s 704M system; the DOT s hazardous materials marking, labeling, and placarding guide; and the Department of Labor s MSDS. It is important that any
and all available clues are used in substance identification, especially obvious sources such as the
information provided on a label or in shipping papers.
14
The aim of emergency personnel should be to make a chemical-specific identification while exercising caution to prevent exposure to any chemicals. Identifying the hazardous material and obtaining
information on its physical characteristics and toxicity are vital steps to the responder s safety and
effective management of the hazardous materials incident. Since each compound has its own unique
set of physical and toxicological properties, early and accurate identification of the hazardous material(s) involved allows emergency personnel to initiate appropriate management steps at the scene.
Many resources are available to provide information concerning response to and planning for hazardous
materials incidents. A selected bibliography of written material is included at the end of each section
of this guidebook; it is not, however, a complete list of the materials available. Printed reference
materials provide several advantages: they are readily available, they can be kept in the response
vehicle, they are not dependent on a power source or subject to malfunction, and they are relatively
inexpensive. Disadvantages include the difficulty of determining the correct identity for an unknown
chemical through descriptive text, the logistics of keeping the materials current, the increased risk of
the documents being lost or damaged because of their small size and soft cover bindings, and the
problem that no single volume is capable of providing all the information that may be needed. EMS
personnel should have immediate access to and be proficient at using the DOT s North American
Emergency Response Guidebook and other medically-oriented response documentation.
There is also a vast array of telephone and computer-based information sources concerning hazardous
materials. They can help by describing the toxic effects of a chemical, its relative potency, and the
potential for secondary contamination. They may also recommend decontamination procedures,
clinical management strategies, and advice on the adequacy of specific types of protective gear.
Exhibit II-lA is a partial listing of the many information resources available by telephone. Exhibit II-1B
is a list of suggested telephone numbers that should be filled in for your community. The regional
Poison Control Center, the Soldier and Biological Chemical Command (SBCCOM), and the
Centers for Disease Control (CDC) can be contacted 24 hours a day to provide vital information on
the medical management of hazardous materials exposure. Exhibit II-2 provides a partial listing of
the available computerized and online information sources. Note, however, that not all online databases are peer reviewed; some medical management information may be based only on DOT or
MSDS data. Care should be exercised when selecting information sources. Planning is an essential
part of every response, and many of these resources can provide guidance in the formation of an
effective response plan.
15
Exhibit II-1A
Telephone Information and Technical Support References
Resource
Contact
Services Provided
Chemical Transportation Emergency Center

(CHEMTREC)
1-800-424-9300
24-hour emergency number connecting with

manufacturers and/or shippers. Advice
provided on handling, rescue gear,
decontamination considerations, etc.
Also provides access to the Chlorine Emergency
Response Plan (CHLOREP).

(ATSDR)
1-404-639-6360
Bureau of Explosives
1-719-585-1881
Emergency Planning and Community

1-800-424-9346
Right-to-Know Act (EPCRA) and
Resource Conservation and Recovery Act (RCRA)
Information Hotline
Environmental Protection Agency (EPA)
Regional Offices
Region I (CT, ME, MA, NH, RI, VT)
Region II (NJ, NY, PR, VI)
Region III (DE, DC, MD, PA, VA, WV)
Region IV (AL, FL, GA, KY, MS, NC, SC, TN)
Region V (IL, IN, MI, MN, OH, WI)

Region VI (AR, LA, NM, OK, TX)
Region VII (IA, KS, MO, NE)
Region VIII (CO, MT, ND, SD, UT, WY)
Region IX (AZ, CA, HI, NV;
Pacific Islands AS, FM, GU, MH, MP, PW)
Region X (AK, ID, OR, WA)
24-hour emergency number for health-related

support in hazardous materials emergencies,
including onsite assistance.
Contact number for technical questions about
railway transport of hazardous materials.
For emergencies, call CHEMTREC
(1-800-424-9300).
Available 9:00 a.m. to 6:00 p.m. (EST).
Provides information on SARA Title III,
list of extremely hazardous substances,
and planning guidelines.
website:
Environmental response teams
www.epa.gov/regional available for technical assistance.
1-617-918-1111
1-212-637-3000
1-215-814-2900;
intra-regional only:
1-800-438-2474
1-404-562-9900;
Emergency Response &
Removal Branch:
1-800-564-7577
1-312-353-2000
1-214-665-2200
1-913-551-7003
1-303-312-6312
1-415-744-1500;
emergencies:
1-415-744-2000
1-206-553-1200
16
Exhibit II-1A (continued)
Resource
National Animal Poison Control Center
Contact
1-800-548-2423
1-888-426-4435
Services Provided
24-hour consultation services concerning
animal poisonings or chemical contamination.
Provides an emergency response team to
investigate incidents and to perform laboratory
analysis.
National Pesticides Information Retrieval System 1-765-494-6616

Contact information for help in searching
(NPIRS)
website:
NPIRS database to get fact sheets on
ceris.purdue.edu/npirs pesticides, insecticides, fungicides, and state
and federally registered chemicals.
National Pesticide Telecommunications Network
(NPTN) (Oregon State University)
1-800-858-7378
Provides information about pesticide-related
website:
topics, including pesticide products,
ace.orst.edu/info/nptn recognition and management of pesticide
poisoning, toxicology, environmental
chemistry, referrals for laboratory analyses,
investigation of pesticide incidents, emergency
treatment, safety, health and environmental
effects, cleanup, and disposal procedures.
National Response Center
1-800-424-8802
A federal hotline for reporting oil and

chemical spills where hazardous materials are
responsible for death, serious injury, property
damage in excess of $50,000, or continuing
danger to life and property.
U.S. Army Soldier and Biological Chemical

Command (SBCCOM)
1-800-368-6498
24-hour consultation service for threats and

releases pertaining to chemical and biological
agents.
17
Exhibit II-1B
Local Telephone Information and Technical Support Resource Worksheet
Resource
Contact
(fill in for future reference)
Services Provided
EPA Regional or State Office

Regional Poison Control Center
State Emergency Response Commission
State Health Department
State Emergency Management Office
Local Fire Department
Local Hazardous Materials
Response Team
Community Police Department
Local Emergency Planning Committee
Local Health Department
State Department of Natural Resources
FEMA Regional Office
State Agriculture Office
State Lab Office
State EMS Office
Hyperbaric Medicine Chamber
Burn Center
CDC
U.S. Army Soldier and Biological Chemical Command
18
Exhibit II-2
Computerized Data Sources for Information and Technical Support
Data System
Contact
Description
CAMEO
CAMEO Database Manager

National Oceanic and Atmospheric
Administration (NOAA)
Hazardous Materials Response Division
7600 Sand Point Way, N.E.
Seattle, Washington 98115
(206) 526-6317
website: www.epa.gov/ceppo/cameo
Computer-aided management of emergency

operations available to on-scene responder(s).
Chemical identification database assists in
determining substance(s) involved, predicting
downwind concentrations, providing response
recommendations, and identifying potential
hazards.
CHRIS
CIS, Inc.
c/o Oxford Molecular Group
11350 McCormick Road
Executive Plaza, Suite 1100
Hunt Valley, Maryland 21031
(800) 247-8737
website: www.oxmol.com/software/cis/
details/CHRIS.shtml
Chemical Hazard Response Information

System, developed by the Coast Guard and
comprised of reviews on fire hazards,
fire-fighting recommendations, reactivities,
physicochemical properties, health hazards, use
of protective clothing, and shipping
information for over 1,000 chemicals.
HAZARDTEXT
Micromedex, Inc.
Suite 300
6200 S. Syracuse Way
Englewood, Colorado 80111-4740
(800) 525-9083
website: www.micromedex.com/products/
pd-main.htm
Assists responders dealing with incidents

involving hazardous materials, such as spills,
leaks, and fires. Provides information on
emergency medical treatment and
recommendations for initial hazardous
response.
HMIS
Kevin Coburn
Information Systems Manager
U.S. Department of Transportation
D.H.M. 63 - Room 8104
400 7th Street SW
Washington, D.C. 20590-0001
website: www.dlis.dla.mil/hmis.htm
Hazardous Material Information Systems

contains information on hazardous materials.
Transportation-related incidents may be
reported on DOT form 5800.1 (Hazardous
Materials Incident Report Form).
HSDB
HSDB Representative
National Library of Medicine
Specialized Information Systems
8600 Rockville Pike
Bethesda, Maryland 20894
(301) 496-6531
website: sis.nlm.nih.gov/sis1
Hazardous Substances Data Bank, compiled by

the National Library of Medicine, provides
reviews on the toxicity, hazards, and regulatory
status of over 4,000 frequently used chemicals.
19
Exhibit II-2 (continued)
Data System
Contact
Description
1st MEDICAL RESPONSE Micromedex, Inc.

PROTOCOLS
Suite 300
Englewood, Colorado 80111
(800) 525-9083
pd-main.htm
Helps develop training programs and establish

protocols for first aid or initial workplace
response to a medical emergency.
MEDITEXT
Micromedex, Inc.
Suite 300
(800) 525-9083
pd-main.htm
Provides recommendations regarding the

evaluation and treatment of exposure to
industrial chemicals.
OHMTADS
Oxford Molecular Group, Inc.

11350 McCormick Rd.
Executive Plaza 3, Suite 1100
(800) 247-8737
details/OHMTADS.shtml
Oil and Hazardous Materials/Technical

Assistance Data Systems provides information
on the effects of spilled chemical compounds
and their hazardous characteristics and
properties, assists in identifying unknown
substances, and recommends procedures for
handling cleanups.
TOMES
Micromedex, Inc.
Suite 300
(800) 525-9083
pd-main.htm
The Tomes Plus Information Systems is a series

of comprehensive databases on a single
CD-ROM disc. It provides information
regarding hazardous properties of chemicals
and medical effects from exposure. The Tomes
Plus database contains Meditext, Hazardtext,
HSBD, CHRIS, OHMTADS, and 1st Medical
Response Protocols.
TOXNET
Toxicology Data Network (TOXNET)

Specialized Information Services
8600 Rockville Pike
(301) 496-6531
A computerized system of three toxicologically

oriented data banks operated by the National
Library of Medicine the Hazardous
Substances Data Bank, the Registry of Toxic
Effects of Chemical Substances, and the
Chemical Carcinogenesis Research Information
System. TOXNET provides information on the
health effects of exposure to industrial and
environmental substances.
20
PRINCIPLES OF TOXICOLOGY FOR EMERGENCY MEDICAL SERVICE PERSONNEL

Exposure to hazardous chemicals may produce a wide range of adverse health effects. The likelihood
of an adverse health effect occurring, and the severity of the effect, are dependent on: (1) the toxicity of the chemical; (2) the route of exposure; (3) the nature and extent of exposure; and (4) factors
that affect the susceptibility of the exposed person, such as age and the presence of chronic disease.
To better understand potential health effects, emergency medical personnel should understand the
basic principles and terminology of toxicology.
Toxicology is the science that deals with poisons and their effect on living organisms. Examples of
these adverse effects, sometimes called toxic end points, include carcinogenicity (development of cancer), hepatotoxicity (liver damage), neurotoxicity (nervous system damage), and nephrotoxicity (kidney damage). This is merely a sample list of toxic end points that might be encountered (Exhibit II-3).
Toxic chemicals often produce injuries at the site which they come into contact with the body. A
chemical injury at the site of contact, typically the skin and the mucous membranes of the eyes,
nose, mouth, or respiratory tract, is termed a local toxic effect. Irritant gases such as chlorine and
ammonia can, for example, produce a localized toxic effect in the respiratory tract, while corrosive
acids and bases can result in local damage to the skin. In addition, a toxic chemical may be absorbed
into the bloodstream and distributed to other parts of the body, producing systemic effects. Many
pesticides, for example, are absorbed through the skin, distributed to other parts of the body, and
produce adverse effects such as neurological, cardiac, respiratory, or other problems. It is important
for medical providers to recognize that exposure to chemical compounds can result not only in the
development of a single systemic effect but also in the development of multiple systemic effects or a
combination of systemic and local effects. Some of these effects may be delayed, sometimes for
as long as 48 hours or more. Health effects can also be acute or chronic. Acute health effects are
short-term effects that manifest within hours or days, such as vomiting or diarrhea. Chronic health
effects are long-term effects that may take years to manifest, such as cancer.
Routes and Extent of Exposure

There are three main routes of chemical exposure: inhalation, dermal contact (with skin or mucous
membranes), and ingestion. Inhalation results in the rapid introduction of toxic compounds into the
respiratory system. Most of the compounds that are commonly inhaled are gases or vapors of
volatile liquids. However, solids and liquids can be inhaled as dusts or aerosols. Inhalation of toxic
agents generally results in a rapid and effective absorption of the compound into the bloodstream
because of the large surface area of the lung tissue and number of blood vessels in the lungs.
Knowing a chemical s vapor pressure (VP) can be useful in determining the inhalation risk for a
particular exposure. The lower the VP, the less likely the chemical will produce an inhalable gas and
vice versa. Water solubility is also an important contributor for symptom development. Irritant agents
that are water soluble usually cause early upper respiratory tract irritation, resulting in coughing and
throat irritation. Partially water-soluble chemicals penetrate into the lower respiratory system, causing
delayed symptoms (12 to 24 hours) which include trouble breathing, pulmonary edema, and coughing
up blood. Asphyxiants are chemicals that impede the body s ability to obtain or utilize oxygen.
Simple asphyxiants are inert gases (e.g., argon, propane, nitrogen) that displace oxygen in inspired
air. Chemical asphyxiants produce harm by preventing oxygen delivery or utilization for energy
production by the body s cells. Carbon monoxide and cyanide are examples of asphyxiants.
21
Exhibit II-3
Examples of Adverse Health Effects from Exposure to Toxic Chemicals
Toxic End Point
Target Organ
Systems
Example of
Causative
Agent
Health Effect
Acute
Health Effect
Chronic
Carcinogenicity
All
Benzene
Dermatitis
Headache
Dizziness
Sleepiness
Acute myelogenous
leukemia
Hepatotoxicity
Liver
1, 1, 1-1
trichloroethane
Vomiting
Abdominal pain
Dizziness
Liver necrosis
Fatty liver
Neurotoxicity
Nervous system
Lead
Nausea
Vomiting
Abdominal pain
Wrist drop
IQ deficits
Encephalopathy
Nephrotoxicity
Kidney
Cadmium
Vomiting
Diarrhea
Chest pain
Kidney damage
Anemia
Dermal contact does not typically result in as rapid absorption as inhalation, although some chemicals
are readily taken in through the skin. Many organic compounds are lipid (fat) soluble and can therefore
be rapidly absorbed through the skin and mucus membranes. Absorption is increased by damage to
the skin and by warm weather, and some areas of the body (e.g., the groin) absorb chemicals
faster than others (e.g., the hands).
Ingestion is a less common route of exposure for emergency response personnel at hazardous materials
incidents. However, incidental hand-to-mouth contact, smoking, and swallowing of saliva and
mucus that contains contaminants may also result in exposure by this route. In addition, emergency
medical personnel in both hospital and prehospital settings treat chemical exposures in patients who
have ingested toxic substances as a result of accidental poisonings or suicide attempts.
Compounds may also be introduced into the body through injection, although this is a relatively
uncommon scenario in spills or discharges of hazardous materials. Explosions may result in injection
injuries and lead to imbedded foreign bodies, which may themselves be chemically contaminated.
22
The route by which personnel are exposed to a compound plays a role in determining the total
amount of the compound taken up by the body because a compound may be absorbed by one route
more readily than by another. In addition, the route of exposure may affect the nature of the symptoms that develop. The amount of the compound absorbed by the body also depends on the duration
of exposure and the concentration of the compound to which one is exposed.
It is important to recognize that children may be more susceptible to many toxic exposures. A child s
immature central nervous system, liver, and renal system increases his or her susceptibility to injury
as a result of exposure to chemicals. Children are also likely to receive a higher dose relative to
body weight than an adult. This occurs for a number of reasons. First, children are shorter than
adults and since most toxic gases are heavier than air, the concentrations increase as you get closer to
the ground. Second, children have a larger lung surface area relative to their weight than adults, as
well as a greater respiratory volume (liters/min/kg of body weight). It is also probable that the child s
lung is a more effective absorbent surface than that of the adult. Third, children have a larger skin area
relative to their weight than do adults, allowing more effective surface area for absorption in dermal
exposures. A child s skin is more easily penetrated by chemicals, allowing for a more rapid and effective dermal absorption. Finally, children are more likely to ingest toxic chemicals because of
increased hand-to-mouth behavior, including pica. All of these factors may lead to an increased dose
relative to size in children as compared to adults, even when they all are exposed to the same scenario.
A complex relationship exists between the total amount of the compound absorbed by the body (dose)
and the concentration of that compound in the environment. This relationship is important for emergency response personnel to understand because the adverse effects produced by a toxic compound
are often related to the dose of that compound received by a patient. However, because we usually
only monitor the concentration of the toxic substance in the environment (e.g., parts per million (ppm)
of a compound in air), the actual dose of the compound received by the patient is seldom known.
Factors specific to the exposed individual, such as area of skin surface exposed, presence of open
wounds or breaks in the skin, and the rate and depth of respirations, are important in estimating the
dose of the compound received by the patient. Injuries that disrupt the skin may lead to absorption
of chemicals that would not normally penetrate the skin.
Dose-Response Relationship
The effect produced by a toxic compound is primarily a function of the dose. This principle, termed
the dose-response relationship, is a key concept in toxicology. Many factors affect the normal doseresponse relationship and they should be considered when attempting to extrapolate toxicity data to
a specific situation (Exhibit II-4).
23
Exhibit II-4
Classification of Factors Influencing Toxicity
Type
Examples
Factors related to the chemical
Composition (salt, freebase, etc.); physical characteristics

(size, liquid, solid, etc.); physical properties (volatility, solubility, etc.);
presence of impurities; breakdown products; carriers
Factors related to exposure
Dose; concentration; route of exposure (inhalation, ingestion, dermal);

duration
Factors related to the exposed person
Heredity; immunology; nutrition; hormones; age; sex; health status;

preexisting diseases; pregnancy
Factors related to environment
Media (air, water, soil, etc.); additional chemicals present; temperature;

humidity; air pressure; and fire
Typically, as the dose increases, the severity of the toxic response increases. Humans exposed to 100
ppm of tetrachloroethylene, a solvent that is commonly used for dry-cleaning fabrics, may experience
relatively mild symptoms, such as headache and drowsiness. However, exposure to 200 ppm tetrachloroethylene can result in a loss of motor coordination in some individuals, and exposure to 1,500
ppm tetrachloroethylene for 30 minutes may result in loss of consciousness (Exhibit II-5). As shown
in Exhibit II-5, the severity of the toxic effect also depends on the duration of exposure, a factor that
influences the dose of the compound in the body.
Toxicity information is often expressed as the dose of a compound that causes an effect in a percentage
of the exposed subjects, which are usually experimental animals. These dose-response terms are
often found in the Material Safety Data Sheets (MSDSs) and other sources of health information.
One dose-response term that is commonly used is the lethal dose 50 (LD50). This is the dose that
is lethal to 50 percent of an animal population from exposure by a specific route (except inhalation)
when given all in one dose. A similar term is the lethal concentration 50 (LC50), which is the concentration of a material in air that on the basis of respiratory exposure in laboratory tests is expected
to kill 50 percent of a group of test animals when administered as a single exposure (usually 1 hour).
Exhibit II-6 lists a number of chemicals that may be encountered in dealing with hazardous materials
incidents, and the reported acute LD50 values of these compounds when they are administered by
ingestion to rats.
24
Exhibit II-5
Dose-Response Relationship for Humans Inhaling Tetrachloroethylene Vapors
Levels in Air
Duration of Exposure
50 ppm
Effects on Nervous System

Odor threshold
100 ppm
7 hours
Headache, drowsiness
200 ppm
2 hours
Dizziness, uncoordination
600 ppm
10 minutes
Dizziness, loss of inhibitions
1,000 ppm
1-2 minutes
Marked dizziness, intolerable eye and

respiratory tract irritation
1,500 ppm
30 minutes
Coma
From Exhibit II-6 it can be seen that a dose of 3,000 to 3,800 mg/kg tetrachloroethylene is lethal to
50 percent of rats that received the compound orally; however, only 6.4 to 10 mg/kg of sodium
cyanide is required to produce the same effect. Therefore, compounds with low LD50 values are
more acutely toxic than substances with higher LD50 values.
The LD50 values that appear on an MSDS or in the literature must be used with caution by emergency
medical personnel. These values are an index of only one type of response and give no indication of
the ability of the compound to cause nonlethal, adverse or chronic effects. They also do not reflect
possible additive effects from the mixture of chemicals sometimes found with exposure to hazardous
materials. Furthermore, LD50 values typically come from experimental animal studies. Because of
the anatomical and physiological differences between animals and humans, it is difficult to compare
the effects seen in experimental animal studies to the effects expected in humans exposed to hazardous materials in the field. LC50 and LD50 values are also usually determined in healthy adult
animals. Values determined in young animals may be quite different, as may values determined in
animals with an underlying disease. It is known that many chemicals are more toxic (lower LD50 or
LC50 values) in young or newborn animals than in adults. This same age dependence may exist in
humans. Because several organs, particularly the brain, are still developing in young children, damage
to these organs may be more extensive and can be permanent. Also, infants may not be able to
excrete chemicals from the body as efficiently as adults because their kidneys and liver are not fully
developed. This may lead to longer and greater exposure to the chemical than would occur in an adult
with the same relative exposure. The immaturity of metabolizing enzymes in the liver may lead to
either increased or decreased toxicity in infants relative to adults. Which may occur is difficult to
predict for many chemicals. Therefore, emergency medical personnel should remember that the LD50
and LC50 values are only useful for comparing the relative toxicity of compounds.
25
Exhibit II-6
Acute LD50 Values for Representative Chemicals When
Administered Orally to Rats
Chemical
Acute Oral LD50

(mg/kg)1
Sodium cyanide
6.4-10
Pentachlorophenol
50-230
Chlordane
83-560
Lindane
88-91
Toluene
2,600-7,000
Tetrachloroethylene
3,000-3,800
Milligrams of the compound administered per kilogram body weight of the experimental animal.
Responses to toxic chemicals may differ among individuals because of the physiological variability
that is present in the human population. Some individuals, for example, are more likely to experience
adverse health effects after exposure to a toxic chemical because of a reduced ability to metabolize
that compound. The presence of preexisting medical conditions (e.g., chronic obstructive pulmonary
disease (COPD), diabetes, renal disease) can also increase one s susceptibility to toxic chemicals.
Respiratory distress in patients or workers with asthma may be triggered by exposure to toxic chemicals at lower levels than might be expected to produce the same effect in individuals without respiratory disease. Factors such as age, personal habits (e.g., smoking, diet), previous exposure to toxic
chemicals, and medications may also increase an individual s sensitivity to toxic chemicals.
Therefore, exposure to concentrations of toxic compounds that would not be expected to result in
the development of a toxic response in most individuals may cause an effect in susceptible individuals. Not all chemicals, however, have a threshold level. Some carcinogens (cancer-causing chemicals) may produce a response (tumors) at any dose level, and any exposure to these compounds
may be associated with some risk of developing cancer. Thus, literature values for levels which are
not likely to produce an effect do not guarantee that an effect will not occur.
EMS personnel need a strong knowledge of toxicology principles to assess the degree of hazard in a
hazmat incident. Among the key questions to consider are:
l
What is the route of exposure and how can further exposure be minimized?
Do the acute symptoms give clues as to the potential exposure and chronic health effects?
26
Is this individual at increased risk because of greater susceptibility: for example, a child or an
adult with preexisting health problems?
Can an exposure dose be estimated and will this help to estimate short- and long-term health
effects?
Exposure Limits
The various occupational exposure limits found in the literature or in an MSDS are based primarily
on time-weighted average limits, ceiling values, or ceiling concentration limits to which the worker
can be exposed without adverse effects. Examples of these are listed in Exhibit II-7A.
The values listed in Exhibit II-7A were established to provide worker protection in occupational
settings. Because the settings in which these values are appropriate are quite different than an
uncontrolled spill site, it is difficult to interpret how these values should be used by emergency medical personnel dealing with a hazardous materials incident. These values are designed for a healthy
adult working population and have limited utility when applied to some of the at risk groups previously mentioned. At best, TLV, PEL, IDLH, and REL values can be used as benchmarks for determining relative toxicity, and perhaps to assist in selecting appropriate levels of personal protective
equipment (PPE). Furthermore, these occupational exposure limits are only useful if trained personnel with special detection equipment are available for measuring the levels of toxic chemicals at
the spill site. Of the occupational exposure limit values shown in Exhibit II-7A, only the OSHA values
are regulatory limits. The ACGIH values are for guidance only and have certain caveats that may or
may not affect the usefulness of the values. Some of these conditions are individual susceptibility or
aggravation of a preexisting condition. Because of the limitations of PELs and TLVs, special exposure limits have been established. Emergency Response Planning Guidelines (ERPGs), Short-term
Public Emergency Guidance Levels (SPEGLs), and Acute Exposure Guidelines (AEGLs, under
development by the EPA), have been designed to assist emergency response personnel in making
decisions regarding nonworkplace exposure (Exhibit II-7B). Emergency medical personnel responsible for the management of chemically contaminated patients should be familiar with all of these
exposure limits because they will be encountered in various documents dealing with patient care
or the selection of PPE. Additional expertise can be obtained by taking classes offered by the
ACGIH or at many colleges and universities.
This brief discussion highlights some fundamental concepts of toxicology. Emergency medical
personnel responsible for managing chemically contaminated patients are encouraged to obtain further
training in their recognition and treatment. A list of general toxicology references is provided at
the end of this section that will allow emergency medical personnel to undertake a more in-depth
examination of the principles of toxicology.
27
Exhibit II-7A
Occupational Exposure Limits
Value
Abbreviation
Definition
Threshold Limit Value (ACGIH)1
TLV
Refers to airborne concentrations of

substances and represents conditions under
which it is believed that nearly all workers may
be repeatedly exposed day after day without
adverse effect.
Threshold Limit Value:

Time-Weighted Average (ACGIH)1
TLV-TWA
The time-weighted average concentration for a

normal 8-hour work day and a 40-hour work
week, to which nearly all workers may be
repeatedly exposed, day after day, without
adverse effect.

Short-Term Exposure Limit (ACGIH)1
TLV-STEL
The concentration to which workers can be

exposed continuously for a short period of
time without suffering from (1) irritation,
(2) chronic or irreversible tissue damage, or
(3) narcosis of a sufficient degree to increase
the likelihood of accidental injury, to impair
self-rescue, or to materially reduce work
efficiency; and provided that the daily
TLV-TWA is not exceeded.

Ceiling (ACGIH)1
TLV-C
The concentration that should not be exceeded

during any part of the working exposure.
Permissible Exposure Limit (OSHA)2
PEL
Same as TLV-TWA.
Immediately Dangerous to Life and Health

(OSHA)2
IDLH
A maximum airborne concentration from

which one could escape within 30 minutes
without any escape-impairing symptoms or any
irreversible health effects.
Recommended Exposure Limit (NIOSH)3
REL
Highest allowable airborne concentration that

is not expected to injure a worker; expressed as
a ceiling limit or time-weighted average for an
8- or 10-hour work day.
American Conference of Governmental Industrial Hygienists

Occupational Safety and Health Administration
3
National Institute for Occupational Safety and Health
2
28
Exhibit II-7B
General Population Exposure Limits
Value
Abbreviation
Definition
Emergency Response Planning Guidelines (AIHA)1 ERPG
Maximum airborne concentration below which

it is believed that nearly all individuals could
be exposed for up to 1 hour without
(1) experiencing other than mild transient
adverse health effects or perceiving a clearly
defined objectionable odor (ERPG-1),
(2) experiencing or developing irreversible or
other serious health effects or symptoms that
could impair an individual s ability to take
protective action (ERPG-2), or
(3) experiencing or developing life-threatening
health effects (ERPG-3).
Short-term Public Emergency Guidance Level

(NRC)2
SPEGL
An acceptable concentration for unpredicted,

single, short-term exposure of the general
public in emergency situations. May be
developed for different exposure periods
(e.g., 1, 2, 4, 8, 16, 24 hours).
Acute Exposure Guidelines (EPA NAC/AEGL)3
AEGL
Proposed short-term threshold or ceiling

exposure value intended for the protection of
the general public, including susceptible or
sensitive individuals but not those who are
hypersusceptible or hypersensitive. Represents
the airborne concentration of a substance at or
above which it is predicted that the general
population (as defined above) could experience
(1) notable discomfort (AEGL-1),
(2) irreversible or other serious, long-lasting
effects or impaired ability to escape (AEGL-2),
or (3) life-threatening effects or death
(AEGL-3). Developed for four exposure
periods: 30 minutes, and 1, 4 , and 8 hours.
Synonymous with the NAS4 term,
Community Emergency Exposure Levels
(CEELs).
American Industrial Hygiene Association

National Research Council
3
EPA National Advisory Committee/AEGL Committee
4
National Academy of Sciences
2
29
PERSONNEL PROTECTION AND SAFETY PRINCIPLES

This section provides emergency medical services personnel with information on protective equipment
and safety principles. In the majority of cases, however, EMS staff will not experience incidents
involving chemically contaminated patients frequently enough to keep them optimally trained or
their equipment properly maintained. Staff must be trained initially in the proficient use of personal
protective equipment (PPE), specifically respiratory equipment, and must maintain that proficiency.
According to state and federal regulations, equipment must be maintained according to OSHA
specifications; for example, respirators and their cartridges have to be properly fitted, tested, and
stored. Many EMS agencies, given their workload and fiscal constraints, may not be able to
expend the funds and time necessary to provide the highest level of PPE protection for their employees. EMS personnel should, at a minimum, be prepared to work in Level C attire (see below, Levels of
Protection). In cases where EMS personnel have no PPE, they should make arrangements with the
local fire department or hazmat team to be ready, if the situation warrants, to completely decontaminate patients, especially those who are to be transported to a hospital. Considerations in determining what an EMS s capabilities should be include the number of incidents occurring locally (several per week versus only a few per year), proximity to industries or transportation routes that have
the potential for a hazardous materials incident (see Section I SARA Title III), and risks posed
from terrorism.
Federal Regulations Pertaining to Use of Personal Protective Equipment (PPE)

The term personal protective equipment (PPE) is used in this document to refer to both clothing and
equipment. The purpose of PPE is to shield or isolate individuals from the chemical, physical, and
biological hazards that may be encountered at a hazardous materials incident.
Training is essential before any individual attempts to use PPE. OSHA standards mandate specific
training requirements (8 hours of initial training or sufficient experience to demonstrate competency)
for personnel engaged in emergency response to hazardous substances incidents at the First Responder
Operations Level. In addition, each agency must develop a health and safety program and provide
for emergency response. These standards also are intended to provide particular protection for
those who respond to hazardous materials incidents, such as firefighters, police officers, and EMS
personnel. OSHA s final rule (March 6, 1989, 29 CFR (1910.120)) as it applies to emergency
medical personnel states: Training shall be based on the duties and functions to be performed by
each responder of an emergency response organization.
No single combination of protective equipment and clothing is capable of protecting against all
hazards. Thus, PPE should be used in conjunction with other protective methods. The use of PPE
can itself create significant worker hazards, such as heat stress, physical and psychological stress, and
impaired vision, mobility, and communication. In general, the greater the level of PPE protection, the
greater are the associated risks. For any given situation, equipment and clothing should be selected
that provide an adequate level of protection. Excessive protection can be as hazardous as underprotection, and should be avoided. In addition, personnel should not be expected to use PPE without
adequate training.
The two basic objectives of any PPE program are to protect the wearer from safety and health
hazards and to prevent injury to the wearer from incorrect use and/or malfunction of the PPE. To
30
accomplish these goals, a comprehensive PPE program should include: (1) hazard identification;
(2) medical monitoring; (3) environmental surveillance; (4) selection, use, maintenance, and
decontamination of PPE; and (5) training.
PPE Complications
Personnel wearing PPE are likely to encounter a number of potential problems, including limited
visibility, reduced dexterity, claustrophobia, restricted movement, suit breach, insufficient air supply,
dehydration, and the effects of heat and cold. Only individuals who are physically fit and have met
the OSHA/NIOSH/NFPA training requirements should be wearing PPE during an incident. Proper
donning and doffing procedures must be followed, with assistance from other onsite personnel.
Medical surveillance evaluations should be conducted on all personnel both before and immediately
after their use of PPE. Personnel not meeting prescribed inclusion criteria set by the hazmat team or
by the EMS Medical Director should be reassigned to an area not requiring the use of PPE. The
actions of all personnel wearing PPE should be closely observed by the Safety Officer and others
during each work period. In addition, an emergency distress signal should be identified in the briefing before individuals enter the work area. Following the completion of technical decontamination,
all personnel should be examined to ascertain marked changes in health. Appropriate medical care
should be initiated when illness or injury is discovered.
Levels of Protection
EPA has designated four levels of protection to assist in determining which combinations of respiratory
protection and protective clothing should be employed:
Level A protection should be worn when the highest level of respiratory, skin, eye, and mucous
membrane protection is needed. It consists of a fully-encapsulated, vapor-tight, chemical-resistant
suit, chemical-resistant boots with steel toe and shank, chemical-resistant inner/outer gloves,
coveralls, hard hat, and self-contained breathing apparatus (SCBA).
Level B protection should be selected when the highest level of respiratory protection is needed, but
a lesser degree of skin and eye protection is required. It differs from Level A only in that it provides
splash protection through use of chemical-resistant clothing (overalls and long-sleeved jacket, two-piece
chemical splash suit, disposable chemical-resistant coveralls, or fully- encapsulated, non-vapor-tight
suit and SCBA).
Level C protection should be selected when the type of airborne substance(s) is known, concentration
is measured, criteria for using air-purifying respirators are met, and skin and eye exposures are
unlikely. This involves a full facepiece, air-purifying, canister-equipped respirator and chemicalresistant clothing. It provides the same degree of skin protection as Level B, but a lower level of
respiratory protection.
Level D is primarily a work uniform. It provides no respiratory protection and minimal skin protection, and it should not be worn on any site where respiratory or skin hazards exist.
Exhibit II-8 illustrates these four levels of protection. For more information on this subject,
Appendix C outlines the protective equipment recommended for each level of protection.
31
Level A
Level B
Level C
Level D
32
Exhibit II-8
Factors to be considered in selecting the proper level of protection include the potential routes of
entry for the chemical(s), the degree of contact, and the specific task assigned to the user. Activities
can also be undertaken to determine which level of protection should be chosen. The EPA and
NIOSH recommend that initial entry into unknown environments or into a confined space that has not
been chemically characterized be conducted wearing at least Level B, if not Level A, protection.
Routes of Entry
PPE is designed to provide emergency medical personnel with protection from hazardous materials
that can affect the body by one of three primary routes of entry: inhalation, ingestion, and direct
contact. Inhalation occurs when emergency personnel breathe in chemical fumes or vapors.
Respirators are designed to protect the wearer from contamination by inhalation but they must be
worn properly and fit-tested frequently to ensure continued protection. Ingestion usually is the result
of a health care provider transferring hazardous materials from his hand or clothing to his mouth.
This can occur unwittingly when an individual wipes his mouth with his hand or sleeve, eats, drinks,
or smokes tobacco. Direct contact refers to chemical contact with the skin or eye. Skin is protected
by garments, and full-face respirators protect against ingestion and direct eye contact. Mucous
membranes in the mouth, nose, throat, inner ear, and respiratory system may be affected by more
than one of these routes of entry. Many hazardous materials adhere to and assimilate with the
moist environment provided by these membranes, become trapped or lodged in the mucus, and are
subsequently absorbed or ingested.
Chemical Protective Clothing (CPC)

Protective clothing is designed to prevent direct contact of a chemical contaminant with the skin or
body of the user. There is, however, no one single material that will afford protection against all
substances. As a result, multilayered garments may be employed in specific situations despite their
negative impact on dexterity and agility. CPC is designed to afford the wearer a known degree of
protection from a known type, a known concentration, and a known length of exposure to a hazardous
material, but only if it is properly fitted and worn correctly. Improperly used equipment can expose
the wearer to danger. Another factor to keep in mind when selecting CPC is that most protective
clothing is designed to be impermeable to moisture, thus limiting the transfer of heat from the body
through natural evaporation. This is a particularly important factor in hot environments or for strenuous
tasks since such garments can increase the likelihood of heat-related injuries. Research is now
underway to develop lightweight suits that are breathable but still protective against a wide range of
chemicals. Cooling vests are sometimes used in warm weather situations to keep the body temperature
normal, but with mixed results.
Essential to any protective ensemble are chemical resistant boots with steel toe and shank. Chemical
resistant inner and outer layered gloves must also be worn. Compatibility charts should be consulted
to determine the appropriate type of boot and gloves to use, since no one material presently provides
protection against all known chemicals. Wearing multiple layers of gloves impairs dexterity and
makes performing basic aspects of patient assessment (e.g., checking breathing, taking a pulse)
difficult without constant practice.
33
The effectiveness of CPC can be reduced by three actions: degradation, permeation, and penetration.
Chemical degradation occurs when the characteristics of the material in use are altered through
contact with chemical substances or aging. Examples of degradation include cracking and brittleness,
and other changes in the structural characteristics of the garment. Degradation can also result in an
increased permeation rate through the garment.
Permeation is the process by which chemical compounds cross the protective barrier of CPC
because of passive diffusion. The rate at which a compound permeates CPC is dependent on factors
such as the chemical properties of the compound, the nature of the protective barrier in the CPC, and
the concentration of the chemical on the surface of the protective material. Most CPC manufacturers
provide charts on the breakthrough time the time it takes for a chemical to permeate the material
of a protective suit for a wide range of chemical compounds.
Penetration occurs when there is an opening or a puncture in the protective material. These openings can include unsealed seams, buttonholes, and zippers. Often such openings are the result of
faulty manufacture or problems with the inherent design of the suit.
Protective clothing is available in a wide assortment of forms, ranging from fully-encapsulated body
suits to gloves, hard hats, earplugs, and boot covers. CPC comes in a variety of materials, offering a
range of protection against a number of chemicals. Emergency medical personnel must evaluate the
properties of the chemical versus the properties of the protective material. Selection of the appropriate
CPC will depend on the specific chemical(s) involved, and on the specific tasks to be performed.
RESPIRATORY PROTECTION
Substantial information is available for the correct selection, training, and use of respirators. The
correct respirator must be employed for the specific hazard in question. Material Safety Data Sheets
(if available) often specify the type of respirator that will protect users from risks. In addition,
manufacturers suggest the types of hazards against which their respirators can offer protection.
OSHA has set mandatory legal minimum requirements (29 CFR (1910.134)) for respiratory protection.
In addition, NIOSH has established comprehensive requirements for the certification of respiratory
protection equipment.
Personnel must be fit-tested for use of all respirators. Even a small space between the respirator
and you could permit exposure to a hazardous substance(s) by allowing in contaminated air. Anyone
attempting to wear any type of respirator must be trained and drilled in its proper use. Furthermore,
equipment must be inspected and checked for serviceability on a routine basis.
There are two basic types of respirators: air-purifying and atmosphere-supplying. Atmospheresupplying respirators include self-contained breathing apparatus (SCBA) and supplied-air respirators
(SAR).
34
Air-Purifying Respirators (APRs)

An air-purifying respirator purifies ambient air by passing it through a filtering element before
inhalation. The major advantage of the APR system is the increased mobility it affords the wearer.
However, a respirator can only be used where there is sufficient oxygen (19.5 percent) since it depends
on ambient air to function. In addition, APRs should not be used when substances with poor warning properties are known to be involved or, if the agent is unknown, when environmental levels of
a substance exceed the filtration capacity of the canisters.
Three basic types of APRs are used by emergency personnel: chemical cartridges or canisters,
disposables, and powered air-purifiers. The most commonly used APR depends on cartridges
(Exhibit II-9) or canisters to purify the air by chemical reaction, filtration, adsorption, or absorption.
Cartridges and canisters are designed for specific materials at specific concentrations. To aid the
user, manufacturers have color-coded the cartridges and canisters to indicate the chemical or class of
chemicals for which the device is effective. NIOSH recommends that use of a cartridge not exceed
one work shift. However, if breakthrough of the contaminant occurs first, then the cartridge or canister
must be immediately replaced. After use, cartridges and canisters should be considered contaminated
and disposed of accordingly.
Disposable APRs are usually designed for use with particulates, such as asbestos, although some
are approved for use with other contaminants. These respirators are typically half-masks that cover
the face from nose to chin, but do not provide eye protection. Once used, the entire respirator is
usually discarded. This type of APR depends on a filter to trap particulates. Filters may also be
used in combination with cartridges and canisters to provide an individual with increased protection
from particulates. The use of half-mask APRs is not generally recommended by most emergency
response organizations.
Exhibit II-9
Chemical Cartridge Air-Purifying Respirator
35
Powered Air-Purifying Respirators (PAPRs) have the advantage of creating an improved facemask
seal, thus reducing the risk of inhalation injury. Air being blown into the mask can also have a
cooling affect. PAPRs come with either full facemasks or pullover hoods. Some individuals find the
hooded system to be more comfortable and less claustrophobic than the mask. According to OSHA
guidelines, men with beards can wear the hooded system but not the full facemask.
Atmosphere-Supplying Respirators
Atmosphere-supplying respirators consist of two basic types: the self-contained breathing apparatus
(SCBA), which contains its own air supply, and the supplied-air respirator (SAR), which depends
on an air supply provided through a line linked to a distant air source. Exhibit II-10 illustrates an
example of each.
Exhibit II-10
Self-Contained Breathing Apparatus and Supplied-Air Respirators
36
Self-Contained Breathing Apparatus (SCBA)

A self-contained breathing apparatus respirator is composed of a facepiece connected by a hose
to a compressed air source. There are three varieties of SCBAs: open-circuit, closed-circuit, and
escape. Open-circuit SCBAs, most often used in emergency response, provide clean air from a
cylinder to the wearer, who exhales into the atmosphere. Closed-circuit SCBAs, also known as
rebreathers, recycle exhaled gases and contain a small cylinder of oxygen to supplement the
exhaled air of the wearer. Escape SCBAs provide air for a limited amount of time and should
only be used for emergency escapes from a dangerous situation. One disadvantage of SCBAs
is that they are bulky and heavy, and can be used for only the period of time allowed by air in
the tank.
The most common SCBA is the open-circuit, positive-pressure type. In this system, air is supplied
to the wearer from a cylinder and enters the facepiece under positive pressure. In contrast to the
negative-pressure units, a higher air pressure is maintained inside the facepiece than outside. This
affords the SCBA wearer the highest level of protection against airborne contaminants since any
leakage in the facepiece may force the contaminant out. When wearing a negative-pressure-type
apparatus, there is always the potential danger that contaminants may enter the facemask if it is
not properly sealed. The use of a negative-pressure SCBA is prohibited by OSHA under 29 CFR
(1910.120(q)(iv)) in incidents where personnel are exposed to hazardous materials.
Supplied-Air Respirators (SARs)

Supplied-air respirators differ from SCBAs in that the air is supplied through a line that is connected
to a source away from the contaminated area. SARs are available in both positive- and negativepressure models. However, only positive-pressure SARs are recommended for use at hazardous
materials incidents. One major advantage the SAR has over the SCBA device is that it allows an
individual to work for a longer period. In addition, SARs are less bulky than the SCBAs. By necessity,
however, a worker must retrace his steps to stay connected to the SAR, and therefore cannot leave
the contaminated work area by a different exit. SARs also require the air source to be in close
proximity (within 300 feet) to the work area. In addition, personnel using an SAR must carry an
immediately operable emergency escape supply of air, usually in the form of a small, compressed
air cylinder, for use in case of an emergency.
SITE CONTROL
Hazardous materials incidents often attract large numbers of people and equipment. This complicates
the task of minimizing risks to humans, property, and the environment.
An Incident Command System (ICS) coordinates management of facilities, equipment, personnel,
and communications during a hazardous materials incident. An Incident Commander (IC) is
responsible for control of the scene and for keeping contaminants on site. This includes delineating
work zones, establishing levels of protection, and implementing decontamination activities.
To enhance control at the site of a chemical incident, rules regarding access to the site must be
implemented. Inactive individuals and equipment should be kept at a safe distance from the area
of possible contamination, and public access from all directions must be restricted promptly.
37
In addition, media access should be limited to an area established as the Public Information
Sector by a designated Public Information Officer. All access to the incident site must be approved
by the Incident Commander and the press personnel who enter the site must be escorted by a
Public Information Officer.
Work Zones
NIOSH, OSHA, USCG, and EPA recommend dividing the incident area into three zones, establishing
access control points, and delineating a contamination reduction corridor. Exhibit II-11 illustrates the
recommended zones. The Exclusion (Hot) Zone should encompass all known or suspected hazardous
materials contamination. The respective radius of the Contamination Reduction (Warm) Zone is
determined by the length of the decontamination corridor, which contains all of the needed decontamination stations. The Support (Cold) Zone should be clean, meaning it is free of all hazardous
materials contamination, including discarded protective clothing and respiratory equipment. The
command post and staging areas for necessary support equipment should be located in the Support
Area, upwind and uphill of the Exclusion Zone. Personnel in charge of each sector should be easily
recognized (e.g., with a command vest). Equipment that may eventually be needed should be kept in
staging areas beyond the crowd control line. Access to the different zones should be tightly controlled
and limited to as few people as possible. Communication between work areas should be face-to-face
whenever possible. Use of radios or other electronic devices (e.g., bullhorns) may be restricted
depending on the hazards involved.
DECONTAMINATION OF EMERGENCY MEDICAL SERVICE PERSONNEL

Decontamination is the process of removing or neutralizing harmful materials that have gathered
on personnel and/or equipment during the response to a chemical incident. Many incidents have
occurred involving seemingly successful rescue, transport, and treatment of chemically contaminated
individuals by unsuspecting emergency personnel who, in the process, contaminate themselves,
the equipment, and the hospital where the patient is taken. Decontamination is of the utmost
importance because it:
l
Protects all hospital personnel by sharply limiting the transfer of hazardous materials from the
contaminated area into clean zones.
Protects the community by preventing transportation of hazardous materials from the hospital to
other sites in the community by secondary contamination.
Protects workers by reducing the contamination and resultant permeation of, or degradation to,
their protective clothing and equipment.
Protects other patients already receiving care at the hospital.
38
Exhibit II-11
NIOSH/OSHA/USCG/EPA Recommended Zones
39
This section only addresses the steps necessary for dealing with worker decontamination. Patient
decontamination is addressed in Section III, Response and Patient Management. It should be
stressed that to carry out proper decontamination, personnel must have received at least the same
degree of training as required for workers who respond to hazardous materials incidents. The design
of the decontamination process should take into account the degree of hazard and should be
appropriate for the situation. For example, a nine-station decontamination process need not be set up
if only a bootwash station would suffice.
Avoiding contact is the easiest method of decontamination that is, not to get the material on the
worker or his protective equipment in the first place. However, if contamination is unavoidable,
then proper decontamination and/or disposal of the worker s outer gear will be necessary.
Segregation and proper placement of the outer gear in a polyethylene bag or steel drum will be
necessary until thorough decontamination is completed. With extremely hazardous materials, it
may be necessary to dispose of the contaminated items altogether.
Physical decontamination of protective clothing and equipment (known as technical decontamination) can be achieved by several different means. These all include the systematic removal of
contaminants by physical methods, such as dilution, brushing, scraping, and vacuuming, and by
chemical methods where the contaminant is degraded, neutralized, solidified, or disinfected
through some type of chemical process. There is an increasing trend toward using disposable
clothing (e.g., suits, boots, gloves) and systematically removing these garments in a manner that
precludes contact with the contaminants. The used items of clothing are then thrown away in a
sealed container. Reusable suits will require thorough cleaning and testing after each use. The
appropriate decontamination procedure will depend on the contaminant and its physical properties,
and on the type of CPC being worn. Thoroughly researching the chemicals involved and their
properties, or consultation with an expert, is necessary to make these kinds of decisions.
In addition to understanding the technical decontamination steps to be used for CPC and equipment,
EMS responders must be familiar with the emergency procedures to be followed if a responder
wearing PPE becomes ill or is injured and needs to be quickly decontaminated prior to normal
removal of his suit.
Care must be taken at all times to ensure that the decontamination methods being used do not
introduce fresh hazards into the situation. In addition, the residues of the decontamination process
must be treated as hazardous wastes. The decontamination stations and process should be confined to the Contamination Reduction Zone (see Exhibit II-11). Steps for personnel decontamination are outlined in Exhibit II-12, and the technical decontamination process is discussed below.
40
Exhibit II-12
Nine-Step Personnel Decontamination Plan
41
Technical Decontamination Process for EMS Personnel

Personnel should remove protective clothing in the following sequence.
1. Remove tape (if used) securing gloves and boots to suit.
2. Remove outer gloves, turning them inside out as they are removed.
3. Remove suit, turning it inside out and folding it downward. Avoid shaking.
4. Remove boot/shoe cover from one foot and step over the clean line. Remove other
boot/shoe cover and put that foot over the clean line.
5. Remove mask. The last person removing his/her mask may want to wash all masks with
soapy water before removing his/her suit and gloves. Place the masks in plastic bag and
hand the bag over the clean line for placement in second bag held by another staff member.
Send bag for decontamination.
6. Remove inner gloves and discard them in a drum inside the dirty area.
7. Secure the dirty area until the level of contamination is established and the area is properly
cleaned.
8. Personnel should then move to a shower area, remove undergarments and place them in a
plastic bag. Double-bag all clothing and label bags appropriately.
9. Personnel should shower and redress in normal working attire and then report for
medical surveillance.
COMMUNICATIONS
Effective communications are essential to maintaining incident control. These include a dedicated
radio frequency and a sufficient number of radios for distribution to all participating agencies.
Another network should link the onsite command post to support groups, such as the regional
Poison Control Center, the Health Department, and CHEMTREC. Other networks that may have to
be activated include one linking EMTs to the hospital emergency department or medical control and
one dedicated for use by the teams in the Exclusion and Contamination Reduction Zones. If a sufficient number of radios are not available or cannot be used in the Exclusion Zone, then line of sight
must be maintained at all times for personnel in those Zones. Use of whiteboards, PA systems, or
designated hand signals may be useful alternatives. When an Incident Command System is activated, one person should be assigned to manage communications.
American Conference of Governmental Industrial Hygienists. 1988. Guidelines for the Selection of
Chemical Protective Clothing. Cincinnati, OH.
American Academy of Pediatrics. 1994. Handbook of Common Poisonings in Children. 3rd ed. Elk
Grove Village, IL.
42
Borak, J., M. Callan, and W. Abbott. 1991. Hazardous Materials Exposure-Emergency Response and
Patient Care. Englewood Cliffs, NJ: Brady.
Bowen, J. E. 1995. Emergency Management of Hazardous Materials Incidents. Quincy, MA:
National Fire Protection Association.
Bronstein, A.C. and P.L. Currance. 1994. Emergency Care for Hazardous Materials Exposure. 2nd
ed. St. Louis, MO: Mosby.
Budavari, S., A. Smith, P. Heckelman and J. Kinneary. 1996. The Merck Index: An Encyclopedia of
Drugs, Chemicals, and Biologicals. 12th ed. Chapman & Hall.
Chemical Manufacturers Association (CMA) and the Association of American Railroads. 1987.
Terms for Personal Protective Equipment. Washington, DC: CMA.
Clayton, G.D. and F.E. Clayton. 1994. Patty s Industrial Hygiene and Toxicology. 4th ed.New York,
NY: John Wiley and Sons.
Currance, P.L. and A.C. Bronstein. 1999. Hazardous Materials for EMS. St. Louis, MO: Mosby.
DeLorenzo, R.A. and R.S. Porter. 1999. Weapons of Mass Destruction Emergency Care. NJ:
Prentice Hall.
Ellenhorn, M.J. and D.G. Barceloux. 1997. Medical Toxicology: Diagnosis and Treatment of Human
Poisoning. 2nd ed. New York, NY: Elsevier.
Forsberg, K. and S.Z. Mansdorf. 1993. Quick Selection Guide to Chemical Protective Clothing. 2nd
ed. New York, NY: Van Nostrand Reinhold.
Goldfrank, L.R. 1998. Goldfrank s Toxicological Emergencies. 6th ed. Stamford, CT: Appleton and
Lange.
Hayes, A.W. (ed.). 1994. Principles and Methods of Toxicology. 2nd ed. Books on Demand.
Hodgson, E. and P.E. Levi. 1997. A Textbook of Modern Toxicology. 2nd ed. Stamford, CT: Appleton
and Lange.
Klaassen, C.D., M.O. Amdur, and J. Doull (eds.). 1996. Casarett and Doull s Toxicology: The Basic
Science of Poisons. 5th ed. McGraw-Hill Health Professions Division.
Levine, S.P. and W.F. Martin (eds.). 1993. Protecting Personnel at Hazardous Waste Sites. 2nd ed.
Boston, MA: Butterworth Publishers.
Lu, F.C. 1996. Basic Toxicology: Fundamentals, Target Organs, and Risk Assessment. 3th ed. Taylor
& Francis, Inc.
Training. Emmitsburg, MD: HMEP Curriculum Guidelines.
National Fire Academy and National Emergency Training Center. 1985. Recognizing and Identifying
Hazardous Materials. Capitol Heights, MD: National Audio-Visual Center.
43
Association.
2nd ed. Stillwater, OK: Fire Protection Publications.
Olson, K.R. (ed.). 1999. Poisoning and Drug Overdose. 3rd ed. Stamford, CT: Appleton and Lange.
Proctor, N.H., J.R. Hughes, and M.L. Fishman. 1989. Chemical Hazards of the Workplace. 2nd ed.
New York, NY: Van Nostrand Reinhold.
Rom, W. 1992. Environmental and Occupational Medicine. 2nd ed. Boston, MA: Little, Brown.
Sax, N.I. 1992. Dangerous Properties of Industrial Materials. 8th ed. New York, NY: Van Nostrand
Reinhold.
Schwope, A.D., P.P. Costas, J.O. Jackson, and D.J. Weitzman. 1987. Guidelines for the Selection of
Chemical Protective Clothing. 3rd ed. Cincinnati, OH: American Conference of Governmental
Industrial Hygienists.
Stutz, R. and S. Ulin. 1992. Handbook for Prehospital Care. 3rd ed. Beltsville, MD: Bradford.
Stutz, R. and S. Ulin. 1993. HAZTOX EMS Response For Hazardous Materials Incidents. Miramar,
FL: GDS Communications.
Sullivan, J.B., Jr. and G.R. Krieger. 1992. Hazardous Materials Toxicology: Clinical Principles of
Tokle, G. (ed.). 1993. Hazardous Materials Response Handbook. 2nd ed. Quincy, MA: National Fire
Protection Association.
U.S. Environmental Protection Agency, Region VII. 1989. Chemical Response Planning and
Operations. Washington, DC: Environmental Protection Agency.
U.S. Federal Emergency Management Agency and U.S. Fire Administration. 1999. Hazardous
Materials Guide for First Responders. Washington, DC: Government Printing Office.
Varla, J. (ed.). 1996. Hazardous Materials Handbook for Emergency Responders. New York, NY:
Van Nostrand Reinhold.
Viccellio, P. 1993. Handbook of Medical Toxicology. Boston: Little Brown.
44
Section III. Response and Patient Management

An EMS protocol for responding to potential hazardous materials incidents should consider: (1)
activities to undertake en route and upon arrival at the scene; (2) guidelines for assessment, decontamination, and treatment of affected persons; and (3) patient transport to the hospital. Steps in the
protocol must be practiced before a hazardous materials emergency occurs. EMS personnel should
know their responsibilities and how to perform them, and all required equipment should be readily
accessible and ready to use.
EN ROUTE TO A HAZARDOUS MATERIALS SCENE

First responders must be alert for hazardous materials when responding to every call. The dispatcher
may provide information such as unusual signs and symptoms (e.g., pungent odor, eye irritation) or
the address might suggest that the call may involve a chemical release. The presence of hazardous
materials may be obvious, as in the case of noxious fumes, gasoline, or corrosive liquid spills. In
other situations, the hazardous nature of the chemical(s) may not be immediately apparent, as with
odorless but poisonous and/or flammable vapors and liquids, or radioactive materials. If a vehicle
has a diamond-shaped placard or an orange-numbered panel on the side or rear, the cargo should
be assumed to be hazardous. Unfortunately, not all hazardous materials transport vehicles are
clearly marked. Many delivery trucks regularly carry hazardous materials that could be released in a
collision, yet the appropriate signage is often missing. Therefore, first responders should use caution
when attempting rescues at any incident scene. The hazard, or lack thereof, must be determined
immediately before first responders enter a chemically contaminated area.
While in transit to an incident scene, the responder should pay attention to clues that suggest the
possibility of hazardous materials. For example, billowing smoke or clouds of vapor could indicate the
presence of a dangerous substance(s). The senses are among the best tools for detecting chemicals,
particularly the sense of smell. Should an odor be detected, however, responders are advised to
move a safe distance away until they ascertain its source. Failure to do so could result in injury, illness, or death. Despite their value, sensory signals, such as smell, color, and nasal or eye irritation,
are not always reliable indicators. Their presence depends on the chemical(s) involved and on the surrounding conditions. The nature of an incident is also key to identifying the possibility of hazardous
materials. Accidents involving railroad tank cars or tanker trucks, or incidents at fixed locations where
chemicals are used or stored, often indicate the presence of hazardous materials.
Emergency responders should pay attention to factors such as wind direction and topography when
approaching a suspected hazardous materials incident and advance upwind and upgrade of suspected
chemical emissions. They also need to consider that low-lying areas such as streambeds and gulleys,
or in urban areas places such as courtyards or near tall buildings, may contain vapor clouds protected
from dispersal by the wind.
45
Responders should attempt to gather as much information as possible while traveling to an incident.
A checklist to help determine initial actions should be developed and made available to all EMS
personnel. It should include:
l
Type and nature of incident
Caller s telephone number
Knowledge of whether a chemical(s) may be involved
Chemical and trade name(s) of substance(s) involved
Number and ages of victims
Signs and symptoms being experienced by the patients
Nature of injuries
State of the material (solid, liquid, gas)
Routes of exposure (inhalation, dermal contact, etc.)
Length of exposure
Using as much information as can be gleaned en route, emergency responders should relay their
observations to a predesignated resource center (e.g., regional Poison Control Center, ATSDR)
for information regarding definitive care procedures. If a hazardous substance has been identified,
responders should locate specific information on the chemical(s) by consulting reference guidebooks, websites, database networks, telephone hotlines, MSDSs, and the DOT s North American
Emergency Response Guidebook, in addition to the designated resource center (see Section I
Hazard Recognition). Chemical-specific information can help identify possible health hazards,
including: (1) the nature of possible injuries; (2) potential routes of exposure; (3) risk of secondary
contamination; (4) required PPE; (5) the need for decontamination; (6) decontamination procedures;
and (7) the appropriate safe distance from the hazard to protect EMS personnel, the public, and
property from exposure to contaminants or other dangers such as fire or explosion. If available, preplans should be reviewed to assist with locating proper vehicle staging locations, evacuation routes,
and patient treatment centers. This information may also be available from a command post, if one
has been established.
Communications with other agencies or services should also be initiated while en route to the event
site. If an Incident Command System (ICS) has been implemented, the Incident Commander (IC)
will identify the best approach route, the possible dangers involved, and the estimated number of
injuries. Communications between onsite response personnel and receiving facilities should be kept
open to relay as much advance information as possible. Communications should also be established
with local fire and police departments, and with the hazmat response team, if appropriate.
46
ARRIVAL AT THE SCENE

Many first responders (e.g., police officers, the fire-rescue squad, EMS personnel) are accustomed to
immediately attending an injured victim, often disregarding the possibility of danger to themselves.
In such cases, a rescuer entering a contaminated area also risks exposure and the potential to become
another victim. Even though rescue of an injured patient is important, it should only be attempted
without undue risk to the responder(s). While training and experience are valuable in these situations,
often these types of decisions are, at best, a judgment call. Rescue should only be attempted by trained
and equipped EMS, fire department, or hazardous materials response team personnel. Exhibit III-1
illustrates a typical decision tree for making choices about risk and response.
Upon arrival at a scene, an initial assessment of the nature and extent of the incident should be conducted and additional support requested, if necessary. A first-in responder should also confirm that
local authorities have been notified and are aware that hazardous materials might be involved.
Onsite assistance should include police, fire, and health departments; the hazmat response team(s);
and the local industry response team(s). Unless otherwise directed, responders should park at a safe
distance that is upwind, upgrade, and pointing away from any incident where hazardous materials are
suspected. Safe distances for specific chemicals may be determined from the DOT s North American
Emergency Response Guidebook, or by consulting CHEMTREC or other written or electronic references. Responders must also remain alert to the possibility that the incident is the result of an intentional criminal act, with the presence of secondary devices intended to injure emergency personnel.
General guidelines for responders include:
l
Do not drive or walk through any spilled or released materials, including smoke, vapors,
and puddles.
Avoid unnecessary contamination of equipment.
Do not attempt to recover shipping papers or manifests unless adequately protected.
Avoid exposure while approaching a scene.
Do not approach anyone coming from contaminated areas.
Do not attempt rescue unless trained and equipped with appropriate PPE for the situation.
Report all suspicious packages, containers, or people to the command post.
The first units to arrive at a large industrial or storage facility, transportation accident, or a mass gathering location should anticipate a rush by evacuating victims. Proper steps must be taken to keep responders from becoming contaminated or otherwise harmed (e.g., use of a PA system to give instructions).
The top priority for first responders is scene isolation. Keep others away! Keep unnecessary
equipment from becoming contaminated by giving exact information on safe routes of arrival and
vehicle staging locations, and by reporting anything suspicious.
First responders should immediately establish an Exclusion (Hot) Zone, taking care not to become
exposed during the process (see Exhibit II-11). The Exclusion Zone should encompass all contaminated
47
Exhibit III-1
Sample EMS Decision Tree for Chemical Incidents
Chemical Accident/
Injury Event
YES
Self- or
buddy-rescue
OR
Fire dept. or
hazmat rescue
Contaminants
Potentially Life
Threatening or
Unknown
YES
Simultaneously perform gross

decontamination (e.g., remove/
bag clothing, rinse patient from
head to toe with water),1
initiate stabilization of ABCs
NO
Perform gross decontamination
(remove/bag clothing, rinse
patient from head to toe
with water)1
Patient(s) moved to safe

area out of the hazardous
environment and evaluated by
emergency personnel wearing
appropriate PPE
Environmental
or patient conditions
prevent furthur
decontamination
YES
Cover or wrap patient to prevent

spread of contamination; avoid
causing the patient to sweat;
continue needed medical care
(e.g., O 2 ,IV, medications)
NO
Place patient in Contamination
Reduction (Warm) Zone
Perform secondary
decontamination (wash and rinse
until patient is as clean as
possible (ACAP 2 )
Further
medical attention
or surveillance
required
Lifesaving
Procedures
Required?
Ensure that transport crew(s)

and vehicle(s) are adequately
protected to avoid secondary
contamination
YES
NO
Notify and transport to
appropriate medical facility
NO
Notify incident
command and get further
instructions
No patient should be transported without a minimum of gross decontamination performed.
Contamination reduced to a level that is no longer a threat to patient or responder (once achieved, move patient to the Support
[Cold] Zone).
48
areas, and no unauthorized personnel should be allowed to enter that Zone. Anyone leaving the
Exclusion Zone should be considered contaminated, requiring assessment and possible decontamination. Additional zones, including a Contamination Reduction (Warm) Zone and a Support (Cold)
Zone, should be delineated at the first available opportunity. Depending upon available personnel,
this may be the primary responsibility of the Incident Commander (IC) or of responders other than
EMS. Do not remove nonambulatory patients from the Exclusion Zone unless properly trained personnel with the appropriate PPE are available and a decontamination corridor has been established.
The IC should coordinate patient evacuation and emergency care activities. A public address system
(e.g., bullhorn, siren PA system) can be effective for directing ambulatory patients on what to do and
where to go.
EMS responders who are not properly trained and equipped should stay out of the Exclusion and
Contamination Reduction Zones. While it is recommended that all EMS personnel be trained and
equipped to work (at a minimum) in Level C PPE protective attire (see Section II), this does not
provide maximum skin or respiratory protection. Entry into a Hot or Warm Zone requires a determination that the level of PPE being worn affords adequate protection.
In addition to providing patient care in the Support Zone, qualified EMS personnel may be asked to
assume any of the following roles: Safety Officer, EMS Section Officer (e.g., Triage, Treatment,
Transportation, Communications), Rehabilitation Officer, or Public Information Officer. EMS personnel also frequently provide medical surveillance for the hazmat team.
ASSESSMENT, DECONTAMINATION, AND INITIAL TREATMENT OF PATIENTS

The primary goals for emergency personnel in a hazardous materials incident include cessation of
patient exposure, patient stabilization, removal of the patient from danger, containment of the hazard
to prevent further contamination, and patient treatment all without jeopardizing their own safety.
While not all chemicals pose a hazard for secondary contamination, until the risk is known, termination of exposure is best accomplished by removing the patient from the incident area and then
decontaminating the patient. If the victim is removed from the possibility of additional exposure or
other dangers and is no longer considered contaminated, the level of required PPE for emergency
personnel can be downgraded to a level that will better facilitate patient care. The potential for
injury to the patient or to response personnel prohibits any treatment other than basic life support
inside the Exclusion Zone. The dangers of hazardous substances, fire, or explosion, as well as the
mobility restrictions inherent in PPE, outweigh the benefits of time saved by patient care in the Hot
Zone.
The essential requirements for any decontamination task are:
l
A safe area to keep a patient while undergoing decontamination
A method for washing contaminants off a patient
A means of containing the rinsate
Adequate protection for personnel treating the patient
Disposable or cleanable medical equipment to treat the patient
49
Gross Patient Decontamination

Primary assessment can be undertaken while simultaneously performing gross decontamination in
the outer edge of the Exclusion Zone or in the Contamination Reduction Zone. Priority should be
given to the fundamentals of emergency treatment airway, breathing, and circulation (ABCs).
Once life-threatening matters have been addressed, rescue personnel can direct their attention to
more thorough decontamination and secondary patient assessment. Appropriate personal protective
equipment and clothing must be worn until the threat of secondary exposure no longer exists. The
sooner the patient is decontaminated, the sooner he or she can be transferred to the Support Zone
for further evaluation and treatment.
If there is a risk of secondary contamination, gross decontamination should be performed simultaneously with initial patient stabilization. This consists of cutting away or otherwise removing all
potentially contaminated clothing, including jewelry and watches. All removed items should be
doubled-bagged in plastic bags, sealed, and labeled. Any obvious contamination should be brushed
or wiped off, followed by a 1-minute-long rinsing from head to toe with tepid water. If the suspected
chemical is water-reactive, a longer rinsing period and a greater volume of water is required. Care
should be taken to protect any open wounds from contamination by covering them with a waterrepellent dressing (e.g., Chux). Throughout these procedures, every effort should be made by emergency
personnel to avoid contact with any potentially hazardous substance(s).
Secondary or Definitive Decontamination

Effective decontamination consists of making the patient As Clean As Possible (ACAP). If conditions
permit (appropriate personnel, supplies, water, weather), a more deliberate decontamination process
known as secondary or definitive decontamination should be initiated on each patient before transfer
into the Support Zone. This process includes washing the individual, usually with soap and water, in
an organized and thorough manner. Initiating this step implies that contamination has been reduced
to a level that is no longer a threat to the patient or to the responder. Determining the adequacy of
decontamination can be very difficult, however, and is often based on a best clinical judgment rather
than on objective data. Detection monitors (to indicate how clean an area is) have limited value and
are not generally available to most fire departments or EMS agencies. When a patient cannot be
definitively decontaminated, then he or she should be loosely wrapped in a cocoon-like fashion
with a blanket or sheet prior to transfer to the Support Zone.
Exhibit III-2 outlines the minimum equipment that is required for patient decontamination by emergency response personnel. These lists are not comprehensive, and are provided to guide departments
in developing their own equipment lists based on community needs and requirements.
With few exceptions, intact skin is more resistant to hazardous materials than injured flesh, mucous
membranes, or eyes. Therefore, secondary decontamination should begin at the head and proceed
downward, with initial attention paid to contaminated eyes and open wounds. Once wounds have
been cleaned, care should be exercised not to recontaminate them. This can be aided by covering the
wounds with a waterproof dressing. For some chemicals, such as strong alkaline substances, it may
be necessary to flush exposed skin and eyes with water or normal saline for a minimum of 15 minutes.
50
Exhibit III-2
Suggested Decontamination Equipment
The equipment and supplies listed are the minimum necessary to undertake decontamination procedures. In addition, PPE used by decontamination personnel should be no less than one level below
that used for entry into the hazardous environment. Positive-pressure self-contained breathing apparatus (SCBA) and fully-encapsulated suits may be necessary in extreme cases.
l
Containment equipment
Towels and blankets
Pool or tank
Disposable clothes and shoes for ambulatory

patients
Tarps
6-mil construction plastic
Large plastic bags for contaminated clothing

with predetermined unique ID tags to go on
the bag and patient wrist/neck
Small plastic bags for patients valuables

(clear freezer bags are preferable)
Fiberglass backboards
Supports for ambulatory patients
Sawhorses to support backboards
Tags and waterproof pens to mark bags
Water supply
Scissors for clothing removal
Clear, zip-front body suits or large water

repellant blankets to minimize contamination
to transport personnel and ambulances
Mild detergent (dishwashing liquid)
Tape (duct, 4-inch)
Five-gallon buckets
Triage tags
Sponges and soft brushes
Washing should be done using warm water, soft bristle brushes or sponges, and a mild soap, such as
dishwashing liquid. Hot water, stiff brushes, and vigorous scrubbing should seldom be used because
they cause vasodilation, abrasion, and increased entry of toxicants through the skin. The skin of
young children is particularly sensitive and should be treated accordingly. Responders should try to
contain all run-off from decontamination procedures for proper disposal. Whenever possible, men
and women should be provided separate treatment areas. Allowing ambulatory patients to decontaminate themselves under supervision may accelerate the process and reduce the need for response
personnel. In such cases, it may be necessary to provide instructions in multiple languages, preferably
using a prerecorded message, to assure that patients understand the problem and follow instructions.
Patient compliance with clothing removal and decontamination instructions will likely be influenced
by their perception of the threat to their life and health, as well as by the clarity and authoritative
nature of the instructions given.
Decontamination of nonambulatory patients is more difficult and labor-intensive. Careful attention
must be paid to cleaning the back, buttocks, axilla, hair, and genitalia. The backboard and collar
51
along with any other medical equipment used to transport the patient must either be decontaminated
or exchanged prior to the individual entering the Support Zone. If a patient is seriously ill, ventilation support and the administration of medicines may be required while he or she is undergoing
decontamination. However, invasive procedures (e.g., intubation) should not be initiated in the
Contamination Reduction Zone unless absolutely necessary.
All potentially contaminated patient clothing and belongings that have been removed and bagged
should remain in the decontamination area. They should not be transported with the patient in the
ambulance unless approved by the Decontamination Officer or Safety Officer.
Many chemical substances, even though highly toxic, carry no intrinsic risk for contamination to
others. Most toxic gases, such as carbon monoxide or arsine, are highly poisonous, but once the
victim has been brought out of the exposure area and into the fresh air, the amount of leftover gas
in and around the patient is unlikely to poison others, especially when the patient s clothes are
removed. Even many chemicals that have the potential for spreading contamination can be rendered
less hazardous by clothing removal and simple dilution of contaminants with copious amounts of water.
Pediatric Decontamination Considerations

The complexity of managing a hazardous materials incident is increased when children are involved.
While protective to the wearer, PPE may be frightening to a young child, resulting in less cooperation and greater psychological trauma. Whenever possible, children and parents (or other adults
known to them) should remain together while undergoing decontamination, medical treatment, and
transport to the hospital. Constant reassurance and compassion will be especially important if a child
is separated from his or her parent(s). Efforts at reuniting parent and child should be made as early
as is safely possible, either at the scene or at the hospital. Older children, while likely to be more
compliant with instructions and self-sufficient during the decontamination process, may nevertheless
be more susceptible to mass hysteria if not properly informed and reassured.
Increased susceptibility to hypothermia is an important consideration in determining to what degree a
child is decontaminated in the field as opposed to being grossly decontaminated, wrapped in a blanket
for transport, and then given definitive decontamination at the hospital or other heated location.
Mass Population Decontamination

Certain hazmat incidents result in large numbers of patients being exposed (or believing they were
exposed) to a chemical agent. In this situation, responding personnel will find it necessary to implement proper triage to prioritize patients entry through the decontamination process, or to quickly
expand the decontamination system to clean more patients simultaneously. Gaining quick control of
the escaping crowd and initiating immediate decontamination procedures (if indicated) is essential to
minimize secondary contamination, morbidity, mortality and panic. Large volumes of water from
charged hose lines, and specially-mounted nozzles or deluge guns on fire engines, can be used to
quickly rinse large numbers of individuals. Some fire departments or hazmat teams use portable
trailers and/or aerial ladder trucks with special spray systems containing both soap and water (or
bleach and water) to provide gross and/or secondary decontamination for large-scale efforts. Once
through the decontamination steps, patients should be given towels, temporary clothing (e.g., a plain
52
Decontamination
l
Make sure all clothing is removed.
Brush or vacuum particulate matter off of skin.
Decontaminate systematically from the head down with water:

;
Water-wash contaminated area gently under a stream of water, and scrub with a soft brush or
surgical sponge along with soap
Limit mechanical or chemical irritation of the skin by overzealous scrubbing or forceful water
flow
Use warm, never hot, water
Decontaminate exposed wounds and eyes before intact skin areas
Cover wounds with a waterproof dressing after decontamination
Take care not to introduce contaminants into open wounds
Remember the back, under skin folds and genitalia
Watch for any changes in the patient s condition
Remove contaminants to the level that they are no longer a threat to the patient or response personnel, or as far as the situation or their clinical condition allows.
Isolate the patient from the environment by wrapping in blanket/sheet to prevent the spread of
any remaining contaminants.
If possible, contain all runoff from decontamination procedures for proper disposal.
Ensure that all potentially contaminated patient clothing and belongings have been bagged and
tagged:
;
Properly label the bags that contain clothing or other potentially contaminated articles
Consult with proper officials (e.g., Safety Officer, Hazmat Officer) regarding disposition of
bags containing patient valuables
53
Tyvek suit with hood, booties, and gloves), and a blanket, and then directed to the Treatment Sector
for evaluation. Mass decontamination planning should also address issues such as non-Englishspeaking patients, caring for physically impaired patients (e.g., nonambulatory, blind, wheelchairbound), and large numbers of worried but well victims.
CONSIDERATIONS FOR PATIENT TREATMENT

In most aspects, a contaminated patient is like any other patient except that responders must protect
themselves and others from dangers due to secondary contamination. Response personnel must first
address life-threatening issues and gross decontamination before taking supportive measures. If
spinal immobilization appears necessary, it should be initiated as soon as feasible. Primary surveys
should be accomplished simultaneously with decontamination, and secondary surveys completed as
conditions allow. In treating patients, personnel should consider the chemical-specific information
received from the Poison Control Center and other information resources. In multiple patient situations, proper triage procedures should be implemented using local emergency response plans (see
Section I SARA Title III).
Patient Treatment
l
Assign highest priorities to ABCs and decontamination.
Complete primary and secondary surveys as conditions allow. Bear in mind the chemical-specific
information received from the designated poison control or medical control center.
Treat for spinal injury, if indicated.
In multiple patient situations, begin proper triage procedures.
Administer antidotes and dosages per local protocol.
Delay prophylactic measures until the patient is decontaminated.
Perform invasive procedures only in uncontaminated areas.
Reassess the patient frequently because many chemicals have latent physiological effects.
54
The patient should undergo frequent reassessments because many hazardous materials have latent
physiological effects. Unless required by life-threatening conditions, prophylactic invasive procedures,
such as intravenous injections or intubation, should be performed only in fully decontaminated areas
and where conditions permit because they may create a direct route for introducing hazardous material(s) into the patient. Oxygen should be given using a bag valve mask with reservoir device
(rebreather) or with a manually triggered oxygen-powered breathing device. Oxygen bottles and regulators should be encapsulated in plastic to facilitate decontamination, and every effort should be
made to avoid mixing contaminated air with the oxygen. Caution must also be exercised when dealing with patients who are vomiting; off-gassing of a product or absorption through the skin or
mucous membranes can occur from the emesis in some cases.
While some contaminated patients may require treatment with antidotes, most cases can be handled
with symptomatic care. Antidote administration should be based on patient condition, antidote availability, and proximity to the hospital. Emergency personnel must have a thorough understanding and
familiarity with authorized antidotes since they can have significant side effects. Medication dosing
for children must be carefully checked because they are most often administered on a mg/kg basis,
and therapeutic and toxic levels can be very close. Exhibit III-3 lists frequently used antidotes and
selected other pharmacologic treatment agents.
Exhibit III-3
Antidotes and Select Pharmacologic Treatment Agents
Antidote
Toxicant
Atropine1
Organophosphate pesticides and nerve agents
Pralidoxime chloride (2-PAM Chloride)1
Organophosphate pesticides and nerve agents
Cyanide antidote kit
Cyanide
Methylene blue 1%
Methemoglobinema
Activated charcoal
Certain ingested substances
Calcium gluconate (Gel and IV)
Hydrofluoric acid and fluoride toxicity
Oxygen
Carbon monoxide
Can be found combined in auto-injection kit known as Mark I.
55
PATIENT TRANSPORT TO THE HOSPITAL

When transporting a contaminated patient (i.e., only gross decontamination performed) by ambulance,
special care should be exercised to prevent contamination of the vehicle and subsequent patients.
Exposed surfaces that the patient is likely to contact should be protected by disposable sheeting. The
use of both chemically resistant backboards and disposable sheeting are highly recommended. If a
wooden backboard is used, it should be wrapped in a disposable cover or it may have to be discarded.
Unnecessary equipment should be stored in a safe location or removed; equipment that does come in
contact with the patient should be segregated for decontamination or disposal.
Exhibit III-4 outlines suggested equipment for the care and transport of contaminated patients. Items
should be added or deleted based on local needs and experience.
The patient should be as clean as reasonably possible before transport, and further contact with
contaminants should be avoided. No patient should be transported who has not, at a minimum,
undergone gross decontamination. Protective clothing should be worn by response personnel, as
appropriate. If secondary decontamination cannot be performed prior to transport, responders should
attempt to prevent the spread of contamination by wrapping the patient loosely but completely in a
large blanket or sheet. Body bags are not recommended for encapsulating patients for physiological
and mental health reasons. Consideration should also be given to chemicals that present the added
danger of accelerated skin absorption due to heat. The name(s) of the involved chemicals, if identified, and any other data available, should be recorded before leaving the scene. Oxygen should be
administered by rebreather mask for any victim with respiratory problems unless contraindicated
(e.g., end-stage chronic obstructive pulmonary disease (COPD)). Eyes that have been exposed
should be irrigated with available saline or water, and irrigation should be continued en route to the
hospital. Personnel should also be alert for any signs of respiratory distress, cardiovascular collapse,
or gastrointestinal complaints. Seizures may occur and should be treated according to local protocol.
Patients experiencing pain as a result of their injuries should be treated per medical control or
agency protocol. Various types and degrees of burns may be seen and should be treated per local
burn protocol or Burn Center instructions. In the case of acid and alkaline burns to the eyes, they
should be continuously irrigated en route to the hospital. Control and proper disposal of the run-off
is necessary to avoid injury to the patient and prehospital caregiver(s). Verbal reassurances and other
forms of psychological support will also be important to minimize further fear and anxiety.
During transport, ambulance personnel should use appropriate respiratory protection. Provide the
maximum fresh air ventilation (e.g., open windows) that weather conditions permit to the patient s
and driver s compartments, regardless of the presence or absence of odors.
Contact the receiving hospital and provide an update on treatment provided or required and any other
pertinent clinical information. Instructions for the procedure to enter the hospital with a contaminated
patient should also be requested. Facilities receiving a potential hazardous materials patient will
need as much information as possible, as soon as possible.
56
Exhibit III-4
Supplies Needed to Prepare the Ambulance for Care
of a Patient Contaminated with Hazardous Materials
l Sufficient 6-mil construction plastic1 cut to size to:
;
Cover floor of ambulance
Cover squad seat
Cover litter
l Disposable sheet(s)
l Plastic trash bags to contain contaminated medical supply waste, gloves and the victim s clothes, and vomitus
l Personal Protection:
;
CPC disposable suits with built-in hoods and booty/boot covers
Positive-pressure SCBA2
Full-facemask respirator with an orange- and purple-type cartridge (acid gas, organic vapor, highly toxic dust, mist
and fumes, and radionuclides-rated, HEPA cartridge)2
Polyvinyl chloride (PVC) or duct tape for taping closures
Two-piece rainwear
Rubber boots with steel toes
Nitrile gloves with 14-inch cuffs
Duct tape to seal suit seams, if necessary
Wet plastic is slippery; stability is important.
Must not be used without prior training and fit testing.

NOTE: The protective equipment listed is to be used for patient care situations after initial decontamination. It is meant to be used when
complete decontamination of the patients cannot be guaranteed or when assisting with decontamination procedures (in extreme cases
positive-pressure SCBA and encapsulated suites may be required for decontamination procedures). It is not meant to be used in rescue
operations of victims found in a hazardous area. Under no circumstances should this equipment be relied upon for entry into hazardous environments. Protective equipment for entry must be appropriate to and compatible with the products involved. This may
include positive-pressure SCBA and fully encapsulated suits. Many factors must be taken into consideration when determining the
appropriate level of protection. Consequently, selection of protective equipment must be done by a qualified individual.
57
A radio report checklist should be developed and made available for all vehicles and telephone or
radio communication centers. This information will aid in initiating appropriate actions:
l
Number and ages of patients
Nature of injuries
Name of chemical(s) involved, including trade names
Information available at the site concerning the chemical(s), including the MSDSs
Extent of patient decontamination in the field
Estimated time of arrival
The ambulance should park in an area away from the emergency room or go directly to a predesignated decontamination location, thereby limiting exposure to hospital facilities. To protect hospital
staff and other patients, the victim should not be brought into the emergency department before
ambulance personnel receive permission from the hospital staff.
Upon release of the patient to the hospital, any nondisposable equipment that is believed to be contaminated should be double-bagged. Contaminated articles should be kept sealed until the Incident
Commander or his designee gives further instructions. Whenever possible, the use of disposable
equipment is recommended. Inquiries should be made at the hospital to determine where the ambulance can be safely decontaminated, and whether equipment is available for this purpose. The
method of decontamination should be based on the chemical(s) involved and the extent of patient
decontamination prior to transport. In most cases soap and water are adequate for vehicle decontamination. The ambulance should not go back into service until it is determined to be safe by an appropriately trained individual (e.g., a hazmat team coordinator). This again emphasizes the benefits of
thorough patient decontamination prior to transport; if the patient is clean, then the vehicle s interior
will also be clean.
58
Transport to the Hospital

l
Get patient as clean as possible prior to transport.
Avoid contact with contaminants; provide protection to the vehicle; wear protective clothing as
appropriate.
Provide other patient care according to condition and local protocol.
Before leaving the scene, write down the name of the involved chemical(s) and any other available data.
Provide fresh air ventilation to the patient s and the driver s compartments.
Contact the receiving hospital ASAP; provide information on the patient and treatment rendered;
identify the chemical, its toxicology, MSDS, and any other pertinent information.
Obtain instructions on approaching and entering the hospital.
Have open bag ready in case of vomiting and carefully isolate vomitus since off-gassing can
occur.
Be alert for any respiratory distress; administer oxygen by mask for any patient with respiratory
problems (except as contraindicated).
Continue to irrigate eyes as needed with normal saline or water.
Park the ambulance in a location away from the emergency department or go directly to a
predesignated decontamination area.
Do not bring patients into the emergency department before receiving permission from the
hospital staff.
After unloading the patient, check with the hospital to determine where the ambulance can be
safely decontaminated, and the availability of equipment for this purpose.
Decontaminate exposed emergency personnel.
59
Air Transportation of Chemically Exposed Patients

The role of aeromedical support for hazmat incidents is limited because of the potential danger in
transporting patients by helicopter from a hazardous materials site. Especially in cases involving
more severe injuries, decontamination is often incomplete before removal, and as a result the flight
crew risks becoming seriously ill in transit. The flight path to the site may also require their traveling through an unsafe area. Furthermore, the down draft from the helicopter can affect vapor or
fume dispersion at the scene. In many areas, flight program policies specifically preclude the use of
helicopters for these types of incidents.
CRITIQUE
As soon as possible following a hazardous materials incident, all participating units should send
knowledgeable representatives to meet and review the measures that were taken by each unit or
agency. The purpose of this review is to examine which activities succeeded and which did not, and
to evaluate the overall coordination effort with an aim toward making necessary improvements. The
results of the discussion should be shared with all agency personnel. Identified weaknesses or omissions in the response plan should be corrected, and training given on new policies and procedures.
PATIENT MANAGEMENT UNDER MASS CASUALTY CONDITIONS INVOLVING

HAZARDOUS CHEMICALS
Basic medical procedures in a large-scale hazardous materials incident are not substantially different
from life-saving measures in other mass casualty disasters. Primary attention should focus on the
ABC fundamentals of emergency care, with decontamination performed at the same time.
There are, however, several important differences in disasters involving hazardous materials. A hazmat
disaster may require setting up mass screening and decontamination centers. It may also be necessary
to establish casualty collection points to provide stabilizing care in the field prior to transport. A
major chemical incident may overwhelm any one hospital, especially if it occurs along with another
disaster such as an earthquake. Such an event would drastically increase the number of casualties
and the complexity of the medical care that must be provided (e.g., crushing injuries or spinal trauma,
combined with gas inhalation). This would require increased numbers of personnel, perhaps more
sophisticated medical equipment, and a better transport system for taking stabilized victims out of
the area. Training in the appropriate procedures to be followed is essential for potential responders
to a hazardous materials incident involving mass casualties. Triage may also be complicated for chemical exposures associated with the delayed onset of signs and symptoms. If necessary, the patient,
injured or not, must be decontaminated before being transported to the emergency department to
protect EMS and emergency department staff.
CRITICAL INCIDENT STRESS MANAGEMENT

Situations involving large numbers of ill or injured individuals, and risks of harm to the responder(s),
are sources of critical incident stress. To minimize the occurrence of acute or long- term psychological
consequences in response personnel, stress debriefing sessions should be held shortly after the incident. Acute stress reactions recognized during and after the incident should be immediately
addressed by qualified peer debriefers or other mental health professionals.
60
Cashman, J.R. 1995. Hazardous Materials Emergencies: The Professional Response Team. 3rd ed.
Lancaster, PA: Technomic Publishing Co.
Currance, P.L. and A.C. Bronstein. 1994. Emergency Care for Hazardous Materials Exposure. 2nd
Haddad, L.M. and J.F. Winchester. 1998. Clinical Management of Poisoning and Drug Overdose.
3rd ed. Philadelphia, PA: W.B. Saunders Co.
Leonard, R.B. and R. Ricks. 1980. Emergency Department Radiation Accident Protocol. Annals of
Emergency Medicine. September.
Noji, E.K. and G.D. Kelen. 1989. Manual of Toxicologic Emergencies. Chicago, IL: Year Book.
Reigart, J. R. and J.R. Roberts, JR (eds.). 1998. Recognition and Management of Pesticide
Poisonings. 5th ed. National Pesticide Telecommunications & Network (NPTN), U.S.
Environmental Protection Agency.
U.S. Department of Health and Human Services. Agency for Toxic Substances and Disease Registry
(ATSDR). 1996. Managing Hazardous Materials Incidents: Medical Management Guidelines for
Acute Chemical Exposures. Vol. III. Atlanta, GA: US-DHHS.
Washington, DC: Government Printing Office. [available in English, Spanish, and
French][http://hazmat.dot.gov/gydebook.htm]
U.S. Federal Emergency Management Agency. 1981. Hazardous Materials Management System: A
Guide for Local Emergency Managers. Prepared by the Office of Emergency Management.
Washington, DC: Federal Emergency Management Agency.
U.S. Federal Emergency Management Agency. 1985. Guidance for Developing State and Local
Radiological Emergency Response Plans and Preparedness for Transportation Accidents.
61
62
Appendix A
HAZARDOUS MATERIALS CLASSIFICATION SYSTEMS

National Fire Protection Association, 704M System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A3
Department of Transportation, DOT Chart 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A5
U.S. Department of Labor, Material Safety Data Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A9
A1
A2
NATIONAL FIRE PROTECTION ASSOCIATION, 704M SYSTEM

The marking system designed by the National Fire Protection Association identifies hazard characteristics of materials at terminal and industrial sites. It uses a diamond divided into four quadrants,
with each quadrant representing a different characteristic, as explained below.
The risk level ratings, ranging from four (highest risk) to zero (minimum risk), are based upon
protective equipment normally used by firefighters.
Health (Blue)
Health hazards in firefighting generally result from a single exposure, which may vary from a few
seconds up to an hour. Only hazards arising out of an inherent property of the material are considered.
It should be noted, however, that the physical exertion demanded in firefighting or other emergency
conditions tends to intensify the effects of any exposure.
Risk level 4: Materials too dangerous to human health to expose firefighters. A few whiffs of the
vapor could cause death or the vapor or liquid could be fatal on penetrating the firefighter s normal
full protective clothing. The normal full protective clothing and breathing apparatus available to the
average fire department will not provide adequate protection against inhalation or skin contact with
these materials.
Risk level 3: Materials extremely hazardous to health, but areas may be entered with extreme care.
Full protective clothing including self-contained breathing apparatus, coat, pants, gloves, and
boots, with bands around the legs, arms, and waist should be provided. No skin surface should be
exposed.
Risk level 2: Materials hazardous to health, but areas may be entered freely with full facemask
self-contained breathing apparatus that also provides eye protection.
Risk level 1: Materials only slightly hazardous to health. It may be desirable to wear self-contained
breathing apparatus.
Risk level 0: Materials which on exposure under fire conditions would offer no hazard beyond that
of ordinary combustible materials.
Flammability (Red)
Susceptibility to burning is the basis for assigning risk levels within this category. The method of
attacking the fire is influenced by the material s susceptibility factor.
Risk level 4: Very flammable gases or very volatile flammable liquids. Shut off flow and keep
cooling water streams on exposed tanks or containers.
Risk level 3: Materials that can be ignited under almost all normal temperature conditions. Water
may be ineffective because of the low flash point.
A3
Risk level 2: Materials that must be moderately heated before ignition will occur. Water spray may
be used to extinguish the fire because the material can be cooled below its flash point.
Risk level 1: Materials that must be preheated before ignition will occur. Water may cause frothing
if it gets below the surface of the liquid and turns to steam. However, water fog gently applied to the
surface will cause a frothing that will extinguish the fire.
Risk level 0: Materials that will not burn.
Reactivity/Stability (Yellow)
The assignment of degrees in the reactivity category is based upon the susceptibility of materials to
release energy either by themselves or in combination with water. Fire exposure is one of the factors
considered, along with conditions of shock and pressure.
Risk level 4: Materials that (in themselves) are readily capable of detonation or of explosive decomposition or reaction at normal temperatures and pressures. Includes materials that are sensitive to
mechanical or localized thermal shock. If a chemical with this hazard rating is in an advanced or
massive fire, the area should be evacuated.
Risk level 3: Materials that (in themselves) are capable of detonation or of explosive decomposition
or reaction that require a strong initiating source that must be heated under confinement before initiation. Includes materials that are sensitive to thermal or mechanical shock at elevated temperatures
and pressures, or that react explosively with water without requiring heat or confinement.
Firefighting should be done from an explosive-resistant location.
Risk level 2: Materials that (in themselves) are normally unstable and readily undergo violent chemical
change, but do not detonate. Includes materials that can undergo chemical change with rapid release
of energy at normal temperatures and pressures, or that can undergo violent chemical change at elevated temperatures and pressures. Also includes those materials that may react violently with water
or that may form potentially explosive mixtures with water. In advanced or massive fires, firefighting should be done from a safe distance or from a protected location.
Risk level 1: Materials that (in themselves) are normally stable but that may become unstable at
elevated temperatures and pressures or that may react with water with some release of energy, but
not violently. Caution must be used in approaching the fire and applying water.
Risk level 0: Materials that (in themselves) are normally stable even under fire exposure conditions
and that are not reactive with water. Normal firefighting procedures may be used.
Special Information (White)

The quadrant includes information on specific characteristics of the material (e.g., reactivity with
water, tendency to oxidize).
A4
A5
A6
A7
A8
MATERIAL SAFETY DATA SHEETS

The Material Safety Data Sheet (MSDS) has become a major source of chemical information. It is
the key document used to provide hazard information to employees and can become an invaluable
tool for emergency response personnel when used in a chemical emergency.
The Occupational Safety and Health Administration s (OSHA) Hazard Communication Standard
(29 CFR 1910.1200) requires all manufacturers of pure chemicals and/or mixtures to evaluate their
products and relate, via MSDSs, any hazards that may be encountered while handling these materials.
This standard is intended for all workplaces, manufacturing and nonmanufacturing alike. The
Environmental Protection Agency s (EPA) Emergency Response and Community Right-to-Know
Act of 1986 ensures the availability of MSDSs to emergency response personnel, such as fire departments, first aid crews, and hospital emergency room staff.
The MSDS contains a wealth of information that may be understood with a minimum of training.
Below is a brief explanation of the format and information found in a properly prepared MSDS.
Section 1
This section identifies the material by product or trade name and chemical name. It is the product or
trade name that is usually found on the container labels, although the chemical name is also required
by some states. Section I also contains the manufacturer s name, address, and telephone number.
Section 2
Section 2 provides physical data about the product that can be utilized for proper identification.
Included are specifics such as color, odor, specific gravity (weight), vapor pressure, and boiling point.
Section 3
This section lists the chemical ingredients of the material, if they are known or suspected to be
hazardous. Hazardous materials that are not carcinogens must be reported if they represent 1 percent
or more of the product. Carcinogens must be reported and identified as such if their levels are 0.1
percent or higher. Also included in Section 3 are Threshold Limit Values (TLVs) and the OSHA
Permissible Exposure Limit (PEL).
Section 4
Section 4 includes fire and explosion hazard data. This information is especially useful when devising
both in-house and community contingency plans. Plant first responders, local fire departments, and
hazmat teams need unlimited access to this information.
Section 5
Section 5 contains health hazard data. It describes any acute (short-term exposure) and/or chronic
(long-term exposure) effects on the body. These include routes of exposure (inhalation, dermal contact,
ingestion) and the bodily organs affected, as well as the signs and symptoms of overexposure. First
A9
aid procedures are also be found in this section. (NOTE: First aid measures recommended in
MSDSs are not always correct and should be confirmed.)
Section 6
This section contains information on the reactivity of the product. It lists other chemicals that,
when mixed with the product, will result in a chemical reaction. If a product is water reactive, it will
be noted.
Also included in Section 6 is information on hazardous decomposition products, such as carbon
monoxide and other hazardous gases, that are formed and emitted during chemical reactions or fires.
It is imperative that this section be carefully noted by both in-house and local firefighters.
Section 7
Section 7 lists the procedures that should be used if the product spills or leaks, including waste disposal methods.
Section 8
Section 8 contains information regarding the proper personal protective equipment (PPE) necessary
to handle the product in a manner that will minimize exposure. Ventilation practices are also listed
in this section.
Summary
A Material Safety Data Sheet can aid in making the right decisions on health and safety issues in a
plant or in a community. It must be noted, however, that it is but one of many references that should
be used to make final determinations. MSDSs are offered by manufacturers for identification and
verification and are not the last word on safety and health practices.
A10
A11
A12
Appendix B
TYPES OF RESPIRATORY PROTECTION
B1
B2
Appendix B
Types of Respiratory Protection
Type of Respirator
Advantages
Disadvantages
Enhanced mobility
Cannot be used in IDLH or oxygen-deficient

atmospheres (less than 19.5 percent oxygen
at air-purifying respirators
Lighter in weight than an SCBA; generally

weighs 2 pounds or less (except for PAPRs)
Limited duration of protection; may be hard

to gauge safe operating time in field
conditions
Air Purifying
Air-Purifying Respirator
(including powered
sea level)
[PAPRs])
Only protects against specific chemicals, and

up to specific concentrations
Use requires monitoring of contaminant and
oxygen levels
Can only be used: (1) against gas and vapor
contaminants with adequate warning
properties; or (2) for specific gases or vapors
provided that the service is known and a
safety factor is applied, or if the unit has an
ESLI (end-of-service-life-indicator)
Atmosphere-Supplying
Self-Contained Breathing
Apparatus (SCBA)
Provides the highest available level of

protection against airborne contaminants
and oxygen deficiency
Bulky, heavy (up to 35 pounds)

protection under strenuous work conditions
May impair movement in confined spaces
Finite air supply limits work duration
B3
Appendix B (continued)
Type of Respirator
Advantages
Positive Pressure Supplied- Enables longer work periods than an SCBA

Air Respirator (SAR)
(also called air line
respirator)
Disadvantages
Less bulky and heavy than an SCBA;

SAR equipment weigh less than 5 pounds
(or around 15 pounds, if escape SCBA
protection is included)
Not approved for use in IDLH or oxygendeficient atmospheres (less 19.5 percent
oxygen at sea level) unless equipped
with an emergency egress unit, such as an
escape-only SCBA, that can provide
immediate emergency respiratory
protection in case of air line failure
Protects against most airborne contaminants
Impairs mobility
Mine Safety and Health Administration/
NIOSH certification limits hose length to
300 feet
As the length of the hose is increased, the
minimum approved airflow may not be
delivered at the faceplate
Air line is vulnerable to damage, chemical
contamination, and degradation.
Decontamination of hoses may be difficult
Worker must retrace steps to leave work area
Requires supervision/monitoring of the air
supply line
B4
Appendix C
LEVELS OF PROTECTION
C1
C2
Appendix C
Levels of Protection1
Level of
Protection Equipment
A
Should be
used when:
Limiting
Criteria
Recommended:
The highest available
Pressure-demand, full
level of respiratory,
facepiece SCBA or pressure- skin, and eye protection
demand, supplied-air
respirator with escape SCBA
The chemical substance has

been identified and requires the
highest level of protection for
skin, eyes, and the respiratory
systems based on:
Fully-encapsulated
suit; material must
be compatible with
the substances
involved
Fully-encapsulated, chemicalresistant suit
-measured (or potential for)

high concentration of
atmospheric vapors, gases, or
particulates; or
Inner chemical-resistant
gloves
Chemical-resistant safety
boots/shoes
Two-way radio
communication
Optional:
Cooling unit
Coveralls
Long cotton underwear
Hard hat
Disposable gloves and
boot covers
Protection
Provided
-site operations and work

functions involving a high
potential for splash, immersion,
or exposure to unexpected
vapors, gases, or particulates of
materials that are harmful to
skin or capable of being
absorbed through the intact skin
Substances with a high degree of
hazard to the skin are known or
suspected to be present, and
skin contact is possible
Operations must be conducted
in confined, poorly ventilated
areas until the absence of
conditions requiring Level A
protection is determined
Reprinted from NIOSH/OSHA/USCG/EPA, 1985. Occupational Safety and Health Guidance Manual for Hazardous Waste Site
Activities. Washington, DC: Department of Health and Human Services.
C3
Appendix C
Levels of Protection (continued)
Level of
B
Recommended:
Pressure-demand,
full-facepiece SCBA or
pressure-demand, suppliedair respirator with escape
SCBA
Protection
Provided
Should be
used when:
The same level of

respiratory protection,
but less skin protection
than Level A
The type and atmospheric

concentration of substances
have been identified and require
a high level of respiratory
protection, but less skin
It is the minimum level protection. This involves:
Chemical-resistant clothing recommended for initial
(overalls and long sleeved site entries until the
-atmosphere with IDLH
jacket; hooded, one- or
hazards have been
concentrations of specific
two-piece chemical splash further identified
substances that do not
suit; disposable chemicalrepresent a severe skin
resistant one-piece suit)
hazard; or
Inner and outer chemicalresistant gloves
-atmosphere containing less

than 19.5 percent oxygen
boots/shoes
Presence of incompletely
identified vapors or gases is
indicated by direct-reading
organic vapor detection
instrument, but vapors and
gases are not suspected of
containing high levels of
chemicals harmful to skin or
capable of being absorbed
through intact skin
Hard hat
Two-way radio
communications
Limiting
Criteria
Use only when the

vapor or gases
present are not
suspected of
containing high
concentrations of
chemicals that are
harmful to skin or
capable of being
absorbed through
intact skin
Use only when it is
highly unlikely that
the work being
done will generate
either high
concentrations of
vapors, gases, or
particulates or
splashes of
material that
will affect exposed
skin
Optional:
Coveralls
Disposable boot covers
Face shield
C4
Appendix C
Levels of Protection (continued)
Level of
Protection
C
Equipment
Protection
Provided
Recommended:
Full-facepiece, air-purifying, No respiratory
canister-equipped respirator protection; minimal
skin protection
Chemical-resistant clothing
(overalls and long sleeved
jacket: hooded, one- or twopiece chemical splash suit;
disposable chemical-resistant
one-piece suit)
Should be
used when:
Limiting
Criteria
The atmosphere contains no

known hazard
This level should

not be worn in the
Exclusion Zone
Work functions preclude,

splashes immersion, or the
potential for unexpected
inhalation of or contact with
hazardous levels of any
chemicals
The atmosphere
must contain at
least 19.5 percent
oxygen
Hard hat
Optional:
Gloves
Escape mask
Face shield
D
Recommended:
Coveralls
Safety boots/shoes
Safety glasses or chemical
splash goggles
Hard hat
No respiratory
protection; minimal
skin protection

known hazard
Work functions preclude
splashes, immersion, or the
chemicals
This level should

not be worn in the
Exclusion Zone
The atmosphere
must contain at
least 19.5 percent
oxygen
Optional:
Gloves
Escape mask
Face Shield
C5
Comments
The Agency for Toxic Substances and Disease Registry would greatly appreciate your comments
and suggestions for improving future editions of this guidance document. Comments may be addressed
to:
Scott V. Wright
Emergency Response and Scientific Assessment Branch (MS E57)
Agency for Toxic Substances and Disease Registry (ATSDR)
Atlanta, GA 30333
C6
C7
C8
Managing
Hazardous
Materials
Incidents
Volume II
(Revised)

A Planning Guide
for the Management of

The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume
series entitled Managing Hazardous Material Incidents. The series is designed to help emergency
response and health care professionals plan for and respond to hazardous material emergencies.
Volume I

Volume II

Volume III
Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department
personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to hazardous materials.
Agency for Toxic Substances

and Disease Registry.........................................Jeffrey P. Koplan, Ph.D., M.P.H., Administrator
Henry Falk, M.D., M.P.H., Assistant Administrator
Division of Toxicology.........................................Christopher T. DeRosa, Ph.D., Director
Additional copies of this report are available from:

Agency for Toxic Substance and Disease Registry (ATSDR)
Division of Toxicology
Information Center (E57)
Atlanta, Georgia 30333
(404) 639-6357
Internet address: www.atsdr.cdc.gov/prevent.html
2 Printed on recycled paper
DEPARTMENT OF
HEALTH & HUMAN SERVICES
Agency for Toxic Substances and Disease Registry (MS-E57)
Atlanta, GA 30333
Official Business
Penalty for Private Use $300
SPECIAL FOURTH-CLASS RATE

POSTAGE & FEES PAID
PHS/CDC
Permit No. G-284
Volume II - Table of Contents
Page
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
I.
Systems Approach to Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

The Role of the Hospital in a Systems Approach to Planning . . . . . . . . . . . . . . . . . . . . .1
The Spectrum of Hazardous Materials Incidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) . . . . . . . . . . .3
SARA Title III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
The State Emergency Medical Services (EMS) Agency . . . . . . . . . . . . . . . . . . . . . . . . .4
Federal Emergency Response Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Hazard Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Selected Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
II.
Emergency Department Response to Hazardous Materials Incidents . . . . . . . . . . . . . .11

Hazard Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Principles of Toxicology for Emergency Department Personnel . . . . . . . . . . . . . . . . . . 19
Personnel Protection and Safety Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Respiratory Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Emergency Department Personnel Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Communications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Volume II - Table of Contents (Continued)
III.
Patient Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Emergency Department Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Patient Arrival . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Patient Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Considerations for Patient Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Community Education and Briefing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Critique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..48
Patient Management Under Mass Casualty Conditions
Involving Hazardous Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Critical Incident Stress Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Appendix A
Hazardous Materials Classification Systems . . . . . . . . . . . . . . . . . . . . . . . . . A1
Appendix B
Types of Respiratory Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B1
Appendix C
Levels of Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C1
ii
Acknowledgments
who participated in making this a useful guidance document, including:
2000 Revision of Volume I
Emergency Medical Services:
2000 Revision of Volume II

Craig DeAtley, P.A.-C., C.C.T.
George C. Rodgers, Jr., M.D., Ph.D.
Associate Professor, Emergency Medicine

Professor of Pediatrics and Pharmacology/Toxicology
Disaster Medicine and Special Operations Section University of Louisville
George Washington University School of Medicine Louisville, KY
and Health Sciences
Washington, D.C.
Peer Review Panel for revised (2000) Volumes I and II:1

Sella Burchette (U.S. Environmental Protection Agency)
Keith Burkhart, M.D., F.A.C.E.P. (American College of Emergency Physicians)
Andrea Carlson (Physicians for Social Responsibility)
Linda Cochiarella, M.D. (American Medical Association)
Paul Cousins (The National Association of Emergency Medical Technicians)
Richard Duffy (International Association of Firefighters)
Philip Edelmen, M.D. (Association of Occupational and Environmental Clinics)
Robert McCunney, M.D. (American College of Occupational and Environmental Medicine)
Kent Olson, M.D. (American Association of Poison Control Centers)
Leslie Stein-Spencer, R.N. (Emergency Nurses Association)
Milton Tenenbein, M.D. (American Academy of Pediatrics)
John Turley (Emergency Management Institute)
1
The above reviewers were recommended by the organizations listed but do not necessarily represent them.
This project was directed by Scott V. Wright, ATSDR. For the 2000 revision, Linda Stein of Eastern
Research Group, Inc. (ERG) was the project manager, and Chris Reid of ERG was the editor (under
ATSDR Contract No. 205-93-0641).
The following panel of experts contributed to the original (1992) development of Volumes I and II:
Phillip Currance, EMT-P; Ralph B. Monty Leonard, Ph.D., M.D., F.A.C.E.P.; Mary Beth Michos,
R.N.; Eric Noji, M.D., M.P.H., F.A.C.E.P.; Martin J. ONeill; Paul Seidlitz, R.N.
The following experts served as peer reviewers for the original 1992 Volumes I and II:
Ben Blankeshire, Kenneth Bouvier, MacNeil Cross, Robert Daughdril, Craig DeAtley, Eileen Faries,
Steve Finefrock, John Friery, Niel Holtz, Winston E. Jones, William J. Keffer, Gus A. Koehler,
Kenneth Kuntz, Paul Manascalo, Kent Olson, Chappell D. Pierce, Alonzo Smith, Clark Staten, Dave
Tauber, Joe E. Taylor, Sandra L. Tirey, Wallace Weaver, Steve White
iii
iv
Introduction
The presence of hazardous materials or toxic chemicals at an incident location or other emergency
situation adds a new dimension of risk to those handling and treating casualties. The fundamental
difference between a hazardous materials incident and other emergencies is the potential for acute
risk from contamination to both patient and responder. In some cases, traditional practices must be
altered to avoid compounding a critical situation.
Hospital emergency departments must protect their personnel and other people within the hospital,
while providing the best care for the chemically contaminated patient. This guide is intended to help
hospital emergency departments plan for incidents that involve hazardous materials and to improve
their ability to respond to these incidents.
To ensure appropriate and timely patient care, as well as optimal worker protection, emergency
personnel must understand decontamination procedures and personal protective equipment, neither
of which are routinely covered in the course of their professional training. They should also be
aware of community resources that could be called upon to assist with an emergency response.
Current training curricula for emergency room physicians and nurses and emergency medical
technicians (EMTs) often do not adequately prepare these professionals to manage the contaminated
individual or to decontaminate patients exposed to toxic substances. Accurate, specific, and concise
guidance is needed to describe appropriate procedures to be followed by emergency medical personnel
to safely care for a patient, as well as to protect equipment, hospital personnel, patients, and others
from risk of secondary exposure. In response to this need, the Agency for Toxic Substances and
Disease Registry (ATSDR) contracted for the production of a three-volume series entitled Managing
Hazardous Materials Incidents: I. Emergency Medical Services: A Planning Guide for the
Management of Contaminated Patients; II. Hospital Emergency Departments: A Planning Guide for
the Management of Contaminated Patients; and III. Medical Management Guidelines for Acute
Chemical Exposures. The first document is designed for use by emergency medical technicians
and other prehospital care providers to minimize their risks of exposure during the prehospital
period and to provide for the safe and effective treatment of chemically contaminated patients.
This volume, written for emergency department personnel, is designed to familiarize readers with
the concepts, terminology, and key operational considerations that affect the management of incidents
of chemical contamination. It presents uniform guidance for the emergency care of chemically
contaminated patients; provides basic information critical to advance planning and implementation
of emergency medical strategies; illustrates the characteristics of hazardous materials incidents that
compel modifications to traditional emergency response procedures; and presents effective preparatory response actions.
Not all hospital and community emergency response systems are prepared to respond to a hazardous
chemical incident to the same degree. This document may be used to assess a hospital s capabilities
with respect to potential community hazards and to develop response plans using national and
community-specific resources. Employee safety and training are also key factors in the effective
management of medical emergencies. This document also is intended to provide source material
for developing local training and safety protocols.
Section I, Systems Approach to Planning, introduces the guidelines for emergency preparedness and
hazardous materials and waste programs of the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO). Government and private planning activities are also outlined, including
those established under Title III of the Superfund Amendments and Reauthorization Act (SARA);
the National Response Team; the Community Awareness Emergency Response (CAER) program;
and the Chemical Stockpile Emergency Preparedness Program (CSEPP). This chapter discusses
the need for hazard identification and risk analysis pertaining to hazardous materials located in a
community or transported through it.
Section II, Emergency Department Response to Hazardous Materials Incidents, outlines general
principles for hazard recognition, chemical exposure, and personal protective equipment. In addition, the hazard recognition section presents general guidance for determining whether a given situation constitutes a hazardous materials incident and details various hazardous materials classification systems. This section also provides basic toxicological and chemical terminology that emergency personnel need to understand to effectively conduct patient assessments. It also provides an overview of
personal protective equipment, such as respiratory devices and protective clothing.
Section III, Patient Management, includes guidelines for emergency department preparation and
response to a potential hazardous materials incident. This chapter also discusses patient assessment
and decontamination guidelines.
This guidance document is intended to improve the safety of responders as well as of patients. It is
not, however, all-encompassing, nor can it be regarded as a substitute for comprehensive instruction
and training for hazardous materials incidents. Supplemental material that is vital to successful
response to hazardous materials contamination is cited within the document. These materials should
be carefully reviewed before preparing any strategic plans or conducting training exercises on this
topic. Also, this document generally does not cover issues associated with weapons of mass destruction (WMD), although some of the information presented is pertinent to these situations as well.
Other ATSDR documents specifically address WMD concerns.
vi
Section I.
Systems Approach To Planning
THE ROLE OF THE HOSPITAL IN A SYSTEMS APPROACH TO PLANNING

The potential for hazardous materials incidents exists almost everywhere. While infrequent, chemical
incidents are capable of endangering the health of the individuals involved and the emergency personnel directed to assist them. People who have been seriously injured by a hazardous material have
a greater chance of recovery without complications when appropriate emergency treatment is provided by trained EMS personnel at the scene, and when the patient is transported to a facility having the
most appropriate personnel and technical resources to manage his or her care. This requires an integrated emergency medical response. However, many local governments, private businesses, and
hospitals do not have a tested hazardous materials response plan in place that integrates all of the
responding agencies and personnel. This has resulted in several problems:
l
Incidents have been poorly managed onsite by first responders.
Communication channels between the private and public sectors, or among public responders,
have not been clearly identified and formalized.
The medical community has not been firmly integrated into many response systems and may not
be prepared to treat multiple casualties resulting from a serious hazardous materials incident.
Hospitals are a crucial link in the community response system for emergency preparedness planning.
Not only are hospitals asked to treat patients who have been chemically contaminated at remote
sites, but as repositories of hazardous materials themselves, they are potential sites of hazardous
materials incidents. Coordination and communication between hospitals and other elements of an
Emergency Medical Services system can best be achieved by hospital staff, including physicians,
fully participating at local meetings for hazardous materials (hazmat) planning and protocol review.
Hospitals must acknowledge their role as a component of the communitywide emergency response
system. Hospital administrators need to familiarize themselves with the contingency plans of other
participants, such as fire, police, Emergency Medical Services (EMS), and health departments, and
understand what services are expected from hospitals. Optimally, hospital staff should be represented
on planning committees that develop and periodically review these contingency plans.
A common characteristic of the successful management of chemical incidents is adequate contingency
planning. Local emergency planning committees are mandated under federal law to identify high-risk
locations and to ensure adequate response planning and training. Planning requires the involvement
of an array of community institutions, including fire and police departments, and community hospitals.
Not every hospital in an area needs to have an emergency department capable of handling hazardous
materials patients. In fact, many communities have centralized such services into one major area
hospital or trauma center. However, all hospitals should be capable of performing decontamination
and basic care since some patients may come in on their own and not through EMS systems. In
addition, emergency department personnel must be knowledgeable about where to send patients for
further specialized care.
THE SPECTRUM OF HAZARDOUS MATERIALS INCIDENTS

EMS agencies and hospitals should be able to participate in the response to a range of hazmat incidents from the individual level, through the multi-casualty, to the mass-casualty level. The hospital
and emergency medical responders are key components of the local response system. Planning should
integrate hospital personnel, equipment, and supply needs into state and local hazmat plans. In turn,
the hospital must be familiar with these plans and know how to use them if it is involved in a incident
that overwhelms its capabilities.
l
Individual patient: A single individual is contaminated and must be transported to an emergency

department:
;
May pose a problem in rural areas with small hospitals, or where there are low levels of
hazmat skills and experience among EMTs.
Multi-casualty: This situation is usually limited to a single location:

;
Can occur in the workplace, in a public place, or at home.
Involves normal systems of transportation.

Patients are usually treated at the same level facility as a single emergency response, but the
demand on all systems is much greater.
Mass-casualty: Disrupts a large segment of the community:

;
Involves several locations.

Involves additional units to the normal responders (mutual aid); such units may not be part
of the local EMS system, and these units may not know how the system works.
Involves long-range mutual aid; normal systems of transportation (ambulances) are inadequate
or disrupted.
Patients may be treated locally at different facilities that provide various levels of care, or
even outside of the area altogether.
While transportation incidents attract larger media attention, statistics show that almost 75 percent of
all acute hazardous materials events, excluding fuel spills, occur in the fixed locations where the
materials are used or stored. In addition, events resulting in death and injury occur almost 1.5 times
as often in fixed locations as in transit.
Hazardous materials incidents range from small releases at a factory site to rapidly expanding events
that may endanger a community. Regardless of the size or location of an incident, its successful
management depends on preplanning. This preplanning often requires coordination between local,
state, and federal agencies, and industries, as well as those in the community who use and maintain
stocks of potentially hazardous materials. Contributions to hazardous materials planning come from a
variety of sources: regulations from the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO), state and local planning committees established under Title III of the Superfund
Amendments and Reauthorization Act (SARA), state EMS agencies, and federal agencies.
JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS

(JCAHO)
In drawing up contingency plans, hospital administrators have guidance available from the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO). The JCAHO establishes standards that must be met before a hospital can receive accreditation. A comprehensive accreditation
survey takes place once every three years, with intermittent evaluation(s) if a specific area of weakness
is identified at the time of full review.
While the JCAHO has in the past provided very specific guidelines relating to emergency department
resources, handling of hazardous materials, and emergency preparedness, current JCAHO guidance
takes the form of standards to be met. These standards allow hospitals more leeway in how specific
goals are achieved.
SARA TITLE III

Title III of the 1986 Superfund Amendments and Reauthorization Act (SARA) provides for an
infrastructure in states and local communities to plan for effective response to hazardous materials
emergencies. The legislation also provides for public access to information on the presence and
releases of specified hazardous chemicals in communities.
Title III, The Emergency Planning and Community Right-to-Know Act of 1986, requires that
each state establish a State Emergency Response Commission (SERC), consisting of members with
technical expertise in emergency response, environmental and natural resources, public health, occupational safety, media, and transportation. The SERC is responsible for establishing local emergency
planning districts (usually on a county level), appointing and overseeing local emergency planning
committees (LEPCs), establishing procedures for handling public requests for information, and
reviewing LEPC emergency plans.
SARA Title III requires that the local committees include, at a minimum, representatives from the
following groups: state and local officials, law enforcement, civil defense, firefighters, environmental, hospital, media, first aid, health, transportation, and facility owners or operators subject to the
emergency planning requirements. LEPCs were primarily responsible for preparing a comprehensive
emergency response plan for their districts by October 1988, using information about the presence
of potentially hazardous chemicals reported by businesses and other facilities under Title III. LEPCs
were also charged with making information on hazardous chemicals available to the public.
As part of the planning process, each LEPC must evaluate available resources for developing,
implementing, and exercising its plan. The plan must include:
l
Identification of facilities subject to planning provisions under Title III
Identification of transportation routes for extremely hazardous substances
Identification of risk-related facilities
Methods and procedures for response
Designated community and facility coordinators
Procedures for public notification
Methods for determining release occurrence and the area affected
Description of emergency equipment and facilities and those responsible for them
Evacuation plans and training programs
Under Title III s planning provisions, EPA was mandated by Congress to establish a list of chemicals
to help focus local emergency planning activities. In April 1987, EPA listed 406 Extremely Hazardous
Substances (EHSs) and established a Threshold Planning Quantity (TPQ) for each. Any business or
facility that contains one or more of these EHSs in an amount equal to or greater than its respective
TPQ is required to notify the SERC and LEPC. These facilities must also appoint a coordinator to
work with the LEPC for specific inclusion of that facility in the local plan.
Representative facilities covered under the planning provisions include not only major chemical
manufacturing facilities but a wide variety of chemical users, such as farmers, dry cleaners, and
other service-related businesses. Exemptions under this provision apply only to vessels (ship/boat),
federal facilities, and transportation operations. Storage incidental to transportation is exempt
provided that the EHSs are still moving under active shipping papers and have not reached the
final consignee.
Accidental releases of EHSs and other hazardous materials identified in the Comprehensive
Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) must be reported to
the LEPC and SERC. This requirement ensures immediate notification of local response personnel.
Other provisions of Title III provide additional information on the presence, storage, and emissions
of hazardous and toxic chemicals. These data further assist the LEPC in obtaining a comprehensive
picture of chemical risk in the local district.
Hospitals can be better prepared to respond to incidents that involve contaminated patients by actively
participating in the LEPC planning process. Title III provides for the submission of information on
hazardous and toxic chemicals as presented above. In addition, Title III contains a specific provision
requiring facility owners or operators to disclose the chemical identity of substances for which
companies have made trade secret claims. Access to chemical identities assists health professionals,
physicians, and nurses in obtaining further information for diagnostic and treatment recommendations
during emergencies, and for prevention and treatment measures during nonemergencies.
THE STATE EMERGENCY MEDICAL SERVICES (EMS) AGENCY

Planning for hazardous materials incidents should include the appropriate linkage to the state EMS
agency. These state agencies are responsible for overseeing a network of local EMS units, and thus
are an essential part of the planning process. This body is often part of the SERC.
The duties of these agencies vary from state to state. However, EMS agencies usually are responsible
for medical management and medical control of injured civilians and first responders. EMS agencies
must develop medical mutual aid agreements between counties and establish procedures for distribution
of casualties among hospitals. In addition, EMS agencies should maintain an inventory of disaster
medical supplies. EMS agencies should also develop and maintain communications protocols for
onsite activities (e.g., between receiving hospitals and the base hospital, between base hospitals and
ambulances, between all hospitals and the regional Poison Control Center). Further, EMS agencies
must work with local and state officials in designating field casualty decontamination and collection
points for a major disaster, and in arranging for the acquisition of additional equipment, supplies
and pharmaceuticals.
State planning activities include:
l
Medical Direction: The local EMS agency or base hospital should be contacted for information
on how medical control is provided for the EMS system.
Patient Destination: Hospital emergency departments are able to provide supportive care. In
some cases, however, it may be more appropriate to take the patient to a hospital that has expertise
in handling certain kinds of poison exposures. The plan should include directions for obtaining
this information. One option is to go through the regional Poison Control Center or through the
base hospital. The Poison Center will often know which hospitals are best prepared to handle
exposures to which substances.
Decontamination and Medical Management Protocols: The literature on the clinical management
of hazardous materials exposures is sometimes inconsistent in its recommendations. Provisions
should be made in the plan for obtaining field and hospital medical management information
from experienced physicians. For example, the regional Poison Control Center can provide
decontamination and medical management protocols via fax or telephone to all receiving hospitals,
and through the base hospital or via cellular telephone to EMTs in the field. The Poison Center
also has rapid access to experts, including its own medical director, who is a medical toxicologist
with training and experience in hazardous materials. Volume III in this series, Medical Management
Guidelines for Acute Chemical Exposures, provides extensive information on many commonly
encountered chemicals.
Coordination with Burn Centers, Trauma Centers, Hyperbaric Chamber Facilities, and
Other Specialty Centers: Provisions should be made to alert and coordinate patient destination
with various specialty care centers.
FEDERAL EMERGENCY RESPONSE ACTIVITIES

Contingency planning is essential to the successful implementation of any system designed to
manage chemically contaminated patients and to promptly contain the hazard itself. Contingency
plans require a coordinated community response that may also involve state and federal agencies.
Preplanning and coordination of services are equally critical at the national level. The federal government established a National Contingency Plan (NCP) to promote coordination of the resources
and services of federal and state response systems. To oversee this plan, a National Response Team
(NRT) and a National Response Center, a network of Regional Response Teams (RRTs), and a group
of On-Scene Coordinators (OSCs) have been established.
The Hazardous Materials Emergency Planning Guide, referred to as NRT-1, provides guidance to
help local communities prepare for potential hazardous materials incidents. NRT-1 can be used by
local communities developing their own plans, as well as by LEPCs formed in accordance with the
Emergency Planning and Community Right-to-Know Act of 1986 (SARA Title III).
The objectives of the Hazardous Materials Emergency Planning Guide are to:
l
Focus communities on emergency preparedness and response.
Provide communities with information that can be used to organize the emergency planning
task.
Furnish criteria for risk and hazard assessments, and to assist communities in determining
whether a hazardous materials incident plan is needed, in addition to the districtwide plan
developed by the LEPC.
Help LEPCs and individual communities prepare a plan that is appropriate for their needs and
consistent with their capabilities.
Provide a method for revising, testing, and maintaining community emergency plans.
NRT-1 is published by the National Response Team, and was developed cooperatively by its federal
member agencies, including the Department of Defense, Department of the Interior, Department of
Transportation, U.S. Coast Guard, Environmental Protection Agency (EPA), Department of Commerce
(National Oceanic and Atmospheric Administration [NOAA]), Federal Emergency Management
Agency (FEMA), Department of State, Department of Agriculture, Department of Health and
Human Services (Agency for Toxic Substances and Disease Registry [ATSDR]), Department of
Justice, General Services Administration (GSA), Department of the Treasury, Department of Labor
(Occupational Safety and Health Administration [OSHA]), Nuclear Regulatory Commission (NRC),
and the Department of Energy (DOE). NRT-1 represents a concerted effort by federal agencies to
consolidate their general hazardous materials planning guidance into an integrated federal document.
NRT-1 states that an emergency plan must include response procedures for facilities and local
emergency and medical personnel, as well as a description of emergency equipment and facilities in
the community. It also recommends that hospital, emergency medical service, and health department
personnel be included as members of an emergency planning team. As previously mentioned, SARA
Title III requires medical, hospital, and first aid personnel to be members of the local emergency
planning committee. NRT-1 describes relevant publications that provide specific operational guidance
to emergency responders, such as the DOT s North American Emergency Response Guidebook
(NAERG), which provides guidance for firefighters, police, and other emergency services personnel
to help them protect themselves and the public during the initial minutes immediately following a
hazardous materials incident.
In addition, the document provides information on the Chemical Manufacturers Association s (CMA)
Community Awareness Emergency Response (CAER) and Chemical Transportation Emergency
Center (CHEMTREC) programs. The CAER program encourages local chemical manufacturing
facilities to inform area residents, public officials, and emergency response organizations about
industry operations and to integrate their onsite emergency response plans with the planning efforts
of the local community. In some areas of the country, the chemical industry has established physician
networks to encourage better dialogue between company physicians and local health authorities.
CAER has outlined specific steps for industrial plants:
l
Review the plant s emergency plan
Improve employee awareness and training
Prepare a community relations plan
Inventory the status of local emergency planning
Develop a briefing paper
Prepare a list of initial contacts
Meet with initial contacts and identify key officials
Establish a coordinating group
Begin implementation steps
On the federal level, EPA and FEMA provide technical assistance and guidance to local and state
planners through the SARA Title III program.
The NRT-1 document also recommends that contingency plans include standard operating procedures
for entering and leaving sites, accountability for personnel entering and leaving sites, decontamination
procedures, recommended safety and health equipment, and personal safety precautions. The document
suggests that emergency plans include a list of emergency response equipment appropriate to the
various degrees of hazard based on EPA s four levels of protection (Levels A through D; see Section
II). Further, it recommends that the list include the type of respirator (i.e., self-contained breathing
apparatus, supplied-air respirator, or air-purifying respirator) that should be used, the type of
clothing that must be worn, and the equipment needed to protect the head, eyes, face, ears, hands,
arms, and feet.
In addition, NRT-1 recommends that medical personnel be made aware of significant chemical hazards
in the community to prepare for possible hazardous materials incidents. It also states that emergency
medical teams and hospital personnel must be trained in the proper methods for decontaminating
and treating individuals exposed to hazardous chemicals.
HAZARD ANALYSIS
Hazard analysis is a necessary component of comprehensive emergency planning for a community.
It is a three-step decisionmaking process comprised of hazard identification, vulnerability analysis,
and risk analysis. This section focuses primarily on hazard identification.
The first task in conducting such an analysis is to complete an inventory of the hazardous materials
present in the community and to determine the nature of the hazard. This is a key step because it
permits planners to describe and evaluate risks and to allocate resources accordingly. However, the
task of analyzing all relevant hazards may not prove cost effective for many communities. The planning committee should, therefore, assign priorities to the hazards found in its community and establish affordable limits for analysis. It should be noted that several federal agencies (e.g., DOT,
FEMA, EPA) report that frequently encountered substances often pose the most prevalent dangers.
These materials include fuels and chemicals, such as chlorine, ammonia, and hydrochloric and sulfuric acids. Such materials should be given special attention by the LEPC in the planning process.
In this context, a hazard is any situation that is capable of causing injury or impairing an individual s
health. During the process of identifying hazards, facilities or transportation routes will be pinpointed
that contain materials that are potentially dangerous to humans. The identification of hazards also
should provide information on: (1) the types, quantities, and locations of hazardous materials in the
community, or transported through a community; and (2) the nature of the hazard that would accompany incidents, such as explosions, spills, fires, and venting to the atmosphere.
Hazards should be identified at as many facilities in the community as possible. These include the
obvious ones such as chemical plants, refineries, petroleum plants, storage facilities, and warehouses.
In requesting information directly from facilities, remember that the planning provisions under
SARA Title III require certain facilities to provide the LEPC with any information on the facility
that the committee needs to develop and implement its plan. The LEPCs may provide assistance
here, particularly if the committee includes industry representatives. It is essential that these industries
or businesses understand the role this information plays in ensuring a sound emergency response
plan. As previously stated, placing business or industrial representatives on the communitywide
planning committee, as required under SARA Title III, should facilitate their cooperation. The assistance and cooperation of a facility that regularly deals with hazardous materials also presents the
local planning unit with a wide array of services. For example, such a facility can provide technical
experts, Spill Prevention Control and Countermeasure (SPCC) plans, training and safe handling
instructions, and cleanup capabilities.
In identifying hazards, hospitals and educational and governmental facilities should not be overlooked since they all contain a variety of chemicals. Major transportation routes and transfer
points, such as airports, vessels in port, railroad yards, and trucking terminals, should also be
included in the overall hazards identification plan. SARA Title III planning provisions address
many of these potential transportation risk areas by requiring facility cooperation in plan preparation and by including specific risk areas as well as a wide range of chemical handlers, from manufacturers to service-related businesses.
Risk analysis includes the probable damage that may occur if a chemical incident occurs.
Information that is necessary for risk analysis includes:
The type of risk to humans, such as an acute, chronic, or delayed reaction
The groups that are most at risk
The type of risk to the environment, such as permanent damage or a recoverable condition
Many documents can be of assistance in conducting a risk analysis. Risk analysis in transportation
settings is outlined in the DOT s Community Teamwork: Working Together To Promote Hazardous
Materials Safety, A Guide for Local Officials. In conjunction with FEMA and DOT, EPA published a
supplement to NRT-1 in December 1987. This document, entitled Technical Guidance for Hazardous
Analysis and often referred to as the Green Book, provides technical assistance to LEPCs in
assessing the lethal hazards associated with potential airborne releases of extremely hazardous
substances.
Auf der Heide, E. 1989. Disaster Response: Principles of Preparation and Coordination. St. Louis,
MO: Mosby.
Fire Protection Publications. 1983. Incident Command System. Stillwater, OK: Oklahoma State
University Press.
Training. Emmitsburg, MD: HEMP Curriculum Guidelines.
Hazardous Materials Incidents, NFPA 472. Quincy, MA: National Fire Protection Association.
Association.
National Response Team. 1987. Hazardous Materials Emergency Planning Guide. Washington, DC:
Government Printing Office.
2nd. ed. Stillwater, OK: Fire Protection Publications.
SARA Title III Compliance Guidebook. 1988. Government Institutes, Inc. ISBN: 0-86587-749-1.
U.S. Department of Transportation. 1983. Community Teamwork: Working Together To Promote
Hazardous Materials Safety, A Guide for Local Officials. Washington, DC: Government Printing
Office.
U.S. Department of Transportation. 1996. North American Emergency Response Guidebook.
Washington, DC: Government Printing Office. [available in English, Spanish and French][http://hazmat.dot.gov/gydebook.htm]
U.S. Environmental Protection Agency. 1992. EPA Standard Safety Operating Guidelines.
Washington, DC: Government Printing Office.
U.S. Environmental Protection Agency and U.S. Federal Emergency Management Agency. 1987.
Technical Guidance for Hazardous Analysis: Emergency Planning for Extremely Hazardous
Substances. Washington, DC: Environmental Protection Agency.
U.S. Federal Emergency Management Agency. 1981. Planning Guide and Checklist for Hazardous
Materials, FEMA-10. Washington, DC: Government Printing Office.
U.S. Federal Emergency Management Agency. 1985. Guide for Development of State and Local
Emergency Operations Plan. Washington, DC: Government Printing Office.
U.S. Federal Emergency Management Agency. 1996. Guide for all Hazard Emergency Operations
Planning. Washington, DC: Government Printing Office.
U.S. National Institute for Occupational Safety and Health and U.S. Occupational Safety and
Health Administration. 1997. Pocket Guide to Chemical Hazards. Washington, DC: Government
Printing Office.
10
10
Section II.
Emergency Department Response

to Hazardous Materials Incidents
HAZARD RECOGNITION
When dispatched to the scene of an incident, emergency response personnel may not be aware that
the situation involves hazardous materials. As a result, emergency department personnel should
always be alert to the possibility that they may be dealing with a chemically contaminated individual,
and they should ask incident victims and prehospital personnel about the nature of the event.
Emergency departments should also be prepared for exposed patients who arrive unannounced in
privately-owned vehicles. Patients may also originate from situations occurring within the hospital.
An injury at a hazardous materials incident need not invariably involve chemical exposure: it could
have resulted from a physical accident, such as slipping off a ladder. But as a routine precaution, the
involvement of hazardous materials should be considered a possibility in such situations. The manual
Recognizing and Identifying Hazardous Materials (produced by the National Fire Academy and the
National Emergency Training Center) states that there are six primary clues that may signify the
presence of hazardous materials. These clues are included below to facilitate and expedite the
prompt and correct identification of any hazardous materials at the scene of an incident. Hospital
emergency department personnel who are familiar with these clues will find their communication
with field personnel enhanced. For example, patient symptoms reported from the field such as
nausea, dizziness, itching and burning eyes or skin, or cyanosis could suggest to hospital staff the
presence of hazardous materials. They could then request field personnel to examine the site for
these six clues:
l
Occupancy and Location. Community preplanning should identify the specific sites that contain
hazardous materials. In addition, emergency personnel should be alert to the obvious locations in
their communities that use and/or store hazardous materials (e.g., laboratories, factories, farm and
paint supply outlets, construction sites). The Department of Labor s Material Safety Data Sheets
(MSDSs) should also be available, especially for any particularly dangerous chemicals kept on
site. It should be kept in mind, however, that these data sheets may have incomplete information
and that the medical information provided is generally at a basic first aid level.
Container Shape. Department of Transportation (DOT) regulations delineate container specifications for the transport of hazardous materials. There are three categories of packaging: stationary
bulk storage containers at fixed facilities that come in a variety of sizes and shapes; bulk transport vehicles, such as rail and truck tank cars, that vary in shape depending upon the cargo; and
labeled fiberboard boxes, drums, or cylinders for smaller quantities of hazardous materials. The
shape and configuration of the container can often be a useful clue to the presence of hazardous
materials.
11
Markings/Colors. Certain transportation vehicles must use DOT markings, including identification
(ID) numbers. Identification numbers, located on both ends and both sides, are required on all cargo
tanks, portable tanks, rail tank cars, and other packages that carry hazardous materials. Railcars
may have the names of certain substances stenciled on the side of the car. A marking scheme
designed by the National Fire Protection Association (NFPA 704M System) identifies hazard
characteristics of materials at terminals and industrial sites, but does not provide product-specific
information. This system uses a diamond divided into four quadrants. Each quadrant represents
a different characteristic: the left, blue section refers to health; the top, red quarter pertains to flammability; the right, yellow area is for reactivity; and the bottom, white quadrant highlights special
information (e.g., W indicates dangerous when wet, Oxy stands for oxidizer). A number from
zero through four in each quadrant indicates the relative risk of the hazard, with zero representing
the minimum risk. This system does not indicate what the product is, the quantity, or its exact
location. In addition, it does not reveal the compound s reactivity with other chemicals. The military also uses distinctly shaped markings and signs to designate certain hazards. These markings
may be found on vehicles, on the products themselves, or on shipping papers.
Placards/Labels. These convey information through use of colors, symbols, Hazard Communication
Standards, American National Standard Institute (ANSI) Standards for Precautionary Labeling of
Hazardous Industrial Chemicals, United Nations Hazard Class Numbers, and either hazard class
wording or four-digit identification numbers. Placards are used when hazardous materials are
being stored in bulk (usually over 1,001 lb), such as in cargo tanks. Labels designate hazardous
materials kept in smaller packages. Caution must be exercised, however, because the container or
vehicle holding a hazardous material may be improperly labeled or recorded, or it may not have
any exterior warning.
Shipping Papers. Shipping papers can clarify what is labeled as dangerous on placards.
They should provide the shipping name, hazard class, ID number, and quantity, and may indicate
whether the material is waste or poison. Shipping papers, which must accompany all hazardous
material shipments, are now required to list a 24-hour emergency information telephone number.
The location where the shipping papers are stored can be problematical; often they are found in
close proximity to the hazardous material(s) or in other locations not easily accessible during an
emergency. Shipping papers should remain at the incident scene for use by all response personnel.
Senses. Odor, vapor clouds, dead animals or fish, fire, and skin or eye irritation can signal the
presence of hazardous materials. Generally, if one detects an odor of hazardous materials, it
should be assumed that exposure has occurred and the individual is still in the danger area,
although some chemicals have a detectable odor at levels below their toxic concentrations. Some
chemicals, however, can impair an individual s sense of smell (e.g., hydrogen sulfide), and others
have no odor, color or taste at all (e.g., carbon monoxide). Binoculars are helpful to ascertain
visible information from a safe distance.
12
Appendix A provides greater detail on the NFPA s 704M system; the DOT s hazardous materials
marking, labeling, and placarding guide; and the Department of Labor s MSDS. It is important that
any and all available clues are used in substance identification, especially obvious sources such as
the information provided on a label or in shipping papers.
The aim of the health provider should be to make a chemical-specific identification while exercising
caution to prevent exposure to any chemicals. Identifying the hazardous material and obtaining
information on its physical characteristics and toxicity are vital steps to the effective management of
a hazardous materials incident. Since each compound has its own unique set of physical and toxicological properties, early and accurate identification of the hazardous material(s) involved allows
emergency personnel to initiate appropriate management steps.
Many resources are available to provide information concerning response to and planning for
hazardous materials incidents. All such information, however, needs to be interpreted with respect
to the specific release scenario. A selected bibliography of written material is included at the end
of each section of this guidebook; it is not, however, a complete list of the materials available.
Printed reference materials provide several advantages: they are readily available, they can be
kept in the response vehicle, they are not dependent on a power source or subject to malfunction,
and they are relatively inexpensive. Disadvantages include the difficulty of determining the correct identity for an unknown chemical through descriptive text, the logistics of keeping the materials current, and the problem that no single volume is capable of providing all the information
that may be needed.
There is also a vast array of telephone and computer-based information sources concerning hazardous
materials. They can help by describing the toxic effects of a chemical, its relative potency, and the
potential for secondary contamination. They may also recommend decontamination procedures,
clinical management strategies, and advice on the adequacy of specific types of protective gear.
Exhibit II-1A is a partial listing of the many information resources available by telephone. Exhibit
II-1B is a list of suggested telephone numbers that should be filled in for your community, including
the regional Poison Control Center, which is a ready source of information 24 hours a day. Exhibit
II-2 provides a partial listing of computerized and online information sources. Note, however, that
not all online databases are peer reviewed; for example, some medical management information may
be based only on DOT or MSDS data. Care and planning should be used when selecting information
sources. Planning is an essential part of every response, and many of these resources can provide
guidance in the formation of an effective response plan.
13
Exhibit II-1A
Telephone Information and Technical Support References
Resource
Contact
Services Provided
Chemical Transportation Emergency Center

(CHEMTREC)
1-800-424-9300
24-hour emergency number connecting with

manufacturers and/or shippers. Advice
provided on handling, rescue gear,
decontamination considerations, etc.
Also provides access to the Chlorine
Emergency Response Plan (CHLOREP).

(ATSDR)
1-404-639-6360
Bureau of Explosives
1-719-585-1881
Emergency Planning and Community

1-800-424-9346
Right-to-Know Act (EPCRA) and
Resource Conservation and Recovery Act (RCRA)
Information Hotline
Environmental Protection Agency (EPA)
Regional Offices
Region I (CT, ME, MA, NH, RI, VT)
Region II (NJ, NY, PR, VI)
Region III (DE, DC, MD, PA, VA, WV)
Region IV (AL, FL, GA, KY, MS, NC, SC, TN)
Region V (IL, IN, MI, MN, OH, WI)

Region VI (AR, LA, NM, OK, TX)
Region VII (IA, KS, MO, NE)
Region VIII (CO, MT, ND, SD, UT, WY)
Region IX (AZ, CA, HI, NV;
Pacific Islands AS, FM, GU, MH, MP, PW)
Region X (AK, ID, OR, WA)
24-hour emergency number for healthrelated support in hazardous materials

emergencies, including onsite assistance.
Contact number for technical questions about
railway transport of hazardous materials.
For emergencies, call CHEMTREC
(1-800-424-9300).
Available 9:00 a.m. to 6:00 p.m. (EST).
Provides information on SARA Title III,
list of extremely hazardous substances,
and planning guidelines.
website:
Environmental response teams
www.epa.gov/regional available for technical assistance.
1-617-918-1111
1-212-637-3000
1-215-814-2900;
intra-regional only:
1-800-438-2474
1-404-562-9900;
Emergency Response &
Removal Branch:
1-800-564-7577
1-312-353-2000
1-214-665-2200
1-913-551-7003
1-303-312-6312
1-415-744-1500;
emergencies:
1-415-744-2000
1-206-553-1200
14
Exhibit II-1A (continued)
Resource
Contact
Services Provided
1-800-548-2423
1-888-426-4435
24-hour consultation services concerning

animal poisonings or chemical contami
nation. Provides an emergency response
team to investigate incidents and to
perform laboratory analysis.
National Pesticides Information

Retrieval System (NPIRS)
1-765-494-6616
website:
ceris.purdue.edu/npirs
Contact information for help in searching

NPIRS database to get fact sheets on
pesticides, insecticides, fungicides, and
state and federally registered chemicals.
National Pesticide Telecommunications

(NPTN)
(Oregon State University)
1-800-858-7378
Provides information about pesticide-Network

related topics, including pesticide
products, recognition and management
of pesticide poisoning, toxicology,
environmental chemistry, referrals for
laboratory analyses, investigation of
pesticide incidents, emergency
treatment, safety, health and environmental
effects, cleanup, and disposal procedures.
website:
ace.orst.edu/info/nptn
1-800-424-8802
A federal hotline for reporting oil and

chemical spills where hazardous materials
are responsible for death, serious injury,
property damage in excess of $50,000, or
continuing danger to life and property.
U.S. Army Soldier and Biological

Chemical Command (SBCCOM)
1-800-368-6498
24-hour consultation service for threats

and releases pertaining to chemical and
biological agents.
15
Exhibit II-1B
Local Telephone Information and Technical Support Resource Worksheet
Resource
Contact
Services Provided
EPA Regional or State Office

State Emergency Response Commission
State Health Department
State Emergency Management Office
Local Fire Department
Local Hazardous Materials
Response Team
Community Police Department
Local Emergency Planning Committee
Local Health Department
State Department of Natural Resources
FEMA Regional Office
State Agriculture Office
State Lab Office
State EMS Office
Hyperbaric Medicine Chamber
Burn Center
CDC
U.S. Army Soldier and Biological Chemical Command
16
Exhibit II-2
Computerized Data Sources for Information and Technical Support
Data System
Contact
Description
CAMEO
CAMEO Database Manager

7600 Sand Point Way, N.E.
Seattle, Washington 98115
(206) 526-6317
website: www.epa.gov/ceppo/cameo
Computer-aided management of National

Oceanic and Atmospheric Administration
(NOAA) operations available to on-scene
responder(s). Chemical identification
database assists in Hazardous Materials
Response Division determining substance(s)
involved, predicting downwind
concentrations, providing response
recommendations, and identifying potential
hazards.
CHRIS
CIS, Inc.
c/o Oxford Molecular Group
11350 McCormick Road
Executive Plaza, Suite 1100
(800) 247-8737
details/CHRIS.shtml
Chemical Hazard Response Information

System, developed by the Coast Guard and
comprised of reviews on fire hazards,
fire-fighting recommendations, reactivities,
physicochemical properties, health hazards,
use of protective clothing, and shipping
information for over 1,000 chemicals.
HAZARDTEXT
Micromedex, Inc.
Suite 300
Englewood, Colorado 80111-4740
(800) 525-9083
pd-main.htm
Assists responders dealing with incidents

involving hazardous materials, such as spills,
leaks, and fires. Provides information on
emergency medical treatment and
recommendations for initial hazardous
response.
HMIS
Kevin Coburn
Information Systems Manager
U.S. Department of Transportation
D.H.M. 63 - Room 8104
400 7th Street SW
Washington, D.C. 20590-0001
website: www.dlis.dla.mil/hmis.htm
Hazardous Material Information Systems

contains information on hazardous materials.
Transportation-related incidents may be
reported on DOT form 5800.1 (Hazardous
Materials Incident Report Form).
HSDB
HSDB Representative
Specialized Information Systems
8600 Rockville Pike
(301) 496-6531
Hazardous Substances Data Bank, compiled

by the National Library of Medicine,
provides reviews on the toxicity, hazards, and
and regulatory status of over 4,000 frequently
used chemicals.
17
Exhibit II-2 (continued)
Data System
Contact
Description
1st MEDICAL RESPONSE Micromedex, Inc.

PROTOCOLS
Suite 300
(800) 525-9083
pd-main.htm
Helps develop training programs and establish

protocols for first aid or initial workplace
response to a medical emergency.
MEDITEXT
Micromedex, Inc.
Suite 300
(800) 525-9083
pd-main.htm
Provides recommendations regarding the

evaluation and treatment of exposure to
industrial chemicals.
OHMTADS
Oxford Molecular Group, Inc.

11350 McCormick Rd.
Executive Plaza 3, Suite 1100
(800) 247-8737
details/OHMTADS.shtml
Oil and Hazardous Materials/Technical

Assistance Data Systems provides information
on the effects of spilled chemical compounds
and their hazardous characteristics and
properties, assists in identifying unknown
substances, and recommends procedures for
handling cleanups.
TOMES
Micromedex, Inc.
Suite 300
(800) 525-9083
pd-main.htm
The Tomes Plus Information Systems is a series

of comprehensive databases on a single
CD-ROM disc. It provides information
regarding hazardous properties of chemicals
and medical effects from exposure. The Tomes
Plus database contains Meditext, Hazardtext,
HSBD, CHRIS, OHMTADS, and 1st Medical
Response Protocols.
TOXNET
Toxicology Data Network (TOXNET)

Specialized Information Services
8600 Rockville Pike
(301) 496-6531
A computerized system of three toxicologically

oriented data banks operated by the National
Library of Medicine the Hazardous
Substances Data Bank, the Registry of Toxic
Effects of Chemical Substances, and the
Chemical Carcinogenesis Research Information
System. TOXNET provides information on the
health effects of exposure to industrial and
environmental substances.
18
PRINCIPLES OF TOXICOLOGY FOR EMERGENCY DEPARTMENT PERSONNEL

Exposure to hazardous chemicals may produce a wide range of adverse health effects. The likelihood
of an adverse health effect occurring, and the severity of the effect, are dependent on: (1) the toxicity of
the chemical; (2) the route of exposure; (3) the nature and extent of exposure; and (4) factors that
affect the susceptibility of the exposed person, such as age and the presence of certain chronic diseases.
To better understand potential health effects, emergency department personnel should understand the
basic principles and terminology of toxicology.
Toxicology is the study of the nature, effects, and detection of poisons in living organisms. Examples of
these adverse effects, sometimes called toxic end points, include carcinogenicity (development of cancer), hepatotoxicity (liver damage), neurotoxicity (nervous system damage), and nephrotoxicity (kidney damage). This is merely a sample list of toxic end points that might be encountered (Exhibit II-3).
Toxic chemicals often produce injuries at the site which they come into contact with the body. A
chemical injury at the site of contact, typically the skin and the mucous membranes of the eyes,
nose, mouth, or respiratory tract, is termed a local toxic effect. Irritant gases such as chlorine and
ammonia can, for example, produce a localized toxic effect in the respiratory tract, while corrosive
acids and bases can result in local damage to the skin. In addition, a toxic chemical may be absorbed
into the bloodstream and distributed to other parts of the body, producing systemic effects. Many
Exhibit II-3
Examples of Adverse Health Effects from Exposure to Toxic Chemicals
Toxic End Point
Target Organ
Systems
Example of
Causative
Agent
Health Effect
Acute
Health Effect
Chronic
Carcinogenicity
Multiple sites
Benzene
Dermatitis
Acute myelogenous
Chest tightness
leukemia
Dizziness
Headache
Hepatotoxicity
Liver
Carbon tetrachloride
Vomiting
Liver necrosis
Abdominal pain
Fatty liver
Dizziness
Rash
Neurotoxicity
Nervous system
Lead
Nausea
Wrist drop
Vomiting
IQ deficits
Abdominal pain
Encephalopathy
Nephrotoxicity
Kidney
Cadmium
Vomiting
Kidney damage
Diarrhea
Anemia
Chest pain
19
pesticides, for example, are absorbed through the skin, distributed to other sites in the body, and
produce adverse effects such as seizures or cardiac, pulmonary, or other problems. It is important for
medical providers to recognize that exposure to chemical compounds can result not only in the
development of a single systemic effect but also in the development of multiple systemic effects or a
combination of systemic and local effects. Some of these effects may be delayed, sometimes for as
long as 48 or more hours. Health effects can also be acute or chronic. Acute health effects are short-term
effects that manifest within hours or days, such as vomiting or diarrhea. Chronic health effects are
long-term effects that may take years to manifest, such as cancer.
Routes and Extent of Exposure

There are three main routes of chemical exposure: inhalation, dermal contact (with skin or mucous
membranes), and ingestion. Inhalation results in the introduction of toxic compounds into the respiratory system, and potentially into the bloodstream. Most of the compounds that are commonly
inhaled are gases or vapors of volatile liquids. However, solids and liquids can be inhaled as dusts or
aerosols. Inhalation of toxic agents generally results in a rapid and effective absorption of the compound
into the bloodstream because of the large surface area of the lung tissue and number of blood vessels
in the lungs. Knowing a chemical s vapor pressure (VP) can be useful in determining the inhalation
risk for a particular exposure. The lower the VP, the less likely the chemical will produce an inhalable
gas and vice versa. Water solubility is also an important contributor for symptom development.
Irritant agents that are water soluble usually cause early upper respiratory tract irritation, resulting in
coughing and throat irritation. Partially water-soluble chemicals penetrate into the lower respiratory
system causing delayed symptoms (12 to 24 h) which include trouble breathing, pulmonary edema,
and coughing up blood. Asphyxiants are chemicals that impede the body s ability to obtain or utilize
oxygen. Simple asphyxiants are inert gases (e.g., argon, propane, nitrogen) that displace oxygen in
inspired air. Chemical asphyxiants produce harm by preventing oxygen delivery or utilization for
energy production by the body s cells. Carbon monoxide and cyanide are examples of asphyxiants.
Dermal contact does not typically result in as rapid absorption as inhalation, although some chemicals
are readily taken in through the skin. Many organic compounds are lipid (fat) soluble and can therefore
be rapidly absorbed through dermal exposure. Some materials that come in contact with the eyes can
also be absorbed.
Ingestion is a less common route of exposure for emergency response personnel at hazardous materials
incidents. However, incidental hand-to-mouth contact, smoking, and swallowing of saliva and
mucus that contains contaminants may also result in exposure by this route. In addition, emergency
medical personnel in both hospital or prehospital settings treat chemical exposures in patients who
have ingested toxic substances as a result of accidental poisonings or suicide attempts.
Compounds may also be introduced into the body through injection, although this is an unlikely
route of exposure in spills or discharges of hazardous materials. Explosions may result in injection
injuries and lead to imbedded foreign bodies, which may themselves be chemically contaminated.
The route by which personnel are exposed to a compound plays a role in determining the total amount
of the substance taken up by the body because a compound may be absorbed by one route more readily
than by another. In addition, the route of exposure may affect the nature of the symptoms that develop.
The amount of the compound absorbed by the body also depends on the duration of exposure and the
concentration of the compound to which one is exposed.
20
It is important to recognize that children may be more susceptible to many toxic exposures, in part
because they are likely to receive a higher dose relative to body weight than an adult. This occurs
for a number of reasons. First, children are shorter than adults and since most toxic gases are heavier
than air, the concentrations increase as you get closer to the ground. Children s immature central
nervous system, liver, and renal system also increase their susceptibility to injury as a result of
exposure to chemicals. In addition, children have a larger lung surface area relative to their weight
than adults, as well as a greater respiratory volume (liters/min/kg of body weight). It is probable that
the child s lung is a more effective absorbent surface than that of the adult. Children also have a
larger skin area relative to their weight than do adults, allowing more effective surface area for
absorption in dermal exposures. A child s skin is also more easily penetrated by chemicals, allowing
for more rapid and effective dermal absorption. Finally, children are more likely to ingest toxic
chemicals because of increased hand-to-mouth behavior, including pica. All of these factors may
lead to an increased dose relative to size in children as compared to adults, even when they all are
exposed to the same scenario.
A complex relationship exists between the total amount of the compound absorbed by the body
(dose) and the concentration of that compound in the environment. This relationship is important for
emergency medical personnel to understand because the adverse effects produced by a toxic compound
are usually related to the dose of that compound received by a patient. However, because we usually
only monitor the concentration of the toxic substance in the environment (e.g., parts per million
(ppm) of a compound in air), the actual dose of the compound received by the patient is seldom
known. Factors specific to the exposed patient, such as area of skin surface exposed, presence of
open wounds or breaks in the skin, and the rate and depth of respirations, are important in estimating
the dose of the compound received by the patient.
Dose-Response Relationship
The effect produced by a toxic compound is primarily a function of the dose of the compound. This
principle, termed the dose-response relationship, is a key concept in toxicology. Many factors affect
the normal dose-response relationship and they should be considered when attempting to extrapolate
toxicity data to a specific situation (Exhibit II-4).
Typically, as the dose increases, the severity of the toxic response increases. Humans exposed to 100
ppm of tetrachloroethylene, a solvent that is commonly used for dry-cleaning fabrics, may experience relatively mild symptoms, such as headache and drowsiness. However, exposure to 200 ppm
tetrachloroethylene can result in a loss of motor coordination in some individuals, and exposure to
1,500 ppm for 30 minutes may result in a loss of consciousness (Exhibit II-5). As shown in Exhibit
II-5, the severity of the toxic effect also depends on the duration of exposure, a factor that influences
the dose of the compound in the body.
21
Exhibit II-4
Classification of Factors Influencing Toxicity
Type
Examples
Factors related to the chemical
Composition (salt, freebase, etc.); physical characteristics

(size, liquid, solid, etc.); physical properties (volatility, solubility, etc.);
presence of impurities; breakdown products; carriers
Factors related to exposure
Dose; concentration; route of exposure (inhalation, ingestion, dermal);

duration
Factors related to the exposed person
Heredity; immunology; nutrition; hormones; age; sex; health status;

preexisting diseases; pregnancy
Factors related to environment
Media (air, water, soil, etc.); additional chemicals present;

temperature; humidity; air pressure; and fire
Exhibit II-5
Dose-Response Relationship for Humans Inhaling Tetrachloroethylene Vapors
Levels in Air
Duration of Exposure
50 ppm
Effects on Nervous System

Odor threshold
100 ppm
7 hours
Headache, drowsiness
200 ppm
2 hours
Dizziness, uncoordination
600 ppm
10 minutes
Dizziness, loss of inhibitions
1,000 ppm
1-2 minutes
Marked dizziness, intolerable eye and

respiratory tract irritation
1,500 ppm
30 minutes
Coma
22
Toxicity information is often expressed as the dose of a compound that causes an effect in a percentage
of the exposed subjects, which are usually experimental animals. These dose-response terms are
often found in the Material Safety Data Sheets (MSDSs) and other sources of health information.
One dose-response term that is commonly used is the lethal dose 50 (LD50). This is the dose that is
lethal to 50 percent of an animal population from exposure by a specific route (except inhalation)
when given all in one dose. A similar term is the lethal concentration 50 (LC50), which is the concentration of a material in air that on the basis of respiratory exposure in laboratory tests is expected
to kill 50 percent of a group of test animals when administered as a single exposure (usually 1 hour).
Exhibit II-6 lists a number of chemicals that may be encountered in dealing with hazardous materials
incidents, and the reported acute LD50 values of these compounds when they are administered by
ingestion to rats.
From Exhibit II-6 it can be seen that a dose of 3,000 to 3,800 mg/kg tetrachloroethylene is lethal to
50 percent of rats that received the compound orally; however, only 6.4 to 10 mg/kg of sodium
cyanide is required to produce the same effect. Therefore, compounds with low LD50 values are
more acutely toxic than substances with higher LD50 values.
The LD50 values that appear in an MSDS or in the literature must be used with caution by emergency
medical personnel. These values are an index of only one type of response and give no indication of
the ability of the compound to cause nonlethal, adverse or chronic effects. They also do not reflect
possible additive effects from the mixture of chemicals sometimes found with exposure to hazardous
materials. Furthermore, LD50 values typically come from experimental animal studies. Because of
the anatomical and physiological differences between animals and humans, it is difficult to compare
the effects seen in experimental animal studies to the effects expected in humans exposed to hazardous
materials in the field. LC50 and LD50 values are also usually determined in healthy adult animals.
Values determined in young animals may be quite different, as may values determined in animals
with an underlying disease. It is known that many chemicals are more toxic (lower LD50 or LC50
values) in young or newborn animals than in adults. This same age dependence may exist in
humans. Because several organs, particularly the brain, are still developing in young children, damage
to these organs may be more extensive and can be permanent. Also, infants may not be able to
excrete chemicals from the body as efficiently as adults because their kidneys and liver are not fully
developed. This may lead to longer and greater exposure to the chemical than would occur in an
adult with the same relative exposure. The immaturity of metabolizing enzymes in the liver may
lead to either increased or decreased toxicity in infants relative to adults. Which may occur is difficult to predict for many chemicals. Therefore, emergency medical personnel should remember that
the LD50 and LC50 values are only useful for comparing the relative approximate toxicity of compounds.
23
Exhibit II-6
Acute LD50 Values for Representative Chemicals When
Administered Orally to Rats
Chemical
Acute Oral LD50

(mg/kg)1
Sodium cyanide
6.4-10
Pentachlorophenol
50-230
Chlordane
83-560
Lindane
88-91
Toluene
2,600-7,000
Tetrachloroethylene
3,000-3,800
Milligrams of the compound administered per kilogram body weight of the experimental animal.
Responses to toxic chemicals may differ among individuals because of the physiological variability
that is present in the human population. Some individuals, for example, are more likely to experience
adverse health effects after exposure to a toxic chemical because of a reduced ability to metabolize
that compound. The presence of preexisting medical conditions (e.g., pulmonary, hepatic, or renal
disease, diabetes) can also increase one s susceptibility to toxic chemicals. Respiratory distress in
people with asthma may be triggered by exposure to toxic chemicals at lower concentrations than
might be expected to produce the same effect in individuals without respiratory disease. Factors
such as age, personal habits (e.g., smoking, diet), previous exposure to toxic chemicals, and medications may also increase an individual s sensitivity to toxic chemicals. Therefore, exposure to concentrations of toxic compounds that would not be expected to result in the development of a toxic
response in most people may cause an effect in susceptible individuals. Not all chemicals, however,
have a threshold level. Some carcinogens (cancer-causing chemicals) may produce a response
(tumors) at any dose level, and any exposure to these compounds may be associated with some risk of
developing cancer. Thus, literature values for levels that are not likely to produce an effect do not
guarantee that an effect will not occur.
Exposure Limits
The various occupational exposure limits found in the literature or on an MSDS are based primarily
on time-weighted average limits, ceiling values, or ceiling concentration limits to which the worker
can be exposed without adverse effects. Examples of these limits are listed in Exhibit II-7A.
24
The values listed in Exhibit II-7A were established to provide worker protection in occupational
settings. Because the settings in which these values are appropriate are quite different than an
uncontrolled spill site, it is difficult to interpret how these values should be used by emergency medical personnel when dealing with a hazardous materials incident. These values are designed for a
healthy adult working population and have limited utility when applied to some of the at risk
groups mentioned previously. At best, TLV, PEL, IDLH, and REL values can be used as benchmarks
for determining relative toxicity, and perhaps to assist in selecting appropriate levels of personal protective equipment (PPE). Furthermore, these occupational exposure limits are only useful if trained
personnel and appropriate instrumentation are available for measuring the levels of toxic chemicals
in the air at the spill site. Of the occupational exposure limit values shown in Exhibit II-7A, only
the OSHA values are regulatory limits. The ACGIH values are for guidance only and are not regulatory limits. In addition, the ACGIH limits have certain caveats that may or may not affect the usefulness of the values. Some of these conditions are individual susceptibility or aggravation of a preexisting condition. Because of the limitations of PELs and TLVs, special exposure limits have been
established. Emergency Response Planning Guidelines (ERPGs), Short-term Public Emergency
Guidance Levels (SPEGLs), and Acute Exposure Guidelines (AEGLs, under development by the
EPA) have been designed to assist emergency personnel in making decisions regarding nonworkplace exposures (Exhibit II-7B). Emergency medical personnel responsible for the management of
chemically contaminated patients should be familiar with all of these exposure limits because they will
be encountered in various documents dealing with patient care or the selection of PPE.
This brief discussion highlights some fundamental concepts of toxicology. Emergency medical
personnel responsible for managing chemically contaminated patients are encouraged to obtain
further training in their recognition and treatment. A list of general toxicology references is provided
at the end of this section that will allow emergency medical personnel to undertake a more in-depth
examination of the principles of toxicology.
PERSONNEL PROTECTION AND SAFETY PRINCIPLES

This section provides information on personal protective equipment (PPE) and safety principles to
emergency medical personnel who, because of their proximity to a chemical industrial area or transport
corridor, may be required to treat chemically contaminated patients. In the majority of cases, hospital
staff will not experience incidents involving chemically contaminated patients frequently enough to
keep them optimally trained or their equipment properly maintained. Staff must be initially trained in
the proficient use of PPE, specifically respiratory equipment, and must maintain that proficiency.
According to state and federal regulations, equipment must be maintained according to OSHA
specifications, and respirators and their cartridges have to be properly fitted, tested, and stored.
Many hospitals, given their workload mix and fiscal constraints, may not be able to expend the
funds and time necessary to accomplish this task. In these cases, these hospitals should make
arrangements with the local fire department or hazmat team to be ready, if the situation warrants, to
decontaminate patients, including those who are transported to a hospital before they are decontaminated. Considerations in determining what a hospital s capabilities should be include the number of
incidents occurring locally (several per week versus only a few per year) and proximity to industries
or transportation routes that have the potential for a hazardous materials incident (see Section I
SARA Title III).
25
Exhibit II-7A
Occupational Exposure Limits
Value
Abbreviation
Definition
Threshold Limit Value (ACGIH)1
TLV
Refers to airborne concentrations of

substances and represents conditions under
which it is believed that nearly all workers
may be repeatedly exposed day after day
without adverse effect.

Time-Weighted Average (ACGIH)1
TLV-TWA
The time-weighted average concentration for a

normal 8-hour work day and a 40-hour work
week, to which nearly all workers may be
repeatedly exposed, day after day, without
adverse effect.

Short-Term Exposure Limit (ACGIH)1
TLV-STEL
The concentration to which workers can be

exposed continuously for a short period of
time without suffering from (1) irritation,
(2) chronic or irreversible tissue damage, or
(3) narcosis of a sufficient degree to increase
the likelihood of accidental injury, to impair
self-rescue, or to materially reduce work
efficiency; and provided that the daily
TLV-TWA is not exceeded.

Ceiling (ACGIH)1
TLV-C
The concentration that should not be exceeded

during any part of the working exposure.
Permissible Exposure Limit (OSHA)2
PEL
Same as TLV-TWA.
Immediately Dangerous to Life and Health

(OSHA)2
IDLH
A maximum airborne concentration from

which one could escape within 30 minutes
without any escape-impairing symptoms or
any irreversible health effects.
Recommended Exposure Limit (NIOSH)3
REL
Highest allowable airborne concentration that

is not expected to injure a worker; expressed
as a ceiling limit or time-weighted average for
an 8- or 10-hour work day.

3
2
26
Exhibit II-7B
General Population Exposure Limits
Value
Abbreviation
Definition
Emergency Response Planning Guidelines (AIHA)1
ERPG
Maximum airborne concentration below which

it is believed that nearly all individuals could
be exposed for up to 1 hour without
(1) experiencing other than mild transient
adverse health effects or perceiving a clearly
defined objectionable odor (ERPG-1),
(2) experiencing or developing irreversible or
other serious health effects or symptoms that
could impair an individual s ability to take
protective action (ERPG-2), or
(3) experiencing or developing life-threatening
health effects (ERPG-3).
Short-term Public Emergency Guidance Level

(NRC)2
SPEGL
An acceptable concentration for unpredicted,

single, short-term exposure of the general
public in emergency situations. May be
developed for different exposure periods
(e.g., 1, 2, 4, 8, 16, 24 hours).
Acute Exposure Guidelines (EPA NAC/AEGL)3
AEGL
Proposed short-term threshold or ceiling

exposure value intended for the protection of
the general public, including susceptible or
sensitive individuals but not those who are
hypersusceptible or hypersensitive. Represents
the airborne concentration of a substance at or
above which it is predicted that the general
population (as defined above) could experience
(1) notable discomfort (AEGL-1),
(2) irreversible or other serious, long-lasting
effects or impaired ability to escape (AEGL-2),
or (3) life-threatening effects or death
(AEGL-3). Developed for four exposure
periods: 30 minutes, and 1, 4 , and 8 hours.
Synonymous with the NAS4 term,
Community Emergency Exposure Levels
(CEELs).

National Research Council
3
EPA National Advisory Committee/AEGL Committee
4
National Academy of Sciences
2
27
Federal Regulations Pertaining to Use of Personal Protective Equipment (PPE)

The term personal protective equipment (PPE) is used in this document to refer to both clothing and
equipment. The purpose of PPE is to shield or isolate individuals from the chemical, physical, and
biological hazards that may be encountered at a hazardous materials incident.
Training is essential before any individual attempts to use PPE. OSHA standards mandate specific training requirements (8 hours of initial training or sufficient experience to demonstrate competency) for personnel engaged in emergency response to hazardous substances incidents at the First
Responder Operations Level. In addition, each employer must develop health and safety programs
and provide for emergency response. These standards also are intended to provide additional protection
for those who respond to hazardous materials incidents, such as firefighters, police officers, and
EMS personnel. OSHA s final rule (March 6, 1989, 29 CFR (1910.120)) as it applies to emergency
medical personnel states: Training shall be based on the duties and functions to be performed by
each responder of an emergency response organization.
No single combination of protective equipment and clothing is capable of protecting against all
hazards. Thus, PPE should be used in conjunction with other protective methods. The use of PPE
can itself create significant worker hazards, such as heat stress, physical and psychological stress,
and impaired vision, mobility, and communication. Responders in PPE can also be frightening to
pediatric patients. In general, the greater the level of PPE protection, the greater are the associated
risks. For any given situation, equipment and clothing should be selected that provide an adequate
level of protection. Excessive protection can be as hazardous as under-protection, and should be
avoided. In addition, personnel should not be expected to use PPE without adequate training.
The two basic objectives of any PPE program should be to protect the wearer from safety and health
hazards and to prevent injury to the wearer from incorrect use and/or malfunction of the PPE. To
accomplish these goals, a comprehensive PPE program should include: (1) hazard identification;
(2) medical monitoring; (3) environmental surveillance; (4) selection, use, maintenance, and decontamination of PPE; and (5) training.
PPE Complications
Personnel wearing PPE are likely to encounter a number of potential problems, including limited
visibility, reduced dexterity, claustrophobia, restricted movement, suit breach, insufficient air supply,
dehydration, and the effects of heat and cold. Only individuals who are physically fit and have met
the OSHA/NIOSH/NFPA training requirements should be wearing PPE during an incident. Proper
donning and doffing procedures must be followed, with assistance from other onsite personnel.
Medical surveillance evaluations should be conducted on all individuals both before and immediately
after their use of PPE. The actions of all personnel wearing PPE should also be closely observed by
the safety officer and others during each work period. In addition, an emergency distress signal
should be identified in the briefing before individuals enter the work area.
28
EPA has designated four levels of protection to assist in determining which combinations of respiratory protection and protective clothing should be employed:
Level A protection should be worn when the highest level of respiratory, skin, eye, and mucous
membrane protection is needed. It consists of a fully-encapsulated, vapor-tight, chemical-resistant
suit, chemical-resistant boots with steel toe and shank, chemical-resistant inner/outer gloves, coveralls,
hard hat, and self-contained breathing apparatus (SCBA).
Level B protection should be selected when the highest level of respiratory protection is needed but
a lesser degree of skin and eye protection is required. It differs from Level A only in that it provides
splash protection through use of chemical-resistant clothing (overalls and long-sleeved jacket, twopiece chemical splash suit, disposable chemical-resistant coveralls, or fully-encapsulated, nonvapor-tight suit and SCBA).
Level C protection should be selected when the type of airborne substances is known, concentration is
measured, criteria for using air-purifying respirators are met, and skin and eye exposures are unlikely.
This involves a full facepiece, air-purifying, canister-equipped respirator and chemical-resistant clothing.
It provides the same level of skin protection as Level B, but a lower level of respiratory protection.
Level D is primarily a work uniform. It provides no respiratory protection and minimal skin protection, and it should not be worn on any site where respiratory or skin hazards exist.
Exhibit II-8 illustrates these four levels of protection. For more information on this subject,
Appendix C outlines the protective equipment recommended for each level of protection.
Factors to be considered in selecting the proper level of protection include the potential routes of
entry for the chemical(s), the degree of contact, and the specific task assigned to the user. Activities
can also be undertaken to determine which level of protection should be chosen. The EPA and
NIOSH recommend that initial entry into unknown environments or into a confined space that has
not been chemically characterized be conducted wearing at least Level B, if not Level A, protection.
Routes of Entry
PPE is designed to provide emergency medical personnel with protection from hazardous materials
that can affect the body by one of three primary routes of entry: inhalation, ingestion, and direct
contact. Inhalation occurs when emergency personnel breathe in chemical fumes or vapors.
Respirators are designed to protect the wearer from contamination by inhalation but they must be
worn properly and fit-tested frequently to ensure continued protection. Ingestion usually is the result
of a health care provider transferring hazardous materials from his hand or clothing to his mouth.
This can occur unwittingly when an individual wipes his mouth with his hand or sleeve, eats, drinks,
or smokes a cigarette. Direct contact refers to chemical contact with the skin or eye. Skin is protected by garments, and full-face respirators protect against ingestion and direct eye contact. Mucous
membranes in the mouth, nose, throat, inner ear, and respiratory system may be affected by more
than one of these routes of entry. Many hazardous materials adhere to and assimilate with the
moist environment provided by these membranes, become trapped or lodged in the mucus, and are
subsequently absorbed or ingested.
29
Exhibit II-8
Level A
Level B
Level C
Level D
30
Chemical Protective Clothing (CPC)

Protective clothing is designed to prevent direct contact of a chemical contaminant with the skin or
body of the user. There is, however, no single material that will afford protection against all substances. As a result, multilayered garments may be employed in specific situations despite their negative impact on dexterity and agility. CPC is designed to afford the wearer a known degree of protection from a known type, a known concentration, and a known length of exposure to a hazardous
material, but only if it is properly fitted and worn correctly. Improperly used equipment can expose
the wearer to danger. Another factor to keep in mind when selecting CPC is that most protective
clothing is designed to be impermeable to moisture, thus limiting the transfer of heat from the body
through natural evaporation. This is a particularly important factor in hot environments or for strenuous tasks since such garments can increase the likelihood of heat-related injuries. Research is now
underway to find lightweight suits that are breathable but still protective against a wide range of
chemicals. Cooling vests are sometimes used in warm weather situations to keep the body temperature normal, but with mixed results.
Essential to any protective ensemble are chemical resistant boots with steel toe and shank. Chemical
resistant inner and outer layered gloves must also be worn. Compatibility charts should be consulted
to determine the appropriate type of boot and gloves to use, since no one material presently provides
protection against all known chemicals. Wearing multiple layers of gloves impairs dexterity and
makes performing basic aspects of patient assessment (e.g., checking breathing, taking a pulse)
difficult without constant practice.
The effectiveness of CPC can be reduced by three actions: degradation, permeation, and penetration.
Chemical degradation occurs when the characteristics of the material in use are altered through
contact with chemical substances or aging. Examples of degradation include cracking and brittleness, and other changes in the structural characteristics of the garment. Degradation can also result
in an increased permeation rate through the garment.
Permeation is the process by which chemical compounds cross the protective barrier of CPC
because of passive diffusion. The rate at which a compound permeates CPC is dependent on factors
such as the chemical properties of the compound, the nature of the protective barrier in the CPC, and
the concentration of the chemical on the surface of the protective material. Most CPC manufacturers
provide charts on the breakthrough time the time it takes for a chemical to permeate the material
of a protective suit for a wide range of chemical compounds.
Penetration occurs when there is an opening or a puncture in the protective material. These openings can include unsealed seams, buttonholes, and zippers. Often such openings are the result of
faulty manufacture or problems with the inherent design of the suit. Protective clothing is available
in a wide assortment of forms, ranging from fully-encapsulated body suits to gloves, hard hats,
earplugs, and boot covers. CPC comes in a variety of materials, offering a range of protection against a
number of chemicals. Emergency medical personnel must evaluate the properties of the chemical
versus the properties of the protective material. Selection of the appropriate CPC will depend on the
specific chemical(s) involved, and on the specific tasks to be performed.
31
RESPIRATORY PROTECTION
Substantial information is available for the correct selection, training, and use of respirators. The
correct respirator must be employed for the specific hazard in question. Material Safety Data Sheets
(if available) often specify the type of respirator that will protect users from risks. In addition,
manufacturers suggest the types of hazards against which their respirators can offer protection.
OSHA has set mandatory legal minimum requirements (29 CFR (1910.134)) for respiratory protection. In addition, NIOSH has established comprehensive requirements for the certification of respiratory protection equipment.
Personnel must be fit-tested for use of all respirators. Even a small space between the respirator
and you could permit exposure to a hazardous substance(s) by allowing in contaminated air. Anyone
attempting to wear any type of respirator must be trained and drilled in its proper use. Furthermore,
equipment must be inspected and checked for serviceability on a routine basis.
There are two basic types of respirators: air-purifying and atmosphere-supplying. Atmospheresupplying respirators include self-contained breathing apparatus (SCBA) and supplied-air respirators
(SAR).
Air-Purifying Respirators (APRs)

An air-purifying respirator purifies ambient air by passing it through a filtering element before
inhalation. The major advantage of the APR system is the increased mobility it affords the wearer.
However, a respirator can only be used where there is sufficient oxygen (19.5 percent) since it
depends on ambient air to function. In addition, APRs should not be used when substances with
poor warning properties are known to be involved or, if the agent is unknown, when environmental
levels of a substance exceed the filtration capacity of the canisters.
Three basic types of APRs are used by emergency personnel: chemical cartridges or canisters, disposables, and powered air-purifiers. The most commonly used APR depends on cartridges (Exhibit II-9)
or canisters to purify the air by chemical reaction, filtration, adsorption, or absorption. Cartridges and
canisters are designed for specific materials at specific concentrations. To aid the user, manufacturers
have color-coded the cartridges and canisters to indicate the chemical or class of chemicals for which
the device is effective. NIOSH recommends that use of a cartridge not exceed one work shift.
However, if breakthrough of the contaminant occurs first, then the cartridge or canister must be
immediately replaced. After use, cartridges and canisters should be considered contaminated and
disposed of accordingly.
Disposable APRs are usually designed for use with particulates, such as asbestos, although some
are approved for use with other contaminants. These respirators are typically half-masks that
cover the face from nose to chin, but do not provide eye protection. Once used, the entire respirator is usually discarded. This type of APR depends on a filter to trap particulates. Filters may also
be used in combination with cartridges and canisters to provide an individual with increased protection from particulates. The use of half-mask APRs is not generally recommended by emergency
response organizations.
32
Exhibit II-9
Chemical Cartridge Air-Purifying Respirator
Powered Air-Purifying Respirators (PAPRs) have the advantage of creating an improved facemask
seal, thus reducing the risk of inhalation injury. Air being blown into the mask can also have a
cooling affect. PAPRs come with either full facemasks or pullover hoods. Some individuals find the
hooded system to be more comfortable and less claustrophobic than the mask. According to OSHA
guidelines, men with beards can wear the hooded system but not the full facemask.
Atmosphere-Supplying Respirators
Atmosphere-supplying respirators consist of two basic types: the self-contained breathing apparatus
(SCBA), which contains its own air supply, and the supplied-air respirator (SAR), which depends on
an air supply provided through a line linked to a distant air source. Exhibit II-10 illustrates an
example of each.
Self-Contained Breathing Apparatus (SCBA)

A self-contained breathing apparatus respirator is composed of a facepiece connected by a hose to a
compressed air source. There are three varieties of SCBAs: open-circuit, closed-circuit, and escape.
Open-circuit SCBAs, most often used in emergency response, provide clean air from a cylinder to
the wearer, who exhales into the atmosphere. Closed-circuit SCBAs, also known as rebreathers,
recycle exhaled gases and contain a small cylinder of oxygen to supplement the exhaled air of the
wearer. Escape SCBAs provide air for a limited amount of time and should only be used for emergency escapes from a dangerous situation. One disadvantage of all SCBAs is that they are bulky and
heavy, and can be used for only the period of time allowed by air in the tank.
The most common SCBA is the open-circuit, positive-pressure type. In this system, air is supplied to
the wearer from a cylinder and enters the facepiece under positive pressure. In contrast to negativepressure units, a higher air pressure is maintained inside the facepiece than outside. This affords the
SCBA wearer the highest level of protection against airborne contaminants since any leakage may
33
Exhibit II-10
Self-Contained Breathing Apparatus and Supplied-Air Respirators
force the contaminant out. When wearing a negative-pressure-type apparatus, there is always the
potential danger that contaminants may enter the facemask if it is not properly sealed. The use of a
negative-pressure SCBA is prohibited by OSHA under 29 CFR (1910.120(q)(iv)) in incidents where
personnel are exposed to hazardous materials.
Supplied-Air Respirators (SARs)

Supplied-air respirators differ from SCBAs in that the air is supplied through a line that is connected
to a source away from the contaminated area. SARs are available in both positive- and negativepressure models. However, only positive-pressure SARs are recommended for use at hazardous
materials incidents. One major advantage the SAR has over the SCBA device is that it allows an
individual to work for a longer period. In addition, SARs are less bulky than SCBAs. By necessity,
however, a worker must retrace his steps to stay connected to the SAR, and therefore cannot leave
the contaminated work area by a different exit. SARs also require the air source to be in close proximity to the work area. In addition, personnel using an SAR must carry an immediately operable
emergency escape supply of air, usually in the form of a small, compressed air cylinder, for use in
case of an emergency.
34
EMERGENCY DEPARTMENT PERSONNEL DECONTAMINATION

Decontamination is the process of removing or neutralizing harmful materials that have gathered on
personnel and/or equipment during the response to a chemical incident. Many incidents have occurred
involving seemingly successful rescue, transport, and treatment of chemically contaminated individuals
by unsuspecting emergency personnel who, in the process, contaminate themselves, the equipment,
and the facilities to which they bring the victim. Decontamination is of the utmost importance
because it:
l
Protects all hospital personnel by sharply limiting the transfer of hazardous materials from the
contaminated area into clean zones.
Protects the community by preventing transportation of hazardous materials from the hospital to
other sites in the community by secondary contamination.
Protects workers by reducing the contamination and resultant permeation of, or degradation to,
their protective clothing and equipment.
Protects other patients already receiving care at the hospital.
This section only addresses the steps necessary for dealing with worker decontamination. Patient
decontamination will be addressed in Section III, Patient Management. It should be stressed that to
carry out proper decontamination, personnel must have received at least the same degree of training
as required for workers who respond to hazardous materials incidents. The design of the decontamination process should take into account the degree of hazard and should be appropriate for the situation.
For example, a nine-station decontamination process need not be set up if only a bootwash station
would suffice.
Avoiding contact is the easiest method of decontamination that is, not to get the material on the
worker or his protective equipment in the first place. However, if contamination is unavoidable, then
proper decontamination or disposal of the worker s outer gear will be necessary. Segregation and
proper disposal of the outer gear in a polyethylene bag or steel drum will be necessary until thorough
decontamination is completed. With extremely hazardous materials, it may be necessary to dispose
of equipment as well.
Physical decontamination of protective clothing and equipment can be achieved by several different
means. These all include the systematic removal of contaminants by washing, usually with soap and
water, and then rinsing. In rare cases, the use of solvents may be necessary. There is a trend toward
using disposable clothing (e.g., suits, boots, gloves) and systematically removing these garments in a
manner that precludes contact with the contaminant. The appropriate decontamination procedure will
depend on the contaminant and its physical properties. Thoroughly researching the chemicals involved
and their properties, or consultation with an expert, is necessary to make these kinds of decisions.
Care must be taken at all times to ensure that the decontamination methods being used do not introduce fresh hazards into the situation. In addition, the residues of the decontamination process must
be treated as hazardous wastes. The decontamination stations and process should be confined to the
Contamination Reduction Zone (see Exhibit II-11). Steps for personnel decontamination are outlined
in Exhibit II-12, and the technical decontamination process is discussed below.
35
Technical Decontamination Process for Hospital Personnel

Personnel should remove protective clothing in the following sequence.
1. Remove tape (if used) securing gloves and boots to suit.
2. Remove outer gloves, turning them inside out as they are removed.
3. Remove suit, turning it inside out and folding it downward. Avoid shaking.
4. Remove boot/shoe cover from one foot and step over the clean line. Remove other
boot/shoe cover and put that foot over the clean line.
5. Remove mask. The last person removing his/her mask may want to wash all masks with
soapy water before removing his/her suit and gloves. Place the masks in plastic bag and
hand the bag over the clean line for placement in second bag held by another staff member.
Send bag for decontamination.
6. Remove inner gloves and discard them in a drum inside the dirty area.
7. Secure the dirty area until the level of contamination is established and the area is properly
cleaned.
8. Personnel should then move to a shower area, remove undergarments and place them in a
plastic bag. Double-bag all clothing and label bags appropriately.
9. Personnel should shower and redress in normal working attire and then report for
medical surveillance.
COMMUNICATIONS
Effective communications are essential to maintaining incident control. These include a dedicated
radio frequency and a sufficient number of radios for distribution to all participating agencies.
Another network should link the onsite command post to support groups, such as the Poison Control
Center and the Health Department. Other networks that may have to be activated include one linking
the hospital emergency department to EMTs and one dedicated for use by the teams in the Exclusion
and Contamination Reduction Zones. When an Incident Command System is activated, one person is
often assigned to manage communications.
36
Exhibit II-11
NIOSH/OSHA/USCG/EPA Recommended Zones
37
Exhibit II-12
Nine-Step Personnel Decontamination Plan
38
American Conference of Governmental Industrial Hygienists. 1988. Guidelines for the Selection of
Chemical Protective Clothing. Cincinnati, OH.
Grove Village, IL.
Borak, J., M. Callan, and W. Abbott. 1991. Hazardous Materials Exposure-Emergency Response and
Patient Care. Englewood Cliffs, NJ: Brady.
Bowen, J. E. 1995. Emergency Management of Hazardous Materials Incidents. Quincy, MA:
National Fire Protection Association.
Bronstein, A.C. and P.L. Currance. 1994. Emergency Care for Hazardous Materials Exposure. 2nd
Budavari, S., A. Smith, P. Heckelman, and J. Kinneary. 1996. The Merck Index: An Encyclopedia of
Drugs, Chemicals, and Biologicals. 12th ed. Chapman & Hall.
Chemical Manufacturers Association (CMA) and the Association of American Railroads. 1987.
Terms for Personal Protective Equipment. Washington, DC: CMA.
Clayton, G.D. and F.E. Clayton. 1994. Patty s Industrial Hygiene and Toxicology. 4th ed. New York,
NY: John Wiley and Sons.
Currance, P.L. and A.C. Bronstein. 1999. Hazardous Materials for EMS. St. Louis, MO: Mosby.
Ellenhorn, M.J. and D.G. Barceloux. 1997. Medical Toxicology: Diagnosis and Treatment of Human
Poisoning. 2nd ed. New York, NY: Elsevier.
Forsberg, K. and S.Z. Mansdorf. 1993. Quick Selection Guide to Chemical Protective Clothing. 2nd
ed. New York, NY: Van Nostrand Reinhold.
Lange.
Grant, W.M. and J.G. Schuman. 1993. Toxicology of the Eye. 4th ed. Springfield, IL: Charles C.
Thomas.
Hayes, A.W. (ed.). 1994. Principles and Methods of Toxicology. 2nd ed. Books on Demand.
Hodgson, E. and P.E. Levi. 1997. A Textbook of Modern Toxicology. 2nd ed. Stamford, CT: Appleton
and Lange.
Klaassen, C.D., M.O. Amdur, and J. Doull (eds.). 1996. Casarett and Doull s Toxicology: The Basic
Science of Poisons. 5th ed. McGraw-Hill Health Professions Division.
Levine, S.P. and W.F. Martin (eds.). 1993. Protecting Personnel at Hazardous Waste Sites.
2nd ed. Boston, MA: Butterworth Publishers.
39
Lu, F.C. 1996. Basic Toxicology: Fundamentals, Target Organs, and Risk Assessment. 3rd ed. Taylor
& Francis, Inc.
Training. Emmitsburg, MD: HMEP Curriculum Guidelines.
National Fire Academy and National Emergency Training Center. 1985. Recognizing and Identifying
Hazardous Materials. Capitol Heights, MD: National Audio-Visual Center.
Proctor, N.H., J.R. Hughes, and M.L. Fishman. 1989. Chemical Hazards of the Workplace. 2nd ed.
New York, NY: Van Nostrand Reinhold.
Rom, W. 1992. Environmental and Occupational Medicine. 2nd ed. Boston, MA: Little, Brown.
Sax, N.I. 1992. Dangerous Properties of Industrial Materials. 8th ed. New York, NY: Van Nostrand
Reinhold.
Schwope, A.D., P.P. Costas, J.O. Jackson, and D.J. Weitzman. 1987. Guidelines for the Selection of
Chemical Protective Clothing. 3rd ed. Cincinnati, OH: American Conference of Governmental
Industrial Hygienists.
Sidell, F.R. and D.R. Franz (eds.). 1997. Medical Aspects of Chemical and Biological Warfare. U.S.
Department of the Army. Washington, DC: Borden Institute.
Stutz, R. and S. Ulin. 1993. HAZTOX EMS Response For Hazardous Materials Incidents. Miramar,
FL: GDS Communications.
Sullivan, J.B., Jr. and G.R. Krieger. 1992. Hazardous Materials Toxicology: Clinical Principles of
Tokle, G. (ed.). 1993. Hazardous Materials Response Handbook. 2nd ed. Quincy, MA: National Fire
Protection Association.
U.S. Environmental Protection Agency, Region VII. 1989. Chemical Response Planning and
Operations. Washington, DC: Environmental Protection Agency.
40
Section III. Patient Management

Growing concern about the proper treatment of chemically contaminated patients has outpaced
adequate guidance on the subject. However, definitive work has been done on cases that bear
similar characteristics (e.g., radioactive exposure), and some of the same principles apply. Many of
these principles are outlined in the article Emergency Department Radiation Accident Protocol
by R.B. Leonard and R.C. Ricks, published in the September 1980 issue of Annals of Emergency
Medicine. Further information on radiation response procedures is contained in Hospital Emergency
Department Management of Radiation Accidents by R.C. Ricks, prepared for the Federal Emergency
Management Agency.
When a hospital receives a call that a patient exposed to hazardous materials is being transported
to its facility, a planned course of action should be implemented. Steps in the protocol must be
practiced before a hazardous materials emergency occurs. Emergency department personnel
should know their responsibilities and how to perform them, and all required equipment should be
immediately accessible.
Individuals receiving a potential hazardous materials call should obtain as much information as possible. A checklist should be developed and made available for all telephone or radio communication
centers. Information that will aid in initiating appropriate actions includes:
l
Caller s telephone number
Number and ages of patients
Nature of injuries
Name of chemical(s) involved, including correct spelling
Extent of patient decontamination in the field
Estimated time of arrival
After the above information is received, a predesignated resource center (e.g., regional Poison
Control Center, ATSDR) should be contacted for information regarding definitive care procedures.
This should include the need for decontamination and what methods should be used.
Communications should be kept open with onsite response personnel to obtain as much advance
information as possible.
If incident notification comes through other than usual emergency communication channels, the call
should be verified before a hazardous materials response plan is initiated. Ambulance personnel
should be notified of any special approach or entrance to the emergency department and also
advised
41
not to bring the patient into the emergency department until he or she has been assessed by appropriate
emergency department staff.
Often patients contaminated by hazardous materials are brought into the emergency department
unannounced or not through regular EMS channels. This could be an ambulatory patient or an
individual transported by private vehicle. The ideal response to this situation is to call the fire
department or a hazmat team that is properly trained and equipped to come to the hospital and set
up a decontamination area outside the ambulance entrance. In any event, these individuals should be
isolated from other patients and assessed and decontaminated as soon as possible. Preplanning with
the fire department and/or hazmat team should determine the location, equipment needs, and logistics
for decontamination outside of the hospital during all weather conditions.
EMERGENCY DEPARTMENT PREPARATION

Every member of the emergency department should be familiar with the hospital s hazardous materials
response plan and be required to participate in scheduled drills. A written copy of the plan should
also be kept in a central location in the emergency department for quick reference. Preparation for
arrival of a contaminated patient should include notification of all services involved, preparation of a
decontamination area, and suiting up of the decontamination team.
Emergency Department Mobilization

The person receiving a call of an incoming victim(s) should notify the Nursing Supervisor or other
designated individual, who will in turn notify the appropriate personnel according to the hospital s
response plan. The hospital operator should be instructed to notify security and maintenance, and the
nurse on duty should contact the predesignated resource center.
Decontamination Area Preparation

Any victim of a hazardous materials incident must be considered to be contaminated until demonstrated otherwise. Therefore, the route from the emergency entrance to the Decontamination Area
may also become contaminated and all persons along that route should be removed by security
personnel prior to the arrival of the contaminated patient. Ideally, this area should be protected with
a barrier of plastic or paper sheeting taped securely to the floor. Care should be exercised in walking
on plastic sheeting because it can become very slippery when wet.
Security personnel should be stationed at the main entrance to the emergency department, close to
the Decontamination Area, to prevent unauthorized entry, to control the entry of contaminated
patients into the department, and to direct the vehicle(s) transporting the patient(s) to the appropriate
area. A reception station should be set up just outside the emergency department entrance, where
arriving patients can be screened for adequate decontamination before entering.
A decontamination area should be large enough to facilitate decontamination of more than one
patient and to accommodate the many personnel involved in patient treatment and contamination
reduction. The ventilation system should either be separate from the rest of the hospital or turned off
to prevent the spread of airborne contaminants through heating and air conditioning ducts to other
42
42
parts of the facility. If the ventilation system is shut off during the handling of a contaminated victim
in an enclosed area, the emergency department staff could be endangered. To address this, OSHA
regulations on atmospheric monitoring (29 CFR (1910.120)(q)(3)(iv)) should be followed, especially
if air-purifying respirators are used.
Weather permitting, the best place to evaluate and initially treat contaminated patients is outside,
where ambient ventilation will keep airborne cross-exposure low. Some hospitals have radiation
decontamination facilities that can be used with minor changes. An outside or portable decontamination system is a viable substitute and would aid in preventing contamination of the emergency
department and other patients. A practical alternative for facilities with limited resources is to have a
warm shower nozzle, soap, a wading pool, and plastic garbage bags in a predesignated area outside
the back door to the emergency department. The patient may be able to remove his or her own
contaminated clothing, place it in a double bag, and do his or her own soap and water decontamination.
A partial tent or curtain can provide for patient privacy. Under most circumstances, ordinary hospital
gowns, plastic goggles, and plain latex gloves will adequately protect hospital staff if they have to
assist the patient in removing soaked clothing, washing exposed skin and hair, or performing eye
irrigation. With large amounts of concentrated corrosives or very oily materials, such as pesticides,
disposable chemical protective clothing and unmilled nitrile gloves offer additional protection. If it
is anticipated that your facility is likely to receive heavily contaminated patients who have not
received prior decontamination, then it may be advisable to purchase appropriate protective gear and
to fit and train emergency department staff in its use. However, no person should wear and use specialized PPE, especially respiratory protective gear, without prior training.
To prevent unnecessary contamination, all nonessential and nondisposable equipment should be
removed from the decontamination area. Door knobs, cabinet handles, light switches, and other
surfaces that have contact with hands should be taped, and the floors should be covered with plastic
or paper sheeting. The floor covering should be securely taped to prevent slippage, and the entrance
to the room marked with a wide strip of colored tape to indicate a contaminated area. Personnel
should not enter the area unless properly protected, and no personnel or equipment should leave the
area until properly decontaminated. A clean member of the staff should stand on the clean side of
the entrance to hand in supplies and receive medical specimens.
The essential requirements for any decontamination task are:
l
A safe area to keep a patient while undergoing decontamination
A method for washing contaminants off a patient
A means of containing the rinsate
Adequate protection for personnel treating the patient
Disposable or cleanable medical equipment to treat the patient
43
Decontamination Team Preparation

A decontamination team should be predesignated and trained in appropriate personal protection
equipment and procedures. The team should consist of:
l
Emergency department physicians
Emergency department nurses and aides
A trauma surgeon, if injuries are present
Support personnel
;
Nursing Supervisor
Occupational Health and Safety Officer
Security
Maintenance
Recorder
The decontamination team should be equipped with personal protective clothing (as discussed in
Section II) for whatever level is deemed appropriate for the substance(s) involved. This may be
determined by consulting reference guidebooks, websites, database networks, telephone hotlines,
or a predesignated resource center (e.g., the regional Poison Control Center).
Appropriate dress for the decontamination team should include:
l
A scrub suit.
Plastic shoe covers.
Disposable chemical protective clothing with built-in hood and booties, and with hood taped at
the neck.
Polyvinyl chloride (PVC) gloves taped to sleeves.
Respiratory protection, as appropriate (see Section II).
Multiple layers of surgical gloves, neoprene or disposable nitrile gloves, with the bottom layer
taped; should be changed whenever torn.
Protective eyewear.
A 2-inch-wide piece of masking tape with the team member s name written on it, and placed on the
back of the protective suit, will assist team members in communicating.
44
44
PATIENT ARRIVAL
The emergency physician-in-charge or an emergency department nurse should meet the ambulance
upon arrival and assess the condition of the patient(s) as well as the degree of contamination. The
recorder should note on a diagram of the body the areas found by the physician to be contaminated.
Personnel should keep in mind that the actual contamination may be (or become) a life-threatening
condition, and triage procedures should be initiated at this point, if necessary. During initial patient
assessment and stabilization, contamination reduction should simultaneously be performed. This
consists of cutting away or otherwise removing all suspected contaminated clothing, including
jewelry and watches, and brushing or wiping off any contamination. Care should be taken to protect
any open wounds from contamination. Emergency department personnel should make every effort to
avoid contact with any potentially hazardous substance(s).
Ideally, decontamination should be performed before patient transport; however, field decontamination facilities are limited and emergency department personnel should consider that all hazardous
materials patients need decontamination unless information has been received indicating that it is
not necessary (e.g., in cases of carbon monoxide exposure). If a patient s clothing was not
removed at the incident site, it should be removed outside the ambulance but before entry into the
emergency department. This will reduce further exposure to the patient and lessen the extent of
contamination introduced into the emergency department. Contaminated clothing should be double-bagged in plastic bags, sealed, and labeled. The decontamination team should bring the prepared stretcher to the ambulance, transfer the patient, and take him or her directly to the
Decontamination Area along the predesignated route.
Priority should be given to the fundamentals of emergency treatment airway, breathing, and circulation simultaneous with contamination reduction. Once life-threatening matters have been addressed,
emergency department personnel can then direct their attention to thorough decontamination and
secondary patient assessment. Identification of the hazardous materials involved can be simultaneously
performed by other personnel. It is important to remember that appropriate personal protective
clothing must be worn until personnel are no longer in danger.
PATIENT DECONTAMINATION
The basic purpose of decontamination is to reduce external contamination, contain the contamination
present, and prevent the further spread of potentially dangerous substances. In other words, remove
what you can and contain what you can t. Effective decontamination consists of making the
patient As Clean As Possible (ACAP). This means that the contamination has been reduced to
a level that is no longer a threat to the patient or to the responder.
With a few exceptions, intact skin is more resistant to hazardous materials than injured flesh, mucous
membranes, or eyes. Therefore, decontamination should begin at the head of the patient and proceed
downward with initial attention paid to contaminated eyes and open wounds. Once wounds have
been cleaned, care should be exercised so that they are not recontaminated. This can be aided by
covering the wounds with a waterproof dressing. For some chemicals, such as strongly alkaline
substances, it may be necessary to flush exposed skin and eyes with water or normal saline for an
extended period of time.
45
External decontamination should be performed using the least aggressive methods. Mechanical or
chemical irritation to the skin should be limited to prevent damage to the epidermal layer, which
results in increased permeability. The skin of young children is particularly sensitive and should be
treated accordingly. Contaminated areas should be gently washed under a spray of warm (never hot)
tap water, using a sponge and a mild soap. If decontamination is performed outside, care must be
taken to avoid hypothermia; young children are particularly sensitive to cold stress. All run-off from
decontamination procedures should be collected for proper disposal.
The first priority in the decontamination process should be treatment of contaminated open wounds.
These areas allow for rapid absorption of hazardous materials. Wounds should be irrigated with
copious amounts of normal saline. Deep debridement and excision should be performed only when
particles or pieces of material have been embedded in the tissues. Decontamination of eyes should
also take high priority. Gentle irrigation of the eyes should be performed with the stream of normal
saline diverted away from the medial canthus so that it does not force material into the lacrimal
duct. Contaminated nares and ear canals should also be gently irrigated, with frequent suction to prevent any material being forced deeper into those cavities. Washing with soap and tepid water,
including the hair, is usually all that is needed to remove contamination. Hot water, stiff brushes, or
vigorous scrubbing should seldom be used because they cause vasodilation and abrasion. This
increases the chances for absorption of hazardous materials through the skin.
Decontamination of young children poses particular problems because they are usually frightened and
may not understand what is happening. If a parent is available and can accompany the child through
decontamination, this may be desirable. If not, a nurse should be assigned to stay with the child.
CONSIDERATIONS FOR PATIENT TREATMENT

The primary goals for emergency department personnel in handling a contaminated individual
include cessation of patient exposure, patient stabilization, and patient treatment all without jeopardizing their own safety. Termination of exposure can best be accomplished by removing the
patient from the incident area and by removing contaminants from the patient.
In treating patients, personnel should consider the chemical-specific information received from the
hazardous materials response resources. In multiple patient situations, proper triage procedures
should be implemented. Symptoms and signs being experienced by patients should be treated as
appropriate and when conditions allow. The sooner a patient becomes decontaminated the sooner
he or she can be treated as a normal patient and protective measures reduced or downgraded.
Recommendations from the designated Poison Control Center and orders from the attending physician
should be carefully followed. Invasive procedures, such as IVs or intubation, should be used only
for life-threatening conditions until decontamination is performed. Patients should be frequently
reassessed and monitored because many hazardous materials have latent physiological effects.
46
46
Information on Materials Involved

Identification of the material(s) involved in a hazardous materials incident should be determined as
early in the process as possible. Using resources outlined elsewhere in this section, and in Section II
under Hazard Recognition, personnel should identify and obtain detailed information involving
treatment, decontamination procedures, and possible adverse health effects of the specific chemical(s) involved. Needed information includes:
l
Chemical name of substance(s) involved
Form of the material (solid, liquid, gas)
Length of exposure
Route(s) of exposure
Possible adverse health effects
Recommended treatment or antidote therapy
PPE required
Decontamination procedures
The importance of getting a rapid but comprehensive overview on an unknown substance cannot be
overemphasized. Based on past hazmat incidents, NIOSH and EPA recommend that Level B protection
is the minimum level to be worn when entering an area containing unknown substances. However, if
the substance in question is suspected to involve the skin as a route of exposure or is otherwise
noted to be dangerous by absorption, corrosion, and the like, Level A protection should be worn
because it provides additional skin protection.
Removal of Patient from Decontamination Room

After the patient has been decontaminated, place a clean piece of plastic on the floor for the patient
and staff to use when exiting the clean area. If the patient is not ambulatory, a clean stretcher or
wheelchair should be brought to the doorway by an individual who has not been exposed. After the
patient is transferred to the clean area, the physician can perform a physical examination and initiate
routine patient management. The patient can be discharged home or admitted to the hospital,
depending on his or her clinical condition. The attending staff must remember that since exposure
to some substances can result in serious delayed effects, sustained observation and monitoring may
be required.
47
COMMUNITY EDUCATION AND BRIEFING

During a hazardous materials incident, the emergency department will be used as a source of information by the community and the media. A plan must be in place to deal with information requests,
whether received by phone or by onsite media representatives. It is essential that all information be
delivered by a knowledgeable person and be coordinated with the agency handling the event in the
field. In the absence of such coordination, misleading or inaccurate information may be released
which may worsen public reaction to an incident. Above all, it is essential that patient confidentiality
be respected. The emergency department may opt to defer all information requests to other involved
agencies, such as the regional Poison Control Center.
CRITIQUE
As soon as possible following a hazardous materials incident, all participating units should send
knowledgeable representatives to review the measures that were taken by each unit or agency. The
purpose of this review is to examine which activities succeeded and which did not, and to evaluate
the overall coordination effort with an aim toward making necessary improvements.
PATIENT MANAGEMENT UNDER MASS CASUALTY CONDITIONS INVOLVING

HAZARDOUS CHEMICALS
Basic medical procedures in a large-scale hazardous materials incident are not substantially different
from life-saving measures in other mass casualty disasters. Primary attention should focus on the
ABC fundamentals of emergency care, with decontamination performed at the same time. A chemical
disaster may overwhelm any one hospital, particularly if it occurs along with another disaster such
as an earthquake. Hospitals need to preplan what steps to take if they are unable to handle the
number of hazmat patients.
CRITICAL INCIDENT STRESS MANAGEMENT

Situations involving large numbers of ill or injured individuals, and risks of harm to the responder(s),
are sources of critical incident stress. To minimize the occurrence of acute or long-term psychological
consequences in response personnel, stress debriefing sessions should be held shortly after the incident
is terminated. Acute stress reactions recognized during the incident should be immediately addressed
by qualified peer debriefers or other qualified mental health professionals.
48
48
Grove, IL: American Academy of Pediatrics.
Cashman, J.R. 1995. Hazardous Materials Emergencies: The Professional Response Team. 3rd ed.
Lancaster, PA: Technomic Publishing Co.
Currance, P.L. and A.C. Bronstein. 1994. Emergency Care for Hazardous Materials Exposure. 2nd
Ellenhorn, M.J. 1997. Ellenhorn s Medical Toxicology. 2nd ed. Baltimore, MD: Williams & Wilkins.
Lange.
Haddad, L.M. and J.F. Winchester. 1998. Clinical Management of Poisoning and Drug Overdose.
3rd ed. Philadelphia, PA: W.B. Saunders Co.
Leonard, R.B. and R. Ricks. 1980. Emergency Department Radiation Accident Protocol. Annals of
Emergency Medicine. September.
Materials Incidents. NFPA 471. Quincy, MA: National Fire Protection Association.
Hazardous Materials Incidents. NFPA 472. Quincy, MA: National Fire Protection Association.
Responders to Hazardous Materials Incidents. NFPA 473. Quincy, MA: National Fire Protection
Association.
Noji, E.K. and G.D. Kelen. 1989. Manual of Toxicologic Emergencies. Chicago, IL: Year Book.
Noll, G., M.S. Hildebrand, and J.G. Yvorra. 1995. Hazardous Materials, Managing the Incident. 2nd
ed. IFSTA.
Reigart, J. R. and J.R. Roberts, JR (eds.). 1998. Recognition and Management of Pesticide
Poisonings. 5th ed. National Pesticide Telecommunications & Network (NPTN), U.S.
Ricks, R.C. 1984. Hospital Emergency Department Management of Radiation Accidents. Oak Ridge,
TN: Oak Ridge Associated Universities.
Sidell, F.R. and D.R. Franz (eds.). 1997. Medical Aspects of Chemical and Biological Warfare. U.S.
Department of the Army. Washington, DC: Borden Institute.
Stutz, D.R. and S. Ulin. 1997. Hazardous Materials Injuries: A Handbook for Pre-Hospital Care.
4th ed. Greenbelt, MD: BRADCOMM, Inc.
49
Sullivan, J.B. and G.R. Kriege. 1992. Hazardous Materials Toxicology: Clinical Principles of
U.S. Department of Health and Human Services, Agency for Toxic Substances and Disease Registry
(ATSDR). 1996. Managing Hazardous Materials Incidents: Medical Management Guidelines for
Acute Chemical Exposures. Vol. III. Atlanta, GA: US-DHHS.
Washington, DC: Government Printing Office. [available in English, Spanish and French][http://
hazmat.dot.gov/gydebook.htm]
U.S. Federal Emergency Management Agency. 1981. Hazardous Materials Management System: A
Guide for Local Emergency Managers. Prepared by the Multnomah County [OR] Office of
Emergency Management. Washington, DC: Federal Emergency Management Agency.
U.S. Federal Emergency Management Agency. 1984. Hospital Emergency Department Management
of Radiation Accidents. Washington, DC: Federal Emergency Management Agency.
U.S. Federal Emergency Management Agency. 1985. Guidance for Developing State and Local
Radiological Emergency Response Plans and Preparedness for Transportation Accidents.
50
50
Appendix A
HAZARDOUS MATERIALS CLASSIFICATION SYSTEMS

National Fire Protection Association, 704M System . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A3
Department of Transportation, DOT Chart 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A5
U.S. Department of Labor, Sample Material Safety Data Sheet (MSDS) . . . . . . . . . . . . . .A9
A1
A2
NATIONAL FIRE PROTECTION ASSOCIATION, 704M SYSTEM

The marking system designed by the National Fire Protection Association identifies hazard characteristics of materials at terminal and industrial sites. It uses a diamond divided into four quadrants,
with each quadrant representing a different characteristic, as explained below.
The risk level ratings, ranging from four (highest risk) to zero (minimum risk), are based upon
protective equipment normally used by firefighters.
Health (Blue)
Health hazards in firefighting generally result from a single exposure, which may vary from a few
seconds up to an hour. Only hazards arising out of an inherent property of the material are considered.
It should be noted, however, that the physical exertion demanded in firefighting or other emergency
conditions tends to intensify the effects of any exposure.
Risk level 4: Materials too dangerous to human health to expose firefighters. A few whiffs of the
vapor could cause death or the vapor or liquid could be fatal on penetrating the firefighter s normal
full protective clothing. The normal full protective clothing and breathing apparatus available to the
average fire department will not provide adequate protection against inhalation or skin contact with
these materials.
Risk level 3: Materials extremely hazardous to health, but areas may be entered with extreme care.
Full protective clothing including self-contained breathing apparatus, coat, pants, gloves, and
boots, with bands around the legs, arms, and waist should be provided. No skin surface should be
exposed.
Risk level 2: Materials hazardous to health, but areas may be entered freely with full facemask
self-contained breathing apparatus that also provides eye protection.
Risk level 1: Materials only slightly hazardous to health. It may be desirable to wear self-contained
breathing apparatus.
Risk level 0: Materials which on exposure under fire conditions would offer no hazard beyond that
of ordinary combustible materials.
Flammability (Red)
Susceptibility to burning is the basis for assigning risk levels within this category. The method of
attacking the fire is influenced by the material s susceptibility factor.
Risk level 4: Very flammable gases or very volatile flammable liquids. Shut off flow and keep
cooling water streams on exposed tanks or containers.
Risk level 3: Materials that can be ignited under almost all normal temperature conditions. Water
may be ineffective because of the low flash point.
A3
Risk level 2: Materials that must be moderately heated before ignition will occur. Water spray may
be used to extinguish the fire because the material can be cooled below its flash point.
Risk level 1: Materials that must be preheated before ignition will occur. Water may cause frothing
if it gets below the surface of the liquid and turns to steam. However, water fog gently applied to the
surface will cause a frothing that will extinguish the fire.
Risk level 0: Materials that will not burn.
Reactivity/Stability (Yellow)
The assignment of degrees in the reactivity category is based upon the susceptibility of materials to
release energy either by themselves or in combination with water. Fire exposure is one of the factors
considered, along with conditions of shock and pressure.
Risk level 4: Materials that (in themselves) are readily capable of detonation or of explosive decomposition or reaction at normal temperatures and pressures. Includes materials that are sensitive to
mechanical or localized thermal shock. If a chemical with this hazard rating is in an advanced or
massive fire, the area should be evacuated.
Risk level 3: Materials that (in themselves) are capable of detonation or of explosive decomposition
or reaction that require a strong initiating source that must be heated under confinement before initiation. Includes materials that are sensitive to thermal or mechanical shock at elevated temperatures
and pressures, or that react explosively with water without requiring heat or confinement. Firefighting
should be done from an explosive-resistant location.
Risk level 2: Materials that (in themselves) are normally unstable and readily undergo violent
chemical change, but do not detonate. Includes materials that can undergo chemical change with
rapid release of energy at normal temperatures and pressures, or that can undergo violent chemical
change at elevated temperatures and pressures. Also includes those materials that may react violently
with water or that may form potentially explosive mixtures with water. In advanced or massive
fires, firefighting should be done from a safe distance or from a protected location.
Risk level 1: Materials that (in themselves) are normally stable but that may become unstable at
elevated temperatures and pressures or that may react with water with some release of energy, but
not violently. Caution must be used in approaching the fire and applying water.
Risk level 0: Materials that (in themselves) are normally stable even under fire exposure conditions
and that are not reactive with water. Normal firefighting procedures may be used.
Special Information (White)

The quadrant includes information on specific characteristics of the material (e.g., reactivity with
water, tendency to oxidize).
A4
A5
A6
A7
A8
MATERIAL SAFETY DATA SHEETS

The Material Safety Data Sheet (MSDS) has become a major source of chemical information. It is
the key document used to provide hazard information to employees and can become an invaluable
tool for emergency response personnel when used in a chemical emergency.
The Occupational Safety and Health Administration s (OSHA) Hazard Communication Standard
(29 CFR 1910.1200) requires all manufacturers of pure chemicals and/or mixtures to evaluate their
products and relate, via MSDSs, any hazards that may be encountered while handling these materials.
This standard is intended for all workplaces, manufacturing and nonmanufacturing alike. The
Environmental Protection Agency s (EPA) Emergency Response and Community Right-to-Know
Act of 1986 ensures the availability of MSDSs to emergency response personnel, such as fire departments, first aid crews, and hospital emergency room staff.
The MSDS contains a wealth of information that may be understood with a minimum of training.
Below is a brief explanation of the format and information found in a properly prepared MSDS.
Section 1
This section identifies the material by product or trade name and chemical name. It is the product or
trade name that is usually found on the container labels, although the chemical name is also required
by some states. Section I also contains the manufacturer s name, address, and telephone number.
Section 2
Section 2 provides physical data about the product that can be utilized for proper identification.
Included are specifics such as color, odor, specific gravity (weight), vapor pressure, and boiling
point.
Section 3
This section lists the chemical ingredients of the material, if they are known or suspected to be
hazardous. Hazardous materials that are not carcinogens must be reported if they represent 1 percent
or more of the product. Carcinogens must be reported and identified as such if their levels are 0.1
percent or higher. Also included in Section 3 are Threshold Limit Values (TLVs) and the OSHA
Permissible Exposure Limit (PEL).
Section 4
Section 4 includes fire and explosion hazard data. This information is especially useful when devising
both in-house and community contingency plans. Plant first responders, local fire departments, and
hazmat teams need unlimited access to this information.
A9
Section 5
Section 5 contains health hazard data. It describes any acute (short-term exposure) and/or chronic
(long-term exposure) effects on the body. These include routes of exposure (inhalation, dermal contact,
ingestion) and the bodily organs affected, as well as the signs and symptoms of overexposure. First
aid procedures are also be found in this section. (NOTE: First aid measures recommended in
MSDSs are not always correct and should be confirmed.)
Section 6
This section contains information on the reactivity of the product. It lists other chemicals that,
when mixed with the product, will result in a chemical reaction. If a product is water reactive, it
will be noted.
Also included in Section 6 is information on hazardous decomposition products, such as carbon
monoxide and other hazardous gases, that are formed and emitted during chemical reactions or fires.
It is imperative that this section be carefully noted by both in-house and local firefighters.
Section 7
Section 7 lists the procedures that should be used if the product spills or leaks, including waste disposal methods.
Section 8
Section 8 contains information regarding the proper personal protective equipment (PPE) necessary
to handle the product in a manner that will minimize exposure. Ventilation practices are also listed
in this section.
Summary
A Material Safety Data Sheet can aid in making the right decisions on health and safety issues in a
plant or in a community. It must be noted, however, that it is but one of many references that should
be used to make final determinations. MSDSs are offered by manufacturers for identification and
verification and are not the last word on safety and health practices.
A10
A11
A12
Appendix B
TYPES OF RESPIRATORY PROTECTION
B1
B2
Appendix B
Types of Respiratory Protection
Type of Respirator
Advantages
Disadvantages
Enhanced mobility
Cannot be used in IDLH or oxygen-deficient

atmospheres (less than 19.5 percent oxygen
at air-purifying respirators
Lighter in weight than an SCBA; generally

weighs 2 pounds or less (except for PAPRs)
Limited duration of protection; may be hard

to gauge safe operating time in field
conditions
Air Purifying
Air-Purifying Respirator
(including powered
sea level)
[PAPRs])
Only protects against specific chemicals, and

up to specific concentrations
Use requires monitoring of contaminant and
oxygen levels
Can only be used: (1) against gas and vapor
contaminants with adequate warning
properties; or (2) for specific gases or vapors
provided that the service is known and a
safety factor is applied, or if the unit has an
ESLI (end-of-service-life-indicator)
Atmosphere-Supplying
Self-Contained Breathing
Apparatus (SCBA)

protection against airborne contaminants
and oxygen deficiency
Bulky, heavy (up to 35 pounds)

protection under strenuous work conditions
May impair movement in confined spaces
Finite air supply limits work duration
B3
Appendix B (continued)
Type of Respirator
Advantages
Positive Pressure Supplied- Enables longer work periods than an SCBA

Air Respirator (SAR)
(also called air line
respirator)
Disadvantages
Less bulky and heavy than an SCBA;

SAR equipment weigh less than 5 pounds
(or around 15 pounds, if escape SCBA
protection is included)
Not approved for use in IDLH or oxygendeficient atmospheres (less 19.5 percent
oxygen at sea level) unless equipped
with an emergency egress unit, such as an
escape-only SCBA, that can provide
immediate emergency respiratory
protection in case of air line failure
Protects against most airborne contaminants
Impairs mobility
Mine Safety and Health Administration/
NIOSH certification limits hose length to
300 feet
As the length of the hose is increased, the
minimum approved airflow may not be
delivered at the faceplate
Air line is vulnerable to damage, chemical
contamination, and degradation.
Decontamination of hoses may be difficult
Worker must retrace steps to leave work area
Requires supervision/monitoring of the air
supply line
B4
Appendix C
LEVELS OF PROTECTION
C1
C2
Appendix C
Levels of Protection1
Level of
A
Should be
used when:
Limiting
Criteria
Recommended:
The highest available
Pressure-demand, full
level of respiratory,
facepiece SCBA or pressure- skin, and eye protection
demand, supplied-air
respirator with escape SCBA
The chemical substance has

been identified and requires the
highest level of protection for
skin, eyes, and the respiratory
systems based on:
Fully-encapsulated
suit; material must
be compatible with
the substances
involved
Fully-encapsulated, chemicalresistant suit
-measured (or potential for)

high concentration of
atmospheric vapors, gases, or
particulates; or
Inner chemical-resistant
gloves
boots/shoes
Two-way radio
communication
Optional:
Cooling unit
Coveralls
Hard hat
Disposable gloves and
boot covers
Protection
Provided
-site operations and work

functions involving a high
potential for splash, immersion,
or exposure to unexpected
vapors, gases, or particulates of
materials that are harmful to
skin or capable of being
absorbed through the intact skin
Substances with a high degree of
hazard to the skin are known or
suspected to be present, and
skin contact is possible
Operations must be conducted
in confined, poorly ventilated
areas until the absence of
conditions requiring Level A
protection is determined
Reprinted from NIOSH/OSHA/USCG/EPA 1985. Occupational Safety and Health Guidance Manual for Hazardous Waste Site
Activities. Washington, D.C.: Department of Health and Human Services.
C3
Appendix C (continued)
Level of
B
Recommended:
Pressure-demand,
full-facepiece SCBA or
pressure-demand, suppliedair respirator with escape
SCBA
Protection
Provided
Should be
used when:
The same level of

respiratory protection,
but less skin protection
than Level A
The type and atmospheric

concentration of substances
have been identified and require
a high level of respiratory
protection, but less skin
It is the minimum level protection. This involves:
Chemical-resistant clothing recommended for initial
(overalls and long sleeved site entries until the
-atmosphere with IDLH
jacket; hooded, one- or
hazards have been
concentrations of specific
two-piece chemical splash further identified
substances that do not
suit; disposable chemicalrepresent a severe skin
resistant one-piece suit)
hazard; or
Inner and outer chemicalresistant gloves
-atmosphere containing less

than 19.5 percent oxygen
boots/shoes
Presence of incompletely
identified vapors or gases is
indicated by direct-reading
organic vapor detection
instrument, but vapors and
gases are not suspected of
containing high levels of
chemicals harmful to skin or
capable of being absorbed
through intact skin
Hard hat
Two-way radio
communications
Limiting
Criteria
Use only when the

vapor or gases
present are not
suspected of
containing high
concentrations of
chemicals that are
harmful to skin or
capable of being
absorbed through
intact skin
Use only when it is
highly unlikely that
the work being
done will generate
either high
concentrations of
vapors, gases, or
particulates or
splashes of
material that
will affect exposed
skin
Optional:
Coveralls
Disposable boot covers
Face shield
C4
Appendix C (continued)
Level of
Protection
C
Equipment
Protection
Provided
Recommended:
Full-facepiece, air-purifying, No respiratory
canister-equipped respirator protection; minimal
skin protection
Chemical-resistant clothing
(overalls and long sleeved
jacket: hooded, one- or twopiece chemical splash suit;
disposable chemical-resistant
one-piece suit)
Should be
used when:
Limiting
Criteria

known hazard
This level should

not be worn in the
Exclusion Zone
Work functions preclude,

splashes immersion, or the
chemicals
The atmosphere
must contain at
least 19.5 percent
oxygen
Hard hat
Optional:
Gloves
Escape mask
Face shield
D
Recommended:
Coveralls
Safety boots/shoes
Safety glasses or chemical
splash goggles
Hard hat
No respiratory
protection; minimal
skin protection

known hazard
Work functions preclude
splashes, immersion, or the
chemicals
This level should

not be worn in the
Exclusion Zone
The atmosphere
must contain at
least 19.5 percent
oxygen
Optional:
Gloves
Escape mask
Face Shield
C5
Comments
The Agency for Toxic Substances and Disease Registry would greatly appreciate your comments
and suggestions for improving future editions of this guidance document. Comments may be addressed
to:
Scott V. Wright
Emergency Response and Scientific Assessment Branch (MS E57)
Atlanta, GA 30333
C6
C7
C8
Managing
Hazardous
Materials
Incidents
Volume III
(Revised)
Medical Management
Guidelines
for
Acute Chemical Exposures

The state of knowledge regarding the treatment of patients potentially exposed to hazardous
substances in the environment is constantly evolving and is often uncertain. In this document, the
Agency for Toxic Substances and Disease Registry (ATSDR) has made diligent effort to ensure
the accuracy and currency of the information presented but makes no claim that the document
comprehensively addresses all possible situations related to this topic. This document is intended
as an additional resource for physicians and other health professionals in assessing the condition
and managing the treatment of patients potentially exposed to hazardous substances. It is not,
however, a substitute for the professional judgment of a health care provider and must be
interpreted in light of specific information regarding the patient available to such a professional
and in conjunction with other sources of authority.

2000
ATSDR
CONTENTS
Page
Acronyms and Abbreviations

Preface
Acknowledgments
Introduction
Chemical Protocols
iii
v
vii
1
Acrylonitrile
Ammonia
Aniline
Arsenic Trioxide
Arsine
Benzene
Blister Agent (H, HD, HT)
Blister Agent (HN1, HN2, HN3)
Blister Agent (HL, L)
1,3-Butadiene
Chlordane
Chlorine
Ethylene Glycol
Ethylene Oxide
Formaldehyde
Gasoline
Hydrogen Chloride
Hydrogen Cyanide
Hydrogen Fluoride
Hydrogen Peroxide
Hydrogen Sulfide
Mercury
Methyl Bromide
Methylene Chloride
Nerve Agent (GA, GB, GD, VX)
Nitrogen Oxides
Parathion
Phenol
Phosgene
Phosgene Oxime
Phosphine
Sodium Hydroxide
Sulfur Dioxide
Tetrachloroethylene
Toluene
Trichloroethylene
Vinyl Chloride
Xylene
ATSDR
Appendix I
Appendix II
Appendix III
Appendix IV
Glossary
ii
ATSDR
Regional Poison Control Centers
Association of Occupational and

Environmental Clinics
State Health Departments
Consultation Resources
A-1
A-11
A-20
A-27
G-1
Acronyms
Acronyms and Abbreviations

AAPCC
ABG
ABS
ACGIH
AIHA
ALS
AOEC
ARDS
ATSDR
BAL
BUN
C
CDC
CAS
CBC
CERCLA
CNS
CPC
CPK
DC
DHHS
dL
DMSA
DNA
DOT
ECG
ED
EEG
EMS
EMSA
EPA
ERPG
F
g
GABA
GAO
GI
G6PD
HAZMAT
HCl
HClO
HSDB
American Association of Poison Control Centers

arterial blood gases
acrylonitrile/butadiene/styrene
advanced life support
Association of Occupational and Environmental Clinics
acute respiratory distress syndrome
British anti-Lewisite (dimercaprol)
blood urea nitrogen
Celsius
Centers for Disease Control and Prevention
Chemical Abstract Service
complete blood count
Comprehensive Environmental Response, Compensation, and Liability Act
central nervous system
chemical protective clothing
creatine phosphokinase
direct current
Department of Health and Human Services
deciliter
2,3-demercaptosuccinic acid
deoxyribonucleic acid
Department of Transportation
electrocardiogram
emergency department
electroencephalogram
emergency medical services
Emergency Medical Services Authority
Environmental Protection Agency
Emergency Response Planning Guideline
Fahrenheit
gram
gamma aminobutyric acid
General Accounting Office
gastrointestinal
glucose-6-phosphate dehydrogenase
hazardous material
hydrochloric acid
hypochlorous acid
Hazardous Substances Data Bank
ATSDR
iii
Acronyms
IARC
IDLH
IRIS
i.v.
kg
L
m
mEq
mg
mL
mm Hg
m3
MSDS
MSHA
MTBE
MW
NAC
NFPA
NIOSH
NO
NPIRS
NTP
OSHA
PAM
PEG
PEL
PhAC
Po2
ppm
PVC
RADS
RBC
SARA
SCBA
STEL
TBA
TOCP
TSCA
TWA
TERIS
UN
UV
WHO
iv
International Agency for Research on Cancer

immediately dangerous to life and health
Integrated Risk Information System
intravenous
kilogram
liter
meter
milliequivalent
milligram
milliliter
millimeters of mercury
cubic meters
Material Safety Data Sheet
Mine Safety and Health Administration
methyl-t-butyl ether
molecular weight
N-acetylcysteine
National Fire Protection Association
nitric oxide
National Pesticides Information Retrieval System
National Toxicology Program
pralidoxime chloride
polyethylene glycol
permissible exposure limit
S-phenyl-N-acetyl cysteine
partial pressure of oxygen
parts per million
polyvinyl chloride
reactive airways dysfunction syndrome
red blood cel1
Superfund Amendments and Reauthorization Act
self-contained breathing apparatus
short-term exposure limit
t-butyl alcohol
tri-o-cresyl phosphate
Toxic Substances Control Act
time-weighted average
Teratogen Information Service
United Nations
ultraviolet
World Health Organization
ATSDR
Preface
Preface
The Agency for Toxic Substances and Disease Registry (ATSDR) is an agency of the Public Health
Service in the U.S. Department of Health and Human Services (DHHS). ATSDR was created by the
U.S. Congress through the Comprehensive Environmental Response, Compensation, and Liability Act
of 1980 (CERCLA). The Agencys responsibilities were markedly increased through the Superfund
Amendments and Reauthorization Act of 1986 (SARA). The mission of ATSDR is to prevent or
mitigate adverse human health effects and diminished quality of life resulting form exposure to
hazardous substances in the environment. In pursuit of this mission, ATSDR provides educational and
referral resources to health care providers who are responsible for chemically exposed patients.
The Medical Management Guidelines for Acute Chemical Exposures (Guidelines) is designed to
assist emergency department physicians. It is the third volume in a 3-volume series provided by
ATSDR. The Guidelines contain 40 chemical-specific protocols that provide recommendations for the
on-scene (prehospital) and hospital (ED) medical management of patients exposed during a hazardous
materials (HAZMAT) incident. Other rescue personnel, such as first responders, emergency medical
technicians, and public health officials, will also find the information useful, but because of the focus
of the protocols, these professions are encouraged to rely on other sources and training in their
primary field for more definitive and complete guidance.
Each chemical protocol is divided into five sections.
(1)
Description: Contains synonyms, appearance, routes of exposure; potential for

secondary contamination, sources/uses, physical properties, and exposure standards.
(2)
Health Effects: Contains organ systems affected by acute exposure, potential

sequelae, and effects of chronic exposure.
(3)
Prehospital Management: Contains personal protection, decontamination, support,

triage, and transportation. Organized by Hot Zone, Decontamination Zone, and
Support Zone.
(4)
Emergency Department Management: Contains specific medical procedures to

treat the exposed patient, and patient disposition. Organized by Decontamination Area
and Critical Care Area.
(5)
Patient Information Sheet: Contains information on exposure, potential effects, and

follow-up instructions for the victims of a HAZMAT incident.
ATSDR
Preface
The Introduction to this volume provides important background information and a brief overview of
the activities at a HAZMAT incident. For more information on managing HAZMAT activities,
consult Volumes I and II, Emergency Medical Services: A Planning Guide for the Management of
Contaminated Patients, and Hospital Emergency Department: A Planning Guide for the
Management of Contaminated Patients, respectively. The Introduction also describes the use,
rationale, and limitations of the data contained in each section of a chemical protocol. It is written in
the format of an individual protocol. The Prehospital Management and Emergency Department
Management sections of the Introduction begin with the recommendations form the Unidentified
Chemical protocol. The recommendations are followed by the rationale for the procedures suggested.
The reader is urged to complete the Introduction before attempting to use the individual protocols.
Appendices I through IV contain resources for the emergency department physician seeking
consultation in treating chemically exposed patients: AAPCC-Certified Regional Poison Control
Centers; Association of Occupational and Environmental Health Clinics; State Health Officials; and
private, university, and government consultants are listed. In addition, the Guidelines contains a
glossary of chemical and medical terminology.
vi
ATSDR
Acknowledgments
Acknowledgments
who participated in making this a useful guidance document.
This project was directed by Scott V. Wright, ATSDR. For the 2000 version, Lisa Ingerman, Ph.D.,
of Syracuse Research Corporation (SRC) was the project manager, and A. Rosa MacDonald, Ph.D.,
Fernando Llados, Ph.D., and Susan Little, Ph.D., of SRC were contributing scientists (under ATSDR
contract No. 205-1999-00024).
The major contributors to the original (1992) Medical Management Guidelines for Acute Chemical
Exposures were Jonathan Borak, MD, Kent R. Olson, MD, and Virginia Sublet, PhD.
The following experts served as peer reviewers for the original 1992 document and the 2000 update:
Eddy Bresnitz, MD, MS, FACP, Frederick M. Burkle. Jr., MD, MPH, Robert Geller, MD, ABMT,
Lewis Goldfrank, MD, FACP, FACEP, ABMT, Alan Hall, MD, FACEP, ABMT, William Lixey,
David C. Logan, MD, MPH, Linda Rae Murray, MD, MPH, Kent R. Olson, MD, FACEP, ABMT,
and Rebecca L. Tominack, MD, ABMT.
ATSDR
ATSDR
Introduction
Introduction
This Introduction, which is in the same format as the individual protocols, describes the use and
limitations of the information presented. The Prehospital and Emergency Department sections
incorporate the Unidentified Chemical protocol as an example. The Introduction is key to the
appropriate use of the protocols. Even trained and experienced responders are urged to read it
before using the individual protocols in an emergency situation.
ATSDR
Introduction
Use of trade names is for identification only and does not imply endorsement by the Public Health Service
or the U.S. Department of Health and Human Services.
ATSDR
Introduction
General Information Section

Chemical Name (Chemical Formula)
CAS Number; UN Number
Common synonyms
C
C
C
Potential for secondary contamination

Common form and important characteristics such as odor and flammability
Routes of exposure and potential for absorption
Secondary Contamination
Primary contamination refers to direct contact of the victim with

the hazardous material. Secondary contamination refers to the
transfer of material from the victim to personnel or equipment.
The potential for secondary contamination has implications for
decontamination and triage of victims and for the protection of
rescue and health care personnel. Immediate victim
decontamination is recommended for materials that pose risks of
secondary contamination; this eliminates both the potential for
rescuer contamination and further exposure to the victim.
A substance poses a risk of secondary contamination if it is both
toxic and likely to be carried on the clothing, skin, or hair of
victims in sufficient quantities to threaten other personnel.
Substances that present the most serious risks of secondary
contamination include the following:
C
C
C
highly toxic liquids and solids or finely divided solids (e.g.,

organophosphate pesticides)
radioactive liquids and dusts
certain biologic agents (e.g., harmful viruses or bacteria)
Every effort must be made to decontaminate contaminated victims

before they are transported to a medical care facility.
Examples of substances with little or no risk of secondary
contamination include the following:
C
C
C
gases (e.g., carbon monoxide, amine)

vapors (unless they condense to a liquid state on clothing or
skin)
substances with no serious toxicity or skin absorption (e.g.,
propylene glycol, motor oil)
Note that although several of the substances listed above are

highly toxic (e.g., arsine, carbon monoxide), they do not pose
ATSDR
General Information
Introduction
risks of secondary contamination because these chemicals will not

contaminate the victim; therefore, they cannot secondarily
contaminate rescuers.
Secondary contamination also may be a risk in cases of ingestion.
Ingested materials may react with stomach acid to produce
noxious gases, which can pose risks to both the victim and
rescuers. Vomitus may off-gas the hazardous material or a
reaction product. Toxic vomitus should be quickly isolated in
closed containers.
Previously published documents on hazardous materials have
recommended zipping patients into body bags to minimize the
transfer of chemical from patient to rescuer. This technique is not
completely effective for preventing rescuer exposure, and it may
pose a significant risk of increased dermal absorption to victims.
Body bags are not recommended as an alternative to thorough
decontamination.
Description
This section summarizes the color, odor, and physical state (solid,
liquid, or gas) of the chemical at room temperature. Methods of
shipment or storage and the physical hazards associated with the
chemical are also described.
Routes of Exposure
The most likely routes of exposure--inhalation, direct contact with

the skin or eyes, and ingestion-are described. For each route of
exposure, the risk of injury depends on the toxicity of the chemical
involved, the concentration of the material, and the duration of
con tact.
Inhalation
Inhalation is the most common route of exposure to gases and

vapors. Liquids and solids may also be inhaled when they are
finely divided mists, aerosols, fumes, or dusts. Highly watersoluble gases and vapors and larger mist or dust particles (greater
than 10 microns in diameter) generally are deposited in the upper
airways. Less soluble gases and vapors and smaller particles can
be inhaled more deeply into the respiratory tract. Usually, highly
water-soluble materials rapidly produce symptoms of upperairway irritation, whereas less soluble materials may produce
delayed symptoms in the lower airways. Inhaled substances may
be absorbed into systemic circulation, causing toxicity to various
organ systems. When available, information is provided on odor
threshold, warning properties, and symptoms to be expected at
specific exposure levels.
Skin/Eye Contact
Skin and eye contact can occur by exposure to solids, liquids, or

gases. Corrosive agents cause direct damage to tissues by various
General Information
ATSDR
Introduction
mechanisms including low or high pH, chemical reaction with

surface tissue, removal of normal skin fats (defatting), or removal
of moisture (desiccant effect). Some chemicals absorbed through
the skin and eyes can produce systemic toxicity. Absorption, and
therefore toxicity, is more likely to occur when the normal skin
barrier is disrupted (e.g., chemical bum, cut, or abrasion) or when
the chemical is highly fat-soluble (e.g., organophosphate and
organochlorine pesticides).
Ingestion
Ingestion is not a common route of exposure in most hazardous

materials (HAZMAT) incidents, although it is common in suicide
attempts. Ingestion of corrosive agents can cause severe burns to
the mouth, throat, esophagus, and stomach. Ingested chemicals
may also be aspirated into the lungs, especially after vomiting,
causing chemical pneumonitis. Ingested chemicals may react with
stomach acid, creating products that are toxic to the patient, and
potentially, the health care provider (e.g., hydrogen cyanide from
ingested cyanide salts).
Sources/Uses
This section describes the chemicals most common uses and the
methods of production.
Standards and Guidelines
Government agencies and professional organizations have

established standards and guidelines for hazardous chemical
exposures. The standards and guidelines address both acute and
chronic exposures.
The Occupational Safety and Health Administration (OSHA)
permissible exposure limit (PEL) is a regulatory limit established
to avoid adverse health effects from exposure. PELs are timeweighted-average (TWA) air concentrations. In most cases, a
healthy, working adult can be exposed to a chemical at the PEL
for an g-hour workday and a 40-hour workweek and suffer no
adverse health effects. If the measured air concentration at a
HAZMAT incident is less than the PEL and the exposure is shortterm, persons at the scene are probably not at serious risk. The
OSHA skin designation indicates the likelihood of dermal
absorption.
The OSHA ceiling is an instantaneous concentration that must not
be exceeded any time. If instantaneous monitoring is not feasible,
the ceiling is normally assessed as a 15minute TWA concentration.
The OSHA short-term exposure limit (STEL) is a 15-minute

(unless otherwise noted) TWA concentration that should not be
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General Information
Introduction
exceeded at any time, even if the 8-hour TWA concentration is

below the PEL.
The National Institute for Occupational Safety and Health
(NIOSH) recommends workplace exposure guidelines. The
NIOSH immediately dangerous to life or health (IDLH) level
represents the maximum chemical concentration from which one
could escape within 30 minutes without a respirator and without
experiencing any escape-impairing (e.g., severe eye irritation) or
irreversible health effects.
The American Industrial Hygiene Association (AIHA) Emergency
Response Planning Guidelines (ERPG) state concentrations at
which one might reasonably anticipate observing adverse effects
from exposure to specific substances. Unlike occupational expo
sure standards, ERPG levels are applicable to the general public,
including children and the elderly. The three ERPG levels vary
with the health effects expected with exposure (transient
symptoms, ability impairment, and life-threatening) and apply to
practically all persons. The table in the Properties section includes
only ERPG-2-the exposure level that could impair a persons
ability to take protective action.
ERPG levels are defined as follows:
ERPG-1 is the maximum airborne concentration below which it is
believed that nearly all persons could be exposed for up to 1 hour
without experiencing symptoms other than mild transient adverse
health effects or perceiving a clearly defined objectionable odor.
believed that nearly all persons could be exposed for up to 1 hour
without experiencing or developing irreversible or other serious
health effects or symptoms that could impair their abilities to take
protective action.
believed that nearly all individuals could be exposed for up to 1
hour without experiencing or developing life-threatening health
effects.
Physical Properties
Description: Physical state and useful characteristics of the

chemical at room temperature are presented.
Warning properties: Odor and irritation are the primary
determinants of exposure awareness. When available, an objective
description of odor (e.g., garlic-like) and the lowest air
General Information
ATSDR
Introduction
concentration that can be detected (i.e., odor threshold) is

provided. For chemicals with an odor threshold below the toxic air
concentration, odor may provide an adequate warning of
dangerous exposure conditions. However, a chemical is
considered to have inadequate warning properties if it has no
detectable odor at toxic air concentrations, has an odor that is not
reliably detected because of olfactory fatigue, or does not cause
irritation.
Molecular weight (MW) is the sum of the weights of the atoms
in a molecule. Molecular weight is provided in daltons, a unit that
is based on the mass of oxygen- 16. Molecular weight can be used
to convert measurements of air concentrations of chemicals from
parts per million (ppm) to milligrams per cubic meter (mg/m3)
using the following equation:
mg/m3 = (ppm x M W) / 22.4 L/mole
(1 mole of gas occupies 22.4 L at standard
temperature and pressure).
Boiling point of a liquid is the temperature at which its vapor
pressure is equal to the atmospheric pressure. A boiling point at
or below room temperature means that the chemical is in the
gaseous state at room temperature.
Freezing point is the temperature at which a chemicals solid
phase is in equilibrium with the liquid phase. Freezing point and
melting point are equal in numeric value. The termfreezing point
refers to the temperature at which a liquid forms a solid; melting
point refers to the temperature at which a solid forms a liquid.
Specific gravity is the ratio of the density of a liquid to the
density of a reference material (usually water). A specific gravity
less than 1 indicates that the substance will float on water; a
specific gravity greater than 1 indicates that the substance will sink
in water.
Vapor pressure is the pressure (expressed in millimeters of
mercury [mm Hg] of a vapor in equilibrium with its liquid or solid
form at a given temperature. The higher the vapor pressure, the
greater the amount of chemical existing in the vapor phase. A
vapor pressure greater than 760 mm Hg at room temperature
indicates that the chemical exists as a gas.
Gas density is the ratio of the density (weight per volume) of a
substance (at a given temperature) to the density of air (at that
temperature). A gas density greater than 1 indicates that the vapor
or gas is heavier than air. A gas heavier than air may collect in
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General Information
Introduction
low-lying areas where it can displace air, creating an oxygendeficient atmosphere.

Water solubility indicates the degree to which a substance
dissolves in water at a specific temperature. Water solubility is
measured in weight of substance per volume of water (e.g.,
g/100 ml or %). Water solubility may indicate the effectiveness of
water in decontamination. A substance that is water soluble is
likely to be removed from the skin and hair with a plain water
wash. Substances that are poorly water soluble may require the
use of soap.
Flammability is the ease with which a material will ignite.
Flammable chemicals have flash points below l00 F; combustible
chemicals have flashpoints between 100 F and 200F; and
nonflammable chemicals have flashpoints above 200 F.
Flammable range (lower explosive limit to upper explosive limit)
is expressed as the percentage of gas or vapor dispersed in air that
will bum when an ignition source is present. The temperature, the
flammable range, and the potential for a vapor or gas to travel to
an ignition source and flash back may affect rescue activities. The
flammable range may indicate the need for special protective
clothing. Most chemical-resistant protective clothing is neither
heat- nor flame-resistant and may melt if a fire occurs.
Incompatibilities
General Information
ATSDR
HAZMAT incidents commonly involve more than one chemical.

Incompatibility and reactivity information, primarily from the
NIOSH Pocket Guide to Chemical Hazards, is included in this
section.
Introduction
Health Effects Section

C
C
Common symptoms
Systemic effects and mechanism of action
Health risk depends on the intrinsic toxic potential of the chemical,

its concentration, and the duration of exposure. Highly toxic
chemicals may pose a risk of illness even if the exposure duration
is brief or the concentration of the substance is low. Even mildly
toxic substances, however, can be hazardous if the exposure is
prolonged or the concentration is high.
Acute Exposure
When suspected or known, the mechanism of action is discussed.

Acute exposure is defined as chemical exposure of less than 14
days duration. Most HAZMAT incidents involve acute exposures
that last only minutes, but the chemical concentration may be
extremely high. Although HAZMAT incident exposures are likely
to be short, risks of adverse health effects still exist. The onset of
health effects caused by acute exposure can be immediate or
delayed.
Organ systems or metabolic processes that are adversely affected
by the chemical are discussed in the following sections. The organ
system or metabolic process mentioned first in each chemical
protocol is the most severely affected, those not affected by the
chemical are not addressed.
Cardiovascular
Many chemicals have direct depressant or stimulatory effects on

cardiac function. Hypotension and dysrhythmias may be
aggravated by hypoxia from respiratory depression or pulmonary
aspiration of gastric contents. Hypotension may also occur
because of volume depletion from excessive vomiting, diarrhea, or
severe chemical bums.
Certain solvents (e.g., chlorinated hydrocarbons, freons, aromatic
hydrocarbons) may lower the myocardial threshold to the
dysrhythmogenic effects of catecholamines. For several hours after
solvent exposure, a victim may be susceptible to ventricular
dysrhythmias (e.g., premature ventricular contractions, ventricular
tachycardia, or ventricular fibrillation) especially from
administered sympathomimetic drugs such as bronchodilators or
dopamine or the increased quantity of endogenous epinephrine
produced during intense physical activity.
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Health Effects
Introduction
CNS
Central nervous system (CNS) depressants (e.g., hydrocarbon

solvents) cause a generalized decrease in brain activity. Headache,
dizziness, confusion, lethargy, stupor, or coma may result. Severe
depression of the brain stem can cause respiratory arrest and
cardiovascular collapse. Some chemical depressants have early
stimulatory effects, producing euphoria and giddiness similar to
ethanol.
CNS stimulants (e.g., organophosphate insecticides) can cause
agitation, anxiety, delirium, and seizures. Excessive muscular
activity associated with seizures can cause hyperthermia.
Dermal
Dermal contact with chemicals can produce local injury; if

absorbed, chemicals can also produce systemic effects. Local
injuries (e.g., burns from mineral acids) usually are immediately
obvious. However, a few chemicals (e.g., alkaline corrosives,
hydrofluoric acid) cause a progressive penetrating injury that may
not be apparent for hours.
The skin generally provides a relatively impermeable protective
barrier. Many chemicals disrupt the skins integrity by removing
fats, producing chemical burns, or destroying cells. Physical injury
such as thermal bums or traumatic events may also result in loss
of the skins barrier effect. Disruption of the normal protective
barrier allows easier entry of chemicals into systemic circulation.
Systemic illness can also occur without skin damage because many
fat-soluble chemicals (e.g., some organophosphate insecticides)
rapidly penetrate intact skin.
10
Electrolyte
Some chemicals can produce effects on serum electrolytes (e.g.,

potassium, calcium, sodium) and total anion gap. Electrolyte
imbalance can cause muscle weakness and cardiac dysrhythmias.
Gastrointestinal
Nausea, vomiting, abdominal pain, and diarrhea are common

symptoms after chemical exposure and may be due to direct
gastrointestinal irritation or to systemic effects. Ingestion of some
chemicals can also cause severe corrosive injury to the mouth,
throat, esophagus, and stomach, with bleeding, perforation,
scarring, or stricture formation as potential sequelae.
Hematologic
Components of the blood and blood-forming organs can be

damaged by many chemicals (e.g., arsine, benzene). Most
hematologic changes (e.g., hemolysis, methemoglobinemia, bone
marrow suppression, and anemia) can be detected by blood tests
or simply by the color or appearance of the blood
Health Effects
ATSDR
Introduction
Hepatic
Some chemical exposures result in acute injury to the liver, which

typically does not manifest for 2 to 3 days after exposure. At that
time, laboratory tests will show abnormal liver function (e.g.,
elevated bilirubin or aminotransferase levels or increased
prothrombin time). Toxic hepatitis may progress to liver failure
and death.
Immunologic
Immunologic effects may include induced sensitivity and allergy.
Metabolic
Metabolic acidosis is the most common adverse metabolic effect

that occurs after chemical exposure. Acidosis results from an
accumulation of acid anions such as formic, lactic, or oxalic acid.
Musculoskeletal
Musculoskeletal damage due to chemical exposure is unusual.

Some effects are arthritis and hardening, destruction, or cancer of
the bone.
Ocular
Most serious ocular injuries result from direct eye contact with
corrosive liquids or solids. High concentrations of or prolonged
exposures to gases or vapors may also injure the eye. Severe eye
exposure carries a risk of blindness or other visual impairment and
demands immediate evaluation by an ophthalmologist.
Most patients who have eye injuries involving the conjunctival or
cornea1 surfaces experience pain and irritation, excessive
lacrimation, and possibly crusting and swelling of the eyelids.
Generally, corneal damage causes intense pain and the sensation
of a foreign body in the eye.
Peripheral Neurologic
Peripheral nervous system effects can include changes in

sensation, reduced reflexes, and impaired motor function. Effects
are pronounced in the largest muscle groups such as those in the
lower limbs.
Renal
Some chemicals injure the kidneys directly. In addition, any

poisoning causing massive muscle destruction can lead to kidney
injury from excessive myoglobin in the kidney tubules.
Respiratory
Inhalation of a chemical irritant (e.g., ammonia, chlorine) usually

causes rapid onset of burning and irritation of the nose, throat, and
upper respiratory tract. Painful coughing, wheezing, and stridor
may develop. If the exposure is massive, death may rapidly ensue
from upper airway obstruction, massive alveolar destruction, or
asphyxiation. Chest radiography may indicate pulmonary edema
when damaged lung cells allow fluid to leak into the alveoli
(referred to as noncardiogenic pulmonary edema because the fluid
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Health Effects
11
Introduction
accumulation is not caused by left ventricular failure, which occurs

in cardiogenic pulmonary edema).
The onset and location of respiratory symptoms is partially related
to the water solubility of the inhaled chemical. Highly watersoluble gases, such as ammonia, cause rapid onset of symptoms
(burning nose and throat, painful cough, stridor, wheezing) as the
gases dissolve in the mucous membranes of the upper respiratory
tract. However, less soluble gases such as phosgene are breathed
deeply into the lower airways and typically cause only mild or no
early symptoms; noncardiogenic pulmonary edema may develop
after 12 to 36 hours.
Injury to the respiratory tract also can occur after ingestion of a
chemical substance. The unconscious or convulsing patient may
vomit and then, because of depressed airway protective reflexes,
may aspirate gastric contents into the lungs. Pulmonary aspiration
of an ingested hydrocarbon can cause severe pneumonitis.
Hydrocarbons irritate the lung tissue and interfere with surface
tension in the alveoli, disrupting gas exchange. Pulmonary
aspiration can sometimes be prevented by inserting a cuffed
endotracheal tube into the patients airway or by placing the
patient in a head-down, left-side position and using suction
immediately if vomiting occurs.
Potential Sequelae
Known or suspected sequelae and the prognosis for recovery after

an acute exposure are described in this section. Signs and
symptoms expected at various stages of recovery and the potential
for permanent deficits are presented.
Chronic Exposure
Repeated, low-level exposures, typically over a long period of

time, may produce health effects that differ in type or degree from
effects of acute exposure. Most information about chronic toxicity
is from epidemiologic studies and case reports of workplace
exposures. Because HAZMAT incidents are unlikely to involve
repeated or long-term exposures, chronic health effects are
outlined only briefly.
Some major concerns of patients who have experienced an acute
chemical exposure are the risks of cancer, reproductive effects, or
impaired fetal development. No data exist on these outcomes from
acute exposure to most chemicals. However, to guide the clinician
who must address these patient concerns, we have included
carcinogenic, reproductive, and developmental effects that have
resulted from chronic exposure to the chemical. It is not known
whether the data from chronic exposures are applicable to victims
who are acutely exposed in a HAZMAT incident.
12
Health Effects
ATSDR
Introduction
Carcinogenicity
Reproductive and
Developmental Effects
The cancer information included in this section is derived from

assessments made by the Department of Health and Human
Services (DHHS), the International Association for Research on
Cancer (IARC), or the Environmental Protection Agency (EPA).
These organizations develop ratings of chemicals that indicate the
cancer-producing ability of the chemicals. The information
included was based on the following hierarchy: DHHS is offered
if available, then IARC, then EPA. Failure of these organizations
to evaluate a chemical does not necessarily mean that the chemical
does not cause cancer.
Information about reproductive and developmental effects was

obtained primarily from three data files that are included in
TOMES Plus, a proprietary database of Micromedex, Inc.,
Denver, CO. These data files are Reprotext, edited by Betty J.
Dabney, PhD; the Teratogen Information System (TERIS),
developed by the University of Washington; and Shepards
Catalog of Teratogenic Agents, written by Thomas H. Shepard,
MD. An additional source of information was Reproductive and
Developmental Toxicants, a 1991 report published by the U.S.
General Accounting Office (GAO Report no. GAOLPEMD-92-3)
that lists 30 chemicals of concern because of widely acknowledged
reproductive and developmental consequences. The 30 chemicals
are alcohol, arsenic, cadmium, carbon disulfide, carbon monoxide,
chlordecone, chloroprene, DDT, DBCP, DES, ethylene
dibromide, EGEE, EGME, ethylene oxide, gossypol,
hexachlorobenzene, lead, lithium, mercury, nicotine, PBBs, PCBs,
2,4,5-T, TCDD, tobacco smoke, toluene, vinyl chloride, vitamin
A, and warfarin.
The topic of reproductive hazards is controversial and emotionally
charged. Potentially high risk to the fetus may warrant considering
termination of the pregnancy. Most clinicians are not adequately
prepared to help the patient make this decision. Expert assistance
may be available from regional poison control centers, regional
reproductive risk/teratogen information centers, or the
MotherRisk Program. For more information, see Appendices I and
III.
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13
Introduction
14
Health Effects
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Introduction
Prehospital Management Section

The Prehospital Management section describes the activities that typically occur in the three concentric
areas surrounding a HAZMAT incident (Figures 1 and 2), particularly those activities that relate to
Emergency Medical Services (EMS) personnel. The Hot Zone (or Exclusion Area) is the area
surrounding the chemical release; it is assumed to pose an immediate health risk. The Decontamination
Zone (or Warm Zone) is the area surrounding the Hot Zone where primary contamination is not expected
but where personnel must use protective clothing and equipment to avoid chemical exposure from
contaminated victims. The Support Zone (or Cold Zone) is the outermost ring where no exposure or risk
is expected. The incident commander, medical personnel, and other support persons and equipment
operate in the Support Zone. The information provided in the chemical protocols is an attempt to offer
an accurate and practical approach to the management of hazardous materials emergencies. The user of
the protocols should be aware that large data gaps exist in the scientific literature.
Goals of the EMS HAZMAT Responder
C
Protect yourself. Approach the Scene cautiously, arriving upwind. Maintain a safe distance and
inspect the scene from a nearby elevated area such as a hill. Respect the established exclusion zones
and resist the temptation to rush in to attempt a rescue. If a command post has been established,
report to the incident commander.
Identify the chemical. Be familiar with the Department of Transportation (DOT) placard system, the
National Fire Protection Association (NFPA) hazard labeling system, Material Safety Data Sheets
(MSDS), and shipping papers.
Consult the appropriate protocol and local sources to obtain information about the chemical, its
health effects, and medical treatment.
Determine the potential for secondary contamination. Understand the risk to yourself and to others
in the Support Zone, ambulance, or hospital if decontamination is not completed at the scene.
Perform appropriate and thorough decontamination.
Provide basic and advanced life support (ALS).
Transport victims to an appropriate medical facility as quickly as possible.
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Prehospital Management
15
Introduction
Figure 1. Organization of a HAZMAT incident area
Adapted from Olson, KR, ed. Poisoning and drug overdose. Norwalk, CT: Appleton and Lange, 1990.
16
ATSDR
Introduction
Figure 2. Detail of decontamination zone
Adapted from Hazardous material medical management protocols, 2nd edition. Sacramento, CA:
Emergency Medical Services Authority, 1991.
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Introduction
18
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Prehospital Management Section

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Health effects expected from an acute exposure
Patient care (supportive care, antidotes)
Secondary contamination is discussed on page 3 of the
Introduction.
In the prehospital setting, the key factors in determining the
potential for secondary contamination are the route and extent of
exposure. Victims exposed only to gas or vapor are not likely to
carry significant amounts of chemical beyond the Hot Zone and
are not likely to endanger personnel outside the Hot Zone.
However, victims whose skin, hair, or clothing is grossly
contaminated with solid or liquid chemical (including condensed
vapor) may contaminate personnel by direct contact or by offgassing vapor. Victims who have ingested a toxic chemical may
expose others through toxic vomitus or by vapor off-gassing from
toxic vomitus.
The bold text below is from the Unidentified Chemical protocol.
It is presented as an example of the information presented in each
section. The plain g&ace provides details or an explanation.
Hot Zone
Rescuers should be trained and appropriately attired

before entering the Hot Zone. If the proper equipment
Is not available, or if rescuers have not been trained in
its use, assistance should be obtained from a local or
regional HAZMAT team or other properly equipped
response organization.
The Hot Zone includes the area immediately around the chemical
spill where persons may be in danger from chemical exposure or
physical hazards (e.g., fire or explosion). Only persons who have
specialized HAZMAT training should enter the Hot Zone.
Although some of these persons may be trained as paramedics,
only limited medical care can be provided in the Hot Zone.
Advanced medical care is provided in the Decontamination Zone
and Support Zone.
Rescuer Protection
When a chemical is unidentified, worst-case possibilities

concerning toxicity must be assumed. The potential for severe
local effects ( e.g., irritation and burning) and severe systemic
ATSDR
19
Introduction
effects (e.g., organ damage) should be assumed when specific

rescuer-protection equipment is selected.
Respiratory Protection: Pressure-demand, selfcontained breathing apparatus (SCBA) should be used
in all response situations.
Skin Protection: Chemical-protective clothing should
be worn when local and systemic effects are unknown.
Trained responders should select protective equipment and
clothing based on the general regulations in 29 CFR 1910.120
(OSHA Hazardous waste operations and emergency response).
The protocols contain chemical-specific recommendations for
rescuer protection. The Rescuer Protection section begins with a
summary of the health hazards that are pertinent for one-time,
short-term exposures such as those expected at a HAZMAT
incident. The respiratory-tract and skin protection (e.g.,
respirators and chemical-protective clothing) recommendations
are based on these health hazards.
Two basic types of respiratory protection are available:
atmosphere-supplying and air-purifying respirators. Atmospheresupplying respirators provide compressed air at greater than
atmospheric pressure to a face mask that is worn by the rescuer
and may be supplied-air or self-contained.
The self-contained breathing apparatus (SCBA) is often used in
HAZMAT incident response to prevent inhalation of hazardous
chemicals because it is self-contained, portable, and familiar.
SCBA consists of a facepiece that seals, a tank of compressed air
carried on the back, and a hose that runs from the air tank to the
facepiece. The specific type of SCBA recommended in the
Guidelines is pressure demand; that is, although air is always
flowing into the facepiece (pressure), the flow increases in
response to inhalation (demand).
Although commonly used at hazardous waste clean-up sites, the
supplied-air respirator should not be used at a HAZMAT incident.
The supplied-air respirator consists of a mask or facepiece
connected to an air hose supplied by a compressor at a distant site.
Because the air hose may be degraded by chemicals or heat and
the hose may become tangled, the supplied-air respirator is not
practical for operations during an emergency.
20
ATSDR
Introduction
Air-purifying respirators do not supply air to the user; they simply

filter the ambient air and are seldom used at HAZMAT incidents.
Air-purifying respirators can use the same type of facepiece as an
air-supplied respirator. Instead of an air-supply hose, they are
connected to a charcoal or other filter-containing cartridge. The
cartridge filters the air before it is inhaled. Conditions that
preclude the use of an air-purifying respirator include
C
C
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oxygen-deficient atmosphere (19.5% O2)

unidentified contaminant
unknown concentration of contaminant
concentration of contaminant above NIOSH IDLH
high relative humidity
Most HAZMAT incidents involve at least one of these conditions;

therefore, air-purifying respirators are rarely appropriate for
emergency response.
Dust or surgical masks are also air-purifying-they filter and
prevent the inhalation of large particles. However, they offer no
protection from the inhalation of chemical vapors or gases and are
not recommended in the Guidelines.
Regardless of the type of respiratory protection used, all
respirators should be approved by NIOSH and the Mine Safety
and Health Administration(MSHA).NIOSH and MSHA designate
performance characteristics of respirators.
Chemical-protective clothing (CPC) is not subject to performance
standards set by a government agency. Chemical-specific
resistance to degradation, penetration, and permeation are
important factors to consider in selecting CPC. CPC that fails can
subject the wearer to significant exposure and adverse health
effects. Degradation involves the chemical breakdown of the suit
material itself, causing exposure. Penetration is movement of a
chemical through an opening in the material or article of clothing
(e.g., through punctures or zippers). Permeation involves chemical
movement through the suit material but not necessarily destruction
of it.
The NFPA has established performance standards for two types
of chemical-protective garments: a vapor-protective suit and a
liquid-splash-protective suit. The standards provide methods for
testing material and suits to assure chemical resistance, overall
durability, and valve/closure construction suitability. The vapor
protective suit is completely encapsulating; once the user is
attired, even exhaled air is trapped inside until pressure activates
ATSDR
21
Introduction
one-way release valves. Suits meeting the NFPA guidelines can be

used to provide protection according to the EPA classifications
described below. The certification accompanying protective
clothing that meets NFPA guidelines specifies the chemicals and
conditions under which the clothing was tested. The NFPA
performance standards do not address respiratory protection;
therefore, no assumptions can be made regarding respiratory
protection based on the NFPA suit designation.
EPA has established a 4-stage classification system to address the
levels of protection afforded by respiratory and chemicalprotective clothing combinations commonly used by HAZMAT
responders. The four classes, in descending order of protection,
are called levels A through D. The EPA definitions do not address
NFPA clothing; however, the equivalent NFPA suit is specified
below.
Level A includes a fully encapsulating chemical-resistant
suit (equivalent to an NFPA vapor-protective suit) and a
pressure-demand SCBA.
Level B includes a nonencapsulating chemical-resistant
suit (equivalent to an NFPA splash-protective suit) and an
SCBA.
Level C includes a nonencapsulating chemical-resistant
suit (equivalent to an NFPA splash-protective suit) and an
air-purifying respirator.
Level D consists of work clothes that do not provide any
specific respiratory or skin protection.
The EPA classification does not address use of the common firefighting ensemble - SCBA with turnouts or bunker gear.
Turnouts are not designed to protect against chemical exposure
and should not be worn when hazardous chemical exposure is
possible.
Specialized personal protective gear should be used only by those
with prior training and fitting. The choice of specific chemicalresistant materials (e.g., Tyvek, Saranex, or butyl rubber) is
beyond the scope of this document and is generally the
responsibility of an expert on the HAZMAT team. Additional
protective equipment may be required when risks of fire or
explosion exist.
22
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Introduction
Although CPC provides protection against adverse health effects

due to chemical exposure, it contributes to heat stress. CPC
prevents both the inward and. outward movement of moisture,
decreasing the availability of evaporative cooling. During an
incident, body heat builds quickly because of the heavy workload
and CPC prevents heat dissipation. Several cooling systems are
available for use under CPC; however, they serve only to reduce
peripheral body temperature and not core body temperature.
Because core body temperature does not decrease, cooling
systems may actually be harmful. By cooling the skin and making
the user feel more comfortable, cooling systems may encourage
rescuers to work longer and build up a dangerously high core
body temperature.
ABC Reminders
Quickly ensure a patent airway. If trauma is suspected,

maintain cervical immobilization manually and apply a
cervical collar and a backboard when feasible.
Only minimal patient care can be performed in the Hot Zone while
wearing Level A or Level B protective gear. Rescuers can often
perform only simple maneuvers such as ensuring a patent airway,
applying a cervical collar, brushing off gross contaminants, and
applying direct pressure to stop arterial bleeding. The goal in the
Hot Zone is to quickly remove the victim from continued
exposure and risk.
Victim Removal
If victims can walk, lead them out of the Hot Zone to

the Decontamination Zone. Victims who are unable to
walk may be removed on backboards or gurneys; if
these are not available, carefully carry or drag victims
to safety.
Victims should be removed from the Hot Zone to the
Decontamination or Support Zone, as appropriate, in the safest
and quickest way possible. Ambulatory victims may need to be
guided to the Decontamination Zone. Nonambulatory victims can
be removed on backboards, litters, or gurneys, or if necessary,
carefully dragged or carried to safety.
Decontamination Zone
Victims exposed only to gas or vapor who have no skin or eye

irritation may be transferred immediately to the Support Zone. All
others require decontamination (see Basic Decontamination,
page 25).
The Decontamination Zone is a corridor between the Hot Zone
and the Support Zone. The Decontamination Zone may be set up
in any convenient location that is safely beyond the Hot Zone, but
ATSDR
23
Introduction
separate from the Support Zone. If possible, the Decontamination

Zone should be established outdoors (preferably upwind and uphill
from the Hot Zone) where natural ventilation will allow dispersion
of vapor off-gassing from contaminated victims. Because
personnel in the Decontamination Zone normally require
protective gear, only trained HAZMAT-team members should be
present.
Decontamination is not required for all victims. Victims exposed
only to gases or vapor who do not have skin or eye irritation
generally do not need decontamination. Victims who have been
decontaminated or who do not require de contamination should be
transferred immediately to the Support Zone.
If the chemical or concentration is unidentified,
personnel in the Decontamination Zone should wear
the same protective equipment used in the Hot Zone
(see Rescuer Protection, page 19).
Rescuer Protection
Personnel in the Decontamination Zone normally require

protective gear; only personnel with prior fitting and training
should be permitted to don protective gear. Generally, the level of
clothing is the same as that worn in the Hot Zone. A lower level
of protective clothing can be used when the risk of secondary
contamination is low. For example, a nonencapsulating suit
(NFPA splash protective suit) can be used if an encapsulating suit
(NFPA vapor-protective suit) is required in the Hot Zone. If the
risk of inhaling off-gassing vapors is also low (i.e., the chemical is
not highly volatile or the decontamination area is set up outside
with good natural ventilation), it may be acceptable to use a lower
level of respiratory protection. Air contaminants must be identified
and measured to assure safety before a lesser level of respiratory
protection is used.
ABC Reminders
Quickly ensure a patent airway. Stabilize the cervical spine with

a collar and a backboard if trauma Is suspected. Administer
supplemental oxygen as required. Assist ventilation with a bag
valve-mask device If necessary.
To provide airway, breathing, and circulatory support for patients
in the Decontamination Zone, the rescuer may have to establish an
artificial airway, administer supplemental oxygen or nebulized
bronchodilators, and assist ventilation. Direct pressure should be
applied to control heavy bleeding. Depending on the concentration
of the chemical and its potential for secondary contamination,
victims with serious trauma or medical complications (e.g.,
24
ATSDR
Introduction
seizures) may have to wait for advanced medical care until gross
contamination is removed.
Rescuers wearing respirators and heavy gloves will find it difficult
to provide advanced medical care such as inserting an intravenous
line or performing endotracheal intubation; therefore, this care is
not administered until the victim is transferred to the Support
Zone. Electronic equipment, such as cardiac monitors, generally
are not taken into the Decontamination Zone because the
equipment may not be safe to operate and may be difficult to
decontaminate.
Basic Decontamination
Victims who are able and cooperative may assist with

their own decontamination. Remove and double-bag
contaminated clothing and personal belongings.
Consider bagging the victims jewelry and other valuables
separately from clothing for easier retrieval later. Nonporous
materials such as metal jewelry may be easy to decontaminate by
washing, whereas clothing or shoes may require disposal. Leather
items can be especially difficult to decontaminate and may need to
be incinerated. Consult a HAZMAT specialist affiliated with the
local fire department, the ATSDR/CDC Emergency Response 24hour Hotline ([404] 639-0615) or the EPA Environmental
Response Team, Edison, New Jersey ([732] 321-6740) for advice
on the disposition of contaminated equipment and clothing.
Flush exposed or irritated skin and hair with water for
3 to 5 minutes. For oily or otherwise adherent
chemicals, use mild soap on the skin and hair.
Flush exposed or irritated eyes with plain water or
saline for at least 5 minutes. Remove contact lenses if
present and easily removable without additional
trauma to the eye. If a corrosive material is suspected
or if pain or injury is evident, continue irrigation while
transferring the victim to the Support Zone.
Many chemicals react violently with water, liberating toxic gases
or creating explosions. Cautions about water reactivity (e.g.,
statement in the DOT Emergency Response Guidebook or in an
MSDS) generally do not apply to flushing eyes, skin, and hair in
the Decontamination Zone. There is little risk of creating a serious
reaction hazard by adding large amounts of water to the small
amount of residual chemical on the victims body. In fact, the
naturally occurring moisture on the skin is already reacting with
ATSDR
25
Introduction
the chemical; hastening removal from the skin is preferable to

leaving the chemical to further injure the victim.
Solids should be gently brushed from hair, skin, and clothing.
During brushing, protect the victims eyes, nose, and mouth. The
length of time recommended for flushing exposed skin or eyes will
vary with the chemical and the circumstances of exposure.
Removal of oily or insoluble materials from the skin and hair
requires washing with soap. Any liquid hand- or dish-washing
soap will be satisfactory. Use only soft-bristled brushes; abrasive
brushing may enhance skin injury and penetration. Most chemicals
that cause only mild skin or eye irritation can be removed by
flushing for 3 to 5 minutes. Ten to 15 minutes may be required for
concentrated or strongly alkaline materials. Eye decontamination
after exposure should be continued while the patient is transferred
to the Support Zone and even during transport to a medical
facility. An attempt should be made to remove contact lenses.
Avoid forceful removal, which may inflict injury. Irrigation and
transfer to the Support Zone should not be delayed because of
difficulty in removing contact lenses.
Bleach, vinegar, or other solutions used for equipment
decontamination should not be used for washing skin, hair, or
eyes. Likewise, neutralizing agents should not be used for
decontamination because the heat from neutralization may cause
added injury. Dilution with large volumes of water is preferred for
decontamination.
In cases of ingestion, do not induce emesis. Victims
who are conscious and able to swallow should be
given 4 to 8 ounces of water. Obtain medical care
immediately.
Generally, vomiting should not be induced. Vomiting is relatively
ineffective in emptying the stomach after a chemical ingestion and
may be harmful to the victim. Vomiting may increase damage to
the esophagus and stomach if irritating or corrosive chemicals
have been ingested. The risk of pulmonary aspiration is also
increased when vomiting occurs.
Activated charcoal adsorbs many chemicals and is relatively easy
to administer. Unless a corrosive chemical has been ingested, a
slurry of 50 to 60 grams of activated charcoal should be given to
an adult patient who is awake and has a gag reflex. Charcoal may
obscure the view when endoscopy is performed (at the hospital)
to determine the extent of injury. See Ingestion Exposure, page
26
ATSDR
Introduction
40, for further

decontamination.
Transfer to Support Zone
discussion
of
gastrointestinal-tract
As soon as basic decontamination is complete, move

the victim to the Support Zone.
Victims should be moved from the Decontamination Zone to the
Support Zone as soon as possible. Ambulatory patients can walk;
others may require transport on a gurney.
Support Zone
Be certain that victims have been decontaminated

properly.
Victims
who
have
undergone
decontamination or have been exposed only to gas or
vapor and who have no evidence of skin or eye
irritation generally pose no serious risks of secondary
contamination. In such cases, Support Zone personnel
require no specialized protective gear.
Because the Support Zone is set up away from the dangers of
physical hazards or chemical exposures, primary contamination is
not a serious problem in this area. Personnel in the Support Zone
do not require special protective clothing if victims have been
decontaminated properly. An exception involves victims exposed
to a potent and adherent chemical (e.g., an organophosphate
pesticide), in which case the Support Zone team should wear
disposable aprons or gowns and latex gloves.
ABC Reminders
Quickly ensure a patent airway. If trauma is suspected, maintain

cervical immobilization manually and apply a cervical collar and a
backboard when feasible. Ensure adequate respiration; administer
supplemental oxygen as required. Ensure a palpable pulse.
Establish intravenous access if necessary. Attach a cardiac
monitor. More sophisticated medical management can begin in the
Support Zone where rescuer movement is less encumbered and
more equipment and personnel are available. Initially, this care is
centered on airway, breathing, and circulatory support for the
patient. Intravenous lines should be inserted as soon as possible.
A cardiac monitor should be attached because of the potential for
some chemicals (e.g., halogenated or aromatic hydrocarbons) to
produce dysrhythmogenic effects.
Additional Decontamination
Continue irrigating exposed skin and eyes, as

appropriate.
In cases of ingestion, do not induce emesis. If the
patient is conscious and able to swallow, administer 4
ATSDR
27
Introduction
to 8 ounces of water if it has not been given previously.

Obtain medical care immediately.
Some victims may require continued irrigation of irritated skin and
eyes. If a cardiac monitor is required, irrigation should be
completed before the monitor is attached. The additional
decontamination recommendations do not imply that the victim
poses a risk of secondary contamination. Exposure to a
concentrated or strongly alkaline material may require continued
irrigation of eyes and skin during transport and in the hospital. Eye
irrigation is easily and conveniently accomplished using saline or
water and intravenous tubing attached to a nasal canula placed
over the bridge of the nose with the prongs pointed down toward
the eyes.
Ingestion exposure is an uncommon occurrence in a HAZMAT
incident. If ingestion has occurred and initial gastrointestinal
decontamination has not been carried out in the Decontamination
Zone, appropriate treatment must be instituted in the Support
Zone. Gastrointestinal decontamination procedures should be
carried out only if the patient is alert and has a gag reflex.
For most chemicals, the protocols do not recommend emesis and
in some cases (e.g., exposure to corrosives or hydrocarbons),
emesis is contraindicated. Many chemicals are effectively
adsorbed on the surface of charcoal. When indicated in the
protocol, a slurry of activated charcoal should be administered as
soon as possible to prevent gastrointestinal absorption. If the
chemical is corrosive or has not been identified, rinse the mouth
and throat by administering 6 to 8 ounces of water. The water will
also dilute the hazardous material in the stomach.
Intubate the trachea in cases of respiratory
compromise. When the patients condition precludes
endotracheal intubation, perform cricothyroidotomy if
equipped and trained to do so.
Advanced Treatment
Treat patients who have bronchospasm with

aerosolized bronchodilators. Use these and all
catecholamines with caution because of the enhanced
risk of cardiac dysrhythmias after exposure to certain
chemicals.
Patients who are comatose, hypotensive, or have
seizures or cardiac dysrhythmias should be treated
according to ALS protocols.
28
ATSDR
Introduction
In the Support Zone, more advanced medical care can be readily

administered. Contact the regional poison control center (see
Appendix 1) or the hospital base station for advice specific to the
incident.
Bronchodilators, such as metaproterenol (Alupent or Metaprel) or
albuterol (Proventil or Ventolin), can be administered by metereddose inhaler, or preferably, by hand-held nebulizer. However,
these medications increase heart rate and may provoke cardiac
dysrhythmias in victims who have been exposed to certain
chlorinated or aromatic hydrocarbons. When bronchodilators are
needed, the lowest effective dose should be given and cardiac
rhythm should be monitored.
Evaluate the patient for possible opioid overdose or hypoglycemia
and administer naloxone (Narcan) and dextrose according to
standard ALS protocols. Consider the possibility that coma or
seizures may be the result of trauma (e.g., head injury) rather than
of chemical poisoning.
Administer specific antidotes as described in the chemical-specific
protocols if within the prehospital scope of practice.
Transport to Medical Facility
Report to the base station and the receiving medical

facility the condition of the patient, treatment given,
and estimated time of arrival at the medical facility.
If a chemical has been ingested, prepare the
ambulance in case the victim vomits toxic material.
Have ready several towels and open plastic bags to
quickly clean up and isolate vomitus.
The base station and receiving medical facility should be apprised
of the patients status. Special procedures for patient care en route
can be discussed, especially if transport time will be lengthy.
Notifying the medical facility of your arrival time ensures
appropriate emergency department preparation.
Before transporting patients who have ingested hazardous
materials, prepare the ambulance by lining a basin or bucket with
open plastic bags to catch and isolate toxic vomitus. Some
chemicals are converted to poisonous gases by the action of
stomach acids (e.g., cyanide salts create hydrogen cyanide gas;
sodium azide can produce hydrazoic acid gas). Toxic vomitus can
contaminate personnel and equipment by direct contact or by offgassing volatile chemicals.
ATSDR
29
Introduction
Ambulances that transport HAZMAT victims require only

standard equipment. Most supplies recommended in the
Guidelines are standard equipment or are easily obtained from
grocery or drug stores. The specific equipment most likely to be
used in HAZMAT response will vary with the training and policies
of individual emergency medical services agencies, but at a
minimum include the following:
C disposable gloves
C splash goggles
C waterproof disposable shoe covers
C disposable gowns to cover EMS personnel clothing
and to be used by stripped and decontaminated
patients
C large supply of oxygen
C plastic garbage bags
C large wash basin or bucket (lined with plastic to isolate
toxic vomitus)
C liquid soap
C saline and intravenous tubing for eye irrigation
C disposable towels to soak up toxic vomitus
Only decontaminated patients or patients not requiring
decontamination should be transported. Some earlier HAZMAT
protocols called for zipping patients into body bags without
proper decontamination. If patients have been decontaminated
effectively, no danger of secondary contamination exists. Use of
the body bag technique is not effective and puts the victim at risk
of substantial skin injury and absorption.
Multi-Casualty Triage
All exposed patients should be transported to a

medical facility for evaluation.
Asymptomatic patients who have not had direct
chemical exposure can be discharged from the scene
after their names, addresses, and telephone numbers
are recorded. Those discharged should be advised to
seek medical care promptly if symptoms develop.
Consult with the base station physician or regional
poison control center for further advice regarding
triage of multiple victims.
Triage is a complex process that identifies victims who have the
most serious injuries and who can benefit most from rapid
treatment and transport. The Multi-Casualty Triage section in
each protocol makes general recommendations for transport
30
ATSDR
Introduction
priorities based only on the chemical; however, the base station

physician or regional poison control center (see Appendix I)
should give advice for specific situations.
ATSDR
31
Introduction
Emergency Department Management Section

The Guidelines, which represent a state-of-the-art, practical approach to the management and treatment
of HAZMAT victims, are based on the consensus of a panel of experts. However, the user of the
protocols should be aware that large data gaps exist in the scientific literature and knowledge regarding
the treatment of patients exposed to hazardous substances is constantly evolving. The protocols are not
a substitute for the professional judgment of a health care provider and must be interpreted in light of
specific information regarding the patient and in conjunction with other sources of authority.
Goals of the Hospital Provider in HAZMAT Incidents:

C
Determine the potential for secondary contamination.
If necessary, decontaminate patients.
Provide supportive and antidotal emergency care (resources for toxicity information include the
Guidelines and a regional poison control center [Appendix I]).
Obtain appropriate laboratory tests.
Arrange for observation, hospital admission, and follow-up care as needed.
32
Emergency Department Management
ATSDR
Introduction
ATSDR
33
Introduction
Emergency Department Management Section

C
C
C

Health effects expected from an acute exposure
Patient care (supportive care, antidotes)
Secondary contamination is discussed on page 3 of the
introduction. Victims who were exposed only to gas or vapor or
who were decontaminated at the scene are not likely to pose a risk
of secondary contamination to hospital personnel. However,
victims whose skin, hair, or clothing is grossly contaminated with
solid or liquid chemical (including condensed vapor) may
endanger health care personnel by direct contact or by off-gassing
vapor. Toxic vomitus can also expose hospital personnel directly
or through off-gassing vapor.
Decontamination Area
Previously decontaminated patients and patients

exposed only to gas or vapor who have no evidence of
skin or eye irritation may be transferred immediately to
the Critical Care Area. Other patients will require
decontamination as described below.
Basic decontamination should be carried out at the scene of the
incident before the victim is transports, however, this does not
always occur. For example, a contaminated victim might be
brought directly to the emergency department by a coworker.
Hospitals should plan for the arrival of contaminated victims.
Contaminated victims received in indoor facilities create
potentially serious risks of secondary contamination to hospital
personnel, especially if materials are volatile. Many hospital
protocols suggest shutting off the ventilation system to protect the
hospital from cross-contamination. However, lack of ventilation
may compound the risk to emergency department personnel
attending the victim. Very few hospitals have the financial
resources to properly construct a separate decontamination room
with appropriate ventilation.
Basic decontamination is safely and practically performed outside
in a naturally ventilated area adjacent to the ambulance entrance.
Suggested equipment and supplies for an outdoor hospital
Decontamination Area include the following:
C
34
Gurney with plastic tub or run-off collector. (Several

companies make disposable or reusable decontamination
ATSDR
Introduction
C
C
C
C
C
C
C
C
C
C
C
C
C
C
ABC Reminders
tables or foldable rubber tubs that can be placed on top of

a gurney.)
A warm-water source with a hose and soft-stream shower
head
Disposable chemical-resistant jumpsuits (e.g., of Tyvek or
Saranex)
Chemical-resistant gloves (e.g., of butyl rubber) in
different sizes
Rubber aprons
Mild soap and shampoo
Soft-bristled brushes
Splash-protective goggles or other protective eye wear
Wading pool for decontamination of ambulatory patients
Plastic garbage bags
Oxygen tanks with delivery supplies
Disposable towels and gauze
Surgical scrubs for decontaminated patients
Extra blankets and sheets for patient privacy and warmth
Portable privacy barriers (do not totally enclose
decontamination area or natural ventilation will be lost)
Evaluate and support airway, breathing, and

circulation. Intubate the trachea in cases of respiratory
compromise. If the patients condition precludes
Intubation, surgically create an airway.
Treat patients who have bronchospasm with
aerosolized bronchodilators; use these and all
catecholamines wlth caution because of the potential
enhanced risk of cardiac dysrhythmias.
seizures or ventricular dysrhythmias should be treated
in the conventional manner.
Generally, decontamination is performed before treatment is
started. However, basic airway, breathing, and circulation must be
addressed in victims who have life-threatening symptoms. Patients
heavily contaminated with highly toxic organophosphate
insecticides pose great risks of secondary contamination to health
care personnel; patients should not be touched until staff is
appropriately gloved and gowned. Persons soaked with flammable
materials cannot be treated with DC countershock until
decontamination has been carried out because of risk of fire and
explosion. Simultaneous treatment and decontamination of
patients should be carried out whenever possible.
ATSDR
35
Introduction
Patients who are able and cooperative may assist with

their own decontamination. Remove and double-bag
contaminated clothing and personal belongings.
Basic Decontamination
For easier retrieval, consider bagging the victims jewelry and

other valuables separately from clothing. Nonporous materials
such as metal jewelry may be easy to decontaminate by washing,
whereas clothing or shoes may require disposal. Leather items can
be especially difficult to decontaminate and may need to be
incinerated.
Flush exposed or irritated skin and hair with plain
water for 3 to 5 minutes. For oily or otherwise adherent
chemicals, use mild soap on the skin and hair. Rinse
thoroughly with water.
Flush exposed or irritated eyes with plain water or
saline for at least 5 minutes. Remove contact lenses if
present and easily removable without additional
trauma to the eye. If a corrosive material is suspected
or if pain or injury is evident, continue irrigation while
transferring the patient to the Critical Care Area.
Some chemicals react violently with water, liberating toxic gases
or creating explosions. Cautions about water reactivity (e.g., the
statements in the DOT Emergency Response Guidebook or in an
MSDS) generally do not apply when decontaminating victims with
water. Adding large amounts of water to the small amount of
residual chemical on the victims body poses little risk of creating
a serious reaction hazard. In fact, the naturally occurring moisture
on the skin will react with the chemical; hastening removal of the
chemical from the skin is preferable to leaving it to potentially
cause further injury.
Solid contaminants should be gently brushed from hair, skin, and
clothing. During brushing, protect the victims eyes. The length of
time for flushing exposed skin or eyes with water will vary with
the chemical and the circumstances of exposure. Chemicals that
cause only mild skin or eye irritation can be flushed for 3 to 5
minutes. Concentrated or strongly alkaline materials may require
10 to 15 minutes. Eye decontamination may be continued while
the patient is transferred to the Critical Care Area. An attempt
should be made to remove contact lenses. Avoid forceful removal
that may inflict injury. Difficulty in removing contact lenses should
not delay irrigation or transfer to the Critical Care Area.
36
ATSDR
Introduction
Removal of oily or insoluble materials from the skin and hair

requires washing with soap or shampoo. Any liquid hand- or dishwashing soap is satisfactory. Use only soft-bristled brushes;
abrasive brushing may enhance skin injury and penetration.
Bleach, vinegar, or solutions used for decontaminating equipment
should not be used for washing skin, hair, or eyes. Neutralizing
agents should not be used because the heat of the neutralization
may cause added injury. Flooding volumes of water are preferable.
In cases of ingestion, do not induce emesis.
Administer 4 to 8 ounces of water to dilute stomach
contents if the patient is conscious and able to
swallow. Immediately transfer the patient to the Critical
Care Area.
Emesis is not generally recommended in the protocols. Vomiting
is relatively ineffective in emptying the stomach after a chemical
ingestion and may be harmful to the victim. Vomiting may
increase the risk of pulmonary aspiration or damage to the
esophagus and stomach if irritating or corrosive chemicals have
been ingested.
Activated charcoal adsorbs many chemicals and is relatively easy
to administer. For most chemical ingestions, a slurry of 50 to 60
grams of activated charcoal should be administered to an adult
patient who is awake and has a gag reflex. If a corrosive chemical
has been ingested, do not administer activated charcoal because it
may obscure the view when endoscopy is performed. See Critical
Care Area below for further discussion of gastrointestinal
decontamination.
Critical Care Area
If appropriate decontamination efforts have been completed before

entry to the Critical Care Area, special precautions, such as
covering floors and walls with plastic or shutting off the
ventilation system, are not needed. However, if the patient has
ingested a chemical, prepare to isolate toxic vomitus quickly (see
Ingestion Exposure, page 40).
Be certain that appropriate decontamination has been
carried out. (See Decontamination Area, page 33.)
ED personnel in the Critical Care Area generally do not need
specialized protective gear. However, if risk of residual skin
contamination exists (e.g., potent chemicals, such as some
organophosphate pesticides, or radioactive dust), water-resistant
gowns or aprons, latex gloves, and eye-splash protection ate
ATSDR
37
Introduction
necessary. Emergency medical care providers usually carry these

protective items for universal infection control or communicable
disease control.
Evaluate and support airway, breathing, and
circulation as in ABC Reminders, page 34. Establish
intravenous access in seriously ill patients.
Continuously monitor cardiac rhythm.
ABC Reminders

seizures or ventricular dysrhythmias should be treated
in the conventional manner.
Many chemicals can cause progressive airway injury or systemic
illness with delayed onset. Watch for signs of laryngeal edema and
respiratory system compromise, such as progressive hoarseness,
strider, hypoventilation, or cyanosis.
Consider the possibility of exposure to multiple chemicals as well
as multiple-system injuries. For example, smoke inhalation can
cause airway injury because of heat and irritant chemicals and
coma from asphyxiants such as carbon monoxide and cyanide.
Consider possible opioid overdose and evaluate for hypoglycemia;
administer naloxone (Narcan) and dextrose according to usual
protocols. Treat patients who have seizures with conventional
anticonvulsants (e.g., diazepam, phenytoin, or phenobarbital).
Consider the possibility that coma or seizures may be from a head
injury or from alcohol or other drug intoxication, rather than from
hazardous material exposure.
Place an intravenous line in all patients who are unconscious,
obtunded, hypotensive, or may become so. Patients exposed to
substances that may cause cardiac sensitization or intravascular
hemolysis may also require intravenous access. An initial bolus of
an appropriate intravenous solution should be given. The fluid
should be titrated to maintain acceptable urine output and blood
pressure. Care must be taken not to overhydrate the patient.
Treat patients who have hypotension using rapid infusions of
normal saline (250 mL to 1 L in adults). Use dopamine or other
inotropic drugs for persistent hypotension. Hypotension may be
complicated by hypothermia or hyperthermia. Hypothermia should
be considered if the victim was stripped and decontaminated with
cold water or in a cold ambient setting. Hyperthermia may result
from certain systemic poisons (e.g., dinitrophenol).
38
ATSDR
Introduction
Inhalation Exposure
Administer supplemental oxygen by mask to patients

who have respiratory complaints. Treat patients who
have bronchospasm with aerosolized bronchodilators;
use these and all catechola mines with caution
because of the potential or possible enhanced risk of
cardiac dysrhythmias.
Bronchodilators may provoke ventricular dysrhythmias in some
patients who have been exposed to aromatic or halogenated
hydrocarbons.
Although pulse oximetry is a convenient way to continuously
monitor oxygenation in patients, it is unreliable or falsely normal
in
patients
who
have
dyshemoglobinemias
(e.g.,
methemoglobinemia or carboxyhemoglobinemia) because it
measures only oxygen dissolved in the blood and not the status of
tissue oxygenation. In patients who have altered hemoglobins, the
pulse oximeter does not reflect the impaired oxygen carrying or
delivery capacity of the red cells. In these situations, a CoOximeter should be used to measure specific levels of
hemoglobins unable to transport oxygen.
Chemically induced pulmonary edema is due to leaky pulmonary
alveoli, not left ventricular failure as is cardiogenic pulmonary
edema. Patients who have chemically induced pulmonary edema
do not benefit from digoxin, morphine, afterload reduction, or
diuretics. Supplementary oxygen, delivered by mechanical ventilation and positive end-expiratory pressure, if needed, are standard
treatments for chemically induced (noncardiogenic) pulmonary
edema.
Corticosteroids and antibiotics have been commonly
recommended for treatment of chemical pneumonitis, but their
effectiveness has not been substantiated.
Soluble irritants (e.g., ammonia or hydrogen chloride) rapidly
produce respiratory effects; poorly soluble irritants (e.g., phosgene
and some nitrogen oxides) produce slow onset of airway irritation
and respiratory distress. Poorly soluble agents are commonly
associated with delayed (12 to 72 hours) onset pulmonary edema.
The time period for developing pulmonary edema varies with the
chemical and is noted in each individual protocol. Watch for signs
of respiratory distress and intubate if necessary.
Skin Exposure
If chemical burns are present, treat as thermal burns.
ATSDR
39
Introduction
The extent and depth of injury in a chemical burn is often not

immediately apparent; hence the severity of the bum is frequently
underestimated. Loss of circulating fluid may occur. In addition,
dermal absorption of a corrosive chemical may contribute to
systemic toxicity.
Patients who have been exposed to highly corrosive, penetrating,
oily, or persistent chemicals may require additional or continuous
decontamination. Residues may remain in the armpits, groin,
buttocks, hair, ears, nostrils, and under the fingernails and toenails.
If the material is highly contaminating (e.g., organophosphate
pesticides or radioactive dust), care givers should wear gowns and
gloves to protect themselves.
Use liquid soap for cleansing the skin and hair. Special
decontaminating agents are recommended for only a few
chemicals (see specific protocols).
Ensure that adequate eye irrigation has been
completed. Test visual acuity. Examine the eyes for
corneal damage using a magnifying device or a slit
lamp and fluorescein stain. For small corneal defects,
use ophthalmic antibiotic ointment or drops, analgesic
medication, and an eye patch. Immediately consult an
ophthalmologist for patients who have corneal
injuries.
Eye Exposure
Ensure that contact lenses have been removed, that no visible

residual material is in the conjunctival sac, and that the pH of the
conjunctival fluid is normal.
Irrigation is easily continued in a hospital setting using intravenous
tubing to provide a steady, low-pressure stream of water or saline.
A Morgan Lenscan also be placed to provide continuous,
thorough eye decontamination. Do not use neutralizing or other
decontaminating solutions.
A corneal burn or abrasion can easily be seen with the aid of
fluorescein stain, a UV light source, and a magnifier or slit lamp.
The disrupted corneal surface allows accumulation of the
fluorescein, which fluoresces under UV light. If serious injury is
evident (e.g., extensive corneal fluorescein accumulation, cloudy
or bloody material in the anterior chamber, or obvious perforation
of the globe), an ophthalmologist should be consulted
immediately.
40
ATSDR
Introduction
Ingestion Exposure
Do not Induce emesis. If the patient is alert and

charcoal has not been given previously, administer a
slurry of activated charcoal. If a corrosive material is
suspected, administer 4 to 8 ounces of water; do not
give a slurry of activated charcoal. Consider
endoscopy to evaluate the extent of gastrointestinaltract injury. If a large dose has been ingested and the
patients condition is evaluated within 30 minutes after
ingestion, consider gastric lavage.
Ingested chemicals and products formed by their reaction with
stomach acid may be hazardous to ED personnel through direct
contact with vomitus or by inhalation of the gases liberated from
the vomitus. For example, ingested cyanide salts are converted to
highly toxic hydrogen cyanide gas in the stomach. Staff must take
measures, therefore, to isolate toxic vomitus or gastric washings.
This can be done by attaching the lavage tube to isolated wall
suction or other closed container.
Activated charcoal is capable of adsorbing most chemicals and
should be given as early as possible. Even chemicals that have
relatively poor adsorption to charcoal (e.g., cyanide and alcohols)
are still bound to some extent. Charcoal may need to be removed
by gastric washing before endoscopy can be performed. Corrosive
liquids should be removed from the stomach as early as possible.
However, care must be taken when placing the gastric tube
because blind gastric-tube placement may further injure the
chemically damaged esophagus or stomach.
Antidotes and Other Treatments
Treatment consists of supportive measures.

The individual guidelines provide information on the use of
specific antidotes.
Laboratory Tests
Routine laboratory studies for all exposed patients

include CBC, glucose, and electrolyte determinations.
Additional studies for patients exposed to an
unidentified chemical Include ECG monitoring, renalfunction tests, and liver-function tests. Chest
radiography
and
pulse
oximetry
(or
ABG
measurements) are recommended for severe inhalation
exposure.
All patients should have CBC, glucose, and electrolyte
determinations. Additional, specific recommendations are listed in
the laboratory tests section to aid both diagnosis and treatment.
ATSDR
41
Introduction
Laboratory test results are often within normal range immediately

after an exposure but may become abnormal after a delay of
several hours or even days, depending on the specific chemical
exposure. For example, chest radiography may not show signs of
pulmonary edema for 12 to 24 hours and signs of liver injury may
not appear for 2 to 3 days following exposure. Pulse oximetry and
routine arterial blood gas determination of Po2 tests may provide
falsely normal, unreliable, or misleading results in patients with
abnormal hemoglobin states (e.g., methemoglobinemia or
carboxyhemoglobinemia).
Tests to measure a specific chemical contaminant in biologic
samples are rarely available on an emergency basis. The turnaround time may be several hours to days; hence, these tests rarely
are clinically useful. However, the results of these tests may aid in
confirming or documenting exposure. A regional poison control
center (Appendix I) can assist with the selection and interpretation
of specialized laboratory tests.
Disposition and Followup
Consider hospitalizing patients who have a suspected

serious exposure and persistent or progressive
symptoms.
Patient disposition should be determined based on the symptoms,
the intrinsic toxicity of the chemical, and course of illness. Some
patients may be safely discharged from the emergency department
while others will require prolonged observation or intensive care.
Delayed Effects
When the chemical has not been identified, the patient

should be observed for an extended period or admitted
to the hospital.
The usual duration of observation in an emergency department is
6 to 8 hours. If the chemical agent is known to produce delayedonset illness or is unidentified, the asymptomatic patient should be
admitted for observation.
Asymptomatic patients who have minimal exposure,
normal initial examinations, and no signs of toxicity
after 6 to 8 hours of observation may be discharged
with instructions to seek medical care promptly if
symptoms develop.
Patient Release
Each protocol includes a detailed Patient Information Sheet with

a list of possible delayed symptoms. This sheet should be reviewed
with the patient before discharge. A signed copy should be
42
ATSDR
Introduction
included in the medical chart, and a copy sent home with the
patient.
Do not release clothing or personal items to the patient before a
determination of residual contamination is made. Most items can
be reused after washing. However, some contaminated articles
cannot be rendered safe for reuse (e.g., leather goods, such as
shoes, that are contaminated with methyl bromide or organophosphate pesticides). Some articles will require disposal at a
hazardous waste site or by incineration. Consult a HAZMAT
specialist affiliated with the local fire department or the
ATSDR/CDC Emergency Response 24-hour Hotline ([404] 6390615) for advice on the disposition of contaminated personal
effects.
Followup
Provide the patient with follow-up instructions to return to the

emergency department or a private physician to reevaluate initial
findings. Patients who have corneal injuries should be reexamined
within 24 hours.
Appendix II contains the telephone numbers and addresses of
members of the Association of Occupational and Environmental
Clinics (AOEC). These clinics employ specialists in the diagnosis
and treatment of chemically exposed patients. They may provide
consultation and follow-up advice.
Reporting
If a work-related incident has occurred, you may be

legally required to file a report; contact your state or
local health department.
Other persons may still be at risk in the setting where
this incident occurred. If the incident occurred in the
workplace, discussing it with company personnel may
prevent future incidents. If a public health risk exists,
notify your state or local health department or other
responsible public agency. When appropriate, inform
patients that they may request an evaluation of their
workplace from OSHA or NIOSH. See Appendices III
and IV for a list of agencies that may be of assistance.
Appendix III contains the telephone numbers of state health
departments. In addition to filing a report, state health
departments or the EPAs Environmental Response Team, Edison,
New Jersey ([732] 321-6740) may be able to assist in determining
procedures for the cleaning of hospital facilities and equipment.
ATSDR
43
Introduction
You may also advise your patients to call the regional OSHA
office to report a suspected violation of safe work practices.
Appendix IV contains the numbers of the NIOSH office that may
be of assistance.
44
ATSDR
Introduction
ATSDR
45
Introduction
Patient Information Sheet

The Patient Information Sheet provides information and follow-up instructions for persons who have
been exposed to the chemical. It is written in an easy to understand question and answer format and
addresses the questions most often asked. It is intended to be given to the patient.
The follow-up instructions on the back of the Patient Information Sheet are statements that the clinician
can check off if they apply to the patient. The instructions include a list of signs and symptoms specific
to each chemical (and directions to the patient to seek medical care if they occur); directions for obtaining
follow-up appointments; and restrictions on activities, medications, alcohol and cigarette smoke. Space
is provided for the clinician to write other instructions.
46
ATSDR
Introduction
ATSDR
47
Appendix I
Appendix I
AAPCC-Certified Regional Poison Control Centers
ATSDR
A-1
Appendix I
A-2
ATSDR
Appendix I
AAPCC-Certified Regional Poison Control Centers

Poison Control Centers were established around 1953 to help physicians deal with poisoning of adults and children in
the United States. In 1983, the American Association of Poison Control Centers (AAPCC) was established as the
professional organization for Poison Control Centers. The Regional Poison Control Centers can act as a valuable resource
in providing information about the toxicity and health effects of hazardous exposures involved in poisonings.
ALABAMA
Alabama Poison Center
2503 Phoenix Drive
Tuscaloosa AL35405
Emergency: (800) 462-0800 (AL only)
(205)345-0600
Childrens Hospital of Alabama Poison Control
Center
1600 7th Avenue South
Birmingham AL 35233
Emergency: (800) 292-6678 (AL only)
(205) 933-4050
ALASKA
Anchorage Poison Control Center
3200 Providence Drive
P.O. Box 196604
Anchorage AK 99519
Emergency: (800) 478-3193
(907) 261-3193
ARIZONA
Arizona Poison and Drug Information Center
Arizona Health Sciences Center
Room 1156
1501 North Campbell Avenue
Tuscon AZ 85724
Emergency: (800) 362-0101 (AZ only)
(602) 626-6016
Samaritan Regional Poison Center
Good Samaritan Regional Medical Center
1111 E. McDowellAncillary 1
Phoenix AZ 85006
Emergency:(800) 362-0101 (AZ only)
(602) 253-3334
ARKANSAS
Arkansas Poison and Drug Information Center
College of Pharmacy
University of Arkansas for Medical Sciences
Mail Slot 552
4301 W. Markham
Little Rock AR 77205
Emergency: (800) 376-4766
TDD/TTY (800) 641-3805
CALIFORNIA
California Poison Control SystemFresno/Madera
Valley Childrens Hospital
9300 Valley Childrens Place
Madera CA 93638
Emergency: (800) 876-4766 (CA only)
California Poison Control System-Sacramento
UC Davis Medical Center
2315 Stockton Boulevard
Sacramento CA 95817
California Poison Control System-Dan Diego
UC San Diego, Medical Center
200 West Arbor Drive
San Diego CA 92103
Emergency: (800) 876-4766
California Poison Control System-San
Francisco
San Francisco General Hospital
1001 Potrero Avenue, Room 1E86
San Francisco CA 94110
COLORADO
Rocky Mountain Poison and Drug Center
9902 E. Ninth Avenue
Denver CO 80220
Emergency: (800) 332-3073 (CO only/outside
metro area)
(303) 739-1123 (Denver metro)
ATSDR
A-3
Appendix I
CONNECTICUT
Connecticut Poison Control Center
University of Connecticut Health Center
263 Farmington Avenue
Farmington CT 06030
Emergency: (800) 343-2722 (CT only)
(860) 679-3456
DELAWARE
The Poison Control Center
3535 Market Street, Suite 985
Philadelphia PA 19104
Emergency: (800) 772-7112
(215) 386-2100
DISTRICT OF COLUMBIA
National Capitol Poison Control Center
3201 New Mexico Avenue, NW
Suite 310
Washington DC 20016
Emergency: (202) 625-3333
TDD/TTY: (202) 362-8563 (TTY)
Atlanta GA 30335
Emergency: (404) 606-9000
TDD/TTY: (404) 606-9287 (TDD)
HAWAII
Hawaii Poison Center
1319 Punahou Street
Honolulu HI 96826
Emergency: (808) 941-4411
IDAHO
Denver CO 80220
Emergency: (800) 860-0620 (ID only)
ILLINOIS
Illinois Poison Center
222 S. Riverside Plaza, Suite 1900
Chicago IL 60606
Emergency: (800) 942-5969 (IL only)
FLORIDA
Florida Poison Information Center-Jacksonville
655 West Eighth Street
Jacksonville FL 32209
Emergency: (800) 282-3171 (FL only)
(904) 549-4480
INDIANA
Indiana Poison Center
Methodist Hospital
I-65 at 21st Street
Indianapolis IN 46206
Emergency: (800) 382-9097 (IN only)
(317) 929-2323
TDD/TTY: (317) 929-2336 (TTY)
Florida Poison Information Center-Miami

University of Miami
Department of Pediatrics
P.O. Box 016960 (R-131)
Miami FL 33101
(305) 585-5253
IOWA
Iowa Poison Center
St. Lukes Regional Medical Center
2720 Stone Park Boulevard
Sioux City IA 51104
Emergency: (800) 352-2222
(712) 277-2222
FLORIDA (continued)
Florida Poison Information Center-Tampa
Tampa General Hospital
P.O. Box 1289
Tampa FL 33601
(813) 253-4444
IOWA (continued)
Poison Control Center
Department of Pharmaceutical Care,CC101
GH
The University of Iowa Hospitals and Clinics
200 Hawkins Drive
Iowa City IA 52242
Emergency: (800) 272-6477 (IA only)
GEORGIA
Georgia Poison Center
Hughes Spalding Childrens Hospital
Grady Health System
80 Butler Street, SE, P.O. Box 26066
A-4
ATSDR
KANSAS
Mid-American Poison Control Center
University of Kansas Medical Center
3901 Rainbow Blvd., Room B-400
Appendix I
Kansas City KS 66160

Emergency: (800) 332-6633
(913) 588-6633
TDD/TTY: (913) 588-6639 (TDD)
KENTUCKY
Louisville
Kentucky Regional Poison Center
Medical Towers South, Suite 572
234 East Gray Street
Louisville KY 40202
Emergency: (502) 589-8222
LOUISIANA
Louisiana Drug and Poison Information Center
Unitversity of Louisiana at Monroe
College of Pharmacy
Sugar Hall
Monroe, LA 71209
Emergency: (800) 256-9822 (LA only)
MAINE
Maine Poison Control Center
Maine Medical Center
22 Bramhall Street
Portland ME 04102
Emergency: (800) 442-6305 (ME only)
(207) 871-2950
MARYLAND
Maryland Poison Center
University of MD at Baltimore
School of Pharmacy
20 North Pine Stree, PH230
Baltimore MD 21201
Emergency: (800) 492-2414 (MD only)
(410) 528-7701
TDD/TTY: (410) 706-1858
Suite 310
Washington DC 20016
Emergency: (202) 625-3333
TDD/TTY: (202) 362-8563 (TTY)
MASSACHUSETTS
Regional Center for Poison Control and
Prevention Services for Massachusetts and
Rhode Island
300 Longwood Avenue
Boston MA 02115
Emergency: (800) 682-9211 (MA and RI only)

(617)232-2120
MICHIGAN
Chidrens Hospital of Michigan
4160 John R Harper Professional Office Bldg,
Suite 616
Detroit MI 48201
Emergency: (800) 764-7661 (MI only)
(313) 745-5711
TTD/TTY: (800) 356-3232 (TTY)
Spectrum Health Regional Poison Center
1840 Wealthy S.E.
Grand Rapids MI 49506
Emergency: (800) 764-7661 (MI only)
TTD/TTY: (800) 356-3232 (TTY)
MINNESOTA
Hennepin Regional Poison Center
Hennepin County Medical Center
701 Park Avenue
Minneapolis MN 55415
Emergency: (800) POISON1 (MN and SD
only)
(612) 347-3141
TDD/TTY: (612) 904-4691 (TTY)
PROSAR International Poison Control Center
1295 Bandana Boulevard
Suite 335
St. Paul MN 55108
Emergency: (888) 779-7921
MISSISSIPPI
Mississippi Regional Poison Control Center
University of Mississippi Medical Center
2500 N. State Street
Jackson MS 39216
Emergency: (601) 354-7660
MISSOURI
Regional Poison Center
Cardinal Glennon Childrens Hospital
1465 S. Grand Blvd.
St. Louis MO 63104
Emergency: (800) 366-8888
(314) 772-5200
MONTANA
ATSDR
A-5
Appendix I

Denver CO 80220
Emergency: (800) 525-5042 (MT only)
NEBRASKA
The Poison Center
Childrens Hospital
8301 Dodge Street
Omaha NE 68114
Emergency: (800) 955-9119 (NE and WY only)
(402) 354-5555
NEVADA
Oregon Poison Center
Oregon Health Sciences University
3181 SW Sam Jackson Park Road
Portland OR 97201
Emergency: (503) 494-8968
NEVADA (continued)
Denver CO 80220
Emergency: (800) 446-6179 (NV only)
NEW HAMPSHIRE
New Hampshire Poison Information Center
Dartmouth-Hitchcock Medical Center
One Medical Center Drive
Lebanon NH 03756
Emergency: (800) 562-8236 (NH only)
(603) 650-8000
NEW JERSEY
New Jersey Poison Information and Education
System
201 Lyons Avenue
Newark NJ 07112
Emergency: (800) POISON-1 (NJ only)
NEW MEXICO
New Mexico Poison and Drug Information
Center
Health Science Center Library
Room 125
University of New Mexico
Albuquerque NM 87131
Emergency: (800) 432-6866 (NM only)
(505) 272-2222
NEW YORK
A-6
ATSDR
Central New York Poison Center

750 East Adams Street
Syracuse NY 13210
Emergency: (800) 252-5655 (NY only)
(315) 476-4766
Finger Lakes Regional Poison and Drug
Information Center
University of Rochester Medical Center
601 Elmwood Avenue
P.O. Box 321
Rochester NY 14642
(716) 275-3232
TDD/TTY: (716) 273-3854 (TTY)
NEW YORK (continued)
Hudson Valley Regional Poison Center
Phelps Memorial Hospital Center
701 North Broadway
Sleepy Hollow NY 10591
(914) 366-3030
Long Island Regional Poison Control Center
Winthrop University Hospital
259 First Street
Mineola NY 11501
Emergency: (516) 542-2323
(516) 663-2650
TTD/TTY: (516) 924-8811 (TDD Suffolk)
(516) 747-3323 (TDD Nassau)
New York City Poison Control Center
NYC Department of Health
455 First Avenue
Room 123, Box 81
New York NY 10016
Emergency: (800) 210-3985
(212) 340-4494; (212) POI-SONS;
(212) VEN-ENOS
TDD/TTY: (212) 689-9014 (TDD)
Western New York Regional Poison Control
Center
Childrens Hospital of Buffalo
219 Bryant Street
Buffalo NY 14222
Emergency: (800) 888-7655 (NY western
regions only)
(716)-878-7654
Appendix I
NORTH CAROLINA
Carolinas Poison Center
Carolinas Medical Center
5000 Airport Center Parkway, Suite B
Charlotte NC 28208
Emergency: (800) 848-6946 (NC only)
(704) 355-4000
NORTH DAKOTA
North Dakota Poison Information Center
Meritcare Medical Center
720 4th Street North
Fargo ND 58122
Emergency: (800) 732-2200 (ND, MN, SD only)
(701) 234-5575
OHIO
Central Ohio Poison Center
700 Childrens Drive, Room L032
Columbus OH 43205
Emergency: (800) 682-7625 (OH only)
(800) 762-0727 (Dayton, OH only)
TDD/TTY: (614) 228-2272
Cincinnati Drug and Poison Information Center
Regional Poison Control System
2368 Victory Parkway, Suite 300
Cincinnati OH 45206
Emergency: (800) 872-5111 (OH only)
(513) 558-5111
Greater Cleveland Poison Control Center
11100 Euclid Avenue
Cleveland OH 44106
Emergency: (888) 231-4455
(216) 231-4455
OKLAHOMA
Oklahoma Poison Control Center
Childrens Hospital of Oklahoma
940 N.E. 13th Street, Room 3512
Oklahoma City OK 73104
Emergency: (800) 764-7661 (OK only)
(405) 271-5454
OREGON
Oregon Poison Center
Oregon Health Sciences University
3181 SW Sam Jackson Park Road
Portland OR 97201
Emergency: (800) 452-7165 (OR only)
(503)494-8968
PENNSYLVANIA
Central Pennsylvania Poison Center
Penn State Geisinger Health System
The Milton S. Hershey Medical Center
MC HO453 PO Box 850
500 University Drive
Hershey PA 17033
Emergency: (800) 521-6110
TDD/TTY: (717) 531-8335
Pittsburgh Poison Center
Childrens Hospital of Pittsburgh
3705 Fifth Avenue
Pittsburgh PA 15213
Emergency: (412) 681-6669
The Poison Control Center
3535 Market Street, Suite 985
Philadelphia PA 19104
Emergency: (800) 772-7112
(215) 386-2100
RHODE ISLAND
Regional Center for Poison Control and
Prevention Services for Massachusetts and
Rhode Island
300 Longwood Avenue
Boston MA 02115
Emergency: (617) 232-2120
SOUTH CAROLINA
Palmetto Poison Center
College of Pharmacy
University of South Carolina
Columbia SC 29208
Emergency: (800) 922-1117 (SC only)
(803) 777-1117
SOUTH DAKOTA
Hennepin Regional Poison Center
Hennepin County Medical Center
701 Park Avenue
Emergency: (800) POISON1 (MN and SD
only)
(612) 347-3141
TDD/TTY: (612) 904-4691 (TTY)
ATSDR
A-7
Appendix I
TENNESSEE
Middle Tennessee Poison Center
The Center for Clinical Toxicology
501 Oxford House
1161 21st Avenue South
Nashville TN 37232
Emergency: (800) 288-9999 (TN only)
(615) 936-2034 (Greater Nashville)
TDD/TTY: (615) 936-2047 (TDD)
Southern Poison Center
875 Monroe Avenue
Suite 104
Memphis TN 35163
Emergency: (800) 288-9999 (TN only)
(901) 528-6048
TEXAS
Central Texas Poison Center
Scott and White Memorial Hospital
2401 South 31st Street
Temple TX 76508
Emergency: (800) POISON-1 (TX only)
(254) 724-7401
North Texas Poison Center
Texas Poison Center Network
Parkland Health and Hospital System
5201 Harry Hines Blvd.
P.O. Box 35926
Dallas TX 75235
Emergency: (800) POISON-1 (TX only)
South Texas Poison Center
The University of Texas Health Science CenterSan Antonio
Forensic Science Building, Room 146
Department of Surgery
7703 Floyd Curl Drive
San Antonio TX 78284
Emergency: (800) 764-7661 (TX only)
Southeast Texas Poison Center
The University of Texas Medical Branch
3.112 Trauma Building
Galveston TX 77555
(409) 765-1420
A-8
ATSDR
TEXAS (continued)
Texas Panhandle Poison Center
1501 S. Coulter
Armarillo TX 79106
West Texas Regional Poison Center
Thomason Hospital
4815 Alameda Aveue
El Paso TX 79905
UTAH
Utah Poison Control Center
410 Chipeta Way, Suite 230
Salt Lake City UT 84108
Emergency: (800) 456-7707 (UT only)
(801) 581-2151
VERMONT
Vermont Poison Center
Fletcher Allen Health Care
111 Colchester Avenue
Burlington VT 05401
Emergency: (877) 658-3456 (toll free)
VIRGINIA
Blue Ridge Poison Center
University of Virginia Health System
PO Box 800774
Charlottesville VA 22908
Emergency: (800) 451-1428 (VA only)
Suite 310
Washington DC 20016
Emergency: (202) 625-3333
TDD/TTY: (202) 362-8563 (TTY)
Virginia Poison Center
Medical College of Virginia Hospitals
Virginia Commonwealth University
PO Box 980552
Richmond VA 23298
Emergency: (800) 552-6337
Appendix I
WASHINGTON
Washington Poison Center
155 NE 100th Street, Suite 400
Seattle WA 98125
Emergency: (800) 732-6985 (WA only)
(206) 526-2121
TDD/TTY: (206) 517-2394 (TDD)
(800) 572-0638 (TDD WA only)
WEST VIRGINIA
West Virginia Poison Center
3110 MacCorkle Ave., S.E.
Charleston WV 25304
Emergency: (800) 642-3625 (WV only)
WISCONSIN
Childrens Hospital of Wisconsin Poison Center
PO Box 1997
Milwaukee WI 53201
Emergency: (800) 815-8855 (WI only)
(608) 262-3702
WYOMING
The Poison Center
Childrens Hospital
8301 Dodge Street
Omaha NE 68114
Emergency: (800) 955-9119 (NE and WY only)
(402) 354-5555
ANIMAL POISON CENTER
ASPCA
1717 South Philo Road
Suite 36
Urbana IL 61802
Emergency: (888) 426-4435
(900) 680-0000
ATSDR
A-9
Appendix I
A-10
ATSDR
Appendix II
Appendix II
ATSDR
A-11
Appendix II
A-12
ATSDR
Appendix II
Association of Occupational and Environmental Clinics (AOEC)

Professionals in the AOEC act as consultants for treatment of persons exposed to hazardous
substances.
ALABAMA
University of Alabama at Birmingham
930 20th Street South
Birmingham, AL 35205
(205) 975-2767; FAX (205) 975-4377
Timothy J. Key, MD, MPH
ARIZONA
Samaritan Occupational and Environmental
Toxicology Clinic
Department of Medical Toxicology
925 E. McDowell Rd., Second Floor
Phoenix AZ 85006
(602) 239-6690; FAX (602) 239-4138
Kevin Wallace, MD
CALIFORNIA
Occupational & Environmental Medicine Clinic
University of California at San Francisco/SFGH
Building 30, 5th floor,
1001 Potrero Avenue
SanFrancisco CA 94110
(415) 206-4320; FAX (415) 206-8949
Patricia Quinlan, MPH, CH
Alt. Contact:
Denise Souza, RN, MSN, OHNP, COHN-S
UCSF Occupational Health Services
University of California at San Francisco
2380 Sutter Street, 3rd Floor
San Francisco, CA 94115
(415) 885-7580; FAX (415) 771-4472
Robert Harrison, MD, MPH
Alt. Contact: Leslie Israel, DO, MPH
Occupational & Environmental Health Clinic
Employee Health Services
University of California, Davis Medical Center
Primary Care Building, Suite A
2221 Stockton Blvd.
Sacramento CA 95817
(916) 734-8393; FAX (916) 734-7510
Appointments: (916) 734-8393
Stephen McCurdy, MD, MPH
Occupational & Health Environmental Clinic

University of California at Irvine
Center for Occupational and Environmental
Health
19722 MacArthur Blvd.
Irvine CA 92715
(949)-824-8641; FAX (949) 824-2345
Dean Baker, MD, MPH
COLORADO
Division of Environmental & Occupational
Health Sciences
National Jewish Medical Research Center
Center
1400 Jackson Street
Denver CO 80206
(303) 398-l520; FAX (303) 398-l452
Appointments (303) 398-1733
Peggy Mroz, MSPH
Alt. Contact: Cecile Rose, MD, MPH
Toxicology Associates
2555 S. Downing Street #260
Denver CO 80210
(303) 765-3800; FAX (303) 765-3804
Scott Phillips, MD, FACP
CONNECTICUT
Yale Occupational & Environmental Medicine
Program
135 College Street, 3rd Floor
New Haven, CT 06510
(203) 785-7267; FAX (203) 785-7391
Mark R. Cullen, MD
Alt. Contact: Peter M. Rabinowitz, MD, MPH
University of Connecticut
Occupational and Environmental Medicine
Program
263 Farmington Avenue
Farmington, CT 06030
(860) 679-2893; FAX (860) 679-4587
Eileen Storey, MD, MPH
CALIFORNIA (continued)
ATSDR
A-13
Appendix II
CONNECTICUT (continued)
Northwest Connecticut Occupational Medical
Center
333 Kennedy Drive, Suite 202
Torrington CT 06790
(860) 482-4552; FAX (860) 489-4647
Gregory E. McCarthy, MD
DISTRICT OF COLUMBIA
Division of Occupational and Environmental
Medicine
School of Medicine, George Washington
University
2300 K Street, NW
Washington, DC 20037
(202) 994-1734; FAX (202) 994-0011
Tee L. Guidotti, MD, MPH
Alt. Contact: Katherine Hunting, PhD, MPH
Section of Occupational & Environmental
Medicine
Washington Hospital Center
110 Irving St., NW
Washington, DC 20010-2975
(202) 877-5466; FAX (202) 877-4136
Laura Welch, MD
GEORGIA
Environmental and Occupational Medicine
Consultative Clinic
The Emory Clinic
1525 Clifton Road, NE, Rm 404
Atlanta, GA 30322
(404) 778-5978; FAX (404) 727-8744
Howard Frumkin, MD, Dr. PH
ILLINOIS
Occupational Medicine Clinic
Cook County Hospital
1900 W. Polk, Rm 500
Chicago IL 60612
(312) 633-5310; FAX (312) 633-6442
Rachel Rubin, MD, MPH
Alt. Contact :Ann Naughton, RN, MPH, COHN
University of Illinois Occupational Medicine
Program
914 S. Wood, M/C 684
Chicago IL 60612
(312) 996-7420; FAX (312) 413-8485
Linda Forst, MD, MPH
A-14
ATSDR
IOWA
University of Iowa, Occupational Medicine
Clinic
Department of Internal Medicine, College of
Medicine
200 Hawkins Drive, C33-GH
Iowa City, IA 52242
(319) 356-4419; FAX (319) 356-7147
Gary Hunninghake, MD
KENTUCKY
University of Kentucky Occupational Medicine
Program
2400 Greatstone Point
Lexington, KY 40504
(606) 257-5150; FAX (606) 257-8982
Terrence Collins, MD, MPH
LOUISIANA
Ochsner Center for Occupational Health
1514 Jefferson Highway
New Orleans, LA 70121
(504) 842-3955; FAX (504) 842-3977
Gregg A. Bendrick, MD, MPH
Alt. Contact: Lori Brown
Tulane Centers for Occupational Health
1415 Tulane Avenue, Box HC31
New Orleans LA 70112
(540) 736-5333; FAX (504) 736-4835
Douglas A. Swift, MD, MPH
MARYLAND
Johns Hopkins University
Health
5501 Hopkins Bayview Circle
Baltimore, MD 21224
(410) 550-2322; FAX (410) 550-3355
Edward J. Bernacki, MD, MPH
Occupational Health Project
University of Maryland School of Medicine
405 Redwood Street
Baltimore, MD 21201
(410) 706-7464; FAX (410) 706-4078
Janie Gordon, ScM
Appendix II
MASSACHUSETTS
Caritas Good Samaritan Occupational Health
Services
Merchants Building
75 Stockwell Dr.
Avon MA 02322
(508) 427-3900; FAX (508) 427-3905
Robert Naparstek, MD
Medicine
Massachusetts Respiratory Hospital
2001 Washington Street
South Braintree, MA 02184
(781) 848-2600; FAX (718) 849-3290
Dianne Plantamura, MSW, Coordinator
Alt. Contact: David Christiani, MD, MPH, MS
Occupational Health Program
Department of Family and Community Medicine
University of Massachusetts
55 Lake Avenue North
Worcester, MA 10655
(508) 856-2818; FAX (508) 856-l 680
Tom Hicks, MD, MPH
Occupational and Environmental Health Center
Cambridge Hospital
1493 Cambridge Street
Cambridge, MA 02139
(617) 665-1580; FAX (617) 665-1671
Rose Goldman, MD, MPH
Occupational & Environmental Health Center
Childrens Hospital
300 Longwood Ave
Boston MA 02115
(617) 355-8177; FAX (617) 738-0032
Michael Shannon, MD, MPH
Alt. Contact: Alan Woolf, MD, MPH
MICHIGAN
Michigan State University
Department of Medicine
117 Est Fee
East Lansing, MI 48824
(517) 353-1846; FAX (517) 432-3606
Kenneth Rosenman, MD
Health
Wayne State/Department of Family Medicine
4201 Street Antoine, Suite 4J
Detroit, Ml 48201
(313) 577-l 420; FAX (313) 577-3070
Appointments/Clinic: (313) 745-4093
Maryjean Schenk, MD, MPH
School of Public Health, University of Michigan
1420 Washington Heights
Ann Arbor, Ml 48109
(734) 764-2594; FAX (734) 763-8095
David Garabrant, MD, MPH
Alt. Contact: Alfred Franzblau, MD
Medicine
22255 Greenfield Rd., Suite 440
Southfield, MI 48075
(248) 559-6663; FAX (248) 559-8254
Laura Harbut, EMT, MBA
Occupational Health Service
St. Lawrence Hospital Work and Health Institute
1210 W. Saginaw
Lansing, MI 48915
(517) 377-0309; FAX (517) 377-0310
R. Michael Kelly, MD, MPH
MINNESOTA
HealthPartners-Regions Hospital
Occupational & Environmental Medicine
640 Jackson St.
St. Paul, MN 55101-2595
(651) 221-3771; FAX (651) 221-8848
Paula Geiger
Alt. Contact: William H. Lohman, MD
Columbia Park Medical Group
Occupational Medicine Department
6401 University Ave., NE #200
(612) 572-5710; FAX (612) 571-3008
Donald Johnson, MD
Alt. Contact: Dorothy Quick
MICHIGAN (continued)
ATSDR
A-15
Appendix II
NEW JERSEY
Environmental and Occupational Health Clinical
Center
Environmental and Occupational Health
Sciences Institute
UMDNJ-Robert Wood Johnson Medical School
170 Frelinghuysen Rd.
Piscataway, NJ 08854
(732) 445-0123; FAX (732) 445-0127
Howard Kipen, MD, MPH
Alt. Contact: Gail Buckler, RN, MPH, COHN-S
NEW MEXICO
Presbyterian Occupational Medicine Clinic
5901 Harper, NE
PO Box 26666
(505) 823-8450; FAX (505) 823-8484
William I. Christensen, MD, MPH
Occupational and Environmental Medicine Clinic
2400 Tucker NE, Rm 177
(505) 272-2900; FAX (505) 272-4494
Karen B. Mulloy, DO, MSCH
NEW YORK
Eastern NY Occupational & Environmental
Health Center
155 Washington Avenue
Albany NY 12210
(518) 436-5511; FAX (518) 436-9110
Anne Tencza, BS, RN, COHN-S
Alt. Contact: Eckardt Johanning, MD
Mount Sinai -Irving J. Selikoff Center for
P.O. Box 1058
Gustave Levy Place
New York, NY 10029
(212) 241-0176; FAX (212) 996-0407
Stephen Mooser, MPH
Alt. Contact: Stephen Levin, MD
OHIO
Community Health Partners Occupational
A-16
ATSDR
NEW YORK (continued)

Center for Occupational & Environmental
Medicine
School of Medicine
Health Sciences Center, Level 3-086
University at Stony Brook
Stony Brook, NY 11794
(516) 444-2196; FAX (516) 444-7525
Wajdy Hailoo, MD, Msc, DIH
Central NY Health Clinical Center
6712 Brooklawn Parkway
Suite 204
Syracuse, NY 13211
(315) 432-8899; FAX (315) 431-9528
Michael B. Lax, MD, MPH
New York University/Bellevue Hospital
Clinic
Bellevue Hospital, Room CD 349
462 1st Avenue
New York, NY 10016
(212) 562-4572; FAX (212) 562-4574
George Friedman-Jimenez, MD
Finger Lakes Occupational Health Services
980 Westfall Road, Suite 210
Rochester NY 14618
(716) 256-0843; FAX (716) 256-2271
Deanna Woodhams, MA
NORTH CAROLINA
Medicine
Duke University Medical Center
Box 3834
Durham, NC 27710
(919) 286-3232; FAX (919) 286-1021
Dennis J. Darcey, MD, MSPH
Alt. Contact: Gary Greenberg, MD, MPH
Health Center
The Lorain Clinic for Occupational Medicine &
Appendix II
Rehabilitation
1800 Livingston Ave
Lorain OH 44052
(440) 233-1068; FAX (440) 246-4560
Kathleen Fagan, MD, MPH
Alt. Contact: Ann Wise, MD
Center for Occupational Health
Holmes Hospital-Tate Wing
University of Cincinnati College of Medicine
Eden and Bethesda Avenue
Cincinnati, OH 45267
(513) 584-1234; FAX (513) 584-1010
James Donovan, MD, MS
Alt. Contact: Susan Pinney, MD
OKLAHOMA
University Occupational Health Services
Medicine
Oklahoma Memorial Hospital
900 NE 10th Street, #2400
Oklahoma City, OK 73104
(405) 271-6177; FAX (405) 271-4125
David Paul, MD, MPH
OREGON
Oregon Health Sciences University (OHSU)
3181 SW Sam Jackson Park Rd.
Mail Code OP-20C
Portland OR 97201
(503) 494-1027; FAX (503) 494-4457
Nina Wolf, RN, BSN, COHN-S
PENNSYLVANIA
Program
University of Pittsburgh
3708 Fifth Avenue, Suite 401,
Medical Arts Bldg.
Pittsburgh, PA 15261
(412) 647-5360; FAX (412) 647-1140
Joseph J. Schwerha, MD, MPH
UTAH
Rocky Mountain Center for Occupational and
Environmental Health
75 South 2000 East
University of Utah
PENNSYLVANIA (continued)
University of Pennsylvania School of Medicine
Occupational Medicine-Silverstein Pavilion
3400 Spruce Street
Philadelphia, PA 19104
(215) 349-5708; FAX (215) 662-3953
Edward A. Emmett, MD
Health
Abington Memorial Hospital
2510 Maryland Road, Suite 101
Willow Grove, PA 19090
(215) 481-5909; FAX (215) 481-5920
Lora S. Regan, MD, MPH
TENNESSEE
Clinic
Meharry Medical College
1005 D.B. Todd Boulevard
Nashville TN 37208
(615) 327-6736; FAX (615) 327-6717
Otis Cosby, MD, MPH
Alt. Contact: Herman Ellis, MD, MPH
TEXAS
Texas Institute of Occupational Safety & Health
11937 U.S. Highway 271
Tyler, TX 75708
(903) 877-5900; FAX (903) 877-7982
Jeffrey Levin, MD, MPH
University of Texas Health Services
7000 Fannin, Suite 1620
Houston TX 77030
(713) 500-3267; FAX (713) 500-3263
Thomas Mackey, RNC, PhD
Salt Lake City, UT 84112

(801) 581-3841; FAX (801) 581-7224
Anthony Suruda, MD, MPH
Alt. Contact: Royce Moser, MD, MPH
ATSDR
A-17
Appendix II
VIRGINIA
Carillon Occupational Medicine
Falin Center
903 S. Jefferson Street
Roanoke, VA 24016
(540) 985-9820; FAX (540) 985-8118
Elaine Gill
Alt. Contact: Hetzal Hartley, MD, MPH
WASHINGTON
Program
University of Washington Harborview Medical
Center
325 9th Avenue, #359739
Seattle, WA 98104
(206) 731-3005; FAX (206) 731-8247
Drew Brodkin, MD, MPH
Alt. Contact: Scott Barnhart, MD, MPH
WEST VIRGINIA
Division of Occupational & Environmental
Health
Department of Family and Community Medicine
Marshall University School of Medicine
1600 Medical Center
Huntington, WV 25755
(304) 691-1178; FAX (304) 691-1153
Chris McGuffin, MSCH, MSOSH
Alt. Contact: James Becker, MD
WEST VIRGINIA (continued)
Institute of Occupational & Environmental Health
West Virginia University School of Medicine
3801 Robert F. Byrd health Science Center
South
Morgantown WV 26506
(304) 293-3693; FAX (304) 293-2629
Alan Ducatman, MD, Msc
CANADIAN CLINICS
ALBERTA
Occupational Medicine Consultation Clinic
University of Alberta
13-103 Clinical Science Bldg.
Edmonton Alberta, CD T6G 2G3
(780) 492-6291; FAX (780) 492-0364
Jim Cheng, MD
MANITOBA
MFL Occupational Health Centre, Inc.
102-275 Broadway
A-18
ATSDR
Winnipeg, Manitoba, CD R3C 4M6

(204) 949-0811; FAX (204) 956-0848
Shiela Braidek
ONTARIO
Occupational Health Clinics for Ontario Workers
15 Gervais Drive, Suite 308
Toronto ON, Canada M3C 1Y8
(416) 449-0009; FAX (416) 449-7772
Andrew King, Executive Director
848 Main Street East
Hamilton ON, Canada L8M 1L9
(905) 549-2552; FAX (905) 549-7993
Chuck Emberson, Executive Director
1780 Regent Street South
Times Square Mall
Sudbury ON, Canada P3C 3Z8
(705) 523-2330; FAX (705) 522-8957
Donna Campbell, Executive Director
ONTARIO (continued)
547 Victoria Ave.
Windsor ON, Canada N9A 4N1
(519) 973-4800; FAX (519) 973-1906
Jim Brophy, Executive Director
171 Kendall St.
Point Edward ON, Canada N7V 4G6
(519) 337-4627;
Jim Brophy, Executive Director
PEDIATRIC ENVIRONMENTAL HEALTH
SPECIALITY UNITS
CALIFORNIA
The University California-San Francisco/
University of California-Irvine Pediatric
Environmental Health Speciality Unit
Contact: (415) 206-4320*
Contact for both sites-San Francisco and Irvine
GEORGIA
The Southeast Pediatric Environmental Health
Speciality Unit
Emory University
Atlanta GA
(877) 33PEHSU (877-337-3478)
Appendix II
ILLINOIS
Pediatric Environmental Health Center
Chicago IL
(312) 633-5310
MASSACHUSETTS
Pediatric Environmental Health Center at
Childrens Hospital
Occupational and Environmental Health Center
at Cambridge Hospital
Boston MA
(888) CHILD14 (888-244-5314)
NEW YORK
Mt. Sinai Pediatric Environmental Health Unit
Mt. Sinai-Irving J Selikoff Center for
New York NY
(212) 241-6173
WASHINGTON
Childrens Environmental Health Center
University of Washington Occupational and
Environmental Medicine Program
Seattle WA
(877) KID-CHEM (877-543-2463)
ALBERTA
Pediatric Environmental Health Clinic
Misericordia Child Health Centr
Edmonton AB
(780) 930-5794
ATSDR
A-19
Appendix III
Appendix III
A-20
ATSDR
Appendix III
ATSDR
A-21
Appendix III

Alabama Department of Public Health
The RSA Tower, Suite 1552
201 Monroe Street
Montgomery, AL 36130
(334) 206-5200
Alaska Department of Health and Social
Services
Alaska Office Building
PO Box 110610
Juneau, AK 99811-0610
(907) 465-3090
District of Columbia Department of Health

825 North Capitol St., NW, Suite 4400
(202) 442-5999
Florida Department of Health
2585 Merchants Row Blvd., Suite 140
Tallahassee, FL 32399
(850) 245-4321
Georgia Department of Human Resources
2 Peachtree Street NW, Suite 15-470
Atlanta, GA 30303
(404) 657-2700
American Samoa Department of Health

Government of American Samoa
LBJ Tropical Medical Center
Pago Pago AS 96799
011-684-6334606
Guam Department of Public Health and Social

Services
PO Box 2816
Agana, GU 96910
011-671-7357102
Arizona Department of Health Services

1740 W. Adams Street, Room 407
Phoenix, AZ 85007
(602) 542-1025
Hawaii Department of Health

1250 Punchbowl Street
PO Box 3378
Honolulu, HI 96813
(808) 586-4410
Arkansas Department of Health

4815 W. Markham Street
Little Rock, AR 72205-3867
(501) 661-2417
California Department of Health Services
714 P Street
Sacramento, CA 95814
(916) 657-1431
Colorado Department of Public Health and
Environment
4300 Cherry Creek Drive South
Denver, CO 80246
(303) 692-2011
Connecticut Department of Public Health
410 Capitol Avenue
Hartford, CT 06134
(860) 509-7101
Delaware Division of Public Health
Jesse Cooper Bldg.
PO Box 637
Dover, DE 19903
(302) 739-4700
A-22
ATSDR
Idaho Department of Health and Welfare

450 W. State Street, Box 83720
Boise, ID 83720
(208) 334-5945
Illinois Department of Public Health
535 W. Jefferson Street
Springfield, IL 62761
(217) 782-4977
Indiana Department
2 North Meridan
Indianapolis, IN 46204
(317) 233-7400
Iowa Department of Public Health
Lucas State Office Bldg.
312 E. 12th Street
Des Moines, IA 50319
(515) 281-5605
Kansas Department of Health and Environment
900 SW Jackson, 6th Floor
Topeka, KS 66612
(785) 296-1086
Appendix III
Kentucky Department for Health Services

275 E. Main Street
Frankfort, KY 40621
(502) 564-3970
Missouri Department of Health

920 Wildwood Drive
Jefferson City, MO 65102
(573) 751-6002
Louisiana Department of Health and Hospitals

PO Box 3214
Baton Rouge, LA 70821
(225) 342-8093
Montana Department of Health and

Human Services
111 North Sanders, 3rd Floor
Helena, MT 59604
(406) 444-5622
Maine Bureau of Health

Department of Human Services
State House Station #11
Augusta, ME 04333
(207) 287-8016
Maryland Department of Health and Mental
Hygiene
201 W. Preston Street, Suite 500
Baltimore, MD 21201
(410) 767-6505
Massachusetts Department of Public Health
250 Washington Street, 2nd Floor
Boston, MA 02108
(617) 624-5200
Michigan Department of Community Health
3423 N. Martin Luther King, Jr. Blvd
PO Box 30195
Lansing, Ml 48909
(517) 335-8024
Micronesia Government of the Federal States of
Micronesia
P.O. Box PS 70, Palikir Stn
Pohnpei FM 96941
011-691-3202619
Minnesota Department of Health
85 East 7th Place, Suite 400
St. Paul, MN 55101
(651) 251-5813
Mississippi State Department of Health
PO Box 1700
2423 N. State Street
Jackson, MS 39215
(601) 960-7634
North Mariana Islands

Department of Public Health
P.O. Box 409, CK
Saipan MP 96950
(670) 234-8950
Nebraska Department of Regulation and
Licensure
PO Box 95007
Lincoln, NE 68509
(402) 471-8566
Nevada State Health Division
Nevada Department of Human Resources
505 E. King Street, Room 201
Carson City, NV 89701
(775) 684-4200
New Hampshire Department of Health and
Human Services
6 Hazen Drive
Concord, NH 03301
(603) 271-8560
New Jersey Department of Health and Senior
Services
PO Box 360, Room 805
Trenton, NJ 08625
(609) 292-7837
New Mexico Health
1190 St. Francis Drive
Santa Fe, NM 87502
(505) 827-2613
New York Department of Health
Corning Tower Building, 14th Floor
Empire State Plaza
Albany, NY 12237
(518) 474-2011
North Carolina Department of Environment,
ATSDR
A-23
Appendix III
Health and Natural Resources

Division of Health Services
101 Blair Drive
Adams Building
Raleigh, NC 27626
(919) 733-4392
North Dakota Department of Health
600 E. Boulevard Avenue
Bismark, ND 58505-0200
(701) 328-2372
Ohio Department of Health
246 N. High Street
PO Box 118
Columbus, OH 43266-0588
(614) 466-2253
South Dakota State Department of Health

600 East Capitol
c/o 500 East Capitol
Pierre, SD 57501
(605) 773-3361
Tennessee Department of Health
3rd Floor, Cordell Hull Bldg.
425 5th Avenue N
Nashville, TN 37247-0101
(615) 741-3111
Texas Department of Health
1100 W. 49th Street
Austin, TX 78756
(512) 458-7376
Oklahoma State Department of Health

1000 NE 10th Street
Oklahoma City, OK 73117
(405) 271-4200
Utah Department of Health

288 North 1460 West
PO Box 142802
Salt Lake City, UT 84114
(801) 538-6111
Oregon Department of Human Services

800 NE Oregon Street, #21
Portland, OR 97232
(503) 731-4000
Vermont Department of Health

PO Box 70
Burlington, VT 05402
(802) 863-7280
Pennsylvania Department of Health

PO Box 90, Room 802.
Harrisburg, PA 17108
(717) 787-6436
Virgin Islands Social and Health

Services
48 Sugar Estate
St. Thomas, VI 00802
(340) 774-0117
Puerto Rico Department of Health

PO Box 70184
San Juan, PR 00936
(787) 274-7600
Rhode Island Department of Health
3 Capitol Hill
Providence, RI 02908
(401) 222-2231
South Carolina Department of Health and
Environmental Control
2600 Bull Street
Columbia, SC 29201
(803) 898-3300
A-24
ATSDR
Virginia Department of Health

1500 East Main Street
PO Box 2448
Richmond, VA 23219
(804) 786-3561
Washington State Department of Health
1112SE Quince Street, Mail Stop 7890
Olympia, WA 98504-7890
(360) 236-4015
West Virginia Department of Health and Human
Services
1900 Kanawha Blvd., Bldg. 3, Room 518
Charleston, WV 25305
(304) 558-2971
Appendix III
Wisconsin Division of Health

PO Box 309
Madison, WI 53701-0309
(608) 266-1511
Wyoming Department of Health
117 Hathaway Bldg.
Cheyenne, WY 82002
(307) 777-7656
ATSDR
A-25
Appendix IV
Appendix IV
A-26
ATSDR
Appendix IV
ATSDR
A-27
Appendix IV
American College of Occupational and Environmental Medicine
114 N. Arlington Heights Road
Arlington Heights, IL 60004
(847) 818-1800
American Board of Medical Toxicology
Heather Miller, Executive Director
777 E. Park Drive
PO Box 8820
Harrisburg PA 17105-8820
(717) 558-7846
Katherine Kirkland, Executive Director
1010 Vermont Avenue
Suite 513
(202) 347-4976
The Association of Occupational and Environmental Clinics (AOEC) is a network of clinics affiliated with
medical schools throughout the U.S. Member clinics provide professional training, community education
about toxic substances, exposure and risk assessment, clinical evaluations, and consultation. A lending
library of training materials is maintained for use by members. Membership is open to any person who
shares the goals of the Association. Clinicians can contact the AOEC office for referrals.
Teratogen Exposure Registry and Surveillance (TERAS)
Frederick Bieber, Ph.D.
Department of Pathology
Brigham and Womens Hospital
75 Francis Street
Boston, MA 02115
(617) 732-6507
TERAS is a network of geneticists and pathologists studying human embryos and fetuses exposed to
teratogens. TERAS maintains information networks for consultation and evaluations.
University programs in occupational health, industrial hygiene, or toxicology
Schools of public health or schools of medicine at universities function as resources to local
communities. In addition, some hospitals have occupational or environmental health clinics that accept
referrals.
A-28
ATSDR
Appendix IV
MotherRisk Program
Gideon Koren, M.D., Director
Hospital for Sick Children
555 University Avenue
Toronto, Ontario M5G lX8
(416) 813-6780
The MotherRisk Program will counsel callers about t he safety of an exposure to drugs, chemicals, or
radiation during pregnancy or breast feeding. The team of physicians and information specialists give
advice on whether medications, X-rays, or chemicals in the work environment will harm the developing
fetus or breast-fed baby. Genetic counseling is available from the Hospital for Sick Childrens Genetic
Department.
ATSDR
A-29
Appendix IV
State/Federal/National Resources
Chemical Emergencies
(800) 424-8802
http://nrc.uscg.mil/index.htm
Hazardous Waste
Emergency Planning and Community RightTo-Know Hotline (EPA)
Developing chemical contingency plans,
gathering site-specific information, list of
more than 400 acutely toxic chemicals
(800) 535-0202
http://www.epa.gov/epaoswer/hotline/in
dex.htm
Superfund Order and Information Line
Provides information about Superfund
Records of Decision-hazardous waste
sites to be cleaned up, actions being taken
(800) 775-5037
http://www.epa.gov/superfund/sites/
phonefax/index.htm
Integrated Risk Information System (IRIS)
Hazardous chemicals information, including
health effects
(513) 569-7254
http://www.epa.gov/iris/
IRIS User Support
(513) 569-7254
Lung Disease
Lungline/National Jewish Hospital
Information on lung disease from chemical
exposure
(800) 222-5864
http://www.NationalJewish.org
Lead
National Center for Environmental Health and
Injury Control (CDC)
Lead poisoning prevention
(404) 488-4880
http://www.cdc.gov
A-30
ATSDR
Child and Maternal Health Clearinghouse

Publications on lead poisoning
(888) 434-4MCH
http://www.nmchc.org/
Occupational Health
NIOSH
Information and publications on health
effects of occupational exposures
(800) 356-4674
http://www.cdc.gov.niosh/
homepage.html
Medical Section/Diagnosis and Treatment
(513) 841-4388
Industrial Hygiene
(513) 841-4374
OSHA (Occupational Safety and Health
Administration)
Regulations for toxic and hazardous
substances in the workplace
For emergencies: (800) 321-6742
For other inquires: (202) 693-1999
http://www.osha.gov
Pesticides
National Pesticide Hotline
(800) 858-7378
http://www.growinglifestyle.com/article/
73p5/a1656.html
National Pesticide Telecommunications
Network
(800) 858-7378
http://ace.orst.edu/info/nptn/
National Pesticide Information Retrieval
System (NPIRS)
Help number for searching NPIRS
database to get fact sheets on
pesticides, insecticides, fungicides, state
and federally registered chemicals.
Funded by EPA/USDA, managed by
Purdue University
(765) 494-6616
http://ceris.purdue.edu/npirs/
npirs.html
Appendix IV
Radon
Radon Hotline
(800) SOS-RADON
http://www.epa.gov/iaq/radon/
index.html
Water
EPA Safe Drinking Water Hotline
(800) 426-4791
www.epa.gov.safewater
EPA Radon Information Center

(800) 438-4318
http://www.epa.gov/iaq/iaqinfo.html
Toxic Substances
Toxicology Information Response Center
(Oak Ridge)
General toxics information, searches
on chemicals
(865) 576-1746
http://www.ornl.gov/
TechResources/tirc/hmepg.html
Agency for Toxic Substances and Disease
Registry (ATSDR)
Emergency Response Section. Rapid
assistance provided about health
issues from chemical exposures.
(404) 639-0615 (24 hours)
(404) 639-6360 (24 hours)
(404) 639-6363 (fax)
http://www.atsdr.cdc.gov/
Toxic Substances Control Act (TSCA)
Hotline/Public Information Office (EPA)
Answers questions and gives general
technical assistance on TSCA.
Guidance on TSCA regulations
(202) 554-1404
Http://es.epa.gov/oeca/ccsmd/
tsca.html
Toxic Chemical Release Inventory System
(EPA)
Information about which chemicals are
used, stored, released by companies
(800) 535-0202
http://toxnet.nlm.nih.gov
CHEMTREC (Chemical Manufacturers
Association)
Nonemergency health and safety
information on chemicals
(800) 282-8200
http://memberexchange.cmahq.co
m/chemtrec.nsf
ATSDR
A-31
Appendix IV
A-32
ATSDR
Glossary
Chemical Glossary
Chemical
Formula
Structural
Formula
Chemical
Name
AsH3
As2O3
CHCl2NO
CHN
CH2Cl2
CH2O
CH3Br
C2Cl4
C2HCl3
C2H3Cl
C2H3Cl3
C2H4O
C2H6O2
C3H3N
C4H6
C6H6
C6H6O
C6H7N
C7H8
C8H10
C9H6N2O2
C10H6Cl8
C10H14NO5PS
COCl2
Cl2
HCI
HF
Hg
H2O2
H2S
NH3
NOx
PH3
NaOH
SO2
AsH3
As2O3
ClC[NOH]Cl
HCN
CH2Cl2
HCHO
CH3Br
Cl2CCCl2
CICHCCl2
CH2CHCl
CH3CCl3
[CH2]2O
HO[CH2]2OH
CH2CHCN
CH2[CH]2CH2
C6H6
C6H5-OH
C6H5NH2
C6H5-CH3
CH3-C6H4-CH3
CH3C6H3[NCO]2
C10H6Cl8
[C2H5O]2P[S]OC6H4NO2
COCl2
Cl2
HCI
HF
Hg
H2O2
H2S
NH3
NOx
PH3
NaOH
O2S
Arsine
Arsenic trioxide
Phosgene oxime
Hydrogen cyanide
Methylene chloride
Formaldehyde
Methyl bromide
Tetrachloroethylene
Trichloroethylene
Vinyl chloride
Ethylene oxide
Ethylene glycol
Acrylonitrile
1,3-Butadiene
Benzene
Phenol
Aniline
Toluene
Xylene
Toluene diisocyanate
Chlordane
Parathion
Phosgene
Chlorine
Hydrogen chloride
Hydrogen fluoride
Mercury
Hydrogen peroxide
Hydrogen sulfide
Ammonia
Nitrogen oxides
Phosphine
Sodium hydroxide
Sulfur dioxide
ATSDR
G-1
Glossary
G-2
ATSDR
Glossary
Chemical Index
Listed below are names of chemical protocols and their synonyms. Subjects of chemical protocols are in
boldface italics (e.g., Arsine)
Acetylene trichloride See Trichloroethylene
Acrylonitrile
Alkron See Parathion
Alleron See Parathion
Aminobenzene See Aniline
Aminophen See Aniline
Ammonia
Ammonia gas See Ammonia
Ammonia solution See Ammonia
Ammonium hydroxide See Ammonia
Amprolenne See Methylene oxide
AN See Acrylonitrile
Anammonide See Hydrogen cyanide
Anhydrous ammonia See Ammonia
Aniline
Aqueous ammonia See Ammonia
Arsenic hydride See Arsine
Arsenic trihydride See Arsine
Arsenic trioxide
Arseniuretted hydrogen See Arsine
Arsenous acid See Arsenic trioxide
Arsenous oxide See Arsenic trioxide
Arsenous hydride See Arsine
Arsine
Arylamine See Aniline
Benzene
Benzenamine See Aniline
Benzenol See Phenol
Benzol See Benzene
Bis(beta-chloroethyl) sulfide See Blister agent (H,
HD, HT)
Bis(2-chloroethyl) sulfide See Blister agent (H, HD,
HT)
Bis(2-chloroethyl)ethylamine See Blister agent
(HN1, HN2, HN3)
Bis(2-chloroethyl)methylamine See Blister agent
(HN1, HN2, HN3)
Blister Agent (H, HD, HT)
Blister Agent (HN1, HN2, HN3)
Blister Agent (HL, L)
Bromoethane See Methyl bromide
1,3-Butadiene
Bivinyl See 1,3-Butadiene
C-100 See Chlordane
Carbolic acid See Phenol
Carbon oxychloride See Phosgene

Carbonic acid dichloride See Phosgene
Carbonic dichloride See Phosgene
Carbonyl chloride See Phosgene
Caustic soda See Sodium hydroxide
Caryolysin See Blister agent (HN1, HN2, HN3)
CD-68 See Chlordane
Chlordan See Chlordane
Chlordane
Chlorine
Chlor-Kil See Chlordane
Chlormethine See Blister agent (HN1, HN2, HN3)
1-Chloro-2(beta-chloroethylthio)ethane See Blister
agent (H, HD, HT)
2-Chloro-N-(2-chloroethyl)-N-ethylethanamine See
Blister agent (HN1, HN2, HN3)
Chloroethene See 1,1,1-Trichloroethane
Chloroethylene See vinyl chloride
Chloroformyl chloride See Phosgene
Chlorohydric acid See Hydrogen chloride
2-Chloro-N,N-bis(2-chloroethyl)ethanamine See
Blister agent (HN1, HN2, HN3)
Coal tar naptha See Benzene
CX See Phosgene oxime
Cyanocthylene See Acrylonitrile
Cyclohexatriene See Benzene
Danthion See Parathion
2,2'-Dichloroethyl sulfide See Blister agent (H, HD,
HT)
Di-2-chloroethyl sulfide See Blister agent (H, HD,
HT)
Dichloromethane See Methylene chloride
2,2'-Dichloro-N-methyldiethylamine See Blister
agent (HN1, HN2, HN3)
Dichloren See Blister agent (HN1, HN2, HN3)
Dichloroformoxime See Phosgene oxime.

2,2'-Dichlorotriethylamine See Blister agent (HN1,
HN2, HN3)
Dihydrogen dioxide See Hydrogen peroxide
Dihydrogen sulfide See Hydrogen sulfide
Diisocyanatotoluene See Toluene diisocyanate
Dimethylbenzene See Xylene
Dimethylene oxide See Ethylene oxide
Dinitrogen tetroxide See Nitrogen oxides
DNTP See Parathion
ATSDR
G-3
Glossary
DPP See Parathion

E-605 See Parathion
Epoxyethane See Ethylene oxide
1,2-Ethanediol See Ethylene glycol
Ethyl-S See Blister agent (HN1, HN2, HN3)
Ethylbis(2-chloroethyl)amine See Blister
agent (HN1, HN2, HN3)
Ethyl parathion See Parathion
Ethylene glycol
Ethylene oxide
Ethylene tetrachloride See Tetrachloroethylene
Ethylene trichloride See Trichloroethylene
Ethinyl trichloride See Trichloroethylene
Etilon See Parathion
ETO See Ethylene oxide
Fluoric acid See Hydrogen fluoride
Fluorine monohydride See Hydrogen fluoride
Formaldehyde
Formalin See Formaldehyde
Formic aldehyde See Formaldehyde
Formonitrile See Hydrogen cyanide
Gasoline
Gas See Gasoline
HL See Blister agent (HL, L)
HN1 See Blister agent (HN1, HN2, HN3)
Hydrochloric acid See Hydrogen chloride
Hydrocyanic acid See Hydrogen cyanide
Hydrofluoric acid See Hydrogen fluoride
Hydrofluride See Hydrogen fluoride
Hydrogen arsenide See Arsine
Hydrogen chloride
Hydrogen cyanide
Hydrogen dioxide See Hydrogen peroxide
Hydrogen fluoride
Hydrogen peroxide
Hydrogen phosphide See Phosphine
Hydrogen sulfide
Hydroperoxide See Hydrogen peroxide
Hydroxybenzene See Phenol
Iprit See Blister agent (H, HD, HT)
Iscobrome See Methyl bromide
Kampstoff Lost See Blister agent (H, HD, HT)
L See Blister agent (HL, L)
Lewisite See Blister agent (HL, L)
Liquid ammonia See Ammonia
Lye See Sodium hydroxide
MBA See Blister agent (HN1, HN2, HN3)
G-4
ATSDR
Mechlorethamine See Blister agent (HN1, HN2,

HN3)
Mercury
Methanal See Formaldehyde
Methane dichloride See Methylene chloride
Methyl aldehyde See Formaldehyde
Methyl benzene See Toluene
Methyl benzol See Toluene
Methyl bromide
Methylchloroform See 1,1,1-Trichloroethane
Methyl toluene See Xylene
Methylene bichloride See Methylene chloride
Methylene chloride
Methylene dichloride See Methylene chloride
Methylene oxide See Formaldehyde
Mixed xylenes See Xylene
Molecular chlorine See Chlorine
Monobromomethane See Methyl bromide
Monohydride See Hydrogen fluoride
Monohydroxybenzene See Phenol
Mononitrogen monoxide See Nitrogen oxides
Monophenol See Phenol
Motor fuel See Gasoline
Muriatric acid See Hydrogen chloride
Mustard gas See Blister agent (H, HD, HT)
Mustard-Lewisite See Blister agent (HL, L)
Mustine See Blister agent (HN1, HN2, HN3)
Nerve agent (GA, GB, GD, VX)
Nitric oxide See Nitrogen oxides
Nitrogen dioxide See Nitrogen oxides
Nitrogen monoxide See Nitrogen oxides
Nitrogen peroxide See Nitrogen oxides
Nitrogen tetroxide See Nitrogen oxides
Glossary
NTO See Nitrogen oxides

Nitrogen fumes See Nitrogen oxides
Nitrous fumes See Nitrogen oxides
Nitrogen oxides
Octachlor See Chlordane
Oxirane See Ethylene oxide
Oxacyclopropane See Ethylene oxide
Oxomethane See Formaldehyde
Paraform See Formaldehyde
Parathion
Perc See Tetrachloroethylene
Perchloroethylene See Tetrachloroethylene
Peroxide See Hydrogen peroxide
Petrol See Gasoline
Phenic acid See Phenol
Phenol
Phenyl alcohol See Phenol
Phenyl hydroxide See Phenol
Phenylic acid See Phenol
Phenylic alcohol See Phenol
Peroxide See Hydrogen peroxide
Phenyl hydride See Benzene
Phenylamine See Aniline
Phenylmethane See Toluene
Phosgene
Phosgene oxime
Phosphine
Phosphorus hydride See Phosphine
Phosphorus trihydride See Phosphine
Phosphoretted hydrogen See Phosphine
Propenenitrile See Acrylonitrile
Prussic acid See Hydrogen cyanide
Pyrrolyene See 1,3-Butadiene
Quick silver See Mercury
Sarin See Nerve agent (GA, GB, GD, VX)
Senfgas See Blister agent (H, HD, HT)
Sewer gas See Hydrogen sulfide
Soda lye See Sodium hydroxide
Sodium hydrate See Sodium hydroxide
Sodium hydroxide
Soman See Nerve agent (GA, GB, GD, VX)
Spirits of salt See Hydrogen chloride
S-yperite See Blister agent (H, HD, HT)
Stathion See Parathion
Stink damp See Hydrogen sulfide
Sulfur dioxide
Sulfur hydride See Hydrogen sulfide
Sulfur mustard agent H See Blister agent (H, HD,
HT)
Sulfur mustard agent HD See Blister agent (H, HD,

HT)
Sulfur mustard agent HT See Blister agent (H, HD,
HT)
Sulfur mustards See Blister agent (H, HD, HT)
Sulphos See Parathion
Sulfuretted hydrogen See Hydrogen sulfide
Sulfur mustard/lewisite See Blister agent (HL, L)
Sulfurous anhydride See Sulfur dioxide
Sulfurous oxide See Sulfur dioxide
TCE See Trichloroethylene
TDI See Toluene diisocyanate
Tabun See Nerve agent (GA, GB, GD, VX)
Termicide C-100 See Chlordane
Tetrachloroethylene
Thiophos See Parathion
Toluene
Toluene diisocyanate
Toluol See Toluene
Tolylene diisocyanate See Toluene diisocyanate
Topichlor See Chlotdane
Toxichlor See Chlordane
Tri See Trichloroethylene
Trichloroethene See Trichloroethylene
Trichloroethylene
2,2',2"-Trichlorotriethylamine See Blister agent
(HN1, HN2, HN3)
Tris(2-chloroethyl)amine See Blister agent (HN1,
HN2, HN3)
VCN See Actylonittile
Velsicol 1068 See Chlordane
Vinyl ethylene See 1,3-Butadiene
Vinyl chloride
Vinyl cyanide See Acrylonitrile
VX See Nerve agent (GA, GB, GD, VX)
White arsenic See Arsenic trioxide
Xylene
Xylol See Xylene
Yellow cross liquid See Blister agent (H, HD, HT)
Yperite See Blister agent (H, HD, HT)
ATSDR
G-5
Glossary
G-6
ATSDR
Glossary
Absorption. The incorporation of liquids or gases into the body. Absorption is also the process by which
liquid hazardous materials are soaked up by sand, sawdust, or other material to limit the spread of contamination.
Acute effect. A pathologic process caused by a single substantial exposure.
Acute exposure. A single encounter to toxic concentrations of a hazardous material or multiple encounters over a
short period of time (usually 24 hours).
Adaptation. The tendency of certain receptors to become less responsive or cease to respond to repeated
or continued stimuli.
Adsorption. The property of a substance to attract and hold to its surface a gas, liquid, or other substance.
Air purification devices. Respirators or filtration devices that remove particulate matter, gases, or vapors
from the atmosphere. These devices range from full-facepiece, dual-cartridge respirators with eye protection to halfmask, facepiece-mounted cartridges with no eye protection.
Air-supplied respirators. A device that provides the user with compressed air for breathing.
Airways. Any parts of the respiratory tract through which air passes during breathing.
Albuminuria. The presence of protein (primarily albumin) in the urine; usually indicative of transient
dysfunction or disease.
Alkali. A basic substance (pH greater than 7) that has the capacity to neutralize an acid and form a salt.
Alveolar ducts. The smallest of the lungs airways that connect terminal bronchioles and alveolar sacs.
Sometimes called bronchioles.
Alveoli (singular alveolus). Microscopic air sacs in which gas exchange between the blood and the lungs
occurs.
Anemia. Any condition in which the number of red blood cells, the amount of hemoglobin, and the
volume of packed red blood cells per 100 milliliters of blood are less than normal.
Anhydrous. Containing no water.
Anisocytosis. Considerable variation in the size of blood cells.
Anorexia. Lack of appetite; aversion to food.
Anoxia. Lack of oxygen in inspired air, blood, or tissues.
Anterior chamber of the eye. The fluid-filled front portion of the eye between the cornea and the lens.
Antidote. An agent that neutralizes a poison or counteracts its effects.
Anuria. Absence of urine production.
ATSDR
G-7
Glossary
Aplastic anemia. A condition characterized by a decrease in the amount of hemoglobin in the blood due
to incomplete or defective development of red blood cells; usually accompanied by defective regeneration
of white blood cells and platelets.
Apnea. Cessation of breathing.
Asphyxia. A condition in which the exchange of oxygen and carbon dioxide in the lungs is absent or
impaired.
Aspiration pneumonia. Inflammation of the lungs due to inhalation of foreign material, usually food or
vomitus, into the bronchi.
Asthma. A chronic condition in which constriction (spasm) of the bronchial tubes occurs in response to
irritation, allergy, or other stimuli.
Ataxia. Incoordination of voluntary movement, especially affecting gait and speech.
Atelectasis. Lung collapse.
Atomic weight. The average weight (or mass) of all the isotopes of an element, as determined from the
proportions in which they are present in a given element, compared with the mass of the 12 isotope of
carbon (taken as precisely 12.000), which is the official international standard; measured in daltons.
Atopy. A tendency or predisposition to allergic reactions.
Autoignition temperature. The lowest temperature at which a gas or vapor-air mixture will ignite from
its own heat source or a contacted heated surface without a spark or flame.
Axon. The part of a nerve cell that conducts nervous impulses away from the nerve cell body to the
remainder of the cell (i.e., dendrites); large number of fibrils enveloped by a segmented myelin sheath.
Axonal. Pertaining to an axon.
Bilirubin. A red pigment that results from normal and abnormal destruction of red blood cells.
Blepharospasm. Involuntary spasmodic blinking or closing of the eyelids due to severe irritation.
Boiling point. The temperature at which the vapor pressure of a liquid equals the atmospheric pressure
and the liquid becomes vapor.
Bradycardia. Slow heart rate, usually under 60 beats per minute.
Bronchi (singular bronchus). Large divisions of the trachea that convey air to and from the lungs.
Bronchiole. A small-diameter airway branching from a bronchus.
Bronchitis. Inflammation of the mucous membrane of the bronchial tubes, usually associated with a
persistent cough and sputum production.
Bronchorrhea. Increased bronchial secretions.
G-8
ATSDR
Glossary
Bronchospasm. Contraction of the smooth muscle of the bronchi, causing narrowing of the bronchi. This
narrowing increases the resistance of air flow into the lungs and may cause a shortness of breath, typically
associated with wheezing.
Bullae. Large fluid-filled blisters.
Carcinogenic. Causing cancer.
Cardiac dysrhythmia. Abnormality in the rate, regularity, or sequence of the heart beat. Formerly
referred to as cardiac arrhythmia.
Cataract. Loss of transparency (clouding) of the lens of the eye.
Catecholamines. Substances of a specific chemical nature (pyrocatechols with an alkylamine side chain).
Catecholamines of biochemical interest am those produced by the nervous system (e.g., epinephrine
[adrenaline] or dopamine) to increase heart rate and blood pressure, or medicines with the same general
chemical structure and effect.
Caustic. Substance that strongly irritates, bums, corrodes, or destroys living tissue.
Cerebellar abnormalities. Any irregularity in the cerebellum of the brain.
Cerebellum. The large brain mass located at the posterior base of the brain, responsible for balance and
coordination of movement.
Cerebral infarctions. Death of tissue in the cerebrum due to lack of blood flow to the area.
Cerebrum. The largest portion of the brain; includes the cerebral hemispheres (cerebral cortex and basal
ganglia).
Chemexfoliation. Chemical skin peeling; use of chemicals to remove scars or pigmentation defects.
Chemical formula. The collection of atomic symbols and numbers that indicates the chemical composition of a pure
substance.
Chemical-protective clothing. Clothing specifically designed to protect the skin and eyes from direct
chemical contact. Descriptions of chemical-protective apparel include nonencapsulating and encapsulating (referred to
as liquid-splash protective clothing and vapor-protective clothing, respectively).
Chronic effect. A pathologic process caused by repeated exposures over a period of long duration.
Chronic exposure. Repeated encounters with a hazardous substance over a period of long duration.
Cognitive function. The ability to think.
Coma. State of profound unconsciousness from which the patient cannot be aroused.
Combustible liquid. Any liquid that has a flash point at or above 100 EF (37.7 EC) and below 200 EF (93.3 EC).
Compressed gas. Gas whose volume has been reduced by pressure.
Congenital anomalies. Birth defects.
ATSDR
G-9
Glossary
Conjunctiva (plural conjuctivae). The delicate mucous membrane that covers the exposed surface of the
eyeball and lines the eyelids.
Conjunctivitis. Inflammation of the conjunctiva; can result in redness, irritation, and tearing of the eye.
Contact dermatitis (allergic). A delayed-onset skin reaction caused by skin contact with a chemical to
which the individual has been previously sensitized.
Contact dermatitis (irritant). Inflammatory skin reaction caused by a skin irritant.
Control zones. Areas at a hazardous materials incident whose boundaries are based on safety and the
degree of hazard; generally includes the Hot Zone, Decontamination Zone, and Support Zone.
Cornea. Transparent membrane that covers the colored part of the eye.
Cornea1 opacification. Clouding of the cornea.
Corrosive. Ability to destroy the texture or substance of a tissue.
Critical Care Area. That area in a hospital designated for the treatment of severely ill patients.
Cyanosis. Bluish discoloration of the skin and mucous membranes due to deficient oxygenation of the
blood; usually evident when reduced hemoglobin (i.e., hemoglobin unable to carry oxygen) exceeds 5%.
Decontamination. The process of removing hazardous materials from exposed persons and equipment at
a hazardous materials incident.
Decontamination Zone. The area surrounding a chemical hazard incident (between the Hot Zone and the
Support Zone) in which contaminants are removed from exposed victims.
Defat. To remove natural oils from the skin.
Degradation. The process of decomposition. When applied to protective clothing, a molecular breakdown
of material because of chemical contact; degradation is evidenced by visible signs such as charring,
shrinking, or dissolving. Testing clothing material for weight changes, thickness changes, and loss of
tensile strength will also reveal degradation.
Delirium. A condition of extreme mental (and sometimes motor) excitement marked by defective perception,
impaired memory, and a rapid succession of confused and unconnected ideas, often with illusions
and hallucinations.
Dementia. A general deterioration of mental abilities.
Demyelination. Removal (destruction) of the myelin sheath that surrounds and protects nerves.
Denervation atrophy. Shrinkage or wasting of muscles due to loss of nerve supply.
Dermal. Relating to the skin.
Dermatitis. Skin inflammation.
G-10
ATSDR
Glossary
Dermis. The layer of the skin just below the epidermis or outer layer. The dermis has a rich supply of
blood vessels, nerves, and skin structures.
Desiccation. Removal of moisture; drying.
Desiccant effect. Drying of the skin caused by removal of soluble oils.
Dilution. The use of water to lower the concentration or amount of a contaminant.
Diaphoresis. Excessive perspiration.
Diplopia. Double vision.
Dyscrasia. Blood disorder.
Dysphagia. Difficulty in swallowing.
Dyspnea. Shortness of breath; difficult or labored breathing.
Dysuria. Painful or difficult urination.
Edema. Accumulation of fluid in body cells or tissues; usually identified as swelling.
Embolization. Obstruction of a blood vessel by a transported clot or other mass.
Embryo. In humans, the developing conceptus up to 8 weeks after fertilization of the egg. See also fetus.
Embryotoxicity. Ability to harm the embryo.
Emergency. A sudden and unexpected event requiring immediate remedial action.
Emesis. Vomiting.
Encephalopathy. Any disease of the brain.
Environmental hazard. A condition capable of posing an unreasonable risk to air, water, or soil quality,
or plant or animal life.
Epidermis. The outermost layer of the skin.
Erythroderma. Intense, widespread reddening of the skin.
Erythema. Redness of the skin.
Esophageal strictures. Narrowing of the esophagus that causes difficulty in swallowing; often due to
scar formation following extensive bums.
Esophagus. The portion of the digestive canal extending from the throat to the stomach. Also referred to
as the gullet.
ATSDR
G-11
Glossary
Euphoria. An intense and exaggerated feeling of well-being.

Exfoliative dermatitis. A skin condition that involves scaling or shedding of the superficial cells of the
epidermis.
Exothermic reaction. Chemical reactions that produce heat.
Explosives. Compounds that are unstable and break down with the sudden release of large amounts of
energy.
Explosivity. The characteristic of undergoing very rapid decomposition (or combustion) to release large
amounts of energy,
Fasciculation. Muscle twitching.
Fetotoxic. Having the ability to harm the fetus.
Fetus. In humans, the conceptus from 8 weeks after fertilization until birth. See also embryo.
Flame-resistant. Slow or unable to bum.
Flammable. The ability of a substance to ignite and bum.
Flammable (explosive) range. The range of gas or vapor concentration (percentage by volume in air)
that will bum or explode if an ignition source is present. Limiting concentrations are commonly called the
lower explosive limit and upper explosive limit. Below the lower explosive limit, the mixture is too lean
to bum; above the upper explosive limit, the mixture is too rich to bum.
Flash point. The minimum temperature at which a liquid produces enough vapor to ignite.
Flashback. The movement of a flame to a fuel source; typically occurs via the vapor of a highly volatile
liquid or by a flammable gas escaping from a cylinder.
Fluorosis. Accumulation of excessive fluoride in the body; characterized by increased bone density and
mineral deposits in tendons, ligaments, and muscles.
Followup. Constant or intermittent contact with a patient after diagnosis or therapy.
Freezing point. Temperature at which crystals start to form as a liquid is slowly cooled; alternatively, the
temperature at which a solid substance begins to melt as it is slowly heated.
Fume. Fine particles (typically of a metal oxide) dispersed in air that may be formed in various ways
(e.g., condensation of vapors, chemical reaction).
Gangrene. Death of tissue due to lack of blood supply.
Gas. A physical state of matter that has low density and viscosity, can expand and contract greatly in
response to changes in temperature and pressure, readily and uniformly distributes itself throughout any
container.
G-12
ATSDR
Glossary
Glaucoma. A disease of the eye characterized by abnormal and damaging high pressure inside the eye;
usually due to a blockage of the channel that normally allows the outflow of fluid from the eye.
Glomerulus (plural glomeruli). A tuft formed of capillary loops that filter blood in the kidney.
Hazard. A circumstance or condition that can cause harm.
Hazardous materials. Substances that, if not properly controlled, pose a risk to people, property, or the
environment.
Hazardous materials incident. The uncontrolled release or potential release of a hazardous material
from its container into the environment.
Hematuria. Condition in which the urine contains an abnormal amount of blood or red blood cells.
Hemodialysis. Removal of soluble substances from the blood by their diffusion through a semipermeable
membrane.
Hemoglobinuria. Condition in which the urine contains an abnormal amount of hemoglobin.
Hemolysis. Destruction or dissolution of red blood cells in such a manner that hemoglobin is liberated
into the medium in which the cells are suspended.
Hemolytic anemia. Any anemia resulting from destruction of red blood cells.
Hemoptysis. The spitting of blood derived from hemorrhage in the lungs or bronchial tubes.
Hepatic. Pertaining to the liver.
Hepatomegaly. Enlargement of the liver.
Hot Zone. The area immediately surrounding a chemical hazard incident, such as a spill, in which
contamination or other danger exists.
Hyperbilirubinemia. A condition in which an abnormally large amount of bilirubin is found in the
blood. Jaundice becomes apparent when the level of bilirubin is double the normal level.
Hyperesthesia. Increased sensitivity to touch, pain, or other sensory stimuli.
Hyperpigmentation. An excess of pigment in a tissue or part of the body.
Hyperreflexia. A condition in which the deep tendon reflexes are exaggerated.
Hypersensitization. Increased sensitivity of the immune system; induced by initial exposure with subsequent
exposures eliciting a greater than expected immunologic response.
Hypertension. High blood pressure.
Hypocalcemia. A condition in which an abnormally low concentration of calcium ions is present in the
blood.
ATSDR
G-13
Glossary
Hypokalemia. A condition in which an abnormally low concentration of potassium ions is present in the
blood.
Hypomagnesemia. A condition in which the plasma concentration of magnesium ions is abnormally
low; may cause convulsions and concurrent hypocalcemia.
Hypophosphatemia. Condition in which an abnormally low concentration of phosphate is found in the
blood.
Hypotension. Low arterial blood pressure.
Hypotonia. A condition in which there is a loss of muscle tone.
Hypoxemia. A condition in which inadequate oxygen is present in arterial blood, short of anoxia.
Hypoxia. Condition in which below-normal levels of oxygen are present in the air, blood, or body tissues,
short of anoxia.
Ignition (autoignition) temperature. The minimum temperature required to ignite gas or vapor without
a spark or flame being present.
Immediately dangerous to life and health (IDLH). That atmospheric concentration of a chemical that
poses an immediate danger to the life or health of a person who is exposed but from which that person
could escape without any escape-impairing symptoms or irreversible health effects. A companion measurement to the
permissible exposure limit (PEL), IDLH concentrations represent levels at which respiratory protection is required.
IDLH is expressed in parts per million (ppm) or mg/m3.
Inadequate warning property. Characteristic (e.g., odor, irritation) of a substance that is not sufficient
to cause a person to notice exposure.
Incident commander. The person responsible for establishing and managing the overall operational plan
at a hazardous material incident. The incident commander is responsible for developing an effective
organizational structure, allocating resources, making appropriate assignments, managing information,
and continually attempting to mitigate the incident.
Insecticide. An agent that has the ability to kill insects.
Intention tremor. Trembling of the extremities during movement.
Interstitial pneumonitis. Inflammation of the alveolar walls and the spaces between them.
Iritis. Inflammation of the colored part of the eye (iris).
Ischemia. Obstruction of blood flow (usually by arterial narrowing) that causes lack of oxygen and other
bloodborne nutrients.
Ischemic necrosis. Death of cells as a result of decreased blood flow to affected tissues.
Jaundice. Yellowing of the skin and whites of the eyes due to an accumulation of bile pigments (e.g.,
bilirubin) in the circulating blood.
G-14
ATSDR
Glossary
Keratitis. Inflammation of the cornea.

Lacrimation. Secretion of tears, especially in excess.
Laryngeal edema. Swelling of the voice box due to fluid accumulation.
Laryngitis. Inflammation of the mucous membrane of the larynx.
Laryngospasm. Spasmodic closure of the vocal apparatus.
Lethargy. A state of extreme tiredness or fatigue.
Leukemia. Progressive proliferation of abnormal leukocytes found in blood and blood-forming tissues
and organs; due to cancer of the bone marrow cells that form leukocytes.
Leukocyte. White cell normally present in circulating blood.
Material safety data sheet (MSDS). Documents prepared by the chemical industry to transmit information about the
physical properties and health effects of chemicals, and about emergency response plans.
Methemoglobin. A transformation product of hemoglobin in which normal Fe+2 is oxidized to Fe+3.
Methemoglobin contains oxygen that is firmly bound to the Fe+3 ion, which prevents the release of oxygen to the tissues.
Methemoglobinemia. Condition in which methemoglobin is present in the circulating blood.
Methemoglobinuria. Condition in which methemoglobin is present in the urine.
Miosis. Contraction of the pupil to a pinpoint.
Miscible. Able to mix (but not chemically combine) in any ratio without separating into two phases (e.g.,
water and alcohol).
Mist. Liquid droplets dispersed in air.
Mitigation. Actions taken to prevent or reduce the severity of harm.
Monocytic leukemia. A form of bone marrow cancer characterized by an increase in the number of large,
mononuclear white blood cells in tissues, organs, and the circulating blood.
Molecular weight. The sum of the atomic weights (q.v.) of the atoms in a molecule; measured in daltons.
Myalgia. Severe muscle pain.
Mydriasis. Dilation of the pupil.
Myelocytic leukemia. A form of bone marrow cancer characterized by the presence of large numbers of
granular white blood cells in tissues, organs, and the circulating blood.
Myocardial ischemia. Insufficient oxygen supply to meet the metabolic demands of heart muscles.
ATSDR
G-15
Glossary
Myocarditis. Inflammation of the muscles of the heart.

Myoclonus. Involuntary spasm or twitching of a muscle or group of muscles.
Myoglobin. The oxygen-transporting, pigmented protein of muscle; resembles blood hemoglobin in
function.
Myoglobinuria. Presence of myoglobin in urine.
Nasopharynx. Relating to the nasal cavity and that part of the throat that lies above the level of the soft
palate.
Necrosis. Death of one or more cells or a portion of a tissue or organ.
Nephrotoxic. Capable of damaging the kidney.
Neuropathy. A disorder of the nervous system; in contemporary usage, a disease involving the cranial or
spinal nerves.
Noncardiogenic pulmonary edema. An accumulation of an excessive amount of fluid in the lungs as a
result of leakage from pulmonary capillaries; not due to heart failure.
Nystagmus. Involuntary rapid movements of the eyeballs, either rhythmical or jerky.
Ocular. Pertaining to the eye.
Odor threshold. The lowest concentration of a vapor or gas that can be detected by smell.
Off-gassing. Giving off a vapor or gas.
Olfactory fatigue. Temporary loss of the sense of smell due to repeated or continued stimulation.
Oliguria. Condition in which abnormally small amounts of urine are produced.
Opisthotonos. Tetanic spasm in which the spine and extremities are bent up and forward so that a reclining body
rests on the head and the heels.
Optic atrophy. Shrinkage or wasting of the optic nerve that may lead to partial vision loss or blindness.
Optic neuritis. Inflammation of the optic nerve.
Osteosclerosis. Abnormal hardening or increase in density of the bone.
Paresthesias. An abnormal sensation such as burning, prickling, or tingling.
Percutaneous absorption. Passage of a substance through unbroken skin.
Peripheral neuropathy. A disorder of the peripheral nerves.
Permeation. The passage of chemicals, on a molecular level, through intact material such as protective
G-16
ATSDR
Glossary
clothing.
Permissible exposure limit (PEL). The maximum time-weighted average concentration mandated by the
Occupational Safety and Health Administration (OSHA) to which workers may be repeatedly exposed for
8 hours per day, 40 hours per week without adverse health effects.
Photophobia. Abnormal sensitiveness to light, especially of the eyes.
Physical state. The state (solid, liquid, or gas) of a chemical under specific conditions of temperature and
pressure.
Pneumonitis. Inflammation of the lungs.
Poikilocytosis. The presence of irregularly shaped red blood cells in the peripheral blood.
Posthypoxic encephalopathy. Condition in which the brain has been damaged as a result of insufficient
oxygen.
Proteinuria. A condition in which an abnormal amount of protein is present in the urine. See also
albuminuria.
Pruritic. Pertaining to itching.
Psychosis. A mental disorder characterized by derangement of personality and loss of touch with reality.
Pulmonary edema. Accumulation of extravascular fluid in the lungs that impairs gas exchange; usually
due to either increased intravascular pressure or increased permeability of the pulmonary capillaries.
Pupil. The circular opening in the center of the iris through which light rays enter the eye.
Reactivity. The ability of a substance to chemically interact with other substances.
Rescuer protection equipment. Gear necessary to prevent injury to workers responding to chemical
incidents.
Respiratory depression. Slowing or cessation of breathing due to suppression of the function of the
respiratory center in the brain.
Response organization. An organization prepared to provide assistance in an emergency (e.g., fire
department).
Response personnel. Staff attached to a response organization (e.g., HAZMAT team).
Retrobulbar neuritis. Inflammation of the portion of the optic nerve behind the eyeball.
Rhinitis. Inflammation of the mucous membranes of the nasal passages.
Rhinorrhea. A discharge from the nasal mucous membrane.
Routes of exposure. The manner in which a chemical contaminant enters the body (e.g., inhalation,
ingestion).
ATSDR
G-17
Glossary
Sclera. The tough, white supporting tunic of the eyeball.

Secondary contamination. Transfer of a harmful substance from one body (primary body) to another
(secondary body), thus potentially permitting adverse effects to the secondary body.
Self-contained breathing apparatus (SCBA). Protective equipment consisting of an enclosed facepiece
and an independent, individual supply (tank) of air; used for breathing in atmospheres containing toxic
substances or underwater.
Sensory neuropathy. Damage to the nerves that carry information about sensation (e.g., touch, pain,
temperature) to the brain.
Sequela (plural sequelae). A condition that follows as a consequence of injury or disease.
Sloughing. The process by which necrotic cells separate from the tissues to which they have been attached.
Solubility. The ability of one material to dissolve in or blend uniformly with another.
Soluble. Capable of being dissolved.
Solution. A homogeneous mixture of two or more substances, usually liquid.
Solvent. A substance that dissolves another substance.
Specific gravity. The ratio of the mass of a unit volume of a substance to the mass of the same volume of
a standard substance (usually water) at a standard temperature.
Status epilepticus. Severe seizures in which recovery does not occur between major episodes.
Stridor. A harsh, high-pitched respiratory sound often heard in acute respiratory obstruction.
Support Zone. That area beyond the Decontamination Zone that surrounds a chemical hazard incident in
which medical care can be freely administered to stabilize a victim.
Surfactant. An agent that reduces surface tension (e.g., wetting agents, detergents, dispersing agents).
Tachycardia. Rapid heartbeat (typically greater than 100 beats per minute).
Tachypnea. Rapid breathing.
Teratogenic. Having the ability to cause congenital anomalies.
Tetany. A condition marked by involuntary muscle contractions or spasms.
Thrombocytopenia. A condition in which there is an abnormally small number of platelets in the blood.
Thrombosis. Blood vessel clotting.
Time-weighted average (TWA) air concentration. That concentration of a substance in air that is
measured by collecting it on a substrate at a known rate for a given period of time.
G-18
ATSDR
Glossary
Tinnitus. Ringing in the ears.

Toxic potential. The inherent ability of a substance to cause harm.
Toxic. Having the ability to harm the body, especially by chemical means.
Tracheitis. Inflammation of the membrane lining the trachea.
Trismus. Lockjaw.
Tubular necrosis. Death of the cells lining the kidney tubules.
Uremia. Condition in which an abnormally high level of urea or other nitrogenous waste is found in the
blood; due to kidney dysfunction.
Urticaria. Hives.
Vapor density. The weight of a given volume of vapor or gas compared to the weight of an equal volume
of dry air, both measured at the same temperature and pressure.
Vapor pressure. A measure of the tendency of a liquid to become a gas at a given temperature.
Vapor. The gaseous form of a substance that is normally a solid or liquid at room temperature and
pressure.
Vascular. Pertaining to blood vessels.
Vasodilation. Increased diameter of the blood vessels.
Ventricular fibrillation. Rapid, tremulous movement of the ventricle that replaces normal contractions
of the heart muscle; results in little or no blood being pumped from the heart
Vertigo. Sensation of spinning or revolving.
Vesicant. An agent that produces blisters.
Vesiculation. The presence or formation of blisters.
Water-reactive material. A substance that readily reacts with water or decomposes in the presence of
water, typically with substantial energy release.
Wheezing. Breathing noisily and with difficulty; usually a sign of spasm or narrowing of the airways.
ATSDR
G-19
Glossary
G-20
ATSDR
Glossary
ATSDR
G-21
In 1998, the Agency for Toxic Substances and Disease Registry (ATSDR) joined with the Association of Occupational
and Environmental Clinics (AOEC) to develop the Pediatric Environmental Health Specialty Unit (PEHSU)
Program as a national resource for pediatricians, other health care providers, and communities. The Program is
designed to (1) reduce environmental health threats to children, (2) improve access to expertise in pediatric
environmental medicine, and (3) strengthen public health prevention capacity. The key focus areas of the units are
medical education and training, clinical consultation, and clinical specialty referral for children who may have been
exposed to hazardous substances in the environment. Five units are fully operational. By the end of 2000, a total of
nine units are scheduled to be in operation in the United States.
Pediatric Environmental Health Center

Childrens Hospital
Boston, Massachusetts
The Pediatric Environmental Health Center was
established in 1998 as a regional center for pediatric
environmental health, with support from ATSDR and
AOEC. The Center is a joint program of the Childrens
Hospital in Boston; the Occupational and
Environmental Health Program at Cambridge
Hospital; Harvard Medical School; and the
Occupational and Environmental Medicine Program,
Harvard School of Public Health.
The Center at Childrens Hospital offers multidisciplinary evaluation and management of children
with known or suspected exposure to environmental
toxins. Staffed by pediatricians, medical toxicologists,
nurses, and resource specialists, the Center provides
medical management for illnesses or intoxications
resulting from heavy metals, indoor air pollutants,
outdoor pollutants, and adolescent occupational
exposures. The Center also provides consultative
services by telephone; publishes articles advancing
the field of pediatric environmental medicine; and
conducts educational activities for medical students,
residents, and other health care providers. Recently,
the center staff developed a teaching tool entitled the
Pediatric Environmental Health History. This tool
is available in a CD-ROM format.
The Director of the Center is Michael Shannon, MD,
MPH. Alan Woolf, MD, MPH, and Rose Goldman,
MD, MPH, serve as Co-Directors. Howard Hu, MD,
MPH, ScD, is affiliated with the Center.
The Pediatric Environmental Health Center can be
contacted by phoning 888-Child14.
Mt. Sinai-Irving J. Selikoff Center

for Occupational and
Environmental Medicine
New York, New York
The Pediatric Environmental Health Unit was
environmental health, with support from ATSDR, the
National Center for Environmental Health, and the
American College of Preventive Medicine. It is a
multi-disciplinary program of research, education,
clinical service, and community partnership.
The major purposes of the Unit are to
provide clinical services to children with diseases
of toxic environmental origin and to children who
have sustained toxic exposures in their
environment. The clinical services provided by
the Unit are available on-site at the Mt. SinaiIrving J. Selikoff Center for Environmental and
Occupational Medicine.
serve as a regional source of referral and

consultation in environmental pediatrics
increase pediatricians knowledge of

environmental threats to childrens health. (This
is being done through unit-sponsored special
education opportunities such as grand rounds and
seminar series, by holding conferences such as
Environmental Influences on Children: Brain,
Development, and Behavior, by publishing
articles, and by training health fellows under the
supervision of faculty of the Departments of
Pediatrics and Community and Preventive
Medicine, Mt. Sinai School of Medicine, Mt.
Sinai Hospital, Mt. Sinai Medical Center.)
Philip Landrigan MD, MSc is the Principal

Investigator at the Mt. Sinai PEHSU.
The Mt. Sinai Unit can be contacted by phoning 212241-6173.
The Southeast Pediatric Environmental

Health Specialty Unit
Emory University
Atlanta, Georgia
The Southeast Pediatric Environmental Health Unit
was established in Fall 1999 as a regional center for
pediatric environmental health, with support from
ATSDR, the U.S. Environmental Protection Agency
(EPA), and AOEC. The Unit links Emory
Universitys Department of Environmental and
Occupational Health, Rollins School of Public
Health, and the Department of Pediatrics, School of
Medicine; the Georgia Poison Center; the Marcus
Institute; and a variety of Emory University-affiliated
clinical facilities, including Childrens Health Care
of Atlanta and the Hughes Spalding Childrens
Hospital.
The objectives of the Unit are to
develop a variety of educational materials on
childrens environmental health;
provide information and carry out health

education activities for families, communities,
and health care providers throughout the
Southeast (Region IV) regarding environmental
hazards and the most effective ways to protect
childrens health;
provide clinical consultation to agencies and

health care providers in the region;
create an infrastructure for delivering pediatric

environmental health care, including
maintaining a database of conditions linked to
environmental hazards and consulting with
government agencies to formulate solutions;
and
The Center for Childrens

Chicago, Illinois
The Center for Childrens Environmental Health was
U.S. Environmental Protection Agency (EPA), and
AOEC. The Center is a joint program of the Division
of Occupational and Environmental Medicine and the
Department of Pediatrics at Cook County Hospital.
The Center is affiliated with the Great Lakes Center
for Occupational and Environmental Safety and
Health at the University of Illinois and Chicagos
Toxikon Consortium. The Center works closely with
the Illinois Poison Control Center; local, state, and
federal environmental and public health agencies; and
local health care institutions.
The Center exists to
evaluate, treat, and prevent environmental
illnesses in infants, children, and adolescents.
The Center has a multi-disciplinary staff with
experts in environmental medicine, pediatrics,
clinical toxicology, and industrial hygiene.
expand the knowledge of childrens

environmental health problems through
research. The Centers faculty includes clinical
and public health scientists who conduct
research on the most effective ways to diagnose,
treat, and prevent childrens environmentassociated illnesses.
provide clinical pediatric environmental health

services, including evaluation of children,
referral of those needing treatment, and
establishment of a network of expert clinicians.
Howard Frumkin, MD, DrPH is the Principal

Investigator for the Southeast PEHSU. Robert Geller,
MD; Leslie Rubin, MD; and Gerald Teague, MD, are
Co-Investigators. Janice Nodvin is the Project
Administrator.
The Southeast Unit can be contacted by phoning 87733PEHSU (877-337-3478).
train pediatricians and other health care

professionals in pediatric environmental health
issues. The Center offers a monthly lecture
series at Cook County Hospital as well as
continuing educational programs and workshops
throughout Region V. The Center is also
developing interactive, web-based case
presentations that can be accessed through the
Centers website at www.uic.edu. The future
website address is www.uic.edu/sph/glakes/kids.
promote childrens environmental health in

communities. The Center is part of the Health
Hazard Evaluation (HHE) Program which
investigates health hazards in communities
through environmental monitoring,
epidemiology, and clinical evaluations.
The Centers Director is Daniel Hryhorczuk, MD,

MPH, FACMT. The Associate Directors are Jay
Mayefsky, MD, MPH, and Carl Baum, MD, FAAP,
ACMT.
The Center for Childrens Environmental Health can
be contacted by phoning 312-633-5310.
Pediatric Environmental Health

Specialty Unit
Harborview Medical Center
Seattle, Washington
The Harborview Pediatric Environmental Health
Specialty Unit (PEHSU) was established in 1998 and
currently serves as a regional center for pediatric
U.S. Environmental Protection Agency (EPA), and
AOEC. This PEHSU was created by the University of
Washingtons Occupational and Environmental
Medicine Program, together with the Washington
Poison Control Center and Childrens Hospital and
Regional Medical Center.
The PEHSUs goal is to provide expertise on
childhood environmental health risk to health care
providers, educators, communities, and families. The
PEHSU staff provide
clinical consultations with experts at the
Washington Poison Center for those concerned
about childhood environmental exposures.
Callers concerns have included the
consumption of well water contaminated with
pesticides and solvent exposures from painting
a childs bedroom. The Poison Center experts
address some 2,000 such inquiries every month.
clinical services on a case-by-case basis to see

children and their families. Providers are
specifically trained in both pediatrics and
environmental medicine. Clinic visits are
available at Childrens Hospital and Regional
Medical Center.
training for health care providers as well as the

public on childhood environmental health
issues. Much of the training curriculum is based
on results from an environmental health survey
completed by school nurses, physicians, parents
of children in Head Start Programs, ParentTeacher Association (PTA) leaders, and others.
The topics of greatest concern reported were air
pollution, allergens, food-related hazards, and

drinking water quality.
To learn more about training opportunities, visit the
PEHSU website at http://depts.washington.edu/
oemp/pehsu/index.html.
The Director of the Harborview PEHSU is
C. Andrew Brodkin, MD, MPH. William O.
Robertson, MD, is the Co-Director.
The Harborview PEHSU can be contacted by
phoning 877-KID-CHEM (west of the Mississippi
River) and 206-526-2121.
University of California - San Francisco

(UCSF)/University of California Irvine (UCI) Pediatric Environmental
Health Specialty Unit
The University of California Pediatric Environmental
Health Unit was established in the winter of 2000 as
a regional center for pediatric environmental health,
with support from the Agency for Toxic Substances
and Disease Registry (ATSDR), the U.S.
Environmental Protection Agency (EPA), and the
Association of Occupational and Environmental
Clinics (AOEC). As a joint collaborative project
providing services in both the northern (UCSF) and
southern (UCI) areas of the state, the unit links the
Occupational and Environmental Medicine Programs
at the respective campuses with the UCSF-Mount
Zion Hospital and UCSF-San Francisco General
Hospital, California Poison Center and the
Departments of Pediatrics at UCSF and UCI.
The objectives for the UC-PEHSU are
to provide consultative services to health
professionals, governmental agencies and the
California Poison Control System through an
effective network of pediatrics specialists in
collaboration with the Occupational and
Environmental Medicine Program at both sites;
to conduct educational activities;
to provide clinical and diagnostic services

either on site or through the Department of
Pediatrics; and
to coordinate program evaluation activities for

the PEHSU.
John Balmes, M.D. is the principal investigator and

Dean Baker, M.D., MPH is the co-prinicipal
investigator. Denise Souza, MSN, C-NP, COHN-S is
the project coordinator. Mary Koebler, RN, COHN-S
serves as the UCI liaison for the project components.
The University of California - San Francisco/
University of California - Irvine PEHSU can be
reached at 415-206-4320 (for both sites).
Southwest Center for Pediatric

University of Texas Health Center
Tyler, Texas
The Southwest Center for Pediatric Health began
operation on September 1, 2000, and is a
collaboration between UTHCTs Occupational
Medicine Program and the Departments of Pediatrics
and Allergy. It was established with support from
(EPA), and AOEC.
In addition, the Southwest Center has assembled a
team that includes the Texas Poison Center Network
and its North Texas Poison Center, the New Mexico
Poison and Drug Information Center and the
Program of Occupational and Environmental Health
at the University of New Mexico. The specific aims
for the SW-CPEH are to
develop materials and present training to

health professionals and public health
officials on environmental health issues and
their impact on childrens health.
answer requests for information regarding
pediatric environmental health and risk
communication from health care professionals, public health agencies, and concerned
parents.
provide clinical consultation services for
patients and their health care providers.
The toll-free number for the Southwest Center for

Pediatric Environmental Health is (888) 901-5665.
Jeffrey Levin, MD, MSPH, and Larry K. Lowry,
PhD, serve as co-principal investigators. Dr. Levin
can be reached directly at (903) 877-5900 or emailed at jeffrey.levin@uthct.cdu. Dr. Lowry can be
reached at (903) 877-5919 or e-mailed at

larry.lowry@uthct.cdu. Both Dr. Levin and Dr.
Lowry can be faxed at (903) 877-7060.
George Washington University Medical

Center
Washington, DC.
The George Washington University specialty unit
will be starting on October 1, 2000. The unit is a
project of the George Washington University
Medical Center (GWUMC) and the Childrens
National Medical Center, and includes collaboration
between the GWUMC Division of Occupational
Medicine and Toxicology and the Department of
Pediatrics. It was established with support from
(EPA), and AOEC.
In addition, they have assembled a team which
includes the Howard University College of Nursing
and faculty from the University of Maryland School
of Medicine and the Medical College of
Pennsylvania.
The goals of the George Washington University
PEHSU are to
increase the cooperation and exchange of
information between pediatricians and occupational and environmental health professionals.
conduct educational activities that will assist both
health professionals and communities in
addressing environmental risks to children.
improve the recognition, evaluation, and
management of environmental health problems in
children.
develop new knowledge about communications
between clinicians, parents, and patients about
environmental health issues.
reduce the environmental health disparities
among children in EPA/ATSDR Region 3.
John Balbus, MD, MPH, Jerome Paulson, MD, and
Benjamin Gitterman, MD, MPH, will serve as coprincipal investigators. Questions concerning the
PEHSU can be directed to Dr. Paulson at (202) 9949914, faxed to (202) 994-4861, or e-mailed at
hcsjap@gwumc.edu.
Additional information on the PEHSU Program can be obtained by calling Katherine Kirkland, MPH, Executive Director,
AOEC, at 202-347-4976 or Christine Rosheim, DDS, MPH, Project Officer, ATSDR, at 404-639-6351. For more information
about ATSDR contact ATSDRs toll-free information line at (888) 42-ATSDR...thats (888) 422-8737 or website at www.atsdr.cdc.gov.
ToxFAQs
OVERVIEW
Division of Toxicology ToxFAQs
April 2003
The ToxFAQs sheets are a series of two page summaries about hazardous
substances and their health effects. They provide answers to the most
frequently asked questions (FAQs) about health effects possible from exposure.
What is a ToxFAQs sheet?

Each ToxFAQs sheet is a two page summary of information about the health effects possible from exposure to one of a variety of individual hazardous (chemical) substances.
The ToxFAQs are written in an easy to
read terms in a question and answer format and
address issues of important interest, such as
how can it affect your health or can it cause cancer. The complete list of questions is shown at
the right.
What is a ToxFAQs sheet?
1
1
1
1
1
1
1
1
1
1
What is [substance X] ?
What happens to [substance X] when it enters the environment ?
How may I be exposed to [substance X] ?
How can [substance X] affect my health ?
How likely is [substance X] to cause cancer ?
How can [substance X] affect children ?
How can families reduce their exposure to [substance X] ?
Is there a medical test to show whether I have been exposed to [substance X] ?
Has the federal government made recommnendations to
protect human health ?
Where can I get further information on [substance X] ?
The ToxFAQs are useful whenever a

quick review or background is needed about Where can I get further information?
that substance, such as during an emergency re- 1 You may call during normal business hours, 1-888-4228737 or 404-498-0160, or fax the Division of Toxicology
sponse or at community meetings. If needed, a
at 404-498-0093.
slightly larger version, the Public Health State- 1 You may visit our web site < http://www.atsdr.cdc.gov>.
ment, is also available for each substance from
1 You may write to ATSDR Division of Toxicology, 1600
ATSDR.
Clifton Road Mailstop E-29 Atlanta, GA 30333.

ToxFAQs
Substance List
Division of Toxicology ToxFAQs
April 2003
This is a complete hyperlinked list of the 182 ToxFAQs information sheets available on this CD-ROM.
You may click on any specific name below to go directly to that substance's ToxFAQs sheet.
Acetone
Acrolein
Acrylonitrile
Aldrin/Dieldrin
Aluminum
Americium
Ammonia
Aniline
Antimony
Arsenic
Arsenic Trioxide
Arsine
Asbestos
Atrazine
Barium
Benzene
Benzidine
2,3-Benzofuran
Beryllium
Bis(2-chloroethyl)ether
Bis(chloromethyl)ether
Blister Agents: Lewisite(L)
Mustard-Lewisite Mixture(HL)
Blister Agents: HN-1,HN-2,HN-3
(Nitrogen Mustards)
Blister Agents: Sulfur Mustard
Agents H/HD, HT
Boron
Bromodichloromethane
Bromoform
Bromomethane
1,3-Butadiene
2-Butanone
2-Butoxyethanol
Cadmium
Calcium Hypochlorite/
Sodium Hypochlorite
Carbon Disulfide
Carbon Tetrachloride
Cesium
Chlordane
Chlorfenvinphos
Chlorinated Dibenzo-p-Dioxins
(CDDs)
Chlorine
Chlorine Dioxide
Chlorobenzene
Chlorodibenzofurans (CDFs)
Chloroethane
Chloroform
Chloromethane
Chlorophenols
Chlorpyrifos
Chromium
Cobalt
Copper
Crankcase Oil, Used
Creosote
Cresols
Crotonaldehyde
Cyanide
DDT, DDE, DDD
Diazinon
Diborane
Dibromochloropropane
1,2-Dibromoethane
1,4-Dichlorobenzene
3,3'-Dichlorobenzidine
1,1-Dichloroethane
1,2-Dichloroethane
1,1-Dichloroethene
1,2-Dichloroethene
1,2-Dichloropropane
1,3-Dichloropropene
Dichlorvos
Di(2-ethylhexyl)phthalate (DEHP)
Diethyl Phthalate
Diisopropylmethylphosphonate
(DIMP)
Di-n-butylphthalate
1,3-Dinitrobenzene
Dinitrocresols
Dinitrophenols
2,4- and 2,6-Dinitrotoluene
1,2-Diphenylhydrazine
Di-n-octylphthalate (DNOP)
Disulfoton
Endosulfan
Endrin
Ethion
Ethylbenzene
Ethylene Oxide
Ethylene Glycol
Fluorides, Hydrogen Fluoride,
and Fluorine
Formaldehyde
Fuel Oils (Kerosene)
Gasoline, Automotive
Heptachlor and Heptachlor Epoxide
Hexachlorobenzene
Hexachlorobutadiene
Continued on page 2 ...

ToxFAQs
Page 2
Substance List
The ToxFAQs Internet address is http://www.atsdr.cdc.gov/toxfaq.html
...continued from page 1.
Hexachlorocyclohexane
(HCH or Lindane)
Hexachlorocyclopentadiene
Hexachloroethane
Hexamethylene Diisocyanate(HDI)
Hexane
2-Hexanone
HMX (Octogen)
Hydraulic Fluids
Hydrazines
Hydrogen Chloride
Hydrogen Peroxide
Hydrogen Sulfide
Iodine
Ionizing Radiation
Isophorone
Jet Fuels JP-4 and JP-7
Jet Fuels JP-5 and JP-8
Kerosene (Fuel Oils)
Lead
Malathion
Manganese
Mercury
Methoxychlor
Methyl Isocyanate
Methyl Mercaptan
Methyl Parathion
Methyl t-Butyl Ether (MTBE)
4,4'-Methylenebis(2-chloroaniline)
(MBOCA)
Methylene Chloride
Methylenedianiline
Mirex and Chlordecone

Mustard Gas
N-Nitrosodimethylamine
N-Nitrosodiphenylamine
N-Nitrosodi-n-propylamine
Naphthalene
Nerve Agents (GA,GB,GD,VX)
Nickel
Nitrobenzene
Nitrogen Oxides
Nitrophenols
Otto Fuel II
Pentachlorophenol
Phenol
Phosgene
Phosgene Oxime
Phosphine
Phosphorus, White
Plutonium
Polybrominated Biphenyls (PBBs)
Polychlorinated Biphenyls (PCBs)
Polycyclic Aromatic Hydrocarbons
(PAHs)
Propylene Glycol
Pyrethrins/Pyrethroids
Pyridine
Sodium Hydroxide
Stoddard Solvent
Strontium
Styrene
Sulfur Dioxide
Sulfur Trioxide
Sulfuric Acid
Synthetic Vitreous Fibers
1,1,2,2-Tetrachloroethane
Tetrachloroethylene (PERC)
Tetryl
Thallium
Thorium
Tin
Titanium Tetrachloride
Toluene
Total Petroleum Hydrocarbons
(TPH)
Toxaphene
Trichloroethylene (TCE)
1,2,3-Trichloropropane
1,3,5-Trinitrobenzene
2,4,6-Trinitrotoluene (TNT)
Uranium
Radium
Radon
RDX (Cyclonite)
Vanadium
Vinyl Acetate
Vinyl Chloride
Selenium
Selenium Hexafluoride
Silver
Xylene
Zinc
Where can I get more information? For more information, contact the Agency for Toxic Substances and Disease
Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone: 1-888-422-8737,
FAX: 404-498-0093. The ToxFAQs Internet address is < http://www.atsdr.cdc.gov/toxfaq.html >. ATSDR can tell you
where to find occupational and environmental health clinics. Their specialists can recognize, evaluate, and treat illnesses
resulting from exposure to hazardous substances. You can also contact your community or state health or environmental
quality department if you have any more questions or concerns.
ACETONE
CAS # 67-64-1
Agency for Toxic Substances and Disease Registry ToxFAQs
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about acetone. For more
information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series of
summaries about hazardous substances and their health effects. Its important you understand this information
because this substance may harm you. The effects of exposure to any hazardous substance depend on the
dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals are present.
SUMMARY: Exposure to acetone results mostly from breathing air, drinking water,
or coming in contact with products or soil that contain acetone. Exposure to moderateto-high amounts of acetone can irritate your eyes and respiratory system, and make
you dizzy. Very high exposure may cause you to lose consciousness. This chemical
has been found in at least 572 of 1,416 National Priorities List sites identified by the
What is acetone?
(Pronounced s-tn)
Acetone is a manufactured chemical that is also found
naturally in the environment. It is a colorless liquid with a
distinct smell and taste. It evaporates easily, is flammable,
and dissolves in water. It is also called dimethyl ketone,
2-propanone, and beta-ketopropane.
Acetone is used to make plastic, fibers, drugs, and other
chemicals. It is also used to dissolve other substances.
It occurs naturally in plants, trees, volcanic gases, forest
fires, and as a product of the breakdown of body fat. It is
present in vehicle exhaust, tobacco smoke, and landfill sites.
Industrial processes contribute more acetone to the environment than natural processes.
q Acetone doesnt bind to soil or build up in animals.

q Its broken down by microorganisms in soil and water.
q It can move into groundwater from spills or landfills.
q Acetone is broken down in water and soil, but the time
required for this to happen varies.
How might I be exposed to acetone?

q Breathing low background levels in the environment.
q Breathing higher levels of contaminated air in the
workplace or from using products that contain acetone
(for example, household chemicals, nail polish, and
paint).
q Drinking water or eating food containing acetone.
q Touching products containing acetone.
q For children, eating soil at landfills or hazardous waste
sites that contain acetone.
What happens to acetone when it enters the

environment?
q Smoking or breathing secondhand smoke.
q A large percentage (97%) of the acetone released during

its manufacture or use goes into the air.
How can acetone affect my health?
q In air, about one-half of the total amount breaks down

from sunlight or other chemicals every 22 days.
If you are exposed to acetone, it goes into your blood

which then carries it to all the organs in your body. If it is a
small amount, the liver breaks it down to chemicals that are
not harmful and uses these chemicals to make energy for
normal body functions. Breathing moderate- to-high levels
q It moves from the atmosphere into the water and soil by

rain and snow. It also moves quickly from soil and water
back to air.

ACETONE
CAS # 67-64-1
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ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html

of acetone for short periods of time, however, can cause nose,
throat, lung, and eye irritation; headaches; light-headedness;
confusion; increased pulse rate; effects on blood; nausea;
vomiting; unconsciousness and possibly coma; and shortening of the menstrual cycle in women.
people have naturally in their bodies varies with each person.

The tests can't tell you if you will experience any health
effects from the exposure.
Swallowing very high levels of acetone can result in

unconsciousness and damage to the skin in your mouth. Skin
contact can result in irritation and damage to your skin.
The test must be performed within 2-3 days after exposure because acetone leaves your body within a few days.
These tests are not routinely performed at your doctor's
office, but your doctor can take blood or urine samples and
send them to a testing laboratory.
The smell and respiratory irritation or burning eyes that

occur from moderate levels are excellent warning signs that
can help you avoid breathing damaging levels of acetone.
Has the federal government made

recommendations to protect human health?
Health effects from long-term exposures are known

mostly from animal studies. Kidney, liver, and nerve damage,
increased birth defects, and lowered ability to reproduce
(males only) occurred in animals exposed long-term. It is not
known if people would have these same effects.
How likely is acetone to cause cancer?

The Department of Health and Human Services, the
International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified acetone for
carcinogenicity.
The EPA requires that spills of 5,000 pounds or more of

acetone be reported.
The Occupational Safety and Health Administration
(OSHA) has set a maximum concentration limit in workplace
air of 1,000 parts of acetone per million parts of air
(1,000 ppm) for an 8-hour workday over a 40-hour week to
protect workers. The National Institute for Occupational
Safety and Health (NIOSH) recommends an exposure limit of
250 ppm in workplace air for up to a 10-hour workday over a
40-hour workweek.
Acetone does not cause skin cancer in animals when

applied to the skin. We don't know if breathing or swallowing acetone for long periods will cause cancer. Studies
of workers exposed to it found no significant risk of death
from cancer.
Glossary
Is there a medical test to show whether Ive

been exposed to acetone?
References
Methods are available to measure the amount of acetone

in your breath, blood, and urine. The test can tell you how
much acetone you were exposed to, although the amount that
Carcinogenicity: Ability to cause cancer.

Evaporate: To change into a vapor or a gas.
Ingesting: Taking food or drink into your body.
Long-term: Lasting one year or longer.
Agency for Toxic Substances and Disease Registry (ATSDR).

1994. Toxicological profile for acetone. Atlanta, GA: U.S.
Department of Health and Human Services, Public Health
Service.
Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone:1-888-422-8737,
FAX: 404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html ATSDR can tell you
ACROLEIN
CAS # 107-02-8
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about acrolein. For more information,
call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series of summaries about
hazardous substances and their health effects. Its important you understand this information because this
substance may harm you. The effects of exposure to any hazardous substance depend on the dose, the duration,
how you are exposed, personal traits and habits, and whether other chemicals are present.
HIGHLIGHTS: Exposure to acrolein occurs mostly from breathing it in the

air. Cigarette smoke and automobile exhaust contain acrolein. Acrolein causes
burning of the nose and throat and can damage the lungs. This chemical has
been found in at least 7 of the 1,177 National Priorities List sites identified by
the Environmental Protection Agency (EPA).
What is acrolein?
(Pronounced kr-ln)
Acrolein is a clear or yellow liquid with a disagreeable
odor. It dissolves in water very easily and quickly changes to
a vapor when heated. It also burns easily. Small amounts of
acrolein can be formed and can enter the air when trees, tobacco, other plants, gasoline, and oil are burned. Acrolein is
used as a pesticide to control algae, weeds, bacteria, and mollusks. It is also used to make other chemicals.
What happens to acrolein when it enters the

environment?
q Acrolein may be found in soil, water, or air.
q It breaks down fairly rapidly in the air (about half will
disappear within 1 day) by reacting with other chemicals
and sunlight.
q Acrolein evaporates rapidly from soil and water.
q Once dissolved in water, acrolein can be broken down to
other chemicals by reactions with water or bacteria.
q Acrolein does not build up in the food chain.
How might I be exposed to acrolein?

q Breathing contaminated air near hazardous waste sites
that contain acrolein.
q Smoking tobacco or breathing air containing tobacco
smoke or automobile exhaust.
q Working in, or living near, industries where it is manufactured or used to make other chemicals.
q Drinking water containing small amounts of acrolein.
q Eating foods, such as fried foods and roasted coffee, that
may contain small amounts of acrolein.
How can acrolein affect my health?

There is very little information about how exposure to
acrolein affects people's health. The information we have
indicates that breathing large amounts damages the lungs and
could cause death. Breathing lower amounts may cause eye
watering and burning of the nose and throat and a decreased
breathing rate.
Animal studies show that breathing acrolein causes irritation to the nasal cavity, lowered breathing rate, and damage to

ACROLEIN
CAS # 107-02-8
Page 2

the lining of the lungs.
must be reported to the EPA.
We do not know if acrolein causes reproductive effects or

birth defects in people or animals.

(OSHA) has set a limit of 0.1 ppm over an 8-hour workday,
40-hour workweek.
How likely is acrolein to cause cancer?
The National Institute of Occupational Safety and Health

(NIOSH) recommends that average workplace air should not
exceed 0.1 ppm acrolein averaged over a 10-hour period or a
40-hour workweek.
There are no definitive studies on the carcinogenic effects

of acrolein in people or animals. The International Agency for
Research on Cancer (IARC) has determined that acrolein is not
classifiable as to human carcinogenicity.
Is there a medical test to show whether Ive been

exposed to acrolein?
Methods have been developed to detect acrolein or breakdown products of acrolein in biological or environmental
samples; however, there are no specific medical tests available
in a doctor's office to determine if you have been exposed to
acrolein.

The EPA recommends that levels in lakes and streams
should be limited to 0.32 parts of acrolein per million parts of
water (0.32 ppm) to prevent possible health effects from drinking water or eating fish contaminated with acrolein. Any release to the environment of more than 1 pound of acrolein
The federal recommendations have been updated as of

July 1999.
Glossary
CAS: Chemical Abstracts Service.
National Priorities List: A list of the nations worst
hazardous waste sites.
Pesticide: A substance that kills pests.
ppm: Parts per million.
Source of Information
(ATSDR). 1990. Toxicological profile for acrolein. Atlanta,
GA: U.S. Department of Health and Human Services, Public
Health Service.
Animal testing is sometimes necessary to find out how
toxic substances might harm people and how to treat people
who have been exposed. Laws today protect the welfare of
research animals and scientists must follow strict guidelines.
ACRYLONITRILE
CAS # 107-13-1
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about acrylonitrile. For more
because this substance may harm you. The effects of exposure to any hazardous substance depend on the dose,
the duration, how you are exposed, personal traits and habits, and whether other chemicals are present.
HIGHLIGHTS: Exposure to acrylonitrile occurs mostly from breathing it in

the air. Acrylonitrile primarily affects the nervous system and lungs. If it is
spilled on the skin, the skin will turn red and blisters may form. This chemical
has been found in at least 3 of the 1,177 National Priorities List sites identified
by the Environmental Protection Agency (EPA).
What is acrylonitrile?
q It is broken down by bacteria in surface water.
(Pronounced -krl n-trl)
q When it is released to soil, some of it will be broken down

by bacteria, but most of it will evaporate to the air or filter
to groundwater.
Acrylonitrile is a colorless, liquid, man-made chemical

with a sharp, onion- or garlic-like odor. It can be dissolved in
water and evaporates quickly.
Acrylonitrile is used to make other chemicals such as
plastics, synthetic rubber, and acrylic fibers. A mixture of
acrylonitrile and carbon tetrachloride was used as a pesticide
in the past; however, all pesticide uses have stopped.
What happens to acrylonitrile when it enters the

environment?
q Acrylonitrile does not build up in the food chain.
How might I be exposed to acrylonitrile?

q Unless you live near a factory where acrylonitrile is made
or near a hazardous waste site that contains acrylonitrile,
you are unlikely to be exposed to it.
q Breathing contaminated air near hazardous waste sites
that contain acrylonitrile.
q Working in, or living near, industries where it is manufactured or used.
q Acrylonitrile may be found in the soil, water, or air near

industrial sites where it is made, or at hazardous waste
sites where it has been disposed of.
q Swallowing food and water that contains small amounts

of acrylonitrile.
q Because acrylonitrile evaporates easily, most of it is released to the air from facilities where it is produced and
used.
How can acrylonitrile affect my health?
q In air, acrylonitrile breaks down quickly (about half will

disappear within 5 to 50 hours) by reacting with other
chemicals and sunlight.
q Acrylonitrile can enter groundwater by filtering through
the soil, but it is not commonly found in groundwater.
Breathing high concentrations of acrylonitrile will cause

nose and throat irritation, tightness in the chest, difficulty
breathing, nausea, dizziness, weakness, headache, impaired
judgment, and convulsions. These symptoms usually disappear when exposure is stopped. If spilled on the skin, acrylonitrile will burn the skin and produce redness and blisters.

ACRYLONITRILE
CAS # 107-13-1
Page 2

Animal studies show effects from breathing acrylonitrile.
These effects include irritation to the nasal cavity and lungs,
changes in the breathing rate, fluid accumulation in the lungs,
weakness, and paralysis. Decreased fertility and birth defects
have been observed in some laboratory animals exposed to
high concentrations of acrylonitrile in air or drinking water.
There is evidence that children are much more sensitive to
acrylonitrile than adults. In a few cases, children have died
following exposure to acrylonitrile vapors that caused only
minor nose and throat irritation in adults.
How likely is acrylonitrile to cause cancer?

The Department of Health and Human Services (DHHS)
has determined that acrylonitrile may reasonably be anticipated to cause cancer in people. Studies of people are inconclusive, while animal studies have shown cancers of the brain
and mammary glands.

exposed to acrylonitrile?
There is a test that can detect acrylonitrile in blood. Other
tests can be used to measure the breakdown products (metabolites) of acrylonitrile in urine. One of the metabolites (cyanide) could come from other chemicals you might have been
exposed to, so it is not a definite indicator of acrylonitrile
exposure. The results of these tests could also be affected by
cigarette smoking. Special equipment is needed for these
tests, and they are not routinely available in a doctors office.

should be limited to 0.058 parts of acrylonitrile per billion
parts of water (0.058 ppb) to prevent possible health effects
from drinking water or eating fish contaminated with acrylonitrile. Any release to the environment greater than 100 pounds
of acrylonitrile must be reported to the EPA.
(OSHA) has set a limit of 2 ppm over an 8-hour workday,
40-hour workweek.
(NIOSH) recommends that average workplace air should not
exceed 1 part per million (1 ppm) acrylonitrile averaged over a
10-hour period.
July 1999.
Glossary
ppb: Parts per billion.
(ATSDR). 1990. Toxicological profile for acrylonitrile.
Atlanta, GA: U.S. Department of Health and Human Services,
Public Health Service.
ALDRIN and DIELDRIN

CAS # 309-00-2 and 60-57-1
Division of Toxicology ToxFAQsTM
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about aldrin and dieldrin.
For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in
a series of summaries about hazardous substances and their health effects. It is important you
understand this information because this substance may harm you. The effects of exposure to any
hazardous substance depend on the dose, the duration, how you are exposed, personal traits and
habits, and whether other chemicals are present.
HIGHLIGHTS: Exposure to aldrin and dieldrin happens mostly from eating

contaminated foods, such as root crops, fish, or seafood. Aldrin and dieldrin
build up in the body after years of exposure and can affect the nervous system.
Aldrin has been found in at least 207 of the 1,613 National Priorities List sites
identified by the Environmental Protection Agency (EPA). Dieldrin has been
found in at least 287 of the 1,613 sites.
What are aldrin and dieldrin?
Aldrin and dieldrin are insecticides with similar chemical
structures. They are discussed together in this fact sheet
because aldrin quickly breaks down to dieldrin in the body
and in the environment. Pure aldrin and dieldrin are white
powders with a mild chemical odor. The less pure commercial
powders have a tan color. Neither substance occurs naturally
in the environment.
Eating food like fish or shellfish from lakes or streams

contaminated with either chemical, or contaminated root
crops, dairy products, or meats.
Air, surface water, or soil near waste sites may contain
higher levels.
Living in homes that were once treated with aldrin or
dieldrin to control termites.
How can aldrin and dieldrin affect my health?

From the 1950s until 1970, aldrin and dieldrin were widely
used pesticides for crops like corn and cotton. Because of
concerns about damage to the environment and potentially
to human health, EPA banned all uses of aldrin and dieldrin
in 1974, except to control termites. In 1987, EPA banned all
uses.
People who have intentionally or accidentally ingested large

amounts of aldrin or dieldrin have suffered convulsions and
some died. Health effects may also occur after a longer
period of exposure to smaller amounts because these
chemicals build up in the body.
What happens to aldrin and dieldrin when they

enter the environment?
Some workers exposed to moderate levels in the air for a

long time had headaches, dizziness, irritability, vomiting, and
uncontrolled muscle movements. Workers removed from the
source of exposure rapidly recovered from most of these
effects.
Sunlight and bacteria change aldrin to dieldrin so that we

mostly find dieldrin in the environment.
They bind tightly to soil and slowly evaporate to the air.
Dieldrin in soil and water breaks down very slowly.
Plants take in and store aldrin and dieldrin from the soil.
Aldrin rapidly changes to dieldrin in plants and animals.
Dieldrin is stored in the fat and leaves the body very
slowly.
How might I be exposed to aldrin or dieldrin?

Dieldrin is everywhere in the environment, but at very low
levels.
Animals exposed to high amounts of aldrin or dieldrin also

had nervous system effects. In animals, oral exposure to
lower levels for a long period also affected the liver and
decreased their ability to fight infections. We do not know
whether aldrin or dieldrin affect the ability of people to fight
disease.
Studies in animals have given conflicting results about
whether aldrin and dieldrin affect reproduction in male
animals and whether these chemicals may damage the sperm.

ALDRIN and DIELDRIN
Page 2
CAS # 309-00-2 and 60-57-1

ToxFAQsTM Internet address is http://www.atsdr.cdc.gov/toxfaq.html
We do not know whether aldrin or dieldrin affect

reproduction in humans.
How likely are aldrin and dieldrin to cause

cancer?
There is no conclusive evidence that aldrin or dieldrin cause
cancer in humans. Aldrin and dieldrin have been shown to
cause liver cancer in mice. The International Agency for
Research on Cancer (IARC) has determined that aldrin and
dieldrin are not classifiable as to human carcinogenicity. The
EPA has determined that aldrin and dieldrin are probable
human carcinogens.
How can aldrin and dieldrin affect children?

Children can be exposed to aldrin and dieldrin in the same
way as adults. There are no known unique exposure
pathways for children. Children who swallowed amounts of
aldrin or dieldrin much larger than those found in the
environment suffered convulsions and some died, as
occurred in adults. However, we do not know whether
children are more susceptible than adults to the effects of
aldrin or dieldrin.
We do not know whether aldrin or dieldrin cause birth
defects in humans. Pregnant animals that ingested aldrin or
dieldrin had some babies with low birth weight and some
with alterations in the skeleton. Dieldrin has been found in
human breast milk, therefore, it can be passed to suckling
infants.
How can families reduce the risk of exposure to

aldrin and dieldrin?
Since aldrin and dieldrin are no longer produced or used,
exposure to these compounds will occur only from past
usage.
Because aldrin and dieldrin were applied to the basement
of some homes for termite protection, before buying a home
families should investigate what, if any, pesticides have been
used within the home.

exposed to aldrin and dieldrin?
There are laboratory tests that can measure aldrin and
dieldrin in your blood, urine, and body tissues. Because
aldrin changes to dieldrin fairly quickly in the body, the test
has to be done shortly after you are exposed to aldrin. Since
dieldrin can stay in the body for months, measurements of
dieldrin can be made much longer after exposure to either
aldrin or dieldrin. The tests cannot tell you whether harmful
health effects will occur. These tests are not routinely
available at the doctors office because they require special
equipment.

The EPA limits the amount of aldrin and dieldrin that may be
present in drinking water to 0.001 and 0.002 milligrams per
liter (mg/L) of water, respectively, for protection against
health effects other than cancer. The EPA has determined
that a concentration of aldrin and dieldrin of 0.0002 mg/L in
drinking water limits the lifetime risk of developing cancer
from exposure to each compound to 1 in 10,000.
sets a maximum average of 0.25 milligrams of aldrin and
dieldrin per cubic meter of air (0.25 mg/m3) in the workplace
during an 8-hour shift, 40 hour week. The National Institute
for Occupational Safety and Health (NIOSH) also
recommends a limit of 0.25 mg/m3 for both compounds for up
to a 10-hour work day, 40-hour week.
The Food and Drug Administration (FDA) regulates the
residues of aldrin and dieldrin in raw foods. The allowable
range is from 0 to 0.1 ppm, depending on the type of food
product.
(ATSDR). 2002. Toxicological Profile for Aldrin/Dieldrin
(Update). Atlanta, GA: U.S. Department of Health and
Human Services, Public Health Service.
Where can I get more information? For more information, contact the Agency for Toxic Substances and
Disease Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone: 1-888-4228737, FAX: 404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html. ATSDR can
tell you where to find occupational and environmental health clinics. Their specialists can recognize, evaluate, and
treat illnesses resulting from exposure to hazardous substances. You can also contact your community or state health
or environmental quality department if you have any more questions or concerns.
ALUMINUM
CAS # 7429-90-5
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about aluminum. For more
HIGHLIGHTS: Everyone is exposed to low levels of aluminum from food, air,

and water. Exposure to high levels of aluminum may result in respiratory
problems. Aluminum has been found in at least 427 of the 1,467 National
Priorities List sites identified by the Environmental Protection Agency (EPA).
What is aluminum?
(Pronounced -lm-nm)
Aluminum occurs naturally and makes up about 8% of
the surface of the earth. It is always found combined with
other elements such as oxygen, silicon, and fluorine.
Aluminum metal is silver-white and flexible. It is often
used in cooking utensils, containers, appliances, and building materials. It is also used in paints and fireworks; to
produce glass, rubber, and ceramics; and in consumer
products such as antacids, astringents, buffered aspirin, food
additives, and antiperspirants.
What happens to aluminum when it enters

the environment?
q It binds to particles in the air.
q It can dissolve in lakes, streams, and rivers depending on
the quality of the water.
q Acid rain may dissolve aluminum from soil and rocks.
q It can be taken up into some plants from soil.
q It is not known to bioconcentrate up the food chain.
How might I be exposed to aluminum?

q Eating small amounts of aluminum in food.
q Breathing higher levels of aluminum dust in workplace

air.
q Drinking water with high levels of aluminum near waste
sites, manufacturing plants, or areas naturally high in
aluminum.
q Eating substances containing high levels of aluminum
(such as antacids) especially when eating or drinking
citrus products at the same time.
q Very little enters your body from aluminum cooking
utensils.
How can aluminum affect my health?

Low-level exposure to aluminum from food, air, water, or
contact with skin is not thought to harm your health. Aluminum, however, is not a necessary substance for our bodies and
too much may be harmful.
People who are exposed to high levels of aluminum in air
may have respiratory problems including coughing and
asthma from breathing dust.
Some studies show that people with Alzheimers disease
have more aluminum than usual in their brains. We do not
know whether aluminum causes the disease or whether the
buildup of aluminum happens to people who already have the
disease. Infants and adults who received large doses of
aluminum as a treatment for another problem developed bone

ALUMINUM
CAS # 7429-90-5
Page 2

diseases, which suggests that aluminum may cause skeletal
problems. Some sensitive people develop skin rashes from
using aluminum chlorohydrate deodorants.
caps so children will not accidentally eat them. Some soybased formulas may contain high levels of aluminum, so
parents may want to consult with their physician when
choosing an infant formula.
How likely is aluminum to cause cancer?

International Agency for Research on Cancer, and the EPA
have not classified aluminum for carcinogenicity. Aluminum
has not been shown to cause cancer in animals.
How can aluminum affect children?

Children with kidney problems who were given aluminum in their medical treatments developed bone diseases.
Other health effects of aluminum on children have not been
studied. It is not known whether aluminum affects children
differently than adults, or what the long-term effects might be
in adults exposed as children. Large amounts of aluminum
have been shown to be harmful to unborn and developing
animals because it can cause delays in skeletal and neurological development. Aluminum has been shown to cause lower
birthweights in some animals.
How can families reduce the risk of exposure

to aluminum?
The most important way families can lower exposure to
aluminum is to know about the sources of aluminum and
lessen exposure to these sources. Since aluminum is so
common and widespread in the environment, families cannot
avoid exposure to aluminum. Exposure to the low levels of
aluminum that are naturally present in food and water and the
forms of aluminum present in dirt and aluminum cookware is
generally not harmful. The best way to reduce exposure to
aluminum is to avoid taking large quantities of soluble forms
of aluminum such as aluminum-containing antacids and
buffered aspirin. Make sure these products have child-proof

been exposed to aluminum?
There are tests to measure aluminum in blood, urine, and
feces. The amount in your urine can tell you whether you
have been exposed to higher than normal levels of aluminum. Tests can also detect aluminum in your hair and
fingernails. Not all of these tests are routinely performed at
your doctors office, but your doctor can take samples and

EPA requires that spills or accidental releases of 5,000
pounds or more of aluminum sulfate be reported. Special
regulations are set for aluminum phosphide because it is a
pesticide.
EPA recommends that the concentration of aluminum in
drinking water not exceed 0.2 parts of aluminum per million
parts of water (0.2 ppm) because of aesthetic effects, such as
taste and odor problems.
The Food and Drug Administration (FDA) has determined that aluminum cooking utensils, aluminum foil,
antiperspirants, antacids, and other aluminum products are
generally safe.
Source of information
1999. Toxicological profile for aluminum. Atlanta, GA: U.S.
Service.
FAX: 404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html ATSDR can tell you where
to find occupational and environmental health clinics. Their specialists can recognize, evaluate, and treat illnesses resulting
from exposure to hazardous substances. You can also contact your community or state health or environmental quality
department if you have any more questions or concerns.
AMERICIUM
CAS #7440-35-9
July 2001
This fact sheet answers the most frequently asked health questions (FAQs) about americium. For
more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a
series of summaries about hazardous substances and their health effects. It is important you
HIGHLIGHTS: Very low levels of americium occur in air, water, soil, and food.
Exposure to very large amounts of radioactive americium may result in
increased cancer risk. Americium has been found in at least 8 of the 1,585
National Priorities List (NPL) sites identified by the Environmental Protection
Agency (EPA).
What is americium?
Americium is a man-made radioactive chemical. Americium
has no naturally occurring or stable isotopes. Two
important isotopes of americium are americium 241 (241Am)
(read as americium two-forty-one) and 243Am. Both isotopes
have the same chemical behavior in the environment and the
same chemical effects on your body.
241Am strongly sticks to soil particles and does not travel

very far into the ground.
Plants may take up small amounts of 241Am from the soil.
Fish may take up 241Am, but little builds up in the fleshy
tissue. In shellfish, 241Am is attached to the shell and not to
the parts you normally eat.
How might I be exposed to americium?

241
Americium is used in ionization smoke detectors. There is

no commercial use for 243Am.
Nuclear explosions or degradation of plutonium generate
Am. 243Am is produced inside nuclear reactors from 241Am
or from the decay of plutonium 241. Both americium
isotopes decay into radioactive elements. Both isotopes
give off alpha particles as they decay. It takes about 432
years for half of 241Am to give off its radiation and about
7,370 years for 243Am; this period of time is called the halflife.
241
What happens to americium when it enters the

environment?
241Am released to the air (from nuclear weapon tests) will
be associated with particles and will settle to the soil and
water in rain or snow. Small particles in air can travel far
from the point of release.
241Am released into water will stick to particles in the
water or the sediment at the bottom.
The general population may be exposed to very small

amounts of 241Am in air, water, soil, and food. They may
also be exposed to very low levels of radiation from smoke
detectors.
People working at sites where nuclear waste is stored or
at nuclear power plants may be exposed to higher levels of
americium.
People producing or handling 241Am in smoke detectors or
other devices may be exposed to higher levels of radiation.
As a result of a nuclear accident, people may be exposed
to higher than normal levels of radiation.
How can americium affect my health?

The radiation from exposure to americium is the primary
cause of adverse health effects from americium. Inside your
body, americium is concentrated in your bones, where it
remains for a long time. The radiation given off by 241Am
can change the genetic material of the bone cells and this
could result in the formation of bone cancers. The chance
of getting cancer is low at low doses, and increases as the
dose increases.

AMERICIUM
Page 2
CAS #7440-35-9
Laboratory animals exposed to very high levels of americium

had damage to the lungs, liver, and thyroid. However,
americium is accumulated in these organs for only a relatively
short time. It is unlikely that you would be exposed to
amounts of americium large enough to cause harmful effects
in these organs.
In the unlikely case that you are exposed to high levels of

radioactive americium because of accidental release at a
manufacturing facility, at a nuclear plant, or because a
nuclear weapon has been damaged or detonated, follow the
advice of public health officials who will publish appropriate
guidelines for reducing exposure.
How likely is americium to cause cancer?

exposed to americium?
No human studies specifically associate exposure to

radioactive americium with an increased cancer risk.
Because radioactive americium emits ionizing radiation, the
same types of cancers as those observed in Japanese
survivors of the atomic bombing incidents might be expected
among individuals acutely exposed to high levels of radiation
from a radioactive americium source.
Studies in animals have demonstrated that internal exposure
to 241Am results in the development of cancer in the tissues
that store this element.
How can americium affect children?

Children can be affected by americium in the same ways as
adults. However, exposure as children would let the
americium build up in bone to higher levels. This could
cause bone cancer after many years. While this may occur,
there are no actual data showing that children are more
sensitive than adults to americium.

americium?
Higher-than-normal levels of americium may be in soil near a
nuclear waste site, nuclear reactor, or plant that manufactures
ionization smoke detectors. Consequently, prevent your
children from eating dirt and make sure they wash their
hands frequently.
If americium were to enter your body from americiumcontaminated air or food, radiation detectors could measure
radiation from your blood, urine, feces, tissue samples, or
teeth. Radiation detectors are not normally available in your
doctors office, so the samples must be sent to a special
laboratory.
Special radiation detectors could also be used to measure the
radiation that leaves your whole body from americium that is
inside your body.

The Nuclear Regulatory Commission (NRC) has set limits of
0.00000002 microcuries per cubic meter of air for 241Am
released to the air and 0.00002 microcuries per liter of water
for releases to water by licensed facilities (microcurie is a
radiation unit).
(ATSDR). 2001. Toxicological Profile for Americium (Draft
for PublicComment). Atlanta, GA: U.S. Department of Health
and Human Services.
AMMONIA
CAS # 7664-41-7
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about ammonia. For more
information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series
of summaries about hazardous substances and their health effects. It is important you understand this
information because this substance may harm you. The effects of exposure to any hazardous substance
depend on the dose, the duration, how you are exposed, personal traits and habits, and whether other
chemicals are present.
HIGHLIGHTS: Ammonia is a gas that occurs naturally in the environment and

is also manmade. Liquid ammonia is found in many household cleaners.
Ammonia is irritating to the skin, eyes, nose, throat, and lungs. Exposure to
high concentrations can cause serious burns. Ammonia has been found in at
least 134 of the 1,613 National Priorities List sites identified by the
Environmental Protection Agency (EPA).
What is ammonia?
Ammonia is a colorless gas with a very sharp odor. It is
made both by humans and by nature. It dissolves easily in
water and evaporates quickly. It is commonly sold in liquid
form.
The amount of ammonia produced by humans every year is
almost equal to that produced by nature. Ammonia is
produced naturally in soil by bacteria, decaying plants and
animals, and animal wastes. Ammonia is essential for many
biological processes.
Most of the ammonia produced in chemical factories is used
to make fertilizers. The remaining is used in textiles,
plastics, explosives, pulp and paper production, food and
beverages, household cleaning products , refrigerants, and
other products. It is also used in smelling salts.
What happens to ammonia when it enters the

environment?
Because ammonia occurs naturally, it is found throughout
the environment in soil, air, and water.
Most of the ammonia in water changes to ammonium, an
odorless liquid. Ammonia and ammonium can change back
and forth in water.
Ammonia is recycled naturally in the environment as part
of the nitrogen cycle. It does not last very long in the
environment.
Plants and bacteria rapidly take up ammonia from soil and

water.
Some ammonia in water and soil is changed to nitrate and
nitrite by bacteria.
Ammonia released to air is rapidly removed by rain or
snow or by reactions with other chemicals.
Ammonia does not build up in the food chain, but serves
as a nutrient source for plants and bacteria.
How might I be exposed to ammonia?

Everybody is regularly exposed to low levels of ammonia
in air, food, soil, and water.
Ammonia has a strong irritating odor that people can
easily smell before it may cause harm.
If you use ammonia cleaning products at home, you will
be exposed to ammonia released to the air and through
contact with your skin.
If you apply ammonia fertilizers or live near farms where
these fertilizers have been applied, you can breathe ammonia
released to the air.
You may be exposed to ammonia from leaks and spills
from production plants, storage facilities, pipelines, tank
trucks, and rail cars.
How can ammonia affect my health?

Exposure to high concentrations of ammonia in the air may
cause severe burns to your skin, eyes, throat, and lungs. In

AMMONIA
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CAS # 7664-41-7
extreme cases, blindness, lung damage, or death could occur.
Breathing lower concentrations will cause coughing and nose
and throat irritation.
If you swallow ammonia, you could suffer burns in your
mouth, throat, and stomach. Concentrated ammonia spilled
on the skin will cause burns. Animal studies show effects
similar to those observed in people. We do not know if
ammonia affects reproduction in humans.
How likely is ammonia to cause cancer?

We do not know whether ammonia can cause cancer in
humans or in laboratory animals. The Department of Health
and Human Services (DHHS), the International Agency for
Research on Cancer (IARC), and the EPA have not classified
ammonia for carcinogenicity.
How can ammonia affect children?

Children are less likely to be exposed to concentrated
ammonia because most exposures of that kind occur in
occupational settings. Children can still be exposed the same
way as adults to ammonia gas from spills or leaks from
ammonia tanks or pipelines, especially on farms where it is
used as a fertilizer. Children can also be exposed to dilute
ammonia solutions from household cleaners containing
ammonia.
The effects of ammonia on children are likely to be the same
as for adults. We do not know if exposure to ammonia
causes birth defects, or if it can pass to the fetus across the
placenta or to infants via breast milk.

ammonia?
Keep products containing ammonia out of the reach of
children.
Maintain adequate room ventilation when using cleaners

containing ammonia and wear proper clothing and eye
protection.
Prevent children from entering a room where ammonia is
being used.
Never store cleaning solutions in containers that may be
attractive to children, such as soda bottles.
Avoid entering fields when ammonia fertilizer is being
applied.

exposed to ammonia?
There are tests that can detect ammonia in blood and urine.
However, these tests cannot definitely determine if you have
been exposed because ammonia is normally found in the
body.
If you were exposed to harmful amounts of ammonia you
would notice it immediately because of the strong,
unpleasant smell and strong taste. Your skin, eyes, nose,
and throat would also be irritated.

has set a limit of 25 parts of ammonia per million parts of air
(25 ppm) in the workplace during an 8-hour shift and a shortterm limit (15 minutes) of 35 ppm.
(ATSDR). 2002. Toxicological Profile for Ammonia (Draft for
Public Comment). Atlanta, GA: U.S. Department of Health
and Human Services, Public Health Service.
ANILINE
CAS #62-53-3
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about aniline. For more information,
hazardous substances and their health effects. It is important you understand this information because this
HIGHLIGHTS: Aniline is a manufactured chemical used by a number of

industries. Significant exposure may occur only if you work with aniline. The
main effect of aniline by any route of exposure is a blood disorder in which
oxygen delivery to the tissues is impaired. This may have mild to severe
consequences depending on the duration and amount of exposure. Acute
exposure to high amounts of aniline may lead to coma and death. Aniline has
What is aniline?
How might I be exposed to aniline?
Aniline is a clear to slightly yellow liquid with a

characteristic odor. It does not readily evaporate at room
temperature. Aniline is slightly soluble in water and mixes
readily with most organic solvents.
The general population may be exposed to aniline by

eating food or drinking water containing aniline, but these
amounts are usually very small.
If you work in a place that makes products like dyes,
varnishes, herbicides, and explosives, you may be exposed
to aniline.
Aniline has also been detected in tobacco smoke, so
people who smoke or breath in second-hand smoke may also
be exposed to aniline.
People living near uncontrolled hazardous waste sites may
be exposed to higher than normal levels of aniline.
Aniline is used to make a wide variety of products such as

polyurethane foam, agricultural chemicals, synthetic dyes,
antioxidants, stabilizers for the rubber industry, herbicides,
varnishes and explosives.
What happens to aniline when it enters the

environment?
Aniline in air will be broken down rapidly by other
chemicals and by sunlight. It will be broken down within a
few days.
Aniline in water can stick to sediment and particulate
matter or evaporate to the air. Most of it will be broken
down by bacteria and other microorganisms.
Aniline will partially stick to the soil. Small amounts may
evaporate into air or pass through the soil to groundwater.
Most of the aniline in soil will be broken down by bacteria
and other microorganisms.
Aniline does not accumulate in the food chain.
How can aniline affect my health?

Aniline can be toxic if ingested, inhaled, or by skin contact.
Aniline damages hemoglobin, a protein that normally
transports oxygen in the blood. The damaged hemoglobin
can not carry oxygen. This condition is known as
methemoglobinemia and its severity depends on how much
you are exposed to and for how long. Methemoglobinemia
is the most prominent symptom of aniline poisoning in
humans, resulting in cyanosis (a purplish blue skin color)
following acute high exposure to aniline. Dizziness,
headaches, irregular heart beat, convulsions, coma, and

ANILINE
Page 2
CAS #62-53-3
death may also occur. Direct contact with aniline can also
produce skin and eye irritation.

aniline?
Long-term exposure to lower levels of aniline may cause

symptoms similar to those experienced in acute high-level
exposure. There is no reliable information on whether aniline
has adverse reproductive effects in humans. Studies in
animals have not demonstrated reproductive toxicity for
aniline.
Most families will not be exposed to significant levels of

aniline.
Children should avoid playing in soils near uncontrolled
hazardous waste sites where aniline may have been
discarded.
How likely is aniline to cause cancer?

exposed to aniline?
The available studies in humans are inadequate to determine

whether exposure to aniline can increase the risk of
developing cancer in people. Rats that ate food
contaminated with aniline for life developed cancer of the
spleen.
The International Agency for Research on Cancer (IARC)
determined that aniline is not classifiable as to its
carcinogenicity to humans. The EPA has determined that
aniline is a probable human carcinogen.
How can aniline affect children?

There are no studies on the health effects of children
exposed to aniline. It is likely that the health effects seen in
children exposed to aniline will be similar to the effects seen
in adults. Newborn infants are more susceptible than adults
to development of methemoglobinemia caused by exposure
to aniline.
Aniline can be measured in the urine. This test shows that

you have been exposed to aniline but not to how much or
how recently. A breakdown product of aniline in the body,
p-aminophenol, also can be measured in the urine; however,
this breakdown product is not specific for aniline exposure.
Methemoglobin can be measured in the blood, but exposure
to many other chemicals also increase methemoglobin levels
in the blood. Methemoglobin levels in blood can be used to
determine the appropriate treatment that exposed individuals
should receive. These tests are not routinely done in a
doctors office.

sets a limit of 5 parts of aniline per million parts of air (5
ppm) in workplace air in any 8-hour shift, 40-hour workweek.
We do not know if exposure to aniline will result in birth

defects or other developmental effects in people. The
studies on developmental effects in animals are not
conclusive.
Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone: 1-888-422-8737, FAX:
404-498-0093. ToxFAQsTM Internet address is http://www.atsdr.cdc.gov/toxfaq.html . ATSDR can tell you where to find
occupational and environmental health clinics. Their specialists can recognize, evaluate, and treat illnesses resulting from
exposure to hazardous substances. You can also contact your community or state health or environmental quality department
if you have any more questions or concerns.
ANTIMONY
CAS # 7440-36-0
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about antimony. For more
summaries about hazardous substances and their health effects. This information is important because
this substance may harm you. The effects of exposure to any hazardous substance depend on the dose,
SUMMARY: Exposure to antimony occurs in the workplace or from skin contact

with soil at hazardous waste sites. Breathing high levels of antimony for a long time
can irritate the eyes and lungs, and can cause problems with the lungs, heart, and
stomach. This chemical has been found in at least 403 of 1,416 National Priorities
List sites identified by the Environmental Protection Agency.
What is antimony?
(Pronounced nt-mn)
Antimony is a silvery-white metal that is found in the
earths crust. Antimony ores are mined and then mixed with
other metals to form antimony alloys or combined with
oxygen to form antimony oxide.
Little antimony is currently mined in the United States. It
is brought into this country from other countries for processing. However, there are companies in the United States that
produce antimony as a by-product of smelting lead and other
metals.
Antimony isn't used alone because it breaks easily, but
when mixed into alloys, it is used in lead storage batteries,
solder, sheet and pipe metal, bearings, castings, and pewter.
Antimony oxide is added to textiles and plastics to prevent
them from catching fire. It is also used in paints, ceramics,
and fireworks, and as enamels for plastics, metal, and glass.
What happens to antimony when it enters

the environment?
q Antimony is released to the environment from natural
sources and from industry.
q In the air, antimony is attached to very small particles that
may stay in the air for many days.
q Most antimony ends up in soil, where it attaches strongly

to particles that contain iron, manganese, or aluminum.
q Antimony is found at low levels in some rivers, lakes, and
streams.
How might I be exposed to antimony?

q Because antimony is found naturally in the environment,
the general population is exposed to low levels of it
every day, primarily in food, drinking water, and air.
q It may be found in air near industries that process or
release it, such as smelters, coal-fired plants, and refuse
incinerators.
q In polluted areas containing high levels of antimony, it
may be found in the air, water, and soil.
q Workers in industries that process it or use antimony ore
may be exposed to higher levels.
How can antimony affect my health?

Exposure to antimony at high levels can result in a
variety of adverse health effects.
Breathing high levels for a long time can irritate your
eyes and lungs and can cause heart and lung problems,
stomach pain, diarrhea, vomiting, and stomach ulcers.
In short-term studies, animals that breathed very high
levels of antimony died. Animals that breathed high levels

ANTIMONY
CAS # 7440-36-0
Page 2

had lung, heart, liver, and kidney damage. In long-term
studies, animals that breathed very low levels of antimony
had eye irritation, hair loss, lung damage, and heart problems.
Problems with fertility were also noted. In animal studies,
problems with fertility have been seen when rats breathed
very high levels of antimony for a few months.
tests are not usually performed in most doctors' offices and

may require special equipment to conduct them.
Ingesting large doses of antimony can cause vomiting.

We don't know what other effects may be caused by ingesting
it. Long-term animal studies have reported liver damage and
blood changes when animals ingested antimony. Antimony
can irritate the skin if it is left on it.
The EPA allows 0.006 parts of antimony per million

parts of drinking water (0.006 ppm). The EPA requires that
discharges or spills into the environment of 5,000 pounds or
more of antimony be reported.
Antimony can have beneficial effects when used for

medical reasons. It has been used as a medicine to treat
people infected with parasites.
How likely is antimony to cause cancer?

International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified
antimony as to its human carcinogenicity.
Lung cancer has been observed in some studies of rats
that breathed high levels of antimony. No human studies are
available. We don't know whether antimony will cause cancer
in people.

been exposed to antimony?
Tests are available to measure antimony levels in the
body. Antimony can be measured in the urine, feces, and
blood for several days after exposure. However, these tests
cannot tell you how much antimony you have been exposed
to or whether you will experience any health effects. Some


(OSHA) has set an occupational exposure limit of 0.5 milligrams of antimony per cubic meter of air (0.5 mg/m3) for an
8-hour workday, 40-hour workweek.
The American Conference of Governmental Industrial
Hygienists (ACGIH) and the National Institute for Occupational Safety and Health (NIOSH) currently recommend the
same guidelines for the workplace as OSHA.
Glossary
Ingestion: Taking food or drink into your body.
Long-term: Lasting one year or more.
Milligram (mg): One thousandth of a gram.
Parasite: An organism living in or on another organism.
Short-term: Lasting 14 days or less.
References
1992. Toxicological profile for antimony. Atlanta, GA: U.S.
Service.
ARSENIC
CAS # 7440-38-2
July 2001
This fact sheet answers the most frequently asked health questions (FAQs) about arsenic. For more information,
HIGHLIGHTS: Exposure to higher than average levels of arsenic occurs mostly

in the workplace, near hazardous waste sites, or in areas with high natural
levels. At high levels, inorganic arsenic can cause death. Exposure to lower
levels for a long time can cause a discoloration of the skin and the appearance
of small corns or warts. Arsenic has been found at 1,014 of the 1,598 National
Priority List sites identified by the Environmental Protection Agency (EPA).
What is arsenic?
How might I be exposed to arsenic?
Arsenic is a naturally occurring element widely distributed in

the earths crust. In the environment, arsenic is combined
with oxygen, chlorine, and sulfur to form inorganic arsenic
compounds. Arsenic in animals and plants combines with
carbon and hydrogen to form organic arsenic compounds.
Eating food, drinking water, or breathing air containing

arsenic.
Breathing contaminated workplace air.
Breathing sawdust or burning smoke from wood treated
with arsenic.
Living near uncontrolled hazardous waste sites containing
arsenic.
Living in areas with unusually high natural levels of
arsenic in rock.
Inorganic arsenic compounds are mainly used to preserve

wood. Organic arsenic compounds are used as pesticides,
primarily on cotton plants.
What happens to arsenic when it enters the

environment?
Arsenic cannot be destroyed in the environment. It can
only change its form.
Arsenic in air will settle to the ground or is washed out of
the air by rain.
Many arsenic compounds can dissolve in water.
Fish and shellfish can accumulate arsenic, but the arsenic
in fish is mostly in a form that is not harmful.
How can arsenic affect my health?

Breathing high levels of inorganic arsenic can give you a
sore throat or irritated lungs. Ingesting high levels of
inorganic arsenic can result in death. Lower levels of arsenic
can cause nausea and vomiting, decreased production of red
and white blood cells, abnormal heart rhythm, damage to
blood vessels, and a sensation of pins and needles in
hands and feet.
Ingesting or breathing low levels of inorganic arsenic for a
long time can cause a darkening of the skin and the

ARSENIC
CAS # 7440-38-2
Page 2

appearance of small corns or warts on the palms, soles,
and torso.
Skin contact with inorganic arsenic may cause redness and
swelling.
Organic arsenic compounds are less toxic than inorganic
arsenic compounds. Exposure to high levels of some organic
arsenic compounds may cause similar effects as inorganic
arsenic.
How likely is arsenic to cause cancer?

Several studies have shown that inorganic arsenic can
increase the risk of lung cancer, skin cancer, bladder cancer,
liver cancer, kidney cancer, and prostate cancer. The World
Health Organization (WHO), the Department of Health and
Human Services (DHHS), and the EPA have determined that
inorganic arsenic is a human carcinogen.
How can arsenic affect children?

We do not know if exposure to arsenic will result in birth
defects or other developmental effects in people. Birth
defects have been observed in animals exposed to inorganic
arsenic.
It is likely that health effects seen in children exposed to high
amounts of arsenic will be similar to the effects seen in
adults.

arsenic?
If you use arsenic-treated wood in home projects, you
should wear dust masks, gloves, and protective clothing to
decrease exposure to sawdust.
If you live in an area with high levels of arsenic in water or
soil, you should use cleaner sources of water and limit
contact with soil.

exposed to arsenic?
There are tests to measure the level of arsenic in blood,
urine, hair, or fingernails. The urine test is the most reliable
test for arsenic exposure within the last few days. Tests on
hair and fingernails can measure exposure to high levels or
arsenic over the past 6-12 months. These tests can
determine if you have been exposed to above-average levels
of arsenic. They cannot predict how the arsenic levels in
your body will affect your health.

EPA has set limits on the amount of arsenic that industrial
sources can release to the environment and has restricted or
canceled many uses of arsenic in pesticides. EPA has set a
limit of 0.05 parts per million (ppm) for arsenic in drinking
water. The EPA arsenic drinking water standard of 0.01 ppm
(10 ppb) reported in the ATSDR February 2001 Arsenic
ToxFAQs was based on the EPA final rule for arsenic in
drinking water, published on January 22, 2001, in the Federal
Register. However, the EPA is currently reviewing the
science and cost estimate supporting this rule, and, in the
interim, has reverted to the previous standard for arsenic.
Thus, the current EPA arsenic drinking water standard
remains at 0.05 ppm (50 ppb).
The Occupational Safety and Health Administration has set
limits of 10 :g arsenic per cubic meter of workplace air (10
:g/m3) for 8 hour shifts and 40 hour work weeks.
(ATSDR). 2000. Toxicological Profile for Arsenic. Atlanta,
Health Service.
FAX: 404-498-0093. ToxFAQsTM Internet address is http://www.atsdr.cdc.gov/toxfaq.html . ATSDR can tell you where to
find occupational and environmental health clinics. Their specialists can recognize, evaluate, and treat illnesses resulting
ASBESTOS
CAS # 1332-21-4
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about asbestos. For more information,
how you are exposed, individual susceptibility and personal habits, and whether other chemicals are present.
HIGHLIGHTS: Exposure to asbestos usually occurs by breathing

contaminated air in workplaces that make or use asbestos. Asbestos is also
found in the air of buildings that are being torn down or renovated. Asbestos
exposure can cause serious lung problems and cancer. This substance has been
found at 83 of the 1,585 National Priorities List sites identified by the
What is asbestos?
How might I be exposed to asbestos?
Asbestos is the name given to a group of six different fibrous

minerals (amosite, chrysotile, crocidolite, and the fibrous
varieties of tremolite, actinolite, and anthophyllite) that occur
naturally in the environment. Asbestos minerals have separable
long fibers that are strong and flexible enough to be spun and
woven and are heat resistant. Because of these characteristics,
asbestos has been used for a wide range of manufactured goods,
mostly in building materials (roofing shingles, ceiling and floor
tiles, paper products, and asbestos cement products), friction
products (automobile clutch, brake, and transmission parts),
heat-resistant fabrics, packaging, gaskets, and coatings. Some
vermiculite or talc products products may contain asbestos.
We are all exposed to low levels of asbestos in the air we breathe.

These levels range from 0.00001 to 0.0001 fibers per milliliter of air
and generally are highest in cities and industrial areas.
What happens to asbestos when it enters the

environment?
Asbestos fibers can enter the air or water from the breakdown of
natural deposits and manufactured asbestos products. Asbestos
fibers do not evaporate into air or dissolve in water. Small
diameter fibers and particles may remain suspended in the air for
a long time and be carried long distances by wind or water before
settling down. Larger diameter fibers and particles tend to settle
more quickly.
Asbestos fibers are not able to move through soil. Asbestos
fibers are generally not broken down to other compounds and
will remain virtually unchanged over long periods.
People working in industries that make or use asbestos products or

who are involved in asbestos mining may be exposed to high levels
of asbestos. People living near these industries may also be
exposed to high levels of asbestos in air.
Asbestos fibers may be released into the air by the disturbance of
asbestos-containing material during product use, demolition work,
building or home maintenance, repair, and remodeling. In general,
exposure may occur only when the asbestos-containing material is
disturbed in some way to release particles and fibers into the air.
Drinking water may contain asbestos from natural sources or from
asbestos-containing cement pipes.
How can asbestos affect my health?

Asbestos mainly affects the lungs and the membrane that surrounds
the lungs. Breathing high levels of asbestos fibers for a long time
may result in scar-like tissue in the lungs and in the pleural
membrane (lining) that surrounds the lung. This disease is called
asbestosis and is usually found in workers exposed to asbestos, but
not in the general public. People with asbestosis have difficulty
breathing, often a cough, and in severe cases heart enlargement.
Asbestosis is a serious disease and can eventually lead to disability
and death.

ASBESTOS
CAS # 1332-21-4
Page 2

Breathing lower levels of asbestos may result in changes called
plaques in the pleural membranes. Pleural plaques can occur in
workers and sometimes in people living in areas with high
environmental levels of asbestos. Effects on breathing from pleural
plaques alone are not usually serious, but higher exposure can lead
to a thickening of the pleural membrane that may restrict breathing.
How likely is asbestos to cause cancer?

The Department of Health and Human Services (DHHS), the World
Health Organization (WHO), and the EPA have determined that
asbestos is a human carcinogen.
It is known that breathing asbestos can increase the risk of cancer
in people. There are two types of cancer caused by exposure to
asbestos: lung cancer and mesothelioma. Mesothelioma is a cancer
of the thin lining surrounding the lung (pleural membrane) or
abdominal cavity (the peritoneum). Cancer from asbestos does not
develop immediately, but shows up after a number of years.
Studies of workers also suggest that breathing asbestos can increase
chances of getting cancer in other parts of the body (stomach,
intestines, esophagus, pancreas, and kidneys), but this is less
certain. Early identification and treatment of any cancer can
increase an individuals quality of life and survival.
Cigarette smoke and asbestos together significantly increase your
chances of getting lung cancer. Therefore, if you have been
exposed to asbestos you should stop smoking. This may be the
most important action that you can take to improve your health
and decrease your risk of cancer.
How can asbestos affect children?

We do not know if exposure to asbestos will result in birth defects
or other developmental effects in people. Birth defects have not
been observed in animals exposed to asbestos.
It is likely that health effects seen in children exposed to high
levels of asbestos will be similar to the effects seen in adults.

asbestos?
Materials containing asbestos that are not disturbed or deteriorated
do not, in general, pose a health risk and can be left alone. If you
suspect that you may be exposed to asbestos in your home,

contact your state or local health department or the regional offices
of EPA to find out how to test your home and how to locate a
company that is trained to remove or contain the fibers.

exposed to asbestos?
Low levels of asbestos fibers can be measured in urine, feces,
mucus, or lung washings of the general public. Higher than average
levels of asbestos fibers in tissue can confirm exposure but not
determine whether you will experience any health effects.
A thorough history, physical exam, and diagnostic tests are needed
to evaluate asbestos-related disease. Chest x-rays are the best
screening tool to identify lung changes resulting from asbestos
exposure. Lung function tests and CAT scans also assist in the
diagnosis of asbestos-related disease.

In 1989, EPA banned all new uses of asbestos; uses established
before this date are still allowed. EPA established regulations that
require school systems to inspect for damaged asbestos and to
eliminate or reduce the exposure by removing the asbestos or by
covering it up. EPA regulates the release of asbestos from
factories and during building demolition or renovation to prevent
asbestos from getting into the environment.
EPA has proposed a concentration limit of 7 million fibers per liter
of drinking water for long fibers (lengths greater than or equal to
5 :m). The Occupational Safety and Health Administration has
set limits of 100,000 fibers with lengths greater than or equal to
5 :m per cubic meter of workplace air for 8-hour shifts and 40hour work weeks.
2001. Toxicological Profile for Asbestos. Update. Atlanta, GA:
U.S. Department of Health and Human Services, Public Health
Service.
FAX: 404-498-0093. ToxFAQsTM Internet address is http://www.atsdr.cdc.gov/toxfaq.html . ATSDR can tell you where to find
ATRAZINE
CAS #1912-24-9
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about atrazine. For more
HIGHLIGHTS: The general population is probably not exposed to atrazine.

However, exposure to atrazine may occur at farms where it has been sprayed.
Atrazine may affect pregnant women by causing their babies to grow more
slowly than normal. Birth defects and liver, kidney, and heart damage has been
seen in animals exposed to high levels of atrazine. This chemical has been
found in at least 20 of the 1,585 National Priorities List sites identified by the
What is atrazine?
How might I be exposed to atrazine?
Atrazine is an herbicide that does not occur naturally. Pure

atrazine is an odorless, white powder that is not very
volatile, reactive, or flammable and that will dissolve in water.
Most people are not exposed to atrazine on a regular

basis.
Farm workers, chemical sprayers, and people who work in
factories that make atrazine may be exposed.
People may also be exposed to atrazine by digging in dirt
that has atrazine in it.
Individuals may also be exposed by drinking water from
wells that are contaminated with the herbicide.
Atrazine is used to kill weeds, primarily on farms, but has

also been used on highway and railroad rights-of-way. The
EPA now restricts how atrazine can be used and applied;
only trained people are allowed to spray it.
What happens to atrazine when it enters the

environment?
Atrazine enters the environment primarily through
spraying on farm crops.
In soil, atrazine is taken up by the plants growing in the
soil or is broken down over a period of days to months.
It may also wash from soil into streams or groundwater
where it will stay for a long time, because breakdown of the
chemical is slow in water.
If atrazine enters the air, it may be broken down by
reactions with chemicals in the air, or it may adhere to
particles such as dust which eventually settle out of the air.
Atrazine does not accumulate in living organisms such as
algae, bacteria, clams, or fish.
How can atrazine affect my health?

Liver, kidney, and heart damage has been observed in
animals exposed to atrazine; we do not know if this would
also occur in humans. Atrazine has also been shown to
cause changes in blood hormone levels in animals that
affected ovulation and the ability to reproduce. These
effects are not expected to occur in humans because of
specific biological differences between humans and these
types of animals.
How likely is atrazine to cause cancer?

Available information is inadequate to definitely state
whether atrazine causes cancer in humans. There are limited

ATRAZINE
Page 2
CAS #1912-24-9
human and animal data that suggest that there may be a link
between atrazine exposure and various types of cancer. A
Cancer Assessment Review Committee (CARC) sponsored by
EPA has classified atrazine as not likely to be carcinogenic to
humans. The International Agency for Research on Cancer
(IARC) has determined that atrazine is not classifiable as to
its carcinogenicity to humans.
individuals should avoid swimming in or drinking from

contaminated water sources and may desire to have personal
well water tested for the presence of atrazine.
How can atrazine affect children?

exposed to atrazine?
Little information is available regarding the effects of atrazine

in children. It is likely that the health effects seen in children
should be similar to the effects seen in adults. We do not
know whether children differ from adults in their
susceptibility to atrazine.
A few studies are available that suggest that atrazine could
affect pregnant women by causing their babies to grow more
slowly than normal or by causing them to give birth early.
However, the women in these studies were also exposed to
other chemicals that may have caused or contributed to
these effects. In pregnant animals, exposure to atrazine
causes a decrease in fetal growth and birth defects.
Exposure to high levels of atrazine during pregnancy caused
reduced survival of fetuses. It is unclear whether or at what
level of exposure this might occur in humans.

atrazine?
The general population is not likely to be exposed to large
amounts of atrazine. Populations living in the areas where
atrazine is used on crops, however, may be exposed to
greater amounts of atrazine. Therefore, staying away from
fields that have been recently sprayed may reduce exposure.
Atrazine may be washed from fields where it is sprayed into
streams and rivers or may migrate into wells used for
drinking and bathing. In areas of high atrazine use,

hazardous waste sites where atrazine may have been
discarded.
Atrazine can be detected in your blood and some other body

tissues within 24 to 48 hours after your last exposure. These
tests are not usually available at your doctors office, but
your doctor can send the samples to a laboratory that can
perform the tests. None of these tests, however, can predict
whether you will experience any health effects.

The EPA allows 0.2 milligrams of atrazine per liter of drinking
water (0.2 mg/L) for lifetime exposure of adults.
has set a limit of 5 milligrams of atrazine per cubic meter of
workplace air (5 mg/m3) for an 8-hour workday and 40-hour
work week.
The EPA has determined maximum levels allowed in foods of
0.02-15 parts atrazine per million parts of food (0.02-15 ppm).
(ATSDR). 2001. Toxicological Profile for Atrazine (Draft for
Public Comment) Atlanta, GA: U.S. Department of Health
BARIUM
CAS # 7440-39-3
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about barium. For more
of summaries about hazardous substances and their health effects. This information is important
because this substance may harm you. The effects of exposure to any hazardous substance depend on
the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals
are present.
SUMMARY: Exposure to barium occurs mostly in the workplace or from drinking

contaminated water. Ingesting high levels of barium can cause problems with the
heart, stomach, liver, kidneys, and other organs. This chemical has been found
in at least 649 of 1,416 National Priorities List sites identified by the Environmental
Protection Agency.
What is barium?
(Pronounced br-m)
Barium is a silvery-white metal found in nature. It occurs
combined with other chemicals such as sulfur or carbon and
oxygen. These combinations are called compounds. Barium
compounds can also be produced by industry.
How might I be exposed to barium?

q Breathing very low levels in air, drinking water, and
eating food.
q Breathing higher levels in air while working in industries
that make or use barium compounds.
q Drinking water containing high levels of barium from
natural sources.
Barium compounds are used by the oil and gas industries

to make drilling muds. Drilling muds make it easier to drill
through rock by keeping the drill bit lubricated. They are
also used to make paint, bricks, tiles, glass, and rubber.
q Breathing air near barium mining or processing plants.
A barium compound (barium sulfate) is sometimes used

by doctors to perform medical tests and to take x-rays of the
stomach.
The health effects of the different barium compounds

depend on how well the compound dissolves in water.
Barium compounds that do not dissolve well in water are not
generally harmful and are often used by doctors for medical
purposes.
What happens to barium when it enters the

environment?
q Barium gets into the air during the mining, refining, and
production of barium compounds, and from the burning
of coal and oil.
q Some barium compounds dissolve easily in water and are
found in lakes, rivers, and streams.
How can barium affect my health?
Those barium compounds that dissolve well in water may

cause harmful health effects in people. Ingesting high levels
of barium compounds that dissolve well in water over the
short term has resulted in
q Difficulties in breathing
q Increased blood pressure
q Barium is found in most soils and foods at low levels.
q Changes in heart rhythm
q Fish and aquatic organisms accumulate barium.
q Stomach irritation.

BARIUM
CAS # 7440-39-3
Page 2

q Brain swelling
q Muscle weakness
q Damage to the liver, kidney, heart, and spleen.
environment of 10 pounds or more of barium cyanide be

reported.
We dont know the effects in people of ingesting low levels of

barium over the long term. Animal studies have found
increased blood pressure and changes in the heart from
ingesting barium over a long time. We dont know the effects
of barium from breathing it or from touching it.

(OSHA), the National Institute for Occupational Safety and
Health (NIOSH), and the American Conference of Governmental Industrial Hygienists (ACGIH) have set an occupational exposure limit of 0.5 milligrams of soluble barium
compounds per cubic meter of air (0.5 mg/m3) for an 8-hour
workday, 40-hour workweek.
How likely is barium to cause cancer?
The OSHA exposure limit for barium sulfate dust in air is

5 to 15 milligrams of barium per cubic meter of air (5
15 mg/m3).

International Agency for Research on Cancer, and the
Environmental Protection Agency (EPA) have not classified
barium as to its human carcinogenicity.
Barium has not been classified because there are no
studies in people and the two available animal studies were
inadequate to determine whether or not barium causes cancer.
NIOSH currently recommends that a level of

50 mg/m3 be considered immediately dangerous to life
and health. This is the exposure level of barium that is
likely to cause permanent health problems or death.
Glossary
been exposed to barium?
There is no routine medical test to show whether you
have been exposed to barium. However, doctors can measure
barium in the blood, bones, urine, and feces, using very
complex instruments. Due to the complexity of the tests, these
tests are usually done only for cases of severe barium poisoning and for medical research.

Soluble: Dissolves well in liquid.
References
EPA allows 2 parts of barium per million parts of drinking
water (2 ppm). EPA requires that discharges or spills into the

1992. Toxicological profile for barium. Atlanta, GA: U.S.
Service.
BENZENE
CAS # 71-43-2
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about benzene. For more
summaries about hazardous substances and their health effects. This information is important because this
substance may harm you. The effects of exposure to any hazardous substance depend on the dose, the
duration, how you are exposed, personal traits and habits, and whether other chemicals are present.
HIGHLIGHTS: Benzene is a widely used chemical formed from both natural

processes and human activities. Breathing benzene can cause drowsiness, dizziness,
and unconsciousness; long-term benzene exposure causes effects on the bone
marrow and can cause anemia and leukemia. Benzene has been found in at least
813 of the 1,430 National Priorities List sites identified by the Environmental
Protection Agency (EPA).
What is benzene?
(Pronounced b.nzn)
q It breaks down more slowly in water and soil, and can pass
through the soil into underground water.
Benzene is a colorless liquid with a sweet odor. It evaporates into the air very quickly and dissolves slightly in water.
It is highly flammable and is formed from both natural processes and human activities.
How might I be exposed to benzene?
Benzene is widely used in the United States; it ranks in

the top 20 chemicals for production volume. Some industries
use benzene to make other chemicals which are used to make
plastics, resins, and nylon and synthetic fibers. Benzene is
also used to make some types of rubbers, lubricants, dyes,
detergents, drugs, and pesticides. Natural sources of benzene
include volcanoes and forest fires. Benzene is also a natural
part of crude oil, gasoline, and cigarette smoke.
q Indoor air generally contains higher levels of benzene

from products that contain it such as glues, paints, furniture wax, and detergents.
What happens to benzene when it enters the

environment?
q Industrial processes are the main source of benzene in the
environment.
q Benzene can pass into the air from water and soil.
q It reacts with other chemicals in the air and breaks down
within a few days.
q Benzene in the air can attach to rain or snow and be carried back down to the ground.
q Benzene does not build up in plants or animals.

q Outdoor air contains low levels of benzene from tobacco
smoke, automobile service stations, exhaust from motor
vehicles, and industrial emissions.
q Air around hazardous waste sites or gas stations will contain higher levels of benzene.
q Leakage from underground storage tanks or from hazardous waste sites containing benzene can result in benzene
contamination of well water.
q People working in industries that make or use benzene
may be exposed to the highest levels of it.
q A major source of benzene exposures is tobacco smoke.
How can benzene affect my health?

Breathing very high levels of benzene can result in death,
while high levels can 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, sleepiness,
convulsions, rapid heart rate, and death.

BENZENE
CAS # 71-43-2
Page 2

The major effect of benzene from long-term (365 days or
longer) exposure is on the blood. Benzene causes harmful
effects on the bone marrow and can cause a decrease in red
blood cells leading to anemia. It can also cause excessive
bleeding and can affect the immune system, increasing the
chance for infection.
Some women who breathed high levels of benzene for
many months had irregular menstrual periods and a decrease in
the size of their ovaries. It is not known whether benzene exposure affects the developing fetus in pregnant women or fertility in men.
Animal studies have shown low birth weights, delayed
bone formation, and bone marrow damage when pregnant animals breathed benzene.

The EPA has set the maximum permissible level of benzene in drinking water at 0.005 milligrams per liter
(0.005 mgL). The EPA requires that spills or accidental releases into the environment of 10 pounds or more of benzene
be reported to the EPA.
(OSHA) has set a permissible exposure limit of 1 part of benzene per million parts of air (1 ppm) in the workplace during
an 8-hour workday, 40-hour workweek.
Glossary
Anemia: A decreased ability of the blood to transport oxygen.
How likely is benzene to cause cancer?
Carcinogen: A substance with the ability to cause cancer.

has determined that benzene is a known human carcinogen.
Long-term exposure to high levels of benzene in the air can
cause leukemia, cancer of the blood-forming organs.

exposed to benzene?
Several tests can show if you have been exposed to benzene. There is test for measuring benzene in the breath; this
test must be done shortly after exposure. Benzene can also be
measured in the blood, however, since benzene disappears
rapidly from the blood, measurements are accurate only for
recent exposures.
In the body, benzene is converted to products called metabolites. Certain metabolites can be measured in the urine.
However, this test must be done shortly after exposure and is
not a reliable indicator of how much benzene you have been
exposed to, since the metabolites may be present in urine from
other sources.
Chromosomes: Parts of the cells responsible for the development of hereditary characteristics.
Metabolites: Breakdown products of chemicals.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Benzene (update) produced by the Agency
for Toxic Substances and Disease Registry, Public Health Service, U.S. Department of Health and Human Services, Public
Health Service in Atlanta, GA.
BENZIDINE
CAS #92-87-5
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about benzidine. For more
HIGHLIGHTS: Benzidine is a manufactured chemical that was used to produce

dyes. Most people are not exposed to benzidine in the environment.
Occupational exposure has been associated with increased risk of urinary
bladder cancer. This substance has been found in at least 28 of the 1,585
National Priorities List sites identified by the Environmental Protection Agency
(EPA).
What is benzidine?
How might I be exposed to benzidine?
Benzidine is a manufactured chemical that does not occur

naturally. It is a crystalline solid that may be grayish-yellow,
white, or reddish-gray. In the environment, benzidine is
found in either its free state (as an organic base), or as a
salt. Benzidine was used to produce dyes for cloth, paper,
and leather. It is no longer produced or used commerically
in the U.S.
The general population is not likely to be exposed to

benzidine through contaminated air, water, soil, or food.
be exposed to benzidine.
What happens to benzidine when it enters the

environment?
Benzidine in the air exists as a vapor or attached to very
small particles. The benzidine in air will eventually settle
over land and water.
Only very small amounts of free benzidine will dissolve in
water; benzidine salts can dissolve more readily in water.
Benzidine released into waterways will sink and become part
of the bottom sludge.
Benzidine in soil is likely to be strongly attached to soil
particles and will not easily pass into underground water.
How can benzidine affect my health?

Except for the cancer discussed next, benzidine has not been
definitely shown to cause major adverse health effects in
humans. If it comes in contact with your skin it may cause a
skin allergy. Liver, kidney, immune, and neurological effects
have been observed in laboratory animals given relatively
high amounts of benzidine. We do not know if these effects
would also occur in humans.
How likely is benzidine to cause cancer?

It is known that long term occupational exposure to
benzidine can increase the risk of developing cancer in
people. The main type of cancer found in workers is cancer
of the urinary bladder.
Benzidine is not likely to accumulate in the food chain.

BENZIDINE
Page 2
CAS #92-87-5
The Department of Health and Human Services (DHHS), the

World Health Organization (WHO), and the EPA have
determined that benzidine is a human carcinogen.
In addition dyes made from benzidine, such as Direct Blue 6,
Direct Black 38, and Direct Brown 95, have been shown to
cause cancer in humans. The DHHS has determined that
Direct Blue 6 and Direct Black 38 cause cancer in animals and
WHO determined that Direct Blue 6, Direct Black 38, and
Direct Brown 95 cause cancer in animals.
How can benzidine affect children?

There are no studies on health effects on children exposed to
benzidine. It is likely that health effects seen in children
exposed to high levels of benzidine will be similar to the
effects seen in adults.
We do not know if exposure to benzidine will result in birth
defects or other developmental effects in people.

benzidine?
Most families will not be exposed to benzidine.
hazardous waste sites where benzidine may have been
discarded.

exposed to benzidine?
Benzidine and its breakdown products can be detected in
your urine, but only within about 2 weeks after your last
exposure. Benzidine and its breakdown products can also
bind to proteins within your red blood cells, and this can be
detected for up to 4 months. These tests are not usually
available at your doctors office, but your doctor can send
the samples to a laboratory that can perform the tests. None
of these tests, however, can predict whether you will
experience any health effects.

The EPA recommends that the amount of benzidine in
drinking water be less than 1 part benzidine in a trillion parts
of water (1 ppt).
The Food and Drug Administration (FDA) allows a maximum
of 1 part benzidine per billion parts of some color additives
for food.
(ATSDR). 2001. Toxicological Profile for Benzidine Atlanta,
Health Service.
2,3-BENZOFURAN
CAS # 271-89-6
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 2,3-benzofuran. For
series of summaries about hazardous substances and their health effects. This information is important
dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals are
present.
SUMMARY: Exposure to 2,3-benzofuran is most likely to occur from breathing

contaminated air at the workplace. Animal studies have shown effects on the liver,
kidneys, lungs, and stomach from exposure to high levels of 2,3-benzofuran. This
chemical has been found in at least 11 of 1,416 National Priorities List sites identified
by the Environmental Protection Agency.
What is 2,3-benzofuran?
waste sites.
(Pronounced 2,3-bn-zfyrn)
2,3-Benzofuran is a colorless, sweet-smelling, oily liquid
made by processing coal into coal oil. It may also be formed
during other uses of coal or oil.
2,3-Benzofuran is not used for any commercial purposes,
but the part of the coal oil that contains 2,3-benzofuran is
made into a plastic called coumarone-indene resin. This resin
resists corrosion and is used to make paints and varnishes. The
resin also provides water resistance and is used in coatings on
paper products and fabrics. It is used as an adhesive in food
containers and some asphalt floor tiles.
The resin has been approved for use in food packages and
as a coating on citrus fruits. We do not know how often the
resin is used or whether any 2,3-benzofuran in the coating or
packaging gets into the food.
What happens to 2,3-benzofuran when it

enters the environment?
q Very little is known about the stability or breakdown of
2,3-benzofuran or of the coumarone-indene resin.
q 2,3-Benzofuran may enter the air, water, and soil during
its manufacture, use, or storage at hazardous waste sites.
q It does not readily dissolve in water, but may enter the

groundwater near manufacturing or hazardous waste sites.
q Limited information indicates that it will move into soil
and sediment from water, but more information is needed.
q 2,3-Benzofuran is not expected to accumulate in fish or
aquatic animals to any great extent.
q One study reported detecting 2,3-benzofuran in human
breast milk, indicating that the mother had been exposed.
How might I be exposed to 2,3-benzofuran?

q Breathing contaminated air or touching the chemical in
the workplace.
q Breathing contaminated air around manufacturing or
q Eating foods from packaging material that contain
coumarone-indene resins, but not much is known about
how much gets into the food.
q Smoking cigarettes.
q Drinking contaminated water near manufacturing or
q Drinking contaminated human breast milk.

2,3-BENZOFURAN
CAS # 271-89-6
Page 2
How can 2,3-benzofuran affect my health?

Very little is known about the possible harmful effects of
2,3-benzofuran to human health. There are no studies that
have looked at the effects in people from exposures to air,
water, or food, or through skin contact. There are some studies
in animals from exposures in food or water.
Rats and mice that ingested high levels of 2,3-benzofuran over a short time had liver and kidney damage. Those
exposed over a long time to moderate levels had liver,
kidney, lung, and stomach damage. In one study, the ability
of animals to reproduce was not affected. We do not know if
people will experience health effects similar to those seen in
animals.
How likely is 2,3-benzofuran to cause

cancer?
The Department of Health and Human Services has not
classified 2,3-benzofuran as to its human carcinogenicity.
The International Agency for Research on Cancer and the
Environmental Protection Agency (EPA) have also not
classified 2,3-benzofuran as to its human carcinogenicity.
This test may only measure 2,3-benzofuran from a recent

exposure. It is not known how long 2,3-benzofuran remains
in your body after you have been exposed. The test can't tell
whether you may develop any health problems from an
exposure.

There are no standards or recommendations specific for
2,3-benzofuran.
The Food and Drug Administration (FDA) allows 200
parts of coumarone-indene resin per million parts of coating
on the peels of citrus fruits (200 ppm).
FDA also allows the use of coumarone-resin as a component of adhesives used in food packaging and as a substance
in plastics intended for repeated use in contact with food.
Glossary
Cancer of the kidneys, lungs, liver, or stomach was seen

in rats and mice that ingested 2,3-benzofuran for long periods
of time.
There are no studies on 2,3-benzofuran's potential to

cause cancer in people.
Long time: Lasting one year or longer.

been exposed to 2,3-benzofuran?
References
There is a test to measure 2,3-benzofuran in the blood or

in breast milk. However, this test requires special equipment
and is not usually available in your doctors office.

Short time: Lasting 14 days or less.

1992. Toxicological profile for 2,3-benzofuran. Atlanta, GA:
U.S. Department of Health and Human Services, Public
Health Service.
BERYLLIUM
CAS #7440-41-7
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about beryllium. For more
HIGHLIGHTS: People working or living near beryllium industries have the

greatest potential for exposure to beryllium. Lung damage has been observed
in people exposed to high levels of beryllium in the air. About 1-15% of all
people occupationally-exposed to beryllium in air become sensitive to beryllium
and may develop chronic beryllium disease (CBD), an irreversible and
sometimes fatal scarring of the lungs. CBD may be completely asymptomatic or
begin with coughing, chest pain, shortness of breath, weakness, and/or fatigue.
Beryllium has been found in at least 535 of the 1,613 National Priorities List
sites identified by the Environmental Protection Agency (EPA).
What is beryllium?
Beryllium is a hard, grayish metal naturally found in mineral
rocks, coal, soil, and volcanic dust. Beryllium ore is mined,
and the beryllium is purified for use in nuclear weapons and
reactors, aircraft and space vehicle structures, instruments, xray machines, and mirrors. Beryllium oxide is used to make
speciality ceramics for electrical and high-technology
applications. Beryllium alloys are used in automobiles,
computers, sports equipment (golf clubs), and dental
bridges.
What happens to beryllium when it enters the

environment?
Beryllium dust enters the air from burning coal and oil.
This beryllium dust will eventually settle over the land and
water.
It enters water from erosion of rocks and soil, and from
industrial waste. Some beryllium compounds will dissolve in
water, but most stick to particles and settle to the bottom.
Most beryllium in soil does not dissolve in water and
remains bound to soil.
Beryllium does not accumulate in the food chain.
How might I be exposed to beryllium?

The general population is normally exposed to low levels
of beryllium in air, food, and water.

People working in industries where beryllium is mined,
processed, machined, or converted into metal, alloys, and
other chemicals may be exposed to high levels of beryllium.
People living near these industries may also be exposed to
higher than normal levels of beryllium in air.
be exposed to higher than normal levels of beryllium.
How can beryllium affect my health?

Beryllium can be harmful if you breathe it. The effects
depend on how much you are exposed to, for how long, and
individual susceptibility. If beryllium air levels are high
enough (greater than 1000 ug/m3), an acute condition can
result. This condition resembles pneumonia and is called
acute beryllium disease Occupational and community air
standards are effective in preventing acute lung damage.
Some exposed workers (1-15%) become sensitive to
beryllium. These individuals may develop an inflammatory
reaction in the respiratory system. This condition is called
chronic beryllium disease (CBD), and can occur years after
exposure to higher than normal levels of beryllium (greater
than 0.2 ug/m3). This disease can make you feel weak and
tired, and can cause difficulty in breathing. It can also result
in anorexia, weight loss, and may also lead to right side heart

BERYLLIUM
Page 2
CAS #7440-41-7
enlargement and heart disease in advanced cases. Some
people who are sensitized to beryllium may not have any
symptoms. The general population is unlikely to develop
chronic beryllium disease because ambient air levels of
beryllium are normally very low (0.00003-0.0002 ug/m3).

hazardous waste sites where beryllium may have been
discarded.
Swallowing beryllium has not been reported to cause effects

in humans because very little beryllium is absorbed from the
stomach and intestines. Ulcers have been seen in dogs
ingesting beryllium in the diet. Beryllium contact with skin
that has been scraped or cut may cause rashes or ulcers.
Beryllium can be measured in samples from your blood,

urine, skin, or lungs. These tests are rarely done because
they are not reliable measures of your exposure over time.
Also, these tests do not show if you have become sensitized
to beryllium.
How likely is beryllium to cause cancer?

Long term exposure to beryllium can increase the risk of
developing lung cancer in people.
The Department of Health and Human Services (DHHS) and
the International Agency for Research on Cancer (IARC)
have determined that beryllium is a human carcinogen. The
EPA has determined that beryllium is a probable human
carcinogen. EPA has estimated that lifetime exposure to
0.04 ug/m3 beryllium can result in a one in a thousand chance
of developing cancer.
How can beryllium affect children?

It is likely that the health effects seen in children exposed to
beryllium will be similar to the effects seen in adults. We do
not know whether children differ from adults in their
susceptibility to beryllium.
We do not know if exposure to beryllium will result in birth
defects or other developmental effects in people. The
studies on developmental effects in animals are not
conclusive.

beryllium?
Individuals working at facilities that use beryllium should
make sure that contaminated clothing and objects are not
brought home.

exposed to beryllium?
Another test, the beryllium lymphocyte proliferation test

(BeLPT), can help your doctor decide if you are sensitized to
beryllium. This test is only done in a few specialized
laboratories, but doctors familiar with the test can collect
blood samples and send them for testing by overnight
carrier. The BeLPT is most often done for people who work
with beryllium. It is also useful for separating chronic
beryllium disease from diagnoses that resemble it (for
example, sarcoidosis). Depending on your exposure history,
clinical findings, and test results, your doctor may also
recommend additional specialized testing.

The EPA restricts the amount of beryllium that industries
may release into the air to 0.01 ug/m3, averaged over a 30day period.
sets a limit of 2 ug/m3 for an 8-hour work shift measured as a
personal sample.
(ATSDR). 2002. Toxicological Profile for Beryllium Atlanta,
Health Service.
BIS(2-CHLOROETHYL)
ETHER
CAS # 111-44-4
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about bis(2-chloroethyl) ether. For
more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series
of summaries about hazardous substances and their health effects. Its important you understand this information
HIGHLIGHTS: Bis(2-chloroethyl) ether is mainly used as a chemical

intermediate to make pesticides, but some of it is used as a solvent and cleaner.
It is irritating to the skin, eyes, nose, throat, and lungs. Bis(2-chloroethyl) ether
has been found at 81 of the 1,518 National Priorities List sites identified by the
What is bis(2-chloroethyl) ether?

(Pronounced bs 2 klr thl thr)
Bis(2-chloroethyl) ether is a colorless, nonflammable
liquid with a strong unpleasant odor. It dissolves easily in
water, and some of it will slowly evaporate to the air. It does
not occur naturally.
Bis(2-chloroethyl) ether is made in factories, and most of
it is used to make pesticides. Some of it is used as a solvent,
cleaner, component of paint and varnish, rust inhibitor, or as a
chemical intermediate to make other chemicals.
What happens to bis(2-chloroethyl) ether when

it enters the environment?
q Bis(2-chloroethyl) ether released to air can be broken
down by reactions with other chemicals and sunlight or
can be removed by rain.
q In water, it can be broken down by bacteria.
q When released to soil, some will filter through the soil to
groundwater, some will be broken down by bacteria, and
some will evaporate to the air.
q Bis(2-chloroethyl) ether does not build up in the food
chain.
How might I be exposed to bis(2-chloroethyl)

ether?
q You are most likely to be exposed to bis(2-chloroethyl)
ether if you work in a factory where it is made or used.
q People who live near a waste site or industrial facility
containing bis(2-chloroethyl) ether may be exposed to it
in the air they breathe or by touching contaminated soil.
q You could be exposed if you drank water that was contaminated with bis(2-chloroethyl) ether.
How can bis(2-chloroethyl) ether affect my

health?
Bis(2-chloroethyl) ether causes irritation to the skin, eyes,
throat, and lungs. In some cases, damage to the lungs can be
severe enough to cause death. Breathing low concentrations
will cause coughing and nose and throat irritation.
Animal studies show effects similar to those observed in
people. These effects include irritation to the skin, nose, and
lungs; lung damage; and a decrease in growth rate. Animals
that survived the exposures recovered fully in 4 to 8 days.

BIS(2-CHLOROETHYL) ETHER
CAS # 111-44-4
Page 2

Some animal studies indicate that bis(2-chloroethyl) ether can
affect the nervous system resulting in sluggish and slow movement, staggering, unconsciousness, and death.

(OSHA) has set a limit of 15 parts per million (15 ppm) over an
We do not know if bis(2-chloroethyl) ether causes reproductive effects or birth defects in people or animals.

(NIOSH) recommends that workplace air should not exceed
5 ppm bis(2-chloroethyl) ether averaged over a 10-hour workday or 40-hour workweek. Their recommended short-term
exposure limit (up to 15 minutes) is 10 ppm averaged over an
8-hour period.
How likely is bis(2-chloroethyl) ether to cause

cancer?
The ability of bis(2-chloroethyl) ether to cause cancer in
humans has not been established. There is some evidence that
bis(2-chloroethyl) ether causes cancer in mice. The International Agency for Research on Cancer (IARC) has determined
that bis(2-chloroethyl) ether is not classifiable as to its carcinogenicity in humans.

exposed to bis(2-chloroethyl) ether?
There are tests that can detect bis(2-chloroethyl) ether in
some animal tissues and in environmental samples, but these
tests have not been developed for measuring bis(2-chloroethyl) ether in people.

July 1999.
Glossary
should be limited to 0.03 parts per billion parts of water
(0.03 ppb) to prevent possible health effects from drinking
water or eating fish contaminated with bis(2-chloroethyl)
ether. Any release to the environment greater than 10 pounds
of bis(2-chloroethyl) ether must be reported to the EPA.

(ATSDR). 1989. Toxicological profile for bis(2-chloroethyl)
ether. Atlanta, GA: U.S. Department of Health and Human
Services, Public Health Service.
BIS(CHLOROMETHYL)
ETHER
CAS # 542-88-1
Jul.y 1999
This fact sheet answers the most frequently asked health questions (FAQs) about bis(chloromethyl) ether. For
HIGHLIGHTS: Bis(chloromethyl) ether is only used in small amounts inside

fully enclosed systems to make other chemicals. Use of this chemical is highly
restricted, so chances for exposure are very low. Bis(chloromethyl) ether is
highly irritating to the skin, eyes, nose, throat, and lungs and it is a carcinogen.
Bis(chloromethyl) ether has been found at 2 of the 1,518 National Priorities
List sites identified by the Environmental Protection Agency (EPA).
What is bis(chloromethyl) ether?
(Pronounced bs klr mthl thr)
Bis(chloromethyl) ether is a clear liquid with a strong
unpleasant odor. It does not occur naturally. It dissolves
easily in water, but degrades rapidly and readily evaporates
into air.
In the past, it was used to make several types of polymers,
resins, and textiles, but its use is now highly restricted. Only
small quantities of bis(chloromethyl) ether are produced in
the United States. The small quantities that are produced are
only used in enclosed systems to make other chemicals.
However, small quantities of bis(chloromethyl) ether may be
formed as an impurity during the production of another
chemical, chloromethyl methyl ether.
q When released to soil, some will evaporate to the air but

most of it will be broken down by reacting with soil moisture.
q Bis(chloromethyl) ether does not build up in the food
chain and does not last long in the environment.
How might I be exposed to bis(chloromethyl)

ether?
q Because bis(chloromethyl) ether does not last long in the
environment and because of its restricted use, you are not
likely to be exposed to this chemical.
q The most likely way to be exposed is by breathing it in
the air if you work at, or live near, an industrial facility
that makes or uses chemicals that may contain
bis(chloromethyl) ether as a contaminant.
What happens to bis(chloromethyl) ether when

How can bis(chloromethyl) ether affect my

health?
q Bis(chloromethyl) ether released to air can be broken

down by reactions with other chemicals and sunlight, or
it can be removed by rain.
Bis(chloromethyl) ether causes irritation to the skin, eyes,

throat, and lungs. In some cases, damage to the lungs can be
severe enough to cause death. Breathing low concentrations
will cause coughing and nose and throat irritation.
q In water, it is broken down quickly to formaldehyde and

hydrochloric acid.

BIS(CHLOROMETHYL) ETHER
CAS # 542-88-1
Page 2

Animal studies show effects similar to those observed in
people. These effects include irritation to the skin, nose, and
lungs and lung damage (swelling and bleeding). Application
of the liquid to the skin of mice and rabbits has produced hair
loss, bleeding, swelling, and destruction of tissue.
We do not know if bis(chloromethyl) ether causes reproductive effects or birth defects in people or animals.
How likely is bis(chloromethyl) ether to cause

cancer?
There is evidence that bis(chloromethyl) ether causes lung
cancer and other tumors in people and animals. The Department of Health and Human Services (DHHS) has determined
that bis(chloromethyl) ether is a known human carcinogen.

exposed to bis(chloromethyl) ether?
Because bis(chloromethyl) ether is broken down rapidly
in the body, there are no specific tests to determine if someone
has been exposed to this chemical. The only available medical tests involve physical examination of the nose and throat,
chest X-rays, or other tests to identify damage to the respiratory tract. However, these tests are not specific for this chemical and can only be used after damage has occurred.

should be limited to 0.0000038 parts per billion parts of water
(0.0000038 ppb) to prevent possible health effects from drink-
ing water or eating fish contaminated with bis(chloromethyl)

ether. Any release to the environment greater than 10 pounds
of bis(chloromethyl) ether must be reported to the EPA.
(OSHA) has set a limit of 1 ppb as the highest acceptable level
in workplace air, and strict controls have been established to
minimize exposure to this chemical.
July 1999.
Glossary
Carcinogen: A substance that can cause cancer.
Polymer: Chemical compounds consisting of repeating
structural units.
Tumor: An abnormal mass of tissue.
(ATSDR). 1989. Toxicological profile for bis(chloromethyl)
ether. Atlanta, GA: U.S. Department of Health and Human
BLISTER AGENTS:
LEWISITE (L) CAS #541-25-3
MUSTARD-LEWISITE MIXTURE (HL)
CAS # NOT AVAILABLE
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about the blister agents, Lewisite
and Mustard-Lewisite. For more information, call the ATSDR Information Center at 1-888-422-8737. This
fact sheet is one in a series of summaries about hazardous substances and their health effects. It is important
you understand this information because this substance may harm you. The effects of exposure to any hazardous
substance depend on the dose, the duration, how you are exposed, personal traits and habits, and whether
other chemicals are present.
HIGHLIGHTS: It is unlikely that the general population will be exposed to

blister agents Lewisite or Mustard-Lewisite. People who breathe in vapors of
Lewisite or Mustard-Lewisite may experience damage to the respiratory
system. Contact with the skin or eye can result in serious burns. Lewisite or
Mustard-Lewisite also can cause damage to bone marrow and blood vessels.
Exposure to high levels may be fatal. Blister agents Lewisite and MustardLewisite have not been found in any of the 1,585 National Priorities List sites
identified by the Environmental Protection Agency (EPA).
What are Lewisite and Mustard-Lewisite?
Lewisite and Mustard-Lewisite will be broken down in

moist soil quickly, but small amounts may evaporate.
Lewisite is an oily, colorless liquid with an odor like

geraniums. Mustard-Lewisite Mixture is a liquid with a
garlic-like odor. Mustard-Lewisite is a mixture of Lewisite
and a sulfur mustard known as HD.
Lewisite and Mustard-Lewisite do not accumulate in the

food chain.
Lewisite might have been used as a chemical weapon by

Japan against Chinese forces in the 1930s, but such reports
have not been confirmed. Any stored Lewisite in the United
States must be destroyed before April 2007, as mandated by
the Chemical Weapons Convention.
What happens to Lewisite and Mustard-Lewisite

when they enter the environment?
How might I be exposed to Lewisite and

Mustard-Lewisite?
The general population will not be exposed to blister
agents Lewisite or Mustard-Lewisite.
Lewisite and Mustard-Lewisite are no longer produced in
the United States.
Blister agents Lewisite and Mustard-Lewisite could enter

the environment from an accidental release.
People that are potentially exposed to Lewisite or

Mustard-Lewisite are soldiers who might be exposed to
chemical weapons or people who work at military sites where
these compounds are stored.
In air, blister agents Lewisite and Mustard-Lewisite will be

broken down by compounds that are found in the air, but
they may persist in air for a few days before being broken
down.
How can Lewisite and Mustard-Lewisite affect

my health?
Lewisite and Mustard-Lewisite will be broken down in

water quickly, but small amounts may evaporate.
If you breathe Lewisite or Mustard-Lewisite vapors, your

airways will immediately become irritated. You could
experience burning pain in the nose and sinuses, laryngitis,

Page 2
BLISTER AGENTS:
LEWISITE (L) CAS #541-25-3
MUSTARD-LEWISITE MIXTURE (HL) CAS # NOT AVAILABLE
cough, shortness of breath, nausea, and vomiting. You

could also experience airway tissue damage and accumulation
of fluid in your lungs, which could result in death.
Contact of the skin with Lewisite or Mustard-Lewisite vapors
or liquid will result in local pain, swelling, and rash, followed
by blistering that might be delayed for hours. If Lewisite or
Mustard-Lewisite vapors or liquid contact your eyes, you
will suffer immediate pain and rapid swelling, as well as
serious damage to the cornea and other parts of the eye.
Ingestion of Lewisite or Mustard-Lewisite will burn your
mouth and throat, will cause severe stomach pain, nausea,
vomiting, and bloody stools.
If some of the Lewisite and Mustard-Lewisite that you
breathe, touch, or ingest, pass to your blood stream, it can
cause bone marrow damage and fluid loss from your blood
vessels, which could result in low blood pressure and
damage to the rest of your body.
We do not know if exposure to Lewisite or Mustard-Lewisite
causes reproductive effects in humans.
How likely are Lewisite and Mustard-Lewisite to

cause cancer?
International Agency for Research on Cancer (IARC), and the
EPA have not classified Lewisite as to its carcinogenicity.
Both the DHHS and IARC have classified the blister agent
H/HD (the sulfur mustard used in the Mustard-Lewisite
mixture) as a human carcinogen. We to not know whether
the Mustard-Lewisite mixture might also be a human
carcinogen.
How can Lewisite and Mustard-Lewisite affect

children?
There is no information on children exposed to Lewisite or
Mustard-Lewisite, but children would probably be affected in
the same ways as adults. We do not know whether children
differ from adults in their susceptibility to these blister
agents.
We do not know whether Lewisite or Mustard-Lewisite can
cause developmental effects in humans.

Lewisite and Mustard-Lewisite?
It is unlikely that families will be exposed to Lewisite or
Mustard-Lewisite.

exposed to Lewisite and Mustard-Lewisite?
There are no specific tests to indicate whether you have
been exposed to Lewisite or Mustard-Lewisite. The presence
of arsenic in the urine could indicate if you have been
exposed to one of these blister agents.

An Airborne Exposure Limit (as recommended by the
Surgeon Generals Working Group, U.S. Department of Health
and Human Services) of 0.003 milligrams of Lewisite and
Mustard-Lewisite per cubic meter of air (0.003 mg/m3) has
been established as a time-weighted average (TWA) for the
workplace.
BLISTER AGENTS HN-1, HN-2, HN-3

(nitrogen mustards)
CAS #538-07-8 (HN-1); CAS #51-75-2 (HN-2);
CAS #555-77-1 (HN-3)
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about nitrogen mustards. For
of summaries about hazardous substances and their health effects. It is important you understand this information
HIGHLIGHTS: It is unlikely that the general public will be exposed to nitrogen

mustards agents HN-1, HN-2, and HN-3. Exposure to vapors of nitrogen
mustards can damage the respiratory airways. Contact with the skin or eyes
may cause burns. When nitrogen mustards are absorbed by the body, they may
cause damage to bone marrow and the immune system. Exposure to high
levels can cause death. Nitrogen mustards HN-1, HN-2, and HN-3 have not
been identified in any of the 1,585 National Priorities List sites identified by the
What are nitrogen mustards?
Nitrogen mustards (HN-1, HN-2, HN-3) are colorless to
yellow, oily liquids that evaporate very slowly. HN-1 has a
faint, fishy or musty odor. HN-2 has a soapy odor at low
concentrations and a fruity odor at higher concentrations.
HN-3 may smell like butter almond.
Nitrogen mustards will be broken down in water quickly,

and only small amounts may evaporate.
Nitrogen mustards will be broken down in moist soil
quickly, and only small amounts may evaporate.
Nitrogen mustards do not accumulate in the food chain.
Although nitrogen mustards could be used in chemical

warfare, there are presently no records of such use. HN-1
has been used to remove warts in the past, and HN-2 has
been used sparingly in chemotherapy.
How might I be exposed to nitrogen mustards?
What happens to nitrogen mustards when they

The nitrogen mustards HN-1, HN-2, and HN-3 are not

manufactured in significant commercial quantities in the
United States. Although several of the nitrogen mustards
have medicinal uses and as chemical warfare agents, they
were never stockpiled as part of the U.S. chemical warfare
inventory.
Nitrogen mustards HN-1, HN-2, and HN-3 could enter the

environment from an accidental release.
The general population will not be exposed to nitrogen

mustards.
When released to air, nitrogen mustards will be broken

down by compounds that are found in the air, but they may
persist in air for a few days before being broken down.

Page 2 BLISTER AGENTS HN-1, HN-2, HN-3 (nitrogen mustards)

CAS #538-07-8 (HN-1); CAS #51-75-2 (HN-2);CAS #555-77-1 (HN-3)
How can nitrogen mustards affect my health?
How can nitrogen mustards affect children?
If you breathe nitrogen mustard vapors, you will likely

experience such effects as nasal and sinus pain or
discomfort, pharyngitis, laryngitis, cough, and shortness of
breath. Damage to cells lining your airways may begin
within hours and get worse over the next several days.
Exposure to high levels could cause death.
Children exposed to nitrogen mustards would probably

experience the same effects seen in exposed adults. But we
do not know whether children differ from adults in their
susceptibility to nitrogen mustards.
Skin contact with nitrogen mustard vapors or liquid, will

likely cause initial swelling and rash, followed by blistering.
Contact with high levels of nitrogen mustards can result in
second- and third-degree burns. If nitrogen mustards touch
the eye, you may experience eye inflammation, pain, swelling,
corneal damage, burns, and even blindness.
If you swallow nitrogen mustards, you will probably
experience burning of the mouth, esophagus, and stomach.
When nitrogen mustards are absorbed by the body, they
may cause damage to your immune system and bone marrow.
There is some evidence that nitrogen mustard treatment in
humans may result in decreased fertility.
How likely are nitrogen mustards to cause

cancer?
The International Agency for Research on Cancer (IARC) has
classified nitrogen mustard HN-2 as probably carcinogenic to
humans, based on evidence that it causes leukemia in
humans and cancers of the lung, liver, uterus, and large
intestine in animals.
A few case reports have linked treatment with HN-2 in

pregnant mothers to changes in the unborn child. Nitrogen
mustards have been shown to cause damage to the fetus in
animals.

nitrogen mustards?
Families are not likely to be exposed to nitrogen mustards.

exposed to nitrogen mustards?
There are no specific tests to indicate whether you have
been exposed to nitrogen mustards.

and Human Services) of 0.003 milligrams of HN-1 per cubic
meter of air (0.003 mg/m3) has been established as a timeweighted average (TWA) for the workplace.
BLISTER AGENTS
SULFUR MUSTARD AGENT H/HD CAS #505-60-2
SULFUR MUSTARD AGENT HT CAS #6392-89-8
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about sulfur mustard blister
agents H/HD and HT. For more information, call the ATSDR Information Center at 1-888-422-8737. This
fact sheet is one in a series of summaries about hazardous substances and their health effects. It is important
HIGHLIGHTS: Exposure to sulfur mustard agents H/HD and HT can occur

due to accidental release from a military storage facility. Exposure to sulfur
mustards can burn the skin and eyes, cause blisters, and cause respiratory
effects such as coughing and bronchitis. Higher levels may cause death. Sulfur
mustard agent H/HD has been identified at 3 of the 1,585 National Priorities
What are sulfur mustards agents H/HD and HT?
Sulfur mustards H/HD and HT are manufactured compounds.
They are colorless when pure, but are typically yellow to
brown oily liquids with a slight garlic or mustard odor.
Agent H contains about 20-30% impurities. The nearly pure
substance is called HD. HT is a mixture of 60% HD and
40% of another substance called agent T. They do not
dissolve much in water, but dissolve easily in oils, fats, and
other solvents. They are stable at ambient temperatures.
Sulfur mustards were introduced as chemical warfare agents
during World War I. More than a dozen countries have
sulfur mustard agents in their chemical arsenals. Destruction
of U.S. stockpiles of chemical agents, including sulfur
mustards, was mandated by the Chemical Weapons
Convention to take place before April 2007.
What happens to sulfur mustards agents H/HD

and HT when they enter the environment?
Sulfur mustards agents H/HD and HT could enter the
When released to air, sulfur mustards will be broken down
by substances that are found in the air, but they may persist
in air for a few days before being broken down.
Sulfur mustards will be broken down in water quickly, but

small amounts may evaporate.
Sulfur mustards may remain in dry soil, but will be broken
down gradually in moist soil, and some might evaporate.
Sulfur mustard agents H/HD and HT do not accumulate in
the food chain.
How might I be exposed to sulfur mustard agents

H/HD and HT?
The general population will not be exposed to sulfur
mustard agents H/HD and HT unless an accidental release
were to occur at military sites where they are stored.
Sulfur mustards are no longer produced in the United
States.
People who might be exposed to chemical weapons or
who work at military sites where these compounds are stored
have the potential of being exposed to these chemicals.
How can sulfur mustard agents H/HD and HT

affect my health?
The primary routes of potential human exposure to sulfur
mustards are inhalation and dermal contact. Sulfur mustards
are chemical warfare agents that can cause skin burns and

Page 2
BLISTER AGENTS
SULFUR MUSTARD AGENT H/HD CAS #505-60-2
SULFUR MUSTARD AGENT HT CAS #6392-89-8
blisters and damage to the respiratory airways. Sulfur

mustards burn your skin and cause blisters within a few days
of exposure. Exposure is particularly harmful around sweaty
parts of the body. It is also more harmful to the skin on hot,
humid days, or in tropical climates. Sulfur mustards make
your eyes burn, your eyelids swell, and cause you to blink a
lot.
If you breath sulfur mustards, it can cause coughing,
bronchitis, and long-term respiratory disease. If you are
exposed to large amounts of sulfur mustards, you can
eventually die from it.
because of the smaller diameter of their airways.

Sulfur mustards did not cause birth defects in rats that
breathed it. We do not know if these substances can cause
birth defects or other developmental effects in humans.

sulfur mustard agents H/HD and HT?
It is unlikely that the general population will be exposed to
sulfur mustard agents H/HD or HT.
Sulfur mustards did not affect reproduction in rats that

breathed it. We do not know if sulfur mustards can affect
peoples ability to reproduce.

exposed to sulfur mustard agents H/HD and HT?
How likely are sulfur mustard agents H/HD and

HT to cause cancer?
There is no effective medical test to determine if you have

been exposed to sulfur mustards. A breakdown product of
sulfur mustards can be measured in urine, but this chemical
can also be found in people who have not been exposed to
sulfur mustards.
The Department of Heath and Human Services (DHHS) has

determined that blister agent H/HD is a known human
carcinogen. The International Agency for Research on
Cancer (IARC) has classified agent H/HD as carcinogenic to
humans. Studies in humans indicate that long-term exposure
to sulfur mustards may lead to cancer of the upper
respiratory airways.
How can sulfur mustard agents H/HD and HT

affect children?

and Human Services) of 0.003 milligrams of H/HD or HT per
cubic meter of air (0.003 mg/m3) has been established as a
time-weighted average (TWA) for the workplace.
There are no studies of children exposed to sulfur mustard

agents H/HD or HT. Children exposed to sulfur mustard
agents H/HD or HT are likely to experience the same toxic
effects experienced by exposed adults. In general, children
may be more vulnerable to corrosive agents than adults
BORON
CAS # 7440-42-8
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about boron. For more
SUMMARY: Exposure to boron occurs in the workplace or from using certain

consumer products. Breathing moderate levels of boron irritates the nose, throat,
and eyes. This chemical has been found in at least 142 of 1,416 National Priorities
What is boron?
(Pronounced brn)
q Boron accumulates in plants and is found in foods,

mainly fruits and vegetables.
Boron is a compound that occurs in nature. It is often

found combined with other substances to form compounds
called borates. Common borate compounds include boric
acid, salts of borates, and boron oxide.
How might I be exposed to boron?
Several companies in the United States produce most of

the world's borates by processing boron compounds. Borates
are used mostly to produce glass. They are also used in fire
retardants, leather tanning industries, cosmetics, photographic
materials, soaps and cleaners, and for high-energy fuel. Some
pesticides used for cockroach control and some wood preservatives also contain borates.
q Eating foods containing high levels.
What happens to boron when it enters the

environment?
q Boron is released to the environment from natural
sources such as oceans, volcanoes, and geothermal
steam.
q Boron is also released from industries that use it.
q No information is available on how long boron remains
in air, water, or soil.
q Boron does not appear to accumulate in fish or other
organisms in water.
q In air, water, and food at low levels.

q Drinking water that contains it from areas where boron is
found naturally at high levels in the earth.
q Working in borax mining and refining plants and at sites
where boric acid is manufactured.
q Using consumer products that contain it, such as cosmetics and laundry products.
How can boron affect my health?

There is little information on the health effects of longterm exposure to boron. Most of the studies are on short-term
exposures.
Breathing moderate levels of boron can result in irritation of the nose, throat, and eyes. Reproductive effects, such
as low sperm count, were seen in men exposed to boron over
the long-term. Animal studies have shown effects on the
lungs from breathing high levels of boron.
Ingesting large amounts of boron over short periods of
time can harm the stomach, intestines, liver, kidney, and

BORON
CAS # 7440-42-8
Page 2

brain. Animal studies of ingestion of boron found effects on
the testes in male animals. Birth defects were also seen in the
offspring of female animals exposed during pregnancy.
The EPA requires that discharges or spills into the

environment of 100 pounds of more of boron trichloride and
boron trifluoride be reported.
We don't know what the effects are in people from skin

contact with boron. Animal studies have found skin irritation
when boron was applied directly to the skin.

(OSHA) has set an occupational exposure limit of 15 milligrams per cubic meter (15 mg/m3) for boron oxide dust in
workplace air for an 8-hour workday, 40-hour workweek.
How likely is boron to cause cancer?
The National Institute for Occupational Safety and

Health (NIOSH) currently recommends an occupational
exposure limit of 10 mg/m3 for boron oxide dust.

International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified boron
as to its human carcinogenicity.
One animal study found no evidence of cancer after
lifetime exposure to boric acid in food. No human studies are
available.

been exposed to boron?
Tests are available to measure boron levels in blood and
urine. These tests must be done shortly after exposure,
because most excess boron leaves the body through the urine
within a few days of exposure.
These tests are not usually performed in doctors' offices
because special equipment is needed to conduct them. It is
not known whether boron levels measured in the body can be
used to predict whether health problems will occur.
NIOSH also recommends that 25 ppm boron trifluoride

be considered immediately dangerous to life and health.
This is the exposure level of a chemical that is likely to cause
permanent health problems or death.
The Food and Drug Administration (FDA) allows no
more than 310 ppm of boron as a food additive.
Glossary
Pesticides: Chemicals used to kill pests.
References
The EPA allows no more than 30 parts of boron per
million parts of cottonseed oil (30 ppm) and 8 ppm of boron
in or on citrus fruits.

1992. Toxicological profile for boron. Atlanta, GA: U.S.
Service.
BROMODICHLOROMETHANE
CAS # 75-27-4
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about bromodichloromethane. For
HIGHLIGHTS: Most bromodichloromethane is formed as a by-product when

chlorine is added to water-supply systems. Bromodichloromethane is not known
to cause adverse health effects in people, but animal studies show that high
concentrations can damage the liver and kidneys and affect the brain.
Bromodichloromethane has been found at 5 of the 1,518 National Priorities
What is bromodichloromethane?
q When released to soil, most will evaporate to the air but

some of it will be broken down by bacteria.
(Pronounced brm d-klr mthn)
q Some bromodichloromethane may filter into the groundwater.
Bromodichloromethane is a colorless, nonflammable

liquid. Small amounts are formed naturally by algae in the
oceans. Some of it will dissolve in water, but it readily evaporates into air.
Only small quantities of bromodichloromethane are
produced in the United States. The small quantities that are
produced are used in laboratories or to make other chemicals.
However, most bromodichloromethane is formed as a by-product when chlorine is added to drinking water to kill bacteria.
What happens to bromodichloromethane when

q Bromodichloromethane released to air is slowly broken
down by reactions with other chemicals and sunlight or it
can be removed by rain.
q In water, it will evaporate to the air and/or be broken
down slowly by bacteria.
q Bromodichloromethane does not build up in the food

chain.
How might I be exposed to bromodichloromethane?

q The most likely way people are exposed to bromodichloromethane is by drinking chlorinated water.
q You may breathe vapors released from chlorinated water
in a swimming pool or in the home (cooking, washing
dishes, bathing, etc.).
q Some bromodichloromethane may enter your body directly through your skin when bathing or swimming.
q People who live near a waste site containing
bromodichloromethane could be exposed by drinking
contaminated groundwater or breathing vapors released
to the air.
q People who work at or live near a laboratory or factory
that makes or uses this chemical could be exposed by
breathing bromodichloromethane in the air.

BROMODICHLOROMETHANE
CAS # 75-27-4
Page 2

How can bromodichloromethane affect my
health?

No studies are available regarding health effects in people

exposed to bromodichloromethane.
The EPA has set a Maximum Contaminant Level (MCL)

of 0.1 parts per million (ppm) for the combination of
bromodichloromethane and a group of similar compounds
(called trihalomethanes) that occur in chlorinated water. The
EPA recommends that levels of halomethanes in lakes and
streams should be limited to 0.19 ppm to prevent possible
health effects from drinking water or eating fish contaminated
with this group of chemicals.
Animal studies indicate that the liver, kidney, and central

nervous system are affected by exposure to bromodichloromethane. The effects of high doses on the central nervous
system include sleepiness and incoordination. Longer exposure to lower doses causes damage to the liver and kidneys.
There is some evidence from animal studies that bromodichloromethane may cause birth defects at doses high enough
to make the mother sick. It is not known if lower doses would
cause birth defects.
Any release to the environment greater than 5,000 pounds

of bromodichloromethane must be reported to the EPA.
July 1999.
How likely is bromodichloromethane to cause

cancer?
Glossary
There is evidence that eating or drinking bromodichloromethane causes liver, kidney, and intestinal cancer in rats and
mice. The Department of Health and Human Services (DHHS)
has determined that bromodichloromethane is reasonably anticipated to be a human carcinogen.


exposed to bromodichloromethane?
Methods are available to measure low levels of bromodichloromethane in human blood, breath, urine, and fat, but
not enough information is available to use such tests to predict
if any health effects might occur. Because special equipment
is needed, these tests are not usually done in the doctor's
office.

(ATSDR). 1989. Toxicological profile for bromodichloromethane. Atlanta, GA: U.S. Department of Health and Human
BROMOFORM and
CHLORODIBROMOMETHANE
CAS # 75-25-2 and 124-48-1
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about bromoform and
chlorodibromomethane. For more information, call the ATSDR Information Center at 1-888-422-8737. This
fact sheet is one in a series of summaries about hazardous substances and their health effects. Its important
HIGHLIGHTS: Small amounts of bromoform and chlorodibromomethane are

naturally produced by ocean plant life. They are also formed as by-products
when chlorine is added to water-supply systems. High levels of bromoform and
chlorodibromomethane can damage the liver and kidneys and affect the brain.
Bromoform and chlorodibromomethane have been found at 14 of the 1,177 National
What are bromoform and chlorodibromomethane?
(Pronounced brm frm and klr d brm mthn)
Bromoform and chlorodibromomethane are colorless,
nonflammable liquids with a sweet odor. Small amounts are
formed naturally by plants in the oceans. They are somewhat
soluble in water and readily evaporate into air. Most of the
bromoform and chlorodibromomethane that enters the environment is formed as by-products when chlorine is added to
drinking water to kill bacteria.
Only small quantities of bromoform and chlorodibromomethane currently are produced in the United States. These
chemicals were used in the past as solvents and flame retardants, or to make other chemicals, but now they are used
mainly as laboratory reagents.
What happens to bromoform and chlorodibromomethane when they enter the environment?
q When released to air, bromoform and chlorodibromomethane are slowly broken down by reactions with other
chemicals and sunlight or can be removed by rain.
q In water, these chemicals will evaporate to the air and/or
be broken down slowly by bacteria.
q When released to soil, most will evaporate to the air, some

will be broken down by bacteria, and some may filter into
the groundwater.
q Bromoform and chlorodibromomethane do not build up
in the food chain.
How might I be exposed to bromoform and

chlorodibromomethane?
q The most likely way people are exposed to bromoform
and chlorodibromomethane is by drinking chlorinated
water.
q You may breathe vapors released from chlorinated water
in a swimming pool or in the home (cooking, washing
dishes, bathing, etc.).
q Some bromoform and chlorodibromomethane may enter
your body directly through your skin while bathing or
swimming.
q People that live near a waste site containing bromoform
or chlorodibromomethane could be exposed by drinking
contaminated groundwater or breathing vapors released
to the air.
q Exposure could occur by breathing bromoform and
chlorodibromomethane in the air in or near a laboratory
or factory that makes or uses this chemical; however, this
is not likely for most people.
BROMOFORM AND
CHLORODIBROMOMETHANE
CAS # 75-25-2 AND 124-48-1
Page 2

How can bromoform and chlorodibromomethane
affect my health?
No studies are available about health effects in people
exposed to chlorodibromomethane. Bromoform was used as a
sedative to treat children with whooping cough during the
early 1900s. Several recorded cases of overdose indicate that
high doses affect the central nervous system causing unconsciousness, loss of reflexes, shallow breathing, erratic heart
rate, and respiratory failure. Milder cases resulted in rapid
breathing, constricted pupils, and tremors.
nervous system are affected by exposure to bromoform and
chlorodibromomethane. The effects on the central nervous
system appear quickly after exposure to high doses and include labored breathing, incoordination, sedation, and death.
Longer-term exposure to lower doses causes drowsiness, increased liver weight, and liver and kidney damage. We do not
know if bromoform and chlorodibromomethane cause birth
defects or infertility.
How likely are bromoform and

chlorodibromomethane to cause cancer?
There is evidence that ingestion of bromoform causes
intestinal cancer in rats and ingestion of chlorodibromomethane causes liver cancer in mice. It is not known if they cause
cancer in people. The International Agency for Research on
Cancer (IARC) has determined that the human carcinogenicity
of bromoform and chlorodibromomethane is not classifiable.

exposed to bromoform or chlorodibromomethane?
Methods are available to measure low levels of bromoform and chlorodibromomethane in human blood, breath, and
fat, but not enough information is available to use such tests to
predict if any health effects might occur. Because special

equipment is needed, these tests are not usually done in the
doctors office.

of 0.1 parts per million (0.1 ppm) for the combination of bromoform and chlorodibromomethane and a group of similar
compounds (called trihalomethanes) that occur in chlorinated
water.
The EPA recommends that levels of halomethanes in lakes
and streams should be limited to 0.19 ppm to prevent possible
human health effects from drinking water or eating fish contaminated with this group of chemicals. Any release to the
environment greater than 100 pounds of bromoform or
chlorodibromomethane must be reported to the EPA.
Because chlorodibromomethane has such a limited use in
industry, the Occupational Safety and Health Administration
(OSHA) has not set limits of exposure for workplace air. OSHA
has set a workplace air concentration limit of 0.5 ppm for bromoform over an 8-hour workday, 40-hour workweek.
July 1999.
(ATSDR). 1989. Toxicological profile for bromoform and
chlorodibromomethane. Atlanta, GA: U.S. Department of
Health and Human Services, Public Health Service.
BROMOMETHANE
CAS # 74-83-9
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about bromomethane. For
present.
SUMMARY: Exposure to bromomethane occurs mostly from breathing contaminated

air in the workplace or at waste sites. It is usually not found in surface water, soil,
or food. Exposure to high levels can affect your lungs and cause breathing difficulty.
It can also damage your kidneys and nervous system, and can even cause death. This
What is bromomethane?
(Pronounced brmmthn)
q It breaks down in groundwater over a period of several

months.
q It does not build up in plants or animals.
Bromomethane is a manufactured chemical. It also

occurs naturally in small amounts in the ocean where it is
formed, probably by algae and kelp. It is a colorless, nonflammable gas with no distinct smell.
How might I be exposed to bromomethane?
Other names for bromomethane are methyl bromide,

mono-bromomethane, and methyl fume. Trade names include
Embafume and Terabol.
q Breathing contaminated air with high levels near waste

sites.
Bromomethane is used to kill a variety of pests including rats, insects, and fungi. It is also used to make other
chemicals or as a solvent to get oil out of nuts, seeds, and
wool.
q Breathing workplace air where it is made or used.
What happens to bromomethane when it

q It moves very quickly into the air when released to the
environment or when present in soil or water.
q It breaks down slowly in air over several years.
q It breaks down quickly in soil over a few days.
q Small amounts can move from the soil into the
groundwater.
q Breathing very, very low background levels in the

environment.
q Breathing air where it has been used as a pesticide.

q Usually not found in surface water, soil, or food.
How can bromomethane affect my health?

If you breathe bromomethane you may develop a
headache and begin to feel weak and nauseated several hours
later. If you breathe large amounts, fluid may build up in your
lungs and it may be hard to breathe. It could cause muscle
tremors, seizures, kidney damage, nerve damage, and even
death.
Exposure levels leading to death vary from 1,600 to
60,000 parts of bromomethane in 1 million parts of air (1,60060,000 ppm), depending on the length of the exposure. These

BROMOMETHANE
CAS # 74-83-9
Page 2

levels are much, much higher than those to which you would
normally be exposed to.
The respiratory, kidney, and neurologic effects are of the
greatest concern to people. No cases of severe effects on the
nervous system from long-term exposure to low levels have
been noted in people, but studies in rabbits and monkeys
have shown moderate to severe injury.
Swallowing bromomethane may cause stomach irritation.
If bromomethane gets on your skin, it can cause itching,
redness, and blisters. These effects are caused by levels that
are higher than levels you might normally encounter.
We do not know if it affects our ability to reproduce.
Studies in animals suggest that bromomethane does not cause
birth defects and does not interfere with reproduction, except
at high exposure levels.
How likely is bromomethane to cause

cancer?
Another test measures the main breakdown product of

bromomethane (bromide) in your blood or urine. Bromide is
normally present in your blood, but the level would be
higher if you had been exposed to bromomethane. This test
is only useful if done within 1-2 days following exposure and
cannot predict if any health effects will occur.
These tests are not routinely performed at doctors'
offices, but your doctor can take blood or urine samples and

EPA requires that spills or accidental releases into the
environment of 1,000 pounds or more of bromomethane be
reported.
The Food and Drug Administration (FDA) set a limit of
125-400 parts of bromide per million parts of food (ppm) for
food treated with bromomethane.
The Environmental Protection Agency (EPA) has determined that bromomethane is not classifiable as to its human
carcinogenicity.
The Occupational Safety and Health Agency (OSHA)

limits the average level of bromomethane in workplace air to
20 ppm for an 8-hour workday over a 40-hour week, and
recommends that exposure be reduced as low as possible.
There are no studies available to indicate that bromomethane is carcinogenic to people. Animal studies do not
provide conclusive evidence.
Glossary

been exposed to bromomethane?
Several tests are available to tell if you have been
exposed to bromomethane. It can be measured in your blood
or in the air you breathe out. This test is not very useful
because most bromomethane doesn't stay in your body long.
References
1992. Toxicological profile for bromomethane. Atlanta,
Health Service.
1,3-BUTADIENE
CAS # 106-99-0
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 1,3-butadiene. For more
SUMMARY: Exposure to 1,3-butadiene occurs mainly from breathing contaminated air. Effects on the nervous system and irritations of the eyes, nose, and
throat have been seen in people who breathed contaminated air. This chemical
has been found in at least 7 of 1,416 National Priorities List sites identified by
the Environmental Protection Agency.
What is 1,3-butadiene?
(Pronounced 1,3-byt-dn)
1,3-Butadiene is a chemical made from the processing of
petroleum. It is the 36th highest volume chemical produced
in the United States. It is a colorless gas with a mild gasolinelike odor.
About 75% of the manufactured 1,3-butadiene is used to
make synthetic rubber. Synthetic rubber is widely used for
tires on cars and trucks.
1,3-Butadiene is also used to make plastics including
acrylics. Small amounts are found in gasoline.
q 1,3-Butadiene may be broken down by microorganisms

in the soil.
q It is not expected to accumulate in fish.
How might I be exposed to 1,3-butadiene?

q Breathing urban and suburban air, but these levels are
generally very low except in polluted cities or near
chemical, plastic, and rubber facilities that use it.
q Breathing contaminated workplace air where it is
manufactured or used.
q Breathing contaminated air from car and truck exhaust,
waste incineration, or wood fires.
q Breathing cigarette smoke.
What happens to 1,3-butadiene when it

q Drinking contaminated water near production or waste

sites.
q It quickly evaporates to the air as a gas from leaks during

production, use, storage, transport, or disposal.
q Ingesting foods contained in plastic or rubber food

containers, but levels are generally very low or not
present at all.
q It breaks down quickly in air by sunlight; in sunny

weather, half of it breaks down in about 2 hours.
q Skin contact with gasoline, but levels are low.
q When not sunny, it takes a few days for about half of it to

break down in the air.
q It evaporates very quickly from water and soil.
q Since it evaporates so easily, it is not expected to be
found in water or soil, but adequate tests are not available
to measure the amounts.
How can 1,3-butadiene affect my health?

Most of the information on the health effects of
1,3-butadiene comes from studies where the exposure was
from breathing contaminated air.

1,3-BUTADIENE
CAS # 106-99-0
Page 2
Breathing very high levels of 1,3-butadiene for a short

time can cause central nervous system damage, blurred vision,
nausea, fatigue, headache, decreased blood pressure and pulse
rate, and unconsciousness. There are no recorded cases of
accidental exposures at high levels that caused death in
humans, but this could occur.

been exposed to 1,3-butadiene?
Breathing lower levels may cause irritation of the eyes,

nose, and throat.

Studies on workers who had longer exposures with lower

levels have shown an increase in heart and lung damage, but
these workers were also exposed to other chemicals. We dont
know for sure which chemical (or chemicals) caused the
effects. We also do not know what levels in the air will cause
these effects in people when breathed over many years.
Animal studies show that breathing 1,3-butadiene during
pregnancy can increase the number of birth defects. Other
effects seen in animals that breathed low levels of 1,3-butadiene for one year include kidney and liver disease, and
damaged lungs. Some of the animals died.
There is no information on the effects of eating or
drinking 1,3-butadiene. Skin contact with liquid 1,3-butadiene can cause irritation and frostbite.
There is currently no reliable medical test to determine

whether you have been exposed to 1,3-butadiene. However,
scientists are working on methods to measure it in the blood.
The Environmental Protection Agency (EPA) requires

that discharges or spills into the environment of 1 pound or
more of 1,3-butadiene be reported.
(OSHA) has set an occupational exposure limit of 1,000 parts
of 1,3-butadiene per million parts of air (1,000 ppm).
Health (NIOSH) recommends that 1,3-butadiene be kept to
the lowest feasible concentration because of its potential to
cause cancer.
Glossary
How likely is 1,3-butadiene to cause cancer?

The Department of Health and Human Services has
determined that 1,3-butadiene may reasonably be anticipated
to be a carcinogen. This is based on animal studies that found
increases in a variety of tumor types from exposure to 1,3butadiene.
Studies on workers are inconclusive because the workers
were exposed to other chemicals in addition to 1,3-butadiene.

References
1992. Toxicological profile for 1,3-butadiene. Atlanta, GA:
Health Service.
2-BUTANONE
CAS # 78-93-3
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 2-butanone. For more
SUMMARY: Exposure to 2-butanone occurs in the workplace or from using

consumer products containing it. Mild irritations of the eyes, nose, and throat
were seen in people who breathed 2-butanone. This chemical has been found in
at least 472 of 1,416 National Priorities List sites identified by the Environmental
Protection Agency.
What is 2-butanone?
(Pronounced 2-byt-nn)
2-Butanone is a manufactured chemical but it is also
present in the environment from natural sources. It is a
colorless liquid with a sharp, sweet odor. It is also known as
methyl ethyl ketone (MEK).
2-Butanone is produced in large quantities. Nearly half
of its use is in paints and other coatings because it will
quickly evaporate into the air and it dissolves many
substances. It is also used in glues and as a cleaning agent.
2-Butanone occurs as a natural product. It is made by
some trees and found in some fruits and vegetables in small
amounts. It is also released to the air from car and truck
exhausts.
What happens to 2-butanone when it enters

the environment?
q 2-Butanone enters the air during production, use and
transport, and from hazardous waste sites.
q In air, one-half of it will break down from sunlight
in 1 day or less.
q It dissolves in water and is broken down more slowly to a
simpler chemical form in about 2 weeks.
q It does not stick to soil and will travel through the soil to
the groundwater.
q Some of the 2-butanone in soil or water will evaporate
into the air.
q It does not deposit in the bottom of rivers or lakes.
q It is not expected to concentrate in fish or increase in the
tissues of animals further up the food chain.
How might I be exposed to 2-butanone?

q Breathing contaminated air from the production or use of
paints, glues, coatings, or cleaning agents containing it.
q Breathing contaminated air near hazardous waste sites.
q Breathing cigarette smoke.
q Sniffing glues.
q Drinking contaminated water from wells near manufacturing or hazardous waste sites.
q Skin contact with the liquid during production or use.
How can 2-butanone affect my health?

The known health effects to people from exposure to
2-butanone are irritation of the nose, throat, skin, and eyes. No
one has died from breathing 2-butanone alone. If 2-butanone is
breathed along with other chemicals that damage health, it can
increase the amount of damage that occurs.

2-BUTANONE
CAS # 78-93-3
Page 2
Serious health effects in animals have been seen only at

very high levels. When breathed, these effects included birth
defects, loss of consciousness, and death.
When swallowed, rats had nervous system effects including drooping eyelids and uncoordinated muscle movements.
There was no damage to the ability to reproduce.
Mice who breathed low levels for a short time showed
temporary behavioral effects. Mild kidney damage was seen in
animals that drank water with lower levels of 2-butanone for a
short time.
There are no long-term studies with animals either
breathing or drinking 2-butanone.
How likely is 2-butanone to cause cancer?

classified 2-butanone as to its human carcinogenicity.
The International Agency for Research on Cancer and the
Environmental Protection Agency (EPA) have also not classified 2-butanone as to its human carcinogenicity.
Two studies of workers exposed to 2-butanone and other
chemicals did not find an increase in cancer. No animal
studies are available that examine the potential for
2-butanone to cause cancer.
doctor can take blood or urine samples and send them to a

testing laboratory.

The EPA requires that discharges or spills into the
environment of 5,000 pounds of more of 2-butanone be
reported.
(OSHA) set an occupational exposure limit of 200 parts of
2-butanone per million parts of workplace air (200 ppm) for
Hygienists (ACGIH) and the National Institute for Occupational Safety and Health (NIOSH) have established the same
guidelines as OSHA for the workplace.
Glossary

been exposed to 2-butanone?
Tests are available to measure 2-butanone or its breakdown products in blood, breath, and urine. These tests are
useful only to measure recent exposures because 2-butanone
and its breakdown products leave the body rapidly. These
tests are not usually performed at your doctor's office, but your
References
1992. Toxicological profile for 2-butanone. Atlanta, GA:
Health Service.
2-BUTOXYETHANOL and
2-BUTOXYETHANOL ACETATE
CAS # 112-07-2 and 111-76-2
August 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 2-butoxyethanol and
2-butoxyethanol acetate. For more information, call the ATSDR Information Center at 1-888-422-8737.
This fact sheet is one in a series of summaries about hazardous substances and their health effects. Its
important you understand this information because this substance may harm you. The effects of exposure
to any hazardous substance depend on the dose, the duration, how you are exposed, personal traits and
HIGHLIGHTS: Exposure to 2-butoxyethanol and 2-butoxyethanol acetate

occurs mainly from breathing air or having skin contact with household products
containing them. Breathing in large amounts of 2-butoxyethanol or
2-butoxyethanol acetate may result in irritation of the nose and eyes, headache,
and vomiting. 2-Butoxyethanol has been found in at least 20 of the 1,430
National Priorities List sites identified by the Environmental Protection Agency.
What are 2-butoxyethanol and 2-butoxyethanol
acetate?
(Pronounced 2-bytks th-nl and
2-bytks th-nl s-tt)
2-Butoxyethanol is a clear colorless liquid that smells
like ether. It has many names including ethylene glycol
monobutyl ether, ethylene glycol butyl ether, ethylene glycol
n-butyl ether, Butyl Cellusolve, butyl glycol, and butyl
Oxitol. It is used as a solvent in spray lacquers, enamels, varnishes, and latex paints and as an ingredient in paint thinners
and strippers, varnish removers, and herbicides. It is also used
in liquid soaps, cosmetics, industrial and household cleaners,
and dry-cleaning compounds.
2-Butoxyethanol acetate is a colorless liquid with a fruity
odor. It is also known as ethylene glycol monobutyl ether
acetate, butoxyethyl acetate, butyl glycol acetate, ethylene
glycol butyl ether acetate, and acetic acid 2-butoxyethyl ester. It is used as a solvent for lacquers, varnishes, enamels, and
epoxy resins. It is also used in some ink and spot remover
compounds.
What happens to 2-butoxyethanol and

2-butoxyethanol acetate when they enter the
environment?
q 2-Butoxyethanol and 2-butoxyethanol acetate may be
released into the air when they are used as solvents and in
household products.
q In air, 2-butoxyethanol and 2-butoxyethanol acetate may

be removed by rain, ice, or snow.
q 2-Butoxyethanol and 2-butoxyethanol acetate may break

down in air into other compounds within a few days.
q Both compounds may pass into air from water and soil.
q 2-Butoxyethanol and 2-butoxyethanol acetate do not
build up in plants and animals.
How might I be exposed to 2-butoxyethanol and

2-butoxyethanol acetate?
q Many people are exposed to small amounts of 2-butoxyethanol and 2-butoxyethanol acetate every day.
q Breathing air or having skin contact with household

cleaners or other liquids that contain these compounds.
q Drinking contaminated water.

Page 2
2-BUTOXYETHANOL and 2-BUTOXYETHANOL

ACETATE CAS # 111-76-2 and 112-07-2

q Working in occupations such as silk-screening, printing,
furniture production and finishing, spray-painting operations, and automobile repair shops that use materials containing 2-butoxyethanol and 2-butoxyethanol acetate.
q Living near a hazardous waste site where 2-butoxyethanol and 2-butoxyethanol acetate are disposed of.
How can 2-butoxyethanol and 2-butoxyethanol

acetate affect my health?
People exposed to high levels of 2-butoxyethanol for
several hours reported irritation of the nose and eyes, headache, a metallic taste in their mouths, and vomiting. No harmful effects were seen on their lungs or hearts. People who swallowed large amounts of cleaning agents containing 2-butoxyethanol have shown breathing problems, low blood pressure,
low levels of hemoglobin (the substance in the blood that
carries oxygen to organs of the body), acidic blood, and blood
in the urine.
It is not known whether 2-butoxyethanol or 2-butoxyethanol acetate can affect reproduction or cause birth defects
in people.
Animal studies have shown hemolysis (destruction of red
blood cells that results in the release of hemoglobin) from
exposure to 2-butoxyethanol and 2-butoxyethanol acetate.
High doses of 2-butoxyethanol can also cause reproductive
problems and minor birth defects in animals.

exposed to 2-butoxyethanol and 2-butoxyethanol
acetate?
Breakdown products of 2-butoxyethanol can be measured
in your blood and urine to see if you have been recently exposed to the chemical. These tests need to be done within a
day after exposure because 2-butoxyethanol and its breakdown products leave your body within 24-48 hours. These
tests cannot tell how much you have been exposed to or
whether health effects will occur. Certain blood tests can tell if
your red blood cells are damaged, but this effect is not specific
to 2-butoxyethanol.

The Occupational Safety and Health Administration has
set an exposure limit of 50 parts of 2-butoxyethanol per million parts of air (50 ppm) for an 8-hour workday, 40-hour
workweek.
Glossary
Herbicides: Substances used to stop plant growth.
Solvents: Chemicals that can dissolve other substances.
How likely are 2-butoxyethanol and 2-butoxyethanol acetate to cause cancer?

The Department of Health and Human Services, the International Agency for Research on Cancer, and Environmental
Protection Agency have not classified 2-butoxyethanol and
2-butoxyethanol acetate as to their human carcinogenicity.
No carcinogenicity studies on 2-butoxyethanol and
2-butoxyethanol acetate are available in people or animals.
(ATSDR). 1998. Toxicological Profile for 2-butoxyethanol
and 2-butoxyethanol acetate. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
CADMIUM
CAS # 7440-43-9
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about cadmium. For more information,
HIGHLIGHTS: Exposure to cadmium happens mostly in the workplace where

cadmium products are made. The general population is exposed from breathing
cigarette smoke or eating cadmium contaminated foods. Cadmium damages the
lungs, can cause kidney disease, and may irritate the digestive tract. This substance
What is cadmium?
q It doesnt break down in the environment, but can change

forms.
(Pronounced kdm-m)
q Fish, plants, and animals take up cadmium from the environment.
Cadmium is a natural element in the earths crust. It is

usually found as a mineral combined with other elements such
as oxygen (cadmium oxide), chlorine (cadmium chloride), or
sulfur (cadmium sulfate, cadmium sulfide).
All soils and rocks, including coal and mineral fertilizers,
contain some cadmium. Most cadmium used in the United
States is extracted during the production of other metals like
zinc, lead, and copper. Cadmium does not corrode easily and
has many uses, including batteries, pigments, metal coatings,
and plastics.
q Cadmium stays in the body a very long time and can

build up from many years of exposure to low levels.
How might I be exposed to cadmium?

q Breathing contaminated workplace air (battery manufacturing, metal soldering or welding).
q Eating foods containing it; low levels in all foods (highest in shellfish, liver, and kidney meats).
q Breathing cadmium in cigarette smoke (doubles the average daily intake).
What happens to cadmium when it enters the

environment?
q Breathing contaminated air near the burning of fossil

fuels or municipal waste.
q Cadmium enters air from mining, industry, and burning

coal and household wastes.
How can cadmium affect my health?
q Cadmium particles in air can travel long distances before

falling to the ground or water.
q It enters water and soil from waste disposal and spills or
leaks at hazardous waste sites.
q It binds strongly to soil particles.
q Some cadmium dissolves in water.
Breathing high levels of cadmium severely damages the

lungs and can cause death. Eating food or drinking water with
very high levels severely irritates the stomach, leading to
vomiting and diarrhea. Long-term exposure to lower levels of
cadmium in air, food, or water leads to a buildup of cadmium
in the kidneys and possible kidney disease.

CADMIUM
CAS # 7740-43-9
Page 2

Other long-term effects are lung damage and fragile
bones. Animals given cadmium in food or water had high
blood pressure, iron-poor blood, liver disease, and nerve or
brain damage.
We dont know if humans get any of these diseases from
eating or drinking cadmium. Skin contact with cadmium is not
known to cause health effects in humans or animals.
How likely is cadmium to cause cancer?

The Department of Health and Human Services (DHHS) has
determined that cadmium and cadmium compounds may reasonably be anticipated to be carcinogens.
How can cadmium affect children?

The health effects in children are expected to be similar to
those in adults (kidney, lung and intestinal damage).
We don't know if cadmium causes birth defects in people.
Cadmium does not readily go from a pregnant woman's body
into the developing child, but some portion can cross the placenta. It can also be found in breast milk. The babies of animals exposed to high levels of cadmium during pregnancy had
changes in behavior and learning ability. Cadmium may also
affect birth weight and the skeleton in developing animals.
Animal studies also indicate that more cadmium is absorbed into the body if the diet is low in calcium, protein, or
iron, or is high in fat. A few studies show that younger animals
absorb more cadmium and are more likely to lose bone and
bone strength than adults.

cadmium?
In the home, store substances that contain cadmium safely,
and keep nickel-cadmium batteries out of reach of young
children. If you work with cadmium, use all safety precautions

to avoid carrying cadmium-containing dust home from work
on your clothing, skin, hair, or tools.
A balanced diet can reduce the amount of cadmium taken
into the body from food and drink.

exposed to cadmium?
Tests are available in some medical laboratories that measure cadmium in blood, urine, hair, or nails. Blood levels
show recent exposure to cadmium, and urine levels show both
recent and earlier exposure. The reliability of tests for cadmium levels in hair or nails is unknown.

The EPA has set a limit of 5 parts of cadmium per billion
parts of drinking water (5 ppb). EPA doesn't allow cadmium in
pesticides.
The Food and Drug Administration (FDA) limits the
amount of cadmium in food colors to 15 parts per million
(15 ppm).
(OSHA) limits workplace air to 100 micrograms cadmium per
cubic meter (100 g/m3) as cadmium fumes and 200 g cadmium/m3 as cadmium dust.
(ATSDR). 1999. Toxicological profile for cadmium. Atlanta,
Health Service.
CALCIUM HYPOCHLORITE
CAS #7778-54-3
SODIUM HYPOCHLORITE
CAS #7681-52-9
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about sodium and calcium
hypochlorite. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
is one in a series of summaries about hazardous substances and their health effects. It is important you
understand this information because this substance may harm you. The effects of exposure to any hazardous
HIGHLIGHTS: The general public can be exposed to small amounts of sodium

and calcium hypochlorite by using household products that contain these
chemicals. Workers in occupations that use these chemicals have the highest
risk of being exposed. Sodium and calcium hypochlorite can cause irritation of
the eyes, skin, respiratory and gastrointestinal tract. Exposure to high levels
can result in severe corrosive damage to the eyes, skin, respiratory and
gastrointestinal tissues and can be fatal. Sodium and calcium hypochlorite have
been found 6 times each in the 1,585 National Priorities List sites identified by
What are sodium and calcium hypochlorite?
Sodium hypochlorite is generally used dissolved in water at
various concentrations. Although available, solid sodium
hypochlorite is not commercially used. Sodium hypochlorite
solutions are clear, greenish to yellow liquids with an odor
of chlorine. Calcium hypochlorite is a white solid that
readily decomposes in water releasing oxygen and chlorine.
It also has a strong chlorine odor. Neither compound occur
naturally in the environment.
Sodium and calcium hypochlorite are used primarily as
bleaching agents or disinfectants. They are components of
commercial bleaches, cleaning solutions, and disinfectants
for drinking water and waste water purification systems and
swimming pools.
What happens to sodium and calcium

hypochlorite when they enter the environment?
When released to air, sodium and calcium hypochlorite are
broken down by sunlight and compounds commonly found
in the air.
In water and soil, sodium and calcium hypochlorite
separate into sodium, calcium and hypochlorite ions (an ion
is an electrically charged atom or molecule). These ions may

react with other substances found in the water.
Sodium and calcium hypochlorite do not accumulate in the
food chain.
How might I be exposed to sodium and calcium

hypochlorite?
You can be exposed to low levels of sodium and calcium
hypochlorite if you use disinfectants like household bleach.
You can also be exposed by swimming in pools where
these chemicals were added to kill bacteria.
Drinking water from public drinking water supplies where
these chemicals were added to kill bacteria.
Workers employed in occupations where these
compounds are used to bleach paper and textiles may be
subject to slightly higher levels of exposure.
How can sodium and calcium hypochlorite affect

my health?
The toxic effects of sodium and calcium hypochlorite are due
primarily to the corrosive properties of hypochlorite. If you
ingest a small amount of household bleaches (3-6%

Page 2
SODIUM HYPOCHLORITE
CALCIUM HYPOCHLORITE
CAS #7681-52-9
CAS #7778-54-3

hypochlorite) you may experience gastrointestinal irritation.
If you ingest a more concentrated commercial bleach (10% or
higher hypochlorite) or hypochlorite powder you may suffer
severe corrosive injuries to the mouth, throat, esophagus and
stomach with bleeding, perforation, and eventually death.
Permanent scars and narrowing of the esophagus may occur
in survivors of severe intoxication.
If you inhale chlorine gas released from concentrated
hypochlorite solutions you may experience nasal irritation,
sore throat, and coughing. Contact of strong hypochlorite
solutions with your skin may cause burning pain,
inflammation, and blisters. Contact of the eye with mild
bleach solutions may cause mild and transitory irritation.
More concentrated solutions may cause severe eye injuries.
Long-term exposure to low levels of hypochlorite can cause
dermal irritation.
We do not know if exposure to chlorine can result in
reproductive effects.
How likely are sodium and calcium hypochlorite

to cause cancer?
We do not know if exposure to sodium and calcium

hypochlorite can result in birth defects or other
developmental effects.

sodium and calcium hypochlorite?
Most families will not be exposed to high levels of sodium
or calcium hypochlorite.
Household products containing sodium or calcium
hypochlorite should be stored in safe locations, out of the
reach of children.

exposed to sodium and calcium hypochlorite?
Specific tests for the presence of sodium, calcium or chlorine
in the blood or urine are not generally useful. If a severe
exposure has occurred, blood and urine analyses and other
tests may show whether damage has occurred to the lungs
and gastrointestinal tract. Some of these tests can be
performed in a doctors office. Some testing may require
hospital facilities.

determined that hypochlorite salts are not classifiable as to
their carcinogenicity to humans.

How can sodium and calcium hypochlorite affect

children?
The Food and Drug Administration (FDA) has set a limit for
chlorine, as sodium hypochlorite or calcium hypochlorite, not
to exceed 0.0082 or 0.0.036 pounds, respectively, of chlorine
per pound of dry food starch.
Children are probably affected by exposure to sodium and

calcium hypochlorite in the same ways as adults. We do not
susceptibility to sodium and calcium hypochlorite. In general,
children may be more vulnerable to corrosive agents than
adults because of the smaller diameter of their airways.
CARBON DISULFIDE
CAS # 75-15-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about carbon disulfide. For more
HIGHLIGHTS: Exposure to carbon disulfide can occur by breathing it in the air

and by drinking water or eating foods that contain it. Breathing very high levels
can be life threatening because of its effects on the nervous system. Breathing low
levels for long periods may result in headaches, tiredness, trouble sleeping, and slight
changes in the nerves. Carbon disulfide has been found in at least 210 of the 1,430
National Priorities List sites identified by the Environmental Protection Agency (EPA).
What is carbon disulfide?

(Pronounced krbn d-slfd)
Pure carbon disulfide is a colorless liquid with a pleasant
odor that is like the smell of chloroform. The impure carbon
disulfide that is usually used in most industrial processes is a
yellowish liquid with an unpleasant odor, like that of rotting
radishes.
Carbon disulfide evaporates at room temperature, and the
vapor is more than twice as heavy as air. It easily explodes in
air and also catches fire very easily.
In nature, small amounts of carbon disulfide are found in
gases released to the earths surface as, for example, in volcanic eruptions or over marshes. Commercial carbon disulfide is
made by combining carbon and sulfur at very high temperatures.
q Carbon disulfide evaporates rapidly when released to the

environment.
q Most carbon disulfide in the air and surface water is from
manufacturing and processing activities.
q It is found naturally in coastal and ocean waters.
q Carbon disulfide does not stay dissolved in water very
long, and it also moves through soils fairly quickly.
q Carbon disulfide does not appear to be taken up in significant amounts by the organisms living in water.
How might I be exposed to carbon disulfide?

q The people most often exposed to carbon disulfide are
workers in plants that use carbon disulfide in their manufacturing processes.
q People may be exposed by breathing air, drinking water,
or eating foods that contain it.
q People may also be exposed through skin contact with
soil, water, or other substances that contain carbon disulfide.
What happens to carbon disulfide when it enters

the environment?
How can carbon disulfide affect my health?
q The amount of carbon disulfide released into the air

through natural processes is difficult to judge because it
is so small.
At very high levels, carbon disulfide may be life-threatening because of its effects on the nervous system. People who

CARBON DISULFIDE
CAS # 75-15-0
Page 2

breathed carbon disulfide near an accident involving a railroad
car showed changes in breathing and some chest pains.
Some workers who breathed high levels during working
hours for at least 6 months had headaches, tiredness, and
trouble sleeping. However, these workers may have been exposed to other chemicals besides carbon disulfide. Among
workers who breathed lower levels, some developed very
slight changes in their nerves.
Studies in animals indicate that carbon disulfide can affect the normal functions of the brain, liver, and heart. After
pregnant rats breathed carbon disulfide in the air, some of the
newborn rats died or had birth defects.
High concentrations of carbon disulfide have caused skin
burns when the chemical accidentally touched people's skin.
How likely is carbon disulfide to cause cancer?

The Department of Health and Human Services (DHHS),
the International Agency for Research on Cancer (IARC), and
the EPA have not classified carbon disulfide for carcinogenicity.
There are no definitive data in humans or animals that
indicate a carcinogenic potential for carbon disulfide.
These tests arent available at most doctors offices, but

can be done at special laboratories that have the right
equipment.

The EPA requires that spills or accidental releases into the
environment of 100 pounds or more of carbon disulfide be
reported to the EPA.
(OSHA) has set a limit of 20 parts of carbon disulfide per million parts of air (20 ppm) for an 8-hour workday for a 40-hour
workweek.
Health (NIOSH) recommends that workroom air levels of carbon disulfide not exceed 1 ppm for a 10-hour workday, 40hour workweek.
Glossary
Carcinogenicity: Ability of a substance to cause cancer.
Dissolve: To disappear gradually.
Evaporate: To change into vapor or a gas.

exposed to carbon disulfide?
One chemical test using urine can be done to tell whether

the levels of breakdown substances from carbon disulfide are
higher than normal. However, the test is not specific for carbon
disulfide exposure.
This ToxFAQs information is taken from the 1996 Toxicological Profile for Carbon Disulfide produced by the Agency
A second test based on a specific breakdown substance is

more sensitive and specific. It also requires special equipment
and cannot tell you exactly how much carbon disulfide you
were exposed to or predict whether harmful effects will occur.

Disease Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone:1888-422-8737, FAX: 404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html
ATSDR can tell you where to find occupational and environmental health clinics. Their specialists can recognize,
evaluate, and treat illnesses resulting from exposure to hazardous substances. You can also contact your community
or state health or environmental quality department if you have any more questions or concerns.
CARBON TETRACHLORIDE
CAS # 56-23-5
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about carbon tetrachloride.
a series of summaries about hazardous substances and their health effects. This information is important
present.
SUMMARY: Exposure to carbon tetrachloride results mostly from breathing air,

drinking water, or coming in contact with soil that is contaminated with it. This is most
likely to occur around hazardous waste sites or in the workplace. In people, exposure
to very high amounts of carbon tetrachloride can damage the liver, kidneys, and nervous
system. This chemical has been found in at least 326 of 1,416 National Priorities List
sites identified by the Environmental Protection Agency.
What is carbon tetrachloride?
(Pronounced krbn ttr klrd)
Carbon tetrachloride is a manufactured compound that
does not occur naturally. It's a clear liquid with a sweet smell
that can be detected at low levels. It's also called carbon
chloride, methane tetrachloride, perchloromethane, tetrachloroethane, or benziform. Trade names include Benzinoform,
Freon 10, Halon 104, Tetraform, or Tetrasol.
Carbon tetrachloride is most often found as a colorless
gas. It's not flammable and doesn't dissolve in water very
easily. It was used in the production of refrigeration fluid
and propellants for aerosol cans, as a pesticide, as a cleaning
fluid and degreasing agent, in fire extinguishers, and in spot
removers. Because of its harmful effects, these uses are now
banned and it is only used in some industrial applications.
q It can be broken down or transformed in soil and water

within several days.
q When it does break down, it forms chemicals that can
destroy ozone in the upper atmosphere.
q It doesn't build up in animals. We do not know if it builds
up in plants.
How might I be exposed to carbon tetrachloride?

q Breathing contaminated air near manufacturing plants or
waste sites.
q Breathing workplace air when it is used.
q Drinking contaminated water near manufacturing plants
and waste sites.
q Breathing contaminated air and skin contact with water
while showering or cooking with contaminated water.
q Swimming or bathing in contaminated water.
q Contact with or eating contaminated soil at waste sites.
What happens to carbon tetrachloride when

q It moves very quickly into the air upon release, so most
of it is in the air.
q It evaporates very quickly from soil and surface water.
q Only a small amount sticks to soil particles; the rest
evaporates or moves into the groundwater.
q It is very stable in air (lifetime of 30-100 years).
How can carbon tetrachloride affect my

health?
High exposure to carbon tetrachloride can cause liver,
kidney, and central nervous system damage. These effects
result from either eating, drinking, or breathing it, and
possibly from exposure to the skin. The liver is especially
sensitive to carbon tetrachloride because it swells and cells

CARBON TETRACHLORIDE
CAS # 56-23-5
Page 2

are damaged or destroyed. Kidneys are also damaged, causing
a buildup of wastes in the blood. If exposure is low and then
stops, the liver and kidneys can repair the damaged cells and
function normally again.

The Environmental Protection Agency (EPA) has set a

limit of 0.005 parts of carbon tetrachloride per million parts
If exposure is very high, the nervous system, including the of drinking water (0.005 ppm). The EPA recommends that
brain, is affected. People may feel intoxicated and experience drinking water exposures should not exceed 0.3 ppm for
headaches, dizziness, sleepiness, and nausea and vomiting.
adults and 0.07 ppm for children for long periods of time (7
These effects may subside if exposure is stopped, but in severe years).
cases, coma and even death can occur.
The EPA has also set limits on how much carbon tetraThere have been no studies in people on carbon
chloride can be released from an industrial plant into wastetetrachloride's effects on reproduction or development, but
water and is preparing to set limits on how much can be
studies in rats showed no adverse effects.
released into outside air.
How likely is carbon tetrachloride to cause

cancer?

(OSHA) set a maximum concentration limit in workplace air
of 10 ppm for an 8-hour workday over a 40-hour workweek.

determined that carbon tetrachloride may reasonably be
anticipated to be a carcinogen.
Glossary
Animals that ingested carbon tetrachloride over a long

time developed liver cancer. We do not know if breathing
carbon tetrachloride causes cancer in animals. We also do not
know if breathing or ingesting it will cause cancer in people.

been exposed to carbon tetrachloride?
References
Several sensitive and specific tests are available to

measure the amount of carbon tetrachloride in your breath,
blood, urine, and body tissues. The tests can't tell you how
much carbon tetrachloride you were exposed to or whether
there will be any effects on your health. The tests must be
done soon after exposure because it leaves your body quickly.
These tests aren't routinely performed in doctors' offices, but
your doctor can tell you where to obtain such a test.


1994. Toxicological profile for carbon tetrachloride. Atlanta,
Health Service.
1992. Case studies in environmental medicine. Carbon
tetrachloride toxicity. Atlanta, GA: U.S. Department of Health
CESIUM
CAS #7440-46-2
July 2001
This fact sheet answers the most frequently asked health questions (FAQs) about cesium. For more
HIGHLIGHTS: Exposure to stable or radioactive cesium occurs from ingesting

contaminated food or drinking water or breathing contaminated air. High levels
of radioactive cesium can cause nausea, vomiting, diarrhea, bleeding, coma,
and even death. This may occur after nuclear accidents or detonation of
atomic bombs. Stable (non-radioactive) cesium has been found in at least 10 of
the 1,585 National Priority List (NPL) sites identified by the Environmental
Protection Agency (EPA). Radioactive cesium has been found in at least 22 of
the 1,585 NPL sites identified by the EPA.
What is cesium?
Cesium is a naturally occurring element found combined with
other elements in rocks, soil, and dust in low amounts.
Naturally occurring cesium is not radioactive and is referred
to as stable cesium. There is only one stable form of cesium
naturally present in the environment, 133Cs (read as cesium
one-thirty-three).
Nuclear explosions or the breakdown of uranium in fuel
elements can produce two radioactive forms of cesium, 134Cs
and 137Cs. Both isotopes decay into non-radioactive
elements. 134 Cs and 137Cs generate beta particles as they
decay. It takes about 2 years for half of 134Cs to give off its
radiation and about 30 years for 137Cs; this period of time is
called the half-life.
What happens to cesium when it enters the

environment?
Stable cesium in air can travel long distances before
settling to the ground or water.
Most cesium compounds dissolve in water.
In most soils, most cesium compounds are very soluble.
Cesium binds strongly to most soils and does not travel
far below the surface of the soil.
Radioactive decay is the only way of decreasing the
amount of 134Cs and 137Cs in the environment.
How might I be exposed to cesium?

You can be exposed to low levels of stable or radioactive
cesium by breathing air, drinking water, or eating food
containing cesium.
Food and drinking water are the largest sources of
exposure to cesium.
You can be exposed to radioactive cesium if you eat food
that was grown in contaminated soil.
Working in industries that process or use natural cesium
or cesium compounds.
Living near uncontrolled radioactive waste sites
containing cesium.
How can cesium affect my health?

It is highly unlikely that you would be exposed to high
enough amounts of stable cesium to cause harmful health
effects. Laboratory animals given very large amounts of
cesium compounds showed changes in behavior, such as
increased or decreased activity.
Exposure to large amounts of radioactive cesium can damage
cells in your body from the radiation You might also
experience acute radiation syndrome which includes nausea,
vomiting, diarrhea, bleeding, coma, and even death in the
case of very high exposures.

CESIUM
Page 2
CAS #7440-46-2
How likely is cesium to cause cancer?

There are no studies regarding non radioactive cesium and
cancer. There are no human studies that specifically
associate exposure to radioactive cesium with increased
cancer risk.
Because radioactive cesium emits ionizing radiation,
carcinogenic effects similar to those observed in Japanese
survivors of the atomic bombing incidents might be expected
among individuals acutely exposed to very high levels of
radiation from a radioactive cesium source.
Rats exposed to high doses of radiation from 137Cs had
increased risk of mammary tumors. Older rats seemed more
resistant than younger ones.
How can cesium affect children?

Children can be affected by cesium in the same ways as
adults. Infants born to atomic bomb survivors exposed to
high doses of ionizing radiation while pregnant, showed later
signs of decreased mental abilities.
Exposure to the radiation from radioactive cesium has caused
birth defects in animals.

cesium?
Since cesium is naturally found in the environment, we
cannot avoid being exposed to it. However, these relatively
low amounts do not warrant immediate steps to reduce
exposure. In the unlikely case that you are exposed to high
levels of radioactive cesium because of accidental release at
a nuclear plant or a nuclear weapon has been detonated,
follow the advice of public health officials who will publish
appropriate guidelines for reducing exposure.

exposed to cesium?
Everyone has small amounts of cesium in their bodies. There
are special laboratory tests to measure cesium in blood,
urine, feces, and tissues. These tests are most useful for
people exposed to high levels, but will not predict whether
harmful effects will occur.
If a person has been exposed to radioactive cesium, special
tests can be used to measure levels of radiation in blood,
feces, or urine. However, it is difficult to determine if a
person has been exposed only to external radiation from
radioactive cesium.

The EPA has established a maximum contaminant level of 4
millirem per year for beta particles and photon radioactivity
for man-made radionuclides (including radioactive cesium
(NIOSH) recommends a limit of 2 milligrams of cesium
hydroxide per cubic meter of air (2 mg/m3) as an average for
a 10-hour workday, 40-hour workweek.
The Nuclear Regulatory Commission (NRC) has set
occupational air limits of 0.04 Ci/m3 for 134Cs and 0.06 Ci/
m3 for 137Cs. NRC also set a limit intake of 0.1 mCi for 134Cs
and 0.2 mCi for 137Cs for on-the-job exposure.
(ATSDR). 2001. Toxicological Profile for Cesium (Draft for
CHLORDANE
CAS # 57-74-9
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about chlordane. For more
SUMMARY: Exposure to chlordane occurs mostly from eating contaminated foods,

such as root crops, meats, fish, and shellfish, or from touching contaminated soil.
High levels of chlordane can cause damage to the nervous system or liver. This chemical
has been found in at least 171 of 1,416 National Priorities List sites identified by the
What is chlordane?
(Pronounced klrdn)
Chlordane is a manufactured chemical that was used as a
pesticide in the United States from 1948 to 1988. Technical
chlordane is not a single chemical, but is actually a mixture of
pure chlordane mixed with many related chemicals. It doesn't
occur naturally in the environment. It is a thick liquid whose
color ranges from colorless to amber. Chlordane has a mild,
irritating smell.
Some of its trade names are Octachlor and Velsicol 1068.
Until 1983, chlordane was used as a pesticide on crops like
corn and citrus and on home lawns and gardens.
Because of concern about damage to the environment and
harm to human health, the Environmental Protection Agency
(EPA) banned all uses of chlordane in 1983 except to control
termites. In 1988, EPA banned all uses.
What happens to chlordane when it enters

the environment?
q Chlordane entered the environment when it was used as a
pesticide on crops, on lawns and gardens, and to control
termites.
q Chlordane sticks strongly to soil particles at the surface
and is not likely to enter groundwater.
q It can stay in the soil for over 20 years.

q Most chlordane leaves soil by evaporation to the air.
q It breaks down very slowly.
q Chlordane doesnt dissolve easily in water.
q It builds up in the tissues of fish, birds, and mammals.
How might I be exposed to chlordane?

q By eating crops grown in soil that contains chlordane.
q By eating fish or shellfish caught in water that is contaminated by chlordane.
q By breathing air or touching soil near homes treated for
termites with chlordane.
q By breathing air or by touching soil near waste sites or
landfills.
How can chlordane affect my health?

Chlordane affects the nervous system, the digestive
system, and the liver in people and animals. Headaches,
irritability, confusion, weakness, vision problems, vomiting,
stomach cramps, diarrhea, and jaundice have occurred in
people who breathed air containing high concentrations of
chlordane or accidentally swallowed small amounts of
chlordane. Large amounts of chlordane taken by mouth can
cause convulsions and death in people.

CHLORDANE
CAS # 57-74-9
Page 2

A man who had long-term skin contact with soil containing high levels of chlordane had convulsions. Japanese workers who used chlordane over a long period of time had minor
changes in liver function.
Animals given high levels of chlordane by mouth for
short periods died or had convulsions. Long-term exposure
caused harmful effects in the liver of test animals.
than 60 parts of chlordane per billion parts of drinking water

(60 ppb) for longer than 1 day. EPA has set a limit in drinking water of 2 ppb.
EPA requires spills or releases of chlordane into the environment of 1 pound or more to be reported to EPA.
The Food and Drug Administration (FDA) limits the

amount of chlordane and its breakdown products in most
We do not know whether chlordane affects the ability of
fruits and vegetables to less than 300 ppb and in animal fat
people to have children or whether it causes birth defects. Ani- and fish to less than 100 ppb.
mals exposed before birth or while nursing developed behavThe Occupational Safety and Health Administration
ioral effects later.
(OSHA), the National Institute for Occupational Health and
Safety (NIOSH), and the American Conference of Governmental Industrial Hygienists (ACGIH) set a maximum level of 0.5
How likely is chlordane to cause cancer?
milligrams of chlordane per cubic meter (mg/m3) in workThe International Agency for Research on Cancer has
place air for an 8-hour workday, 40-hour workweek. These
determined that chlordane is not classifiable as to its carcinoagencies have advised that eye and skin contact should be
genicity to humans. Studies of workers who made or used
avoided because this may be a significant route of exposure.
chlordane do not show that exposure to chlordane is related to
cancer, but the information is not sufficient to know for sure.
Mice fed low levels of chlordane in food developed liver canGlossary
cer.

been exposed to chlordane?

Laboratory tests can measure chlordane and its breakdown Pesticide: A substance that kills pests.
products in blood, fat, urine, feces, and breast milk. The
amount of breakdown products measured in body fat or breast
milk does not tell how much or how long ago you were exposed to chlordane or if harmful effects will occur.
References

In 1988, the EPA banned all uses of chlordane. The EPA
recommends that a child should not drink water with more

1994. Toxicological profile for chlordane (update). Atlanta,
Health Service.
from exposure to hazardous substances. You can also contact your community or state health or environmental quality department if you have any more questions or concerns.
CHLORFENVINPHOS
CAS # 470-90-6
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about chlorfenfinphos. For more
HIGHLIGHTS: Chlorfenvinphos is an insecticide which is no longer used in the

United States. Ingesting chlorfenvinphos results primarily on nervous system
effects, such as headaches, blurred vision, weakness, and confusion.
Chlorfenvinphos been found in at least 1 of the 1,430 National Priorities List sites
What is chlorfenvinphos?
(Pronounced klr fn vn-fs)
Chlorfenvinphos is an insecticide that is a colorless liquid
with a mild odor. It was commonly used until 1991 when all
products containing chlorfenvinphos as an active ingredient
were canceled in the United States. Commercial preparations
commonly sold in stores were usually 90% chlorfenvinphos.
Most of the chlorfenvinphos used was in liquid form.
q It may leach into soil and underground water.

q It may also be found in surface waters from rain.
q Chlorfenvinphos may move from soil to the air by evaporation.
q It does not appear to accumulate in plants, fish, or freshwater animals.
How might I be exposed to chlorfenvinphos?
Chlorfenvinphos was widely used to control household

pests such as flies, fleas, and mice. The chemical is manufactured and does not occur naturally in the environment. It was
sold under common trade names including Birlane,
Dermaton, Sapercon, Steladone, and Supona.
q The most common way to be exposed is by eating imported agricultural products contaminated with it.
Use of trade names is for identification only and does not

imply endorsement by the Agency for Toxic Substances and
Disease Registry, the Public Health Service, or the U.S. Department of Health and Human Services.
q If you breathe air or touch soil near a hazardous waste site

containing chlorfenvinphos, you could be exposed to it.
q Another way to be exposed is by using pharmaceutical

products that contain lanolin, a natural grease from sheeps
wool (chlorfenvinphos is often used to control flies in animal buildings and can contaminate sheeps wool).
q If you work in the disposal of chlorfenvinphos or its wastes

you are most likely to be exposed.
What happens to chlorfenvinphos when it enters

the environment?
How can chlorfenvinphos affect my health?
q Chlorfenvinphos enters the environment from runoff after

rainfall and leaching from hazardous waste sites.
The major effect of chlorfenvinphos is on the nervous

system. Ingesting large doses may cause nausea and vomit-

CHLORFENVINPHOS
CAS # 470-90-6
Page 2

ing, abdominal cramps, diarrhea, difficulty in breathing, and
fainting.
Lower doses may cause headaches, dizziness, weakness,
confusion, runny nose, and inability to see clearly. These symptoms may start within 30-60 minutes and reach their maximum
effect after 6-8 hours.
There is no evidence that long-term exposure to small
amounts of chlorfenvinphos causes any harmful health effects
in people.
It is not known whether chlorfenvinphos can affect reproduction or cause birth defects in people. One animal study reported decreased fertility in rats given chlorfenvinphos in their
food, and another study reported that chlorfenvinphos interfered with the development of rats when the pregnant animals
were fed chlorfenvinphos.
Specific tests are available to identify chlorfenvinphos or

its breakdown products in your blood, body tissue, and urine.
These tests arent available at most doctors offices, but can be
done at special laboratories that have the right equipment.

environment of 500 pounds or more of chlorfenvinphos be
The Food and Drug Administration (FDA) has set tolerances for chlorfenvinphos for agricultural products ranging
from 0.005 to 0.2 parts chlorfenvinphos per million parts of
food (0.005-0.2 ppm).
Glossary
How likely is chlorfenvinphos to cause cancer?
It is not known whether chlorfenvinphos causes cancer in

people.
Fertility: Ability to have children.
The Department of Health and Human Services

(DHHS), the International Agency for Research on Cancer
(IARC), and the EPA have not classified chlorfenvinphos
for carcinogenicity.
Insecticide: A substance that kills insects.
Ingest: To eat or drink something.

Long-term: 365 days or longer.
exposed to chlorfenvinphos?
There is a general test that can be used to determine if
you have been exposed to a group of insecticides, including
chlorfenvinphos. This test measures the activity of an enzyme
called acetylcholinesterase in the blood. This test requires
only a small amount of blood and can be done in your
doctors office. It does not specifically show exposure to
chlorfenvinphos.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Chlorfenvinphos produced by the Agency for
Toxic Substances and Disease Registry, Public Health Service,
Service in Atlanta, GA.
CHLORINATED DIBENZO-p-DIOXINS
(CDDs)
February 1999
This fact sheet answers the most frequently asked health questions (FAQs) about chlorinated dibenzo-p-dioxins
(CDDs). For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is
one in a series of summaries about hazardous substances and their health effects. Its important you understand
this information because this substance may harm you. The effects of exposure to any hazardous substance
depend on the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals
are present.
HIGHLIGHTS: Exposure to chlorinated dibenzo-p-dioxins (CDDs) (75 chemicals)

occurs mainly from eating food that contains the chemicals. One chemical in this
group, 2,3,7,8-tetrachlorodibenzo-p-dioxin or 2,3,7,8-TCDD, has been shown to
be very toxic in animal studies. It causes effects on the skin and may cause cancer
in people. This chemical has been found in at least 91 of 1,467 National Priorities
What are CDDs?
CDDs are a family of 75 chemically related compounds
commonly known as chlorinated dioxins. One of these compounds is called 2,3,7,8-TCDD. It is one of the most toxic of
the CDDs and is the one most studied.
In the pure form, CDDs are crystals or colorless solids.
CDDs enter the environment as mixtures containing a number
of individual components. 2,3,7,8-TCDD is odorless and the
odors of the other CDDs are not known.
CDDs are not intentionally manufactured by industry except for research purposes. They (mainly 2,3,7,8-TCDD) may
be formed during the chlorine bleaching process at pulp and
paper mills. CDDs are also formed during chlorination by
waste and drinking water treatment plants. They can occur as
contaminants in the manufacture of certain organic chemicals.
CDDs are released into the air in emissions from municipal
solid waste and industrial incinerators.
q When released in waste waters, some CDDs are broken

down by sunlight, some evaporate to air, but most attach to soil and settle to the bottom sediment in water.
q CDD concentrations may build up in the food chain, resulting in measurable levels in animals.
How might I be exposed to CDDs?

q Eating food, primarily meat, dairy products, and fish,
makes up more than 90% of the intake of CDDs for the
general population.
q Breathing low levels in air and drinking low levels in
water.
q Skin contact with certain pesticides and herbicides.
q Living near an uncontrolled hazardous waste site containing CDDs or incinerators releasing CDDs.
q Working in industries involved in producing certain pesticides containing CDDs as impurities, working at paper
and pulp mills, or operating incinerators.
How can CDDs affect my health?

What happens to CDDs when they enter the
environment?
q When released into the air, some CDDs may be transported long distances, even around the globe.
The most noted health effect in people exposed to large

amounts of 2,3,7,8-TCDD is chloracne. Chloracne is a severe
skin disease with acne-like lesions that occur mainly on the
face and upper body. Other skin effects noted in people exposed to high doses of 2,3,7,8-TCDD include skin rashes, dis-

Page 2
CHLORINATED DIBENZO-p-DIOXINS (CDDs)

coloration, and excessive body hair. Changes in blood and
urine that may indicate liver damage also are seen in people.
Exposure to high concentrations of CDDs may induce longterm alterations in glucose metabolism and subtle changes in
hormonal levels.
In certain animal species, 2,3,7,8-TCDD is especially
harmful and can cause death after a single exposure. Exposure
to lower levels can cause a variety of effects in animals, such
as weight loss, liver damage, and disruption of the endocrine
system. In many species of animals, 2,3,7,8-TCDD weakens the
immune system and causes a decrease in the systems ability to
fight bacteria and viruses. In other animal studies, exposure to
2,3,7,8-TCDD has caused reproductive damage and birth defects. Some animal species exposed to CDDs during pregnancy
had miscarriages and the offspring of animals exposed to
2,3,7,8-TCDD during pregnancy often had severe birth defects
including skeletal deformities, kidney defects, and weakened
immune responses.
How likely are CDDs to cause cancer?

Several studies suggest that exposure to 2,3,7,8-TCDD
increases the risk of several types of cancer in people. Animal
studies have also shown an increased risk of cancer from exposure to 2,3,7,8-TCDD.
The World Health Organization (WHO) has determined
that 2,3,7,8-TCDD is a human carcinogen.
has determined that 2,3,7,8-TCDD may reasonably be anticipated to cause cancer.
How can CDDs affect children?

Very few studies have looked at the effects of CDDs on
children. Chloracne has been seen in children exposed to high
levels of CDDs. We don't know if CDDs affect the ability of
people to have children or if it causes birth defects, but given
the effects observed in animal studies, this cannot be ruled out.

CDDs?
q Children should avoid playing in soils near uncontrolled
q Discourage children from eating dirt or putting toys or
other objects in their mouths.
q Everyone should wash hands frequently if playing or
working near uncontrolled hazardous waste sites.
q For new mothers and young children, restrict eating foods
from the proximity of uncontrolled sites with known
CDDs.

exposed to CDDs?
Tests are available to measure CDD levels in body fat,
blood, and breast milk, but these tests are not routinely available. Most people have low levels of CDDs in their body fat
and blood, and levels considerably above these levels indicate
past exposure to above-normal levels of 2,3,7,8-TCDD. Although CDDs stay in body fat for a long time, tests cannot be
used to determine when exposure occurred.

The EPA has set a limit of 0.00003 micrograms of
2,3,7,8-TCDD per liter of drinking water (0.00003 g/L).
Discharges, spills, or accidental releases of 1 pound or
more of 2,3,7,8-TCDD must be reported to EPA. The Food
and Drug Administration (FDA) recommends against eating
fish and shellfish with levels of 2,3,7,8-TCDD greater than
50 parts per trillion (50 ppt).
(ATSDR). 1998. Toxicological profile for chlorinated dibenzop-dioxins. Atlanta, GA: U.S. Department of Health and Human
CHLORINE
CAS #7782-50-5
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about chlorine. For more information,
hazardous substances and their health effects. It is important you understand this information because this
HIGHLIGHTS: People working in facilities that use chlorine to manufacture

other chemicals have the highest risk of being exposed to chlorine. Chlorine
gas can cause irritation of the eyes, skin, and respiratory tract. Exposure to
high levels can result in corrosive damage to the eyes, skin, and respiratory
tissues, and could lead to pulmonary edema and even death in extreme cases.
Chlorine gas has been found in at least 60 of the 1,591 National Priorities List
What is chlorine?
How might I be exposed to chlorine?
At room temperature, chlorine is a yellow-green gas that is

heavier than air and has a strong irritating odor. It can be
converted to a liquid under pressure or cold temperatures.
The general population is probably not exposed to

chlorine gas, but may be exposed to products which are
made from chlorine like sodium hypochlorite which is used
as a disinfectant in public drinking water and swimming
pools and as a common household bleach.
Chlorine gas is used to synthesize other chemicals and to
make bleaches and disinfectants. Therefore workers
employed in occupations where these products are made
may inhale chlorine gas or get it on their skin.
Chlorine is mainly used as a bleach in the manufacture of

paper and cloth and to make a wide variety of products.
What happens to chlorine when it enters the

environment?
When released to air, chlorine will react with water to form
hypochlorous acid and hydrochloric acid, which are removed
from the atmosphere by rainfall.
Chlorine is slightly soluble in water. It reacts with water
to form hypochlorous acid and hydrochloric acid. The
hypochlorous acid breaks down rapidly. The hydrochloric
acid also breaks down; its breakdown products will lower
the pH of the water (makes it more acidic).
Since chlorine is a gas it is rarely found in soil. If
released to soil, chlorine will react with moisture forming
hypochlorous acid and hydrochloric acid. These compounds
can react with other substances found in soil.
Chlorine does not accumulate in the food chain.
How can chlorine affect my health?

Chlorine gas is irritating and corrosive to the respiratory
tract, eyes, and skin. The effects depend on how much you
are exposed to and for how long. Exposure to low
concentrations of chlorine gas (1 to 10 ppm) may cause sore
throat, coughing, and eye and skin irritation. Exposure to
higher levels could cause burning of the eyes and skin, rapid
breathing, narrowing of the bronchi, wheezing, blue coloring
of the skin, accumulation of fluid in the lungs, and pain in
the lung region. Exposure to even higher levels can produce
severe eye and skin burns, lung collapse, and death.

CHLORINE
Page 2
CAS #7782-50-5

Some people may develop an inflammatory reaction to
chlorine. This condition is called reactive airways
dysfunction syndrome (RADS), a type of asthma caused by
some irritating or corrosive substances.
If you were to come into skin contact with liquified chlorine,
you could experience frostbite.
If you swallow a product that contains sodium hypochlorite,
corrosive chlorine gas could be produced in your stomach
and cause serious corrosive injury.
We do not know if exposure to chlorine can result in
reproductive effects.
How likely is chlorine to cause cancer?

EPA have not classified chlorine as to its carcinogenicity.
There is no additional information to determine whether
exposure to chlorine might cause cancer.
How can chlorine affect children?

Children can be affected by exposure to chlorine in the same
ways as adults. We do not know whether children differ
from adults in their susceptibility to chlorine. In general,
children may be more vulnerable to corrosive agents than
adults because of the smaller diameter of their airways.
We do not know if exposure to chlorine can result in birth
defects or other developmental effects.

chlorine?
Most families will not be exposed to high levels of
chlorine gas.
Household products containing substances such as
sodium hypochlorite (which may release chlorine gas) should
be stored in safe locations, out of the reach of children.

exposed to chlorine?
Specific tests for the presence of chlorine in the blood or
urine are not generally useful. If a severe exposure has
occurred, blood and urine analyses and other tests may
show whether damage has occurred to the lungs and
gastrointestinal tract. Some of these tests can be performed
in a doctors office. Some testing may require hospital
facilities.

The EPA has set a limit for drinking water of 4 milligrams of
chlorine per liter of water (4 mg/L) and also recommends that
levels of chlorine in lakes and streams be limited to 10 mg/L
to prevent possible human health effects from drinking water
or eating fish contaminated with this chemical.
set a ceiling limit of 1 part of chlorine per million parts of
workplace air (1 ppm). The American Conference of
Governmental Industrial Hygienists (ACGIH) recommends a
time-weighted average (TWA) threshold limit value (TLV) of
0.5 ppm of chlorine for an 8-hour per day, 40-hour work
week, and a short-term exposure level (STEL) of 1 ppm of
chlorine.
CHLORINE DIOXIDE and CHLORITE

CAS # 10049-04-4 and 7758-19-2
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about chlorine dioxide and
chlorite. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
is one in a series of summaries about hazardous substances and their health effects. It is important
you understand this information because this substance may harm you. The effects of exposure to any
HIGHLIGHTS: Chlorine dioxide is a gas that does not occur naturally in the
environment. It is used to disinfect drinking water and make it safe to drink.
Chlorite is formed when chlorine dioxide reacts with water. High levels of
chlorine dioxide can be irritating to the nose, eyes, throat, and lungs. Chlorine
dioxide and chlorite have not been found in any of the 1,613 National Priorities
What are chlorine dioxide and chlorite?
Chlorine dioxide is a yellow to reddish-yellow manufactured
gas. It does not occur naturally in the environment.
Chlorine dioxide is used as a bleach at paper manufacturing
plants, and in public water treatment facilities to make water
safe to drink. About 5% of the water treatment facilities
serving more than 100,000 people in the United States use
chlorine dioxide to treat drinking water.
Chlorite ions in water may move into groundwater,

although reaction with soil and sediments may reduce the
amount chlorite ions reaching groundwater.
Neither chlorine dioxide nor chlorite ions build up in the
food chain.
How might I be exposed to chlorine dioxide and

chlorite?
When it reacts in water, chlorine dioxide forms chlorite ion, a

compound which is also very reactive. Chlorite ions in
water combine with metal ions to form soluble salts, like
sodium chlorite.
Chlorine dioxide is added to drinking water to protect

people from harmful bacteria and other microorganisms.
Most people will be exposed to small amounts chlorine
dioxide and chlorite ions by drinking water treated with
chlorine dioxide.
Individuals who are employed at pulp and paper mills,
municipal water treatment facilities, and other facilities that
use chlorine dioxide as a disinfectant may have high
exposures to chlorine dioxide and chlorite (ions or salts).
What happens to chlorine dioxide and chlorite

How can chlorine dioxide and chlorite affect my

health?
Chlorine dioxide is a very reactive compound and will not

exist in the environment for long periods of time.
In air, sunlight will rapidly break down chlorine dioxide
into chlorine gas and oxygen.
In water, chlorine dioxide will quickly form chlorite ions.
Chlorite ions do not exist in air.
Both chlorine dioxide and chlorite react quickly in water or

moist body tissues. Breathing air containing chlorine dioxide
gas may cause nose, throat, and lung irritation. Eating or
drinking large amounts of chlorite salts may cause irritation
in the mouth, esophagus, or stomach. There is no evidence
that chlorine dioxide or chlorite affect reproduction in
humans.
In 2001, chlorine dioxide was used to decontaminate a

number of public buildings following the release of anthrax
spores in the United States.

Page 2
CHLORINE DIOXIDE and CHLORITE

CAS # 10049-04-4 and 7758-19-2
Studies in animals exposed to high amounts of chlorine

dioxide or chlorite have shown effects similar to those seen
in exposed people.
How likely are chlorine dioxide and chlorite to

cause cancer?
There are no studies on cancer in humans exposed to
chlorine dioxide or chlorite. Based on inadequate information
in humans and in animals, the International Agency for
Research on Cancer (IARC) and the EPA have determined
that chlorine dioxide and sodium chlorite are not classifiable
as to human carcinogenicity.
How can chlorine dioxide and chlorite affect

children?
There are no unique exposure pathways for children to
chlorine dioxide and chlorite. Children exposed to large
amounts of chlorine dioxide or chlorite would be expected to
be affected in the same manner as adults.
Studies in rats have shown that exposure of pregnant
animals to chlorine dioxide and chlorite or exposure of pups
shortly after birth may cause delays in the development of
the brain. However, the exposure levels in these studies
were much higher than what humans are usually exposed to
in the drinking water. There are no reliable studies of effects
of chlorine dioxide or chlorite in developing humans.

chlorine dioxide and chlorite?

exposed to chlorine dioxide and chlorite?
There are no routine medical tests available to measure
chlorine dioxide or chlorite in the body. There is a special
test to measure chlorite in tissues, blood, urine, and feces,
but the test cannot tell the extent of the exposure or whether
harmful effects will occur.

The EPA has set a maximum contaminant level of 1 milligram
of chlorite per liter (1 mg/L) of drinking water. The EPA also
has set a goal of 0.8 mg/L for both the maximum residual
disinfectant level for chlorine dioxide and the maximum
contaminant level for chlorite in drinking water treated with
chlorine dioxide as a disinfectant.
has set a limit of 0.1 parts of chlorine dioxide per million
parts of air (0.1 ppm) in the workplace during an 8-hour shift,
40-hour workweek.
(ATSDR). 2002. Toxicological Profile for Chlorine Dioxide
and Chlorite (Draft for Public Comment). Atlanta, GA: U.S.
Service.
Families that drink water treated with chlorine dioxide may

reduce the risk of exposure to chlorine dioxide and chlorite
by drinking bottled water that has not been treated with
these chemicals.
CHLOROBENZENE
CAS # 108-90-7
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about chlorobenzene. For more
HIGHLIGHTS: Chlorobenzene is used as a solvent for some pesticide

formulations, as a degreaser, and to make other chemicals. High levels of
chlorobenzene can damage the liver and kidneys and affect the brain. It has
been found at 97 of the 1,177 National Priorities List sites identified by the
What is chlorobenzene?
(Pronounced klr-bnzn)
Chlorobenzene is a colorless, flammable liquid with an
aromatic, almond-like odor. Some of it will dissolve in water,
but it readily evaporates into air. It does not occur naturally
in the environment.
Chlorobenzene production in the United States has declined by more than 60% from its peak in 1960. It was used in
the past to make other chemicals, such as phenol and DDT.
Now chlorobenzene is used as a solvent for some pesticide
formulations, to degrease automobile parts, and as a chemical
intermediate to make several other chemicals.
What happens to chlorobenzene when it enters

the environment?
q Chlorobenzene released to air is slowly broken down by
reactions with other chemicals and sunlight or can be
removed by rain.
q In water, chlorobenzene will rapidly evaporate to the air
and/or be broken down by bacteria.
q When released to soil, it is broken down rapidly by bacteria, but some will evaporate to the air and some may filter
into the groundwater.
q Chlorobenzene does not build up in the food chain.
How might I be exposed to chlorobenzene?

q If you work where chlorobenzene is made or used you
could be exposed by breathing air with chlorobenzene
vapors or by spilling or splashing chlorobenzene on your
skin.
q People that live near a waste site containing chlorobenzene could be exposed by drinking contaminated groundwater, breathing vapors released to the air, or getting contaminated soil on their skin.
q You could be exposed by eating food contaminated with
chlorobenzene but there is not enough information to
determine how often this occurs.
How can chlorobenzene affect my health?

Workers exposed to high levels of chlorobenzene in the
air complained of headaches, nausea, sleepiness, numbness,
and vomiting. We cannot be certain that all of these effects
were due to chlorobenzene exposure because the workers may
have been exposed to other chemicals.
nervous system are affected by exposure to chlorobenzene.

CHLOROBENZENE
CAS # 108-90-7
Page 2

Effects on the central nervous system from breathing chlorobenzene include unconsciousness, tremors, restlessness, and
death. Longer exposure has caused liver and kidney damage.
The limited data available indicate that chlorobenzene does
not cause birth defects or infertility.
should be limited to 0.488 ppm to prevent possible health

effects from drinking water or eating fish contaminated with
this group of chemicals. Any release to the environment
greater than 100 pounds of chlorobenzene must be reported to
the EPA.
How likely is chlorobenzene to cause cancer?

(OSHA) has set a workplace air concentration limit of 75 ppm
over an 8-hour workday, 40-hour workweek.
It is not known whether chlorobenzene causes cancer in

people. Although chlorobenzene did not produce cancer in
animal studies with rats and mice, liver nodules which can
lead to cancer were produced in male rats. The EPA has determined that chlorobenzene is not classifiable as to human carcinogenicity based on inadequate evidence in both humans and
animals.

exposed to chlorobenzene?
Exposure to chlorobenzene can be determined by measuring it or its metabolites in urine, exhaled air, blood, and body
fat, but these tests cannot be used to predict whether harmful
health effects will occur. These tests are not usually done in
the doctors office because special equipment is needed.
The federal recomendations have been updated as of July

1999.
Glossary
Solvent: A substance that dissolves another substance.
Tremor: Trembling or shaking caused by disease or stress.
of 0.1 parts per million (0.1 ppm) for chlorobenzene in drinking water. Concentrations in drinking water for short-term
exposures (up to 10 days) should not exceed 2 ppm. The EPA
recommends that levels of chlorinated benzenes (a group of
chemicals that includes chlorobenzene) in lakes and streams

(ATSDR). 1990. Toxicological profile for chlorobenzene.
CHLORODIBENZOFURANS
(CDFs)
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about chlorodibenzofurans
(CDFs). For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
is one in a series of summaries about hazardous substances and their health effects. This information is
important because this substance may harm you. The effects of exposure to any hazardous substance
SUMMARY: Exposure to chlorodibenzofurans (CDFs) occurs mainly by

eating certain contaminated foods. In people, exposure to CDFs is most
likely to cause skin and eye irritation, and increased vulnerability to
respiratory infection and nervous system effects. This chemical has been
found in at least 51 of 1,416 National Priorities List sites identified by the
What are chlorodibenzofurans (CDFs)?
(Pronounced klr d bn-z fyrn)
Chlorinated dibenzofurans, or CDFs, are a family of
chemicals that contain one to eight chlorine atoms attached to
the carbon atoms of the parent chemical, dibenzofuran. There
are 135 different types of CDFs with varying harmful health
and environmental effects. The compounds that contain
chlorine atoms at the 2,3,7,8-positions of the dibenzofuran
molecule are known to be especially harmful.
Not all of the different types have been found in large
enough quantities to study the physical properties. However,
of those that have been studied, they do not dissolve in water
easily and appear to be in the form of colorless solids.
There is no known use for these chemicals. Other than
for research purposes, they are not deliberately produced by
industry. Most CDFs are produced in small amounts as undesirable by-products of certain processes, such as manufacturing other chemicals or bleaching at paper and pulp mills.
CDFs can also be released from incinerators.
What happens to CDFs when they enter the

environment?
q CDFs exist in the air as solid particles and sometimes

vapors.
q They can enter the environment from car exhausts or from
burning coal, wood, or oil for home heating, and the
production of electricity.
q Vaporized CDFs are broken down by other chemicals in
the atmosphere.
q They can be removed from the air in snow and rain.
q They attach to soil and sediment in lakes and rivers.
q They are not likely to move into groundwater from soil.
q They accumulate in fish to tens of thousands times higher
levels than in the water or sediment.
q They also build up in other animals, birds, and people
that are exposed to CDFs in their food.
How might I be exposed to CDFs?

q Eating contaminated foods, such as meat, fish, and
milk (90% of daily exposure, which is only a few
picograms [pg], results from eating contaminated
food).
q Breathing air or drinking water that is contaminated,
or coming in contact with contaminated soil.
q Using products such as milk cartons, coffee filters, and
tampons could result in very low exposures.
q Breathing contaminated workplace air.

Page 2
CHLORODIBENZOFURANS (CDFs)
How can CDFs affect my health?

Very little is known about the health effects in people or
animals from breathing or touching CDFs. A study in mice
showed that skin exposure to low levels over several weeks
produced effects similar to those from ingesting CDFs.
Most of the information on the adverse health effects
comes from studies in people who were accidentally exposed
to food contaminated with CDFs. The amounts that these
people were exposed to were much higher than are likely from
environmental exposures or from a normal diet.
CDFs caused skin and eye irritations, including severe
acne, darkened skin color, and swollen eyelids with discharge
from the eyes. CDF poisoning also caused vomiting and
diarrhea, anemia, more frequent lung infections, numbness,
effects on the nervous system, and mild changes in the liver.
Children born to exposed mothers had skin irritation and
more difficulty learning.
Many of the same effects that occurred in people also
occurred in laboratory animals that ate CDFs. Animals also
had severe weight loss, and their stomachs, livers, kidneys,
and immune systems were seriously injured. Some animals
had birth defects and testicular damage, and in severe cases,
some animals died. These effects in animals were seen when
they were fed large amounts of CDFs over a short time, or
small amounts over several weeks or months.
How likely are CDFs to cause cancer?

International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified CDFs
for carcinogenicity.
It is not definitely known if CDFs cause cancer in
people. There are no cancer studies in animals that ate or
breathed CDFs. One study found that when CDFs were

applied to the skin of animals, they did not cause cancer,
but when they were applied with another compound called
MNNG, which is known to initiate tumors, cancer did
develop.
Is there a medical test to show whether I've

been exposed to CDFs?
There are tests available to measure CDFs in your blood,
body fat, and breast milk. The tests can tell you if you have
been exposed, but they can't tell you the exact amount of
CDFs or for how long you were exposed. The tests also
cannot predict whether you will experience harmful health
effects. Nearly everyone in the United States and other
industrialized countries has been exposed to low levels of
CDFs because they are in the environment.

There are no federal guidelines or recommendations for
protecting human health or the environment from exposure to
CDFs.
Glossary
Anemia: A decreased ability of the blood to transport
oxygen.
Picogram (pg): One trillionth of a gram.
References
1994. Toxicological profile for chlorodibenzofurans.
For more information, contact the Agency for Toxic Substances and Disease
CHLOROETHANE
CAS # 75-00-3
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about chloroethane. For more
HIGHLIGHTS: Exposure to chloroethane can occur from breathing air or

drinking water containing it. Exposure to high levels of chloroethane can affect
your nervous system, causing lack of muscle control and unconsciousness. This
substance has been found in at least 282 of the 1,467 National Priorities List
What is chloroethane?
(Pronounced klr th n)
Chloroethane is a colorless gas at room temperature and
pressure. It has a characteristically sharp smell. It is a liquid
when stored in pressurized containers; however, the liquid
evaporates quickly when exposed to room air. Chloroethane
catches fire easily.
It was used in leaded gasoline, but strict new government
regulations have reduced that use dramatically. It is used in
the production of cellulose, dyes, medicinal drugs, and other
commercial products, and as a solvent and refrigerant.
It is also used to numb the skin before medical procedures
such as ear piercing and skin biopsies and as a treatment in
sports injuries.
What happens to chloroethane when it enters

the environment?
Most chloroethane exists as a gas in the atmosphere.
q
q
q
q
It breaks down fairly rapidly (about half disappears within

40 days) by reacting with other substances in the air.
Small amounts can enter groundwater by filtering through
the soil.
In groundwater, chloroethane is slowly changed into a
simpler form by reaction with water.
Some types of bacteria in water may break it down to
smaller compounds.
How might I be exposed to chloroethane?
q
q
q
q
q
q
Chloroethane can be released to air from factories that

manufacture or use it.
It can evaporate from landfills.
It can be released during its use as a solvent, refrigerant,
and anesthetic.
Chloroethane may be present in drinking water as a result
of chlorination.
People may be exposed through skin contact if it is used
in a medical procedure.
Workers who may be exposed include doctors, nurses,
mechanics, plumbers, and painters.

CHLOROETHANE
CAS # 75-00-3
Page 2

How can chloroethane affect my health?
Brief exposure to high levels can produce temporary feelings of drunkenness. At higher levels, it can cause lack of
muscle coordination and unconsciousness. It can also cause
stomach cramps, nausea, vomiting, and eye irritation. Chloroethane is sometimes applied to the skin as a numbing agent
before surgery. If it is applied for too long, frostbite can result.
Some people had allergic reactions to it, and others experienced mild pain after being sprayed for 10 seconds.
How likely is chloroethane to cause cancer?

Laboratory tests in animals have shown that long-term
exposure can cause cancer in mice. It is not known whether it
causes cancer in humans. The International Agency for Research on Cancer (IARC) has concluded that chloroethane is
not classifiable as to its carcinogenicity in humans.
How can chloromethane affect children?

We don't know whether chloroethane exposure can affect
development in people. In animal studies, the babies of mice
exposed to chloroethane during pregnancy had delayed development. It is not known whether children differ from adults in
their susceptibility to chloroethane.

chloroethane?
q
q
q
Avoid using products that contain chloroethane if you are

pregnant.
Limit the use of consumer products that contain it.
Open windows and doors when such products are used in
the home.
q
q
q
Make sure containers are tightly covered.

Make your children aware of the harmful effects of sniffing glue, paints, and other solvents.
Store products containing it safely and follow directions
carefully.

exposed to chloroethane?
There are complex analytical tests that chemists use to
measure chloroethane in blood, milk, or urine. However, no
commonly used medical tests are available to determine
whether or not a person has been exposed to chloroethane.

EPA requires industries to report accidental discharges or
spills of 100 pounds or more of chloroethane to EPA.
(OSHA) regulates the amount of chloroethane in workplace air.
The limit for an 8-hour workday, over a 40-hour workweek, is
1,000 parts per million (1,000 ppm).
Hygienists (ACGIH) recommends a limit of 100 ppm
chloroethane in workplace air.
(ATSDR). 1998. Toxicological profile for chloroethane.
CHLOROFORM
CAS # 67-66-3
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about chloroform. For more
HIGHLIGHTS: Exposure to chloroform can occur when breathing contaminated

air or when drinking or touching the substance or water containing it. Breathing
chloroform can cause dizziness, fatigue, and headaches. Breathing chloroform
or ingesting chloroform over long periods of time may damage your liver and
kidneys. It can cause sores if large amounts touch your skin. This substance has
What is chloroform?
(Pronounced klr-frm)
q Chloroform dissolves easily in water and some of it may

break down to other chemicals.
Chloroform is a colorless liquid with a pleasant, nonirritating odor and a slightly sweet taste. It will burn only when
it reaches very high temperatures.
q Chloroform doesnt appear to build up in great amounts

in plants and animals.
q Chloroform lasts a long time in groundwater.
How might I be exposed to chloroform?
In the past, chloroform was used as an inhaled anesthetic

during surgery, but it isnt used that way today. Today, chloroform is used to make other chemicals and can also be
formed in small amounts when chlorine is added to water.
q Drinking water or beverages made using water containing

chloroform.
Other names for chloroform are trichloromethane and

methyl trichloride.
q Eating food that contains it.
What happens to chloroform when it enters the

environment?
q Chloroform evaporates easily into the air.
q Most of the chloroform in air breaks down eventually, but
it is a slow process.
q The breakdown products in air include phosgene and
hydrogen chloride, which are both toxic.
q It doesnt stick to soil very well and can travel through
soil to groundwater.
q Breathing indoor or outdoor air containing it, especially

in the workplace.
q Skin contact with chloroform or water that contains it,
such as in swimming pools.
How can chloroform affect my health?

Breathing about 900 parts of chloroform per million parts
air (900 ppm) for a short time can cause dizziness, fatigue, and
headache. Breathing air, eating food, or drinking water containing high levels of chloroform for long periods of time may
damage your liver and kidneys. Large amounts of chloroform
can cause sores when chloroform touches your skin.

CHLOROFORM
CAS # 67-66-3
Page 2
It isnt known whether chloroform causes reproductive

effects or birth defects in people.

Animal studies have shown that miscarriages occurred in

rats and mice that breathed air containing 30 to 300 ppm chloroform during pregnancy and also in rats that ate chloroform
during pregnancy. Offspring of rats and mice that breathed
chloroform during pregnancy had birth defects. Abnormal
sperm were found in mice that breathed air containing 400
ppm chloroform for a few days.
The EPA drinking water limit for total trihalomethanes, a

class of chemicals that includes chloroform, is 100 micrograms
per liter of water (100 g/L).
How likely is chloroform to cause cancer?

has determined that chloroform may reasonably be anticipated
to be a carcinogen.
Rats and mice that ate food or drank water with chloroform developed cancer of the liver and kidneys.
The EPA requires that spills or accidental releases of 10

pounds or more of chloroform into the environment be reported to the EPA.
(OSHA) has set the maximum allowable concentration of chloroform in workroom air during an 8-hour workday in a 40-hour
workweek at 50 ppm.
Glossary
Carcinogenicity: A substance with the ability to cause cancer.
Microgram (g): One millionth of a gram.

Miscarriage: Pregnancy loss.
exposed to chloroform?

Although the amounts of chloroform in the air that you
exhale and in blood, urine, and body tissues can be measured, Source of Information
there is no reliable test to determine how much chloroform you
This ToxFAQs information is taken from the 1997 Toxicohave been exposed to or whether you will experience any
logical
Profile for Chloroform (update) produced by the
harmful effects.
Agency for Toxic Substances and Disease Registry, Public
The measurement of chloroform in body fluids and tissues Health Service, U.S. Department of Health and Human Services,
may help to determine if you have come into contact with
Public Health Service in Atlanta, GA.
large amounts of chloroform, but these tests are useful for only
a short time after you are exposed. Chloroform in your body
might also indicate that you have come into contact with other toxic substances might harm people and how to treat people
chemicals.
CHLOROMETHANE
CAS # 74-87-3
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about chloromethane. For more
HIGHLIGHTS: Exposure to high levels of chloromethane can cause serious

problems to your nervous system, including convulsions and coma. It can also
affect your liver, kidneys, and heart. This substance has been found in at least
What is chloromethane?
Most of the chloromethane that is released into the environment is from natural sources, such as chemical reactions that occur in the oceans.
It is also given off when materials like grass, wood, charcoal, and plastics are burned.
It is present in lakes and streams and has been found in

drinking water.
Chloromethane is an impurity in vinyl chloride; exposure

could occur from disposal of vinyl chloride waste.
Other sources of exposure are cigarette smoke, polystyrene insulation, aerosol propellants, and chlorinated
swimming pools.
(Pronounced klr mth n)

Chloromethane is also known as methyl chloride. It is a
clear, colorless gas. It has a faint, sweet odor that is noticeable
only at levels that may be toxic. It is heavier than air, and it is
extremely flammable.
What happens to chloromethane when it enters

the environment?
Chloromethane is found in air, surface water, groundwater,

soil, and sediment.
It is present at very low concentrations throughout the

atmosphere.
Chloromethane breaks down very slowly in air.
It breaks down slowly in water, but certain microorganisms can break it down more quickly.
Most of the chloromethane in soil will move to air.
It does not concentrate in plants, animals, or fish.
How might I be exposed to chloromethane?
Some chloromethane is produced by industry.
How can chloromethane affect my health?

Breathing very high levels, even for a short time, can
have serious effects on your nervous system, including convulsions and coma.
Lower exposures can also cause staggering, blurred or
double vision, dizziness, fatigue, personality changes, confusion, tremors, nausea, or vomiting. These symptoms can last
for several months or years.
Exposure to chloromethane can harm your liver and kidneys. It could also affect your heart rate and blood pressure.

CHLOROMETHANE
CAS # 74-87-3
Page 2

Some animal studies showed that animals that breathed
low levels of chloromethane experienced slower growth and
had brain damage. In other animal studies, males that were
exposed to chloromethane were less fertile, or even sterile, or
produced damaged sperm. Females that became pregnant by
these males lost their developing young.
Teach children the dangers of breathing smoke from burning vinyl plastic or silicone rubber products (chloromethane is released).
Have your drinking water tested if you are concerned

about it.
Check product labels for ingredients; contact manufacturers for additional information if you need it.
How likely is chloromethane to cause cancer?

exposed to chloromethane?
There is no evidence that chloromethane causes cancer in

people. In animal studies, male mice that breathed contaminated air for 2 years developed tumors in their kidneys, but
female mice, and male and female rats did not.
The EPA has determined that chloromethane is a possible
human carcinogen.
How can chloromethane affect children?

There are no studies on the health effects on children from
exposure to chloromethane. We do not know if chloromethane
exposure will harm developing fetuses or young children.
Animal studies show that female rats exposed to chloromethane during pregnancy had young that were smaller than
normal, with underdeveloped bones, and possibly abnormal
hearts (this effect remains uncertain).
There are no known reliable medical tests to determine

whether you have been exposed to chloromethane. Symptoms
resembling drunkenness and food poisoning, along with a
sweet odor of the breath, may suggest to a doctor that a person
has been exposed to chloromethane.

(OSHA) has set a permissible exposure limit for chloromethane
of 100 parts per million (100 ppm) for an 8-hour workday in a
40-hour workweek.
chloromethane?
Keep children away from contaminated areas, such as

workplaces that use chloromethane.
Properly dispose of the older types of refrigerators that

used chlormethane as a refrigerant.
Become familiar with safety practices if you work with or

near chloromethane.

(ATSDR). 1998. Toxicological profile for chloromethane.
Atlanta: U.S. Department of Health and Human Services, Public Health Service.
Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone: 1-888-8737,
CHLOROPHENOLS
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about chlorophenols. For more
HIGHLIGHTS: Chlorophenols are a group of compounds that are used in

a number of industries and products. Exposure to high levels can cause damage
to the liver and immune system. These substances have been found in at least
What are chlorophenols?
(Pronounced klr-f-nlz)
Chlorophenols are a group of chemicals that are produced
by adding chlorines to phenol. Phenol is an aromatic compound derived from benzene. There are 5 basic types of
chlorophenols and 19 different chlorophenols.
q Chlorophenols stick to soil and sediments at the bottom

of lakes, streams, and rivers.
q Low levels of chlorophenols in water, soil, or sediment are
broken down and removed from the environment in a few
days to weeks by microorganisms.
How might I be exposed to chlorophenols?
Most chlorophenols are solid at room temperature. They

have a strong, medicinal taste and smell. Small amounts can
be tasted in water.
q Most people are exposed to very low levels of

chlorophenols in chlorinated drinking water.
Some chlorophenols are used as pesticides. Others are

used in antiseptics. Small amounts are produced when water is
disinfected with chlorine. They are also produced while
bleaching wood pulp with chlorine to make paper.
q You can be exposed if you work with chlorophenols or

use them as pesticides.
What happens to chlorophenols when they enter

the environment?
How can chlorophenols affect my health?
q Chlorophenols can enter the environment when they are

being made or used as pesticides.
q Most chlorophenols released to the environment go into
water.
q Small amounts of chlorophenols enter the air.
q In the air, sunlight helps destroy these compounds and
rain washes them out of the air.
q There are some chlorophenols in city air.
q You can be exposed if you make or use treated wood.
Workers exposed to pesticides that contain chlorophenols

have developed acne and mild injury to their livers.
In laboratory studies, animals that received high levels of
chlorophenols in food or water developed liver and immune
system effects. They did not gain as much weight as animals
not fed the compounds.
High levels of chlorophenols given to pregnant female

CHLOROPHENOLS
Page 2

rats in their drinking water reduced the number of babies they
had, and caused low birth weights. Chlorophenols have not
been shown to cause birth defects in animals.
How likely are chlorophenols to cause cancer?

There is evidence to suggest that people exposed to
chlorophenols for a long time may have slightly higher incidences of cancer. However, the people studied were exposed to
other chemicals as well.
In animal studies, one chlorophenol, 2,4,6-trichlorophenol, caused leukemia in rats and liver cancer in mice. The Department of Health and Human Services (DHHS) has determined that 2,4,6-trichlorophenol may reasonably be anticipated to be a carcinogen.
How can chlorophenols affect children?

Children can be exposed in the same ways as adults; however, children may be more sensitive than adults to the effects
of chlorophenol-based pesticides and herbicides. Chlorophenols leave the body quickly, so they are not likely to accumulate in the mothers tissues or breast milk.
There are no human studies on the effects of chlorophenols on developing fetuses. Studies in rats showed that
chlorophenols can pass through the placenta and produce
toxic effects to the developing fetuses. The most common
problems are delayed hardening of the bones of the breastbone, spine, and skull.

chlorophenols?
Parents should keep children away from areas where
chlorophenols have been used as pesticides. Always check
labels on household products, and store them safely in their
original containers. Never store chemicals in containers that

children might find attractive to eat or drink from, such as
soda bottles.

exposed to chlorophenols?
There is no test to show if you have been exposed to
chlorophenols. There are tests for certain compounds that are
produced in your body when chlorophenols break down. However, exposure to other substances could also produce the
same test results.

EPA recommends that drinking water contain no more
than 0.04 milligrams per liter (0.04 mg/L) of 2-chlorophenol
for a lifetime exposure for an adult, and 0.05 mg/L for a 1-day,
10-day, or longer exposure for a child.
For 2,4-dichlorophenol, EPA recommends that drinking
water contain no more than 0.03 mg/L for a 1-day, 10-day, or
longer exposure for a child.
(ATSDR). 1999. Toxicological profile for chlorophenols.
CHLORPYRIFOS
CAS # 2921-88-2
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about chlorpyrifos. For more
information, all the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series of
HIGHLIGHTS: Chlorpyrifos is an insecticide which has been widely used in

homes and on farms. Breathing or ingesting chlorpyrifos may result in a variety
of nervous system effects, ranging from headaches, blurred vision, and salivation
to seizures, coma, and death, depending on the amount and length of exposure.
Chlorpyrifos has been found in at least 7 of the 1,430 National Priorities List sites
What is chlorpyrifos ?
(Pronounced klr pra-fs)
q Once in the environment, it is broken down by sunlight,

bacteria, or other chemical processes.
Chlorpyrifos is an insecticide that is a white crystal-like

solid with a strong odor. It does not mix well with water, so it is
usually mixed with oily liquids before it is applied to crops or
animals. It may also be applied to crops in a capsule form.
How might I be exposed to chlorpyrifos?
Chlorpyrifos has been widely used in homes and on farms.

In the home, it is used to control cockroaches, fleas, and termites; it is also used in some pet flea and tick collars. On the
farm, it is used to control ticks on cattle and as a spray to control crop pests.
What happens to chlorpyrifos when it enters the

environment?
q Chlorpyrifos enters the environment through direct application to crops, lawns, houses and other buildings.
q It may also enter the environment through volatilization,
spills, and the disposal of chlorpyrifos waste.
q Chlorpyrifos sticks tightly to soil particles.
q It does not mix well with water, so it rarely enters local
water systems.
q Using it to control household pests such as termites, fleas

or cockroaches.
q Breathing air outside of homes or other buildings where
chlorpyrifos was applied to the ground around the foundation to control termites.
q Breathing air in a field where chlorpyrifos was sprayed on
to crops.
q Touching soil or crops in a field where it was sprayed or
touching freshly sprayed areas in a house.
q Putting food or other chlorpyrifos contaminated items in
your mouth.
How can chlorpyrifos affect my health?

Breathing the air in an area in which chlorpyrifos has recently been sprayed may produce a variety of effects on the
nervous system including headaches, blurred vision, watering
of the eyes (called lacrimation), excessive salivation, runny
nose, dizziness, confusion, muscle weakness or tremors, nau-

CHLORPYRIFOS
CAS # 2921-88-2
Page 2

sea, diarrhea, and sudden changes in heart rate. The effect depends on the amount in the air and length of time exposed.
environment of 1 pound or more of chlorpyrifos be reported to

the EPA.
Ingesting chlorpyrifos orally through contaminated food

The EPA also recommends that children not drink water
containers or, in the case of children, putting objects of hands in with chlorpyrifos levels greater than 0.03 milligrams per liter of
their mouth after touching chlorpyrifos, may cause similar
water (0.03 mg/L) for periods of 110 days.
symptoms.
The Food and Drug Administration (FDA) has set tolerExposure to high levels may cause severe sweating, loss of ances for chlorpyrifos for agricultural products ranging from
bowel control, severe muscle tremors, seizures, loss of con0.05 to 15 parts chlorpyrifos per million parts of food (0.05
sciousness (coma), or death.
15 ppm).
There is no information at present to show that chlorpyrifos
either effects the ability of humans to reproduce or causes human birth defects.
Glossary
How likely is chlorpyrifos to cause cancer?

It is not known whether chlorpyrifos can cause cancer in
people. Animal studies have not shown that chlorpyrifos causes Insecticide: A substance that kills insects; a pesticide.
cancer.
The EPA has not classified chlorpyrifos for carcinogenicity. ppm: Parts per million (1 ppm is equal to 1 mg/L in water).

exposed to chlorpyrifos?
There is a general test that can be used to determine if you
have been exposed to a ceratin group of insecticides, including
chlorpyrifos. This test measures the activity of an enzyme called
acetylcholinesterase in the blood. There is also a test which
measures a metabolite, or breakdown product (known as TCP),
of chlorpyrifos in the urine. The metabolite TCP can usually be
found in the urine for several days after the exposure to
chlorpyrifos occurred.

TCP: Metabolite of chlorpyrifos.

Volatilization: The changing of a liquid into a vapor or a gas.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Chlorpyrifos produced by the Agency for
CHROMIUM
CAS # 7440-47-3
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about chromium. For more
HIGHLIGHTS: Exposure to chromium occurs from ingesting contaminated

food or drinking water or breathing contaminated workplace air. Chromium(VI)
at high levels can damage the nose and can cause cancer. Chromium has been
found at 1,036 of the 1,591 National Priority List sites identified by the
What is chromium?
Chromium is a naturally occurring element found in rocks,
animals, plants, soil, and in volcanic dust and gases.
Chromium is present in the environment in several different
forms. The most common forms are chromium(0),
chromium(III), and chromium(VI). No taste or odor is
associated with chromium compounds.
Chromium(III) occurs naturally in the environment and is an
essential nutrient. Chromium(VI) and chromium(0) are
generally produced by industrial processes.
The metal chromium, which is the chromium(0) form, is used
for making steel. Chromium(VI) and chromium(III) are used
for chrome plating, dyes and pigments, leather tanning, and
wood preserving.
What happens to chromium when it enters the

environment?
Chromium enters the air, water, and soil mostly in the
chromium(III) and chromium(VI) forms.
In air, chromium compounds are present mostly as fine
dust particles which eventually settle over land and water.
Chromium can strongly attach to soil and only a small
amount can dissolve in water and move deeper in the soil to

underground water.
Fish do not accumulate much chromium in their bodies
from water.
How might I be exposed to chromium?

Eating food containing chromium(III).
Breathing contaminated workplace air or skin contact
during use in the workplace.
Drinking contaminated well water.
chromium or industries that use chromium.
How can chromium affect my health?

Chromium(III) is an essential nutrient that helps the body
use sugar, protein, and fat.
Breathing high levels of chromium(VI) can cause irritation to
the nose, such as runny nose, nosebleeds, and ulcers and
holes in the nasal septum.
Ingesting large amounts of chromium(VI) can cause stomach
upsets and ulcers, convulsions, kidney and liver damage,
and even death.

CHROMIUM
Page 2
CAS # 7440-47-3
Skin contact with certain chromium(VI) compounds can cause

skin ulcers. Some people are extremely sensitive to
chromium(VI) or chromium(III). Allergic reactions consisting
of severe redness and swelling of the skin have been noted.
How likely is chromium to cause cancer?

Several studies have shown that chromium(VI) compounds
can increase the risk of lung cancer. Animal studies have
also shown an increased risk of cancer.
The World Health Organization (WHO) has determined that
chromium(VI) is a human carcinogen.
determined that certain chromium(VI) compounds are known
to cause cancer in humans.
The EPA has determined that chromium(VI) in air is a human
carcinogen.
How can chromium affect children?

We do not know if exposure to chromium will result in birth
defects have been observed in animals exposed to
chromium(VI).
It is likely that health effects seen in children exposed to
high amounts of chromium will be similar to the effects seen
in adults.

chromium?
hazardous waste sites where chromium may have been
discarded.
Although chromium(III) is an essential nutrient, you

should avoid excessive use of dietary supplements
containing chromium.

exposed to chromium?
Since chromium(III) is an essential element and naturally
occurs in food, there will always be some level of chromium
in your body. There are tests to measure the level of
chromium in hair, urine, and blood. These tests are most
useful for people exposed to high levels. These tests cannot
determine the exact levels of chromium that you may have
been exposed to or predict how the levels in your tissues
will affect your health.

EPA has set a limit of 100 :g chromium(III) and chromium(VI)
per liter of drinking water (100 :g/L).
has set limits of 500 :g water soluble chromium(III)
compounds per cubic meter of workplace air (500 :g/m3),
1,000 :g/m3 for metallic chromium(0) and insoluble chromium
compounds, and 52 :g/m3 for chromium(VI) compounds for
8-hour work shifts and 40-hour work weeks.
(ATSDR). 2000. Toxicological Profile for Chromium. Atlanta,
Health Service.
COBALT
CAS #7440-48-4
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about cobalt. For more
HIGHLIGHTS: The general population is exposed to low levels of cobalt in air,

water, and food. Cobalt has both beneficial and harmful effects on health. At
low levels, it is part of vitamin B12, which is essential for good health. At high
levels, it may harm the lungs and heart. This chemical has been found in at
What is cobalt?
Cobalt is a naturally occurring element found in rocks, soil,
water, plants, and animals. There are non radioactive and
radioactive forms of cobalt.
Non radioactive cobalt, referred to as stable cobalt, is used
to produce alloys (mixtures of metals) used in the
manufacture of aircraft engines, magnets, grinding and
cutting tools, artificial hip and knee joints. Cobalt
compounds are also used to color glass, ceramics and
paints, and used as a drier for porcelein enamel and paints.
The two most commercially important radioactive cobalt
isotopes are 60Co (read as cobalt sixty), and 57Co. 60Co is
used as a source of gamma rays for sterilizing medical
equipment and consumer products, radiation therapy for
treating cancer patients, for manufacturing plastics, and food
irradiation. 57Co is used in medical and scientific research.
It takes about 5.7 years for half of 60Co to give off its
radiation and about 272 days for 57Co; this period of time is
called the half-life.
Cobalt released into water or the soil will stick to particles.

Some cobalt compounds may dissolve in water.
Cobalt cannot be destroyed in the environment. It can
only change its form or become attached or separated from
particles. Radioactive decay is the only way of decreasing
the amount of radioactive cobalt in the environment.
How might I be exposed to cobalt?

You can be exposed to low levels of cobalt by breathing
air, eating food, or drinking water. Food and drinking water
are the largest sources of exposure to cobalt for the general
population.
Working in industries that make or use cutting or grinding
tools; mine, smelt, refine, or process cobalt metal or ores; or
that produce cobalt alloys or use cobalt.
The general population is rarely exposed to radioactive
cobalt unless a person is undergoing radiation therapy.
However, workers at nuclear facilities, irradiation facilities, or
nuclear waste storage sites may be exposed to 60Co or 58Co.
How can cobalt affect my health?
What happens to cobalt when it enters the

environment?
Cobalt has both beneficial and harmful effects on human

health. Cobalt is beneficial for humans because it is part of
vitamin B12.
Cobalt enters the environment from natural sources and

the burning of coal or oil or the production of cobalt alloys.
In the air it will be associated with particles which will
settle to the ground within a few days.
Exposure to high levels of cobalt can result in lung and heart

effects and dermatitis. Liver and kidney effects have also
been observed in animals exposed to high levels of cobalt.

COBALT
Page 2
CAS #7440-48-4
Exposure to large amounts of radioactive cobalt or the

radiation it emits can damage cells in your body from the
radiation You might also experience acute radiation
syndrome which includes nausea, vomiting, diarrhea,
bleeding, coma, and even death.
How likely is cobalt to cause cancer?

Non radioactive cobalt has not been found to cause cancer
in humans or animals following exposure in food or water.
Cancer has been shown, however, in animals who breathed
cobalt or when cobalt was placed directly into the muscle or
under the skin. Based on the laboratory animal data, the
International Agency for Research on Cancer (IARC) has
determined that cobalt and cobalt compounds are possibly
carcinogenic to humans.
Exposure to high levels of cobalt radiation can cause
changes in the genetic materials within cells and may result
in the development of some types of cancer.
How can cobalt affect children?

Little information is available regarding the effects of cobalt
in children. It is likely that the health effects seen in children
should be similar to the effects seen in adults. We do not
susceptibility to cobalt. Studies in animals suggest that
children may absorb more cobalt than adults from foods and
liquids containing cobalt.
We do not know if exposure to cobalt will result in birth
defects have been observed in animals exposed to non
radioactive cobalt. Exposure to cobalt radiation can also
result in developmental effects.

exposed to cobalt?
There are reliable tests that can measure cobalt in the urine
and blood within a couple of days of exposure. These tests
are not available at your doctors office, but your doctor can
send the samples to a laboratory that can perform the tests.
The amount of cobalt in your blood or urine can be used to
estimate how much cobalt you were exposed to. However,
these tests cannot predict whether you will experience any
health effects.
If a person has been exposed to radioactive cobalt, special
tests can be used to measure levels of radiative cobalt in
blood, feces, urine, or the total amount in the body.
However, it is difficult to determine if a person has been
exposed only to external radiation from radioactive cobalt.

has set a limit of 0.1 milligrams of non radioactive cobalt per
cubic meter of workplace air (0.1 mg/m3) for an 8-hour
workday and 40-hour work week.
The Nuclear Regulatory Commission (NRC) has set annual
occupational air limits of 200 Ci for 60Co and 3000 Ci for
57
Co.
(ATSDR). 2001. Toxicological Profile for Cobalt (Draft for

cobalt?
hazardous waste sites where cobalt may have been
discarded.
COPPER
CAS # 7440-50-8
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about copper. For more
HIGHLIGHTS: Copper is a reddish metal that occurs naturally in the

environment. It also occurs naturally in plants and animals. Low levels of
copper are essential for maintaining good health. High levels can cause
harmful effects such as irritation of the nose, mouth and eyes, vomiting,
diarrhea, stomach crumps, and nausea. Copper has been found in at least 884
of the 1,613 National Priorities List sites identified by the Environmental
What is copper?
Copper is a reddish metal that occurs naturally in rocks, soil,
water, and air. Copper also occurs naturally in plants and
animals.
Metallic copper can be easily molded or shaped. Metallic
copper can be found in the U.S. penny, electrical wiring, and
some water pipes. Metallic copper is also found in mixtures
(called alloys) with other metals such as brass and bronze.
Copper is also found as part of other compounds forming
salts. Copper salts occur naturally, but are also
manufactured. The most common copper salt is copper
sulfate. Most copper compounds are blue-green in color.
Copper compounds are commonly used in agriculture to
treat plant diseases like mildew, for water treatment and, as
preservatives for wood, leather, and fabrics.
What happens to copper when it enters the

environment?
Copper can enter the environment from the mining of
copper and other metals and from factories that make or use
metallic copper or copper compounds.
It can also enter the environment through domestic waste
water, combustion of fossil fuels and wastes, wood
production, phosphate fertilizer production, and natural
sources (e.g., windblown dust from soils, volcanoes,
decaying vegetation, forest fires, and sea spray).
Copper in soil strongly attaches to organic material and
minerals.
Copper that dissolves in water becomes rapidly bound to

particles suspended in the water.
Copper does not typically enter groundwater.
Copper carried by particles emitted from smelters and ore
processing plants is carried back to the ground by gravity or
in rain or snow.
Copper does not break down in the environment.
How might I be exposed to copper?

Breathing air, drinking water, eating food, and by skin
contact with soil, water, or other copper-containing
substances.
Some copper in the environment can be taken up by
plants and animals.
Higher exposure may occur if your water is corrosive and
you have copper plumbing and brass water fixtures. You
may be exposed to higher amounts of copper if you drink
water or swim in lakes or reservoirs recently treated with
copper to control algae or receive cooling water from a
power plant that may have high amounts of dissolved
copper.
Using some garden products (e.g., fungicides) to control
plant diseases.
Living near bronze and brass production facilities may
expose you to higher copper levels in soil.
You may breathe copper-containing dust or have skin
contact if you work in the industry of mining copper or

COPPER
Page 2
CAS # 7440-50-8
processing the ore. You may breathe high levels if you grind
or weld copper metal.
How can copper affect my health?

Copper is essential for good health, but high amounts can be
harmful. Long-term exposure to copper dust can irritate your
nose, mouth, and eyes, and cause headaches, dizziness,
nausea, and diarrhea.
Drinking water with higher than normal levels of copper may
cause vomiting, diarrhea, stomach cramps, and nausea.
Intentionally high intakes of copper can cause liver and
kidney damage and even death.
How likely is copper to cause cancer?

We do not know whether copper can cause cancer in
humans. The EPA has determined that copper is not
classifiable as to carcinogenicity.
How can copper affect children?

Exposure to high levels of copper will result in the same type
of effects in children and adults. Studies in animals suggest
that the young children may have more severe effects than
adults; we do not know if this would also be true in humans.
There is a very small percentage of infants and children who
are unusually sensitive to copper.
We do not know if copper can cause birth defects or other
developmental effects in humans. Studies in animals suggest
that ingestion of high levels of copper may cause a decrease
in fetal growth.

copper?
The greatest potential source of copper exposure is
through drinking water, especially in water that is first drawn
in the morning after sitting in copper pipes and brass faucets
overnight.
To reduce exposure, run the water for at least 15-30
seconds before using it.
If you are exposed to copper at work, you may carry
copper home on your skin, clothes, or tools. You can avoid

this by showering, and changing clothing before leaving
work, and your work clothes should be kept separate from
other clothes and laundered separately.

exposed to copper?
Copper is normally found in all tissues of the body, blood,
urine, feces, hair, and nails. High levels of copper in these
samples can show that you have been exposed to higher
than normal levels of copper. Tests to measure copper levels
in the body are not routinely available at the doctors office
because they require special equipment. These tests cannot
tell the extent of exposure or whether you will experience
harmful effects.

The EPA has determined that drinking water should not
contain more than 1.3 milligrams of copper per liter of water
(1.3 mg/L).
has set a limit of 0.1 mg per cubic meter (0.1 mg/m3) of
copper fumes (vapor generated from heating copper) and 1
mg/m3 of copper dusts (fine metallic copper particles) and
mists (aerosol of soluble copper) in workroom air during an
8-hour work shift, 40-hour workweek.
The Food and Nutrition Board of the Institute of Medicine
recommends dietary allowances (RDAs) of 340 micrograms
(340 g) of copper per day for children aged 1-3 years, 440
g/day for children aged 4-8 years, 700 g/day for children
aged 9-13 years, 890 g/day for children aged 14-18 years,
and 900 g/day for adults.
(ATSDR). 2002. Toxicological Profile for Copper (Draft for
USED MINERAL-BASED
CRANKCASE OIL
CAS # 8002-05-9
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about used mineral-based crankcase
oil. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in
a series of summaries about hazardous substances and their health effects. Its important you understand this
information because this substance may harm you. The effects of exposure to any hazardous substance depend
on the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals are
present.
HIGHLIGHTS: Used mineral-based crankcase oil is also called used engine oil.
Exposure to this oil can occur when you change the oil of your car or another type
of engine. Exposure to very high levels of used oil can cause skin rashes, headaches
and tremors. Used oil has been found in at least 85 of the 1,416 National Priorities
What is used mineral-based crankcase oil?
q The hydrocarbon components of the oil generally stick

to the soil surface.
Used mineral-based crankcase oil is the brown-to-black,

oily liquid removed from the engine of a motor vehicle when
the oil is changed. It is similar to unused oil except it contains
additional chemicals from its use as an engine lubricant.
q Some hydrocarbons evaporate into the air very quickly,

and others evaporate more slowly.
The chemicals in oil include hydrocarbons, which are distilled from crude oil, and various additives that improve the
oil's performance. Used oil also contains chemicals formed
when the oil is exposed to high temperatures and pressures inside an engine. It also contains some metals from engine parts
and small amounts of gasoline, antifreeze, and chemicals that
come from gasoline when it burns inside the engine.
q Hydrocarbons from used mineral-based crankcase oil

may build up in shellfish or other organisms.
The chemicals found in used mineral-based crankcase oil

vary depending on the brand and type of oil, whether gasoline
or diesel fuel was used, the mechanical condition of the engine
that the oil came from, and the amount of use between oil
changes. Used oil is not naturally found in the environment.
What happens to used mineral-based crankcase

oil when it enters the environment?
q Used mineral-based crankcase oil enters the air through
the exhaust system during engine use.
q It may enter water or soil when disposed of improperly.
q Hydrocarbon components of the oil that enter surface

water bind to small particles in the water and eventually
settle to the bottom.
q Some metals in used mineral-based crankcase oil dissolve in water and move through the soil easily and may
be found in surface water and groundwater.
How might I be exposed to used mineral-based

crankcase oil?
q When you change the engine oil in your car.
q Breathing a small amount of the chemicals from the oil
in exhaust fumes or from burning the oil as heating fuel.
q Touching contaminated soil or drinking contaminated
water.
How can used mineral-based crankcase oil

affect my health?
The health effects of used mineral-based crankcase oil
vary depending on the brand and type of oil used and the

Page 2
USED MINERAL-BASED CRANKCASE OIL

CAS # 8002-05-9
characteristics of the engine it came from.

Mechanics and other auto workers who are exposed to
used mineral-based crankcase oil from a large number of cars
have experienced skin rashes, blood effects (anemia), and
headaches and tremors. However, these workers are also exposed to other chemicals, which may have caused these health
effects.
Volunteers who breathed mists of used mineral-based
crankcase oil for a few minutes had slightly irritated noses,
throats, and eyes. Animals that ate large amounts of this oil
developed diarrhea. Thus, people who swallow used mineralbased crankcase oil may also have diarrhea.
Some cows that ate used oil containing metals such as
molybdenum and lead in contaminated pastures experienced
anemia and tremors. Some of the cows died.
We do not know if exposure to used mineral-based
crankcase oil affects the reproductive ability of men or
women or whether it causes birth defects.

exposed to used mineral-based crankcase oil?
Used mineral-based crankcase oil is a mixture of a large
number of chemicals. Its composition depends on the brand of
oil and the characteristics of the engine in which it was used.
However, there are methods for determining if you have been
exposed to some of the chemicals in used oil. These tests arent
available at most doctors offices, but can be done at special
laboratories that have the right equipment.

The EPA and most states have developed regulations regarding disposal of used oil, its recycling, spraying used oil
onto road surfaces for dust control, or burning it as a fuel.
Glossary
How likely is used mineral-based crankcase oil

to cause cancer?
Evaporate: To enter the air as a vapor.
Long-term exposure (365 days or longer) of the skin to

used mineral-based crankcase oil causes skin cancer in mice.
Oils contain PAHs. Some PAHs have been identified as the
cancer-causing agents. Animal tests have shown that the
higher the PAH content in oil, the more likely for the oil to
be carcinogenic.
The Department of Health and Human Services

(IARC), and the EPA have not classified used mineral-based
crankcase oil with regard to its carcinogenicity in people.
PAHs: Polyaromatic hydrocarbons; a group of chemicals found

in oil and other minerals.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Used Mineral-based Crankcase Oil produced
by the Agency for Toxic Substances and Disease Registry, Public Health Service, U.S. Department of Health and Human Services, Public Health Service in Atlanta, GA.
CREOSOTE
CAS # 8021-39-4, 8001-58-9, 8007-45-2
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about creosote. For more
HIGHLIGHTS: Creosote is a mixture of many chemicals. Eating food or

drinking water with high levels of creosote may cause burning in the mouth and
throat, and stomach pain. Long-term contact with creosote has been
associated with increased risk of contracting cancer. Creosote has been found
in at least 46 of the 1,613 National Priorities List sites identified by the
What is creosote?
Creosote is the name used for a variety of products: wood
creosote, coal tar creosote, coal tar, coal tar pitch, and coal
tar pitch volatiles. These products are mixtures of many
chemicals created by burning of beech and other woods,
coal, or from the resin of the creosote bush.
Once in groundwater, it may take years for it to break

down.
Coal tar creosote can build up in plants and animals.
We do not know what happens to wood creosote when it
enters the environment.
How might I be exposed to creosote?

Wood creosote is a colorless to yellowish greasy liquid with
a smoky odor and burned taste. Coal tar creosote is a thick,
oily liquid typically amber to black in color. Coal tar and coal
tar pitch are usually thick, black, or dark-brown liquids or
semi-solids, with a smoky odor.
Wood creosote has been used as a disinfectant, a laxative,
and a cough treatment, but has since been replaced by
better medicines. Coal tar products are used in medicines to
treat skin diseases such as psoriasis, and also as animal and
bird repellents, insecticides, animal dips, and fungicides.
Coal tar creosote is the most widely used wood preservative
in the United States. Coal tar, coal tar pitch, and coal tar
pitch volatiles are used for roofing, aluminum smelting, and
coking.
Using products that contain creosote to improve skin

problems such as eczema or psoriasis.
Eating herbal remedies containing the leaves from the
creosote bush, which are sold as dietary supplements.
Working in the wood preservative, coke-producing, or
asphalt industries.
Using creosote-treated wood in building fences, bridges,
or railroad tracks, or installing telephone poles.
Living in treated-wood houses that may result in air or
skin contact with creosote.
Drinking water contaminated by a hazardous waste site.
How can creosote affect my health?
What happens to creosote when it enters the

environment?
Eating food or drinking water contaminated with high levels

of creosotes may cause a burning in the mouth and throat,
and stomach pains. Taking large amounts of herbal remedies
containing creosote bush leaves may cause damage to the
liver or kidney.
Coal tar creosote is released to water and soil mainly as a

result of its use in the wood preservation industry.
Components of creosote that do not dissolve in water will
remain in place in a tar-like mass.
Some components of coal tar creosote dissolve in water
and may move through the soil to groundwater.
Brief direct contact with large amounts of coal tar creosote

may result in a rash or severe irritation of the skin, chemical
burns of the surfaces of the eyes, convulsions and mental
confusion, kidney or liver problems, unconsciousness, and
even death. Longer direct skin contact with low levels of

CREOSOTE
Page 2
CAS # 8021-39-4, 8001-58-9, 8007-45-2

creosote mixtures or their vapors can result in increased light
sensitivity, damage to the cornea, and skin damage. Longer
exposure to creosote vapors can cause irritation of the
respiratory tract.
How likely is creosote to cause cancer?

Long-term exposure to low levels of creosote, especially
direct contact with the skin during wood treatment or
manufacture of coal tar creosote-treated products, has
resulted in skin cancer and cancer of the scrotum. Cancer of
the scrotum in chimney sweeps has been associated with
long-term skin exposure to soot and coal tar creosotes.
Animal studies have also shown skin cancer from skin
exposure to coal tar products.
determined that coal tar is carcinogenic to humans and that
creosote is probably carcinogenic to humans. The EPA has
determined that coal tar creosote is a probable human
carcinogen.
How can creosote affect children?

There is no unique exposure pathway of children to
creosote. Children exposed to creosote will probably
experience the same health effects seen in adults exposed to
creosote. Children who played on soil contaminated with
creosote had more skin rashes than children who played in
uncontaminated areas. We do not know whether children
differ from adults in their susceptibility to health effects from
creosote.
Studies in animals have shown birth defects in the young of
mothers exposed to high levels of creosote during
pregnancy, but we do not know whether the same effects
would occur in humans. Some animal studies indicate that
creosotes may cross the placenta and reach the fetus.
Because chemical components (PAHs, cresol, phenols) of
coal tar creosote may be stored in body fat, they may be
found in breast milk and could pass to nursing infants.

creosote?
If you live in a residential area that used to have a wood
preservation facility or gas manufacturing plant nearby, wear
long-sleeved shirts and long pants when working or playing
outside and avoid using water contaminated with creosote.
Instruct children not to come in contact with creosotetreated wood when playing on or near railroad tracks, in
ditches close to utility poles, in old barns or other farm
structures, or on bridges or piers.
Avoid using herbal remedies containing the leaves of the
creosote bush and seek alternatives to skin remedies
containing creosote.
If you are exposed to creosote in the workplace, make
sure you do not carry the chemical home in your clothing,
skin, hair, tools, or other objects from the workplace (shower
before going home).

exposed to creosote?
There is no medical test to determine if you have been
exposed to creosote. Some components of creosote mixtures
can be measured in body tissues, urine, or blood after
exposure to creosote. These tests cannot tell whether
harmful health effects will occur. The tests are not routinely
equipment.

has set an exposure limit of 0.2 milligrams of coal tar pitch
volatiles per cubic meter of air (0.2 mg/m3) in workplace air
during an 8-hour day, 40-hour workweek.
(ATSDR). 2002. Toxicological Profile for Creosote (Update).
CRESOLS
CAS # 1319-77-3
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about cresols. For more
SUMMARY: Exposure to cresols occurs mainly from breathing air containing

car exhaust, breathing air from homes heated with coal or wood, and smoking
cigarettes. Cresols, when breathed at very high levels, may cause irritation of the
nose and throat. These chemicals have been found in at least 314 of 1,416
What are cresols?
(Pronounced kr-slz)
q In air, cresols quickly break down into other chemicals.
Cresols are a widely occurring natural and manufactured

group of chemicals. In their pure form, they are colorless
solids and may be liquids if they are mixtures. Cresols smell
like medicine.
q Cresols may last longer in deep groundwater or water that

does not have bacteria.
There are three forms of cresols that are only slightly

different in their chemical structure: ortho-cresol (o-cresol),
meta-cresol (m-cresol), and para-cresol (p-cresol). These forms
occur separately or as a mixture. They are used to dissolve
other chemicals, as disinfectants and deodorizers, and to make
certain chemicals that kill insect pests.
q Cresols do not appear to accumulate in fish or meat.
Cresols are found in many foods and in wood and

tobacco smoke, crude oil, coal tar, and in brown mixtures such
as creosote and cresylic acids, which are wood preservatives.
Small organisms in soil and water produce cresols when they
break down materials in the environment.
What happens to cresols when they enter the

environment?
q Cresols enter the environment from natural sources, car
exhaust, combustion, manufacturing use, and waste sites.
q Cresols appear everywhere in our environment, but
usually at low levels, because they quickly break down.
q Cresols do not evaporate quickly from water, but they can

be removed by bacteria.
q In soil, half the total amount of cresols will break down in

about a week.
How might I be exposed to cresols?

q Breathing contaminated air from car exhaust, coal or
wood combustion, oil refineries, or cigarette smoke.
q Breathing workplace air or skin contact in the workplace.
q Eating foods, including ketchup, tomatoes, cheese,
butter, and bacon, but generally the levels are not
harmful.
q Drinking contaminated water near manufacturing sites,
waste sites, or landfills.
How can cresols affect my health?

Most exposures to cresols are at very low levels that are
not harmful. When cresols are breathed, ingested, or applied
to the skin at very high levels, they can be very harmful.
Effects observed in people include irritation and burning of

CRESOLS
CAS # 1319-77-3
Page 2
skin, eyes, mouth, and throat; abdominal pain and vomiting;

heart damage; anemia; liver and kidney damage; facial
paralysis; coma; and death.
Breathing high levels of cresols for a short time results in
irritation of the nose and throat. Aside from these effects, very
little is known about the effects of breathing cresols, for
example, at lower levels over longer times.
exposure since cresols break down quickly in the body.

Since cresols occur naturally in the body, results of tests
for cresol exposure would have to be compared to results of
tests taken from the same person both before and several days
after the exposure. These tests are usually not available in
your doctors office.
Ingesting high levels results in kidney problems, mouth

and throat burns, abdominal pain, vomiting, and effects on the
blood and nervous system.

Skin contact with high levels of cresols can burn the skin
and damage the kidneys, liver, blood, brain, and lungs.
The EPA requires that discharges or accidental spills of

1,000 pounds or more of cresols be reported.
Short-term and long-term studies with animals have

shown similar effects from exposure to cresols. No human or
animal studies have shown harmful effects from cresols on the
ability to have children.

(OSHA) has set an exposure limit of 22 milligrams per cubic
meter (22 mg/m3) for cresols in workplace air for an 8-hour
workday, 40-hour workweek. OSHA advises avoiding eye
and skin contact because this may be a route of significant
exposure.
It is not known what the effects are from long-term

ingestion or skin contact with low levels of cresols.
How likely are cresols to cause cancer?

The Environmental Protection Agency (EPA) has determined that cresols are possible human carcinogens.
No studies are available in people on the carcinogenic
effects of cresols. Animal studies show that cresols may
increase the ability of some carcinogenic chemicals to cause
tumors.
Glossary
References
been exposed to cresols?
Tests are available that measure the amount of cresols in
the urine. The tests must be performed within one day of

1992. Toxicological profile for cresols: o-cresol, p-cresol, &
m-cresol. Atlanta, GA: U.S. Department of Health and Human
404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html ATSDR can tell you where to find
exposure to hazardous substances. You can also contact your community or state health or environmental quality department if
you have any more questions or concerns.
CROTONALDEHYDE
CAS #4170-30-3
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about crotonaldehyde. For more
summaries about hazardous substances and their health effects. It is important you understand this information
HIGHLIGHTS: The general population can be exposed to crotonaldehyde by

inhaling tobacco smoke, gasoline and diesel engine exhausts, and smoke from
wood burning. People working with crotonaldehyde to manufacture other
chemicals may be exposed to higher levels. Damage to the respiratory system
may occur if you breathe in crotonaldehyde vapors. Contact with the skin or
eye can result in severe injury. This substance has been found in at least 3 of
the 1,585 National Priorities List sites identified by the Environmental
What is crotonaldehyde?
Crotonaldehyde is a clear, colorless to straw colored liquid
with a strong, suffocating odor. It is highly flammable and
produces toxic vapors at room temperature. Crotonaldehyde
is found naturally in emissions of some vegetation and
volcanoes; many foods contain crotonaldehyde in small
amounts.
Crotonaldehyde is mainly used in the manufacture of sorbic
acid, which is a yeast and mold inhibitor. Crotonaldehyde
has been used as a warning agent in fuels, as alcohol
denaturant, as stabilizer for tetraethyl-lead, in the preparation
of rubber accelerators, and in leather tanning.
What happens to crotonaldehyde when it enters

the environment?
When released to air, crotonaldehyde will exist solely as a
gas. Crotonaldehyde gas is degraded rapidly in the
atmosphere by reacting with substances commonly found in
the air. It will only persist in the atmosphere for several
hours to a few days before being degraded.
Crotonaldehyde is soluble in water. It can be broken
down by reacting with substances found in sunlit surface
waters and can also be degraded by bacteria.

Crotonaldehyde also evaporates from water.
Crotonaldehyde is a highly mobile liquid and does not
stick to soil surfaces. Therefore, if it is released to soil it can
travel below the soil surface and contaminate groundwater.
Crotonaldehyde can also evaporate from soil or be degraded
by bacteria commonly found in soil.
Crotonaldehyde does not accumulate in the food chain.
How might I be exposed to crotonaldehyde?

Crotonaldehyde is emitted from the combustion of
gasoline, the burning of wood and the burning of tobacco.
Therefore, the general population may be exposed to
crotonaldehyde through inhalation of tobacco smoke,
gasoline and diesel engine exhausts, and smoke from wood
burning.
Crotonaldehyde is a liquid chemical used to synthesize
other chemicals. Therefore workers employed in occupations
where crotonaldehyde is used may inhale crotonaldehyde
vapors or get the liquid on their skin.
be exposed to higher than normal levels of crotonaldehyde.

CROTONALDEHYDE
Page 2
CAS #4170-30-3

How can crotonaldehyde affect my health?
How can crotonaldehyde affect children?
Crotonaldehyde in the air can irritate your eyes, nose, throat,

and lungs, possibly causing you to cough and experience
chest tightness and shortness of breath. High levels of
crotonaldehyde can cause a build-up of fluid in your lungs,
which may result in death.
Children are probably affected by exposure to

crotonaldehyde in the same ways as adults. We do not
susceptibility to crotonaldehyde.
Some people may become sensitive to crotonaldehyde and

develop a reaction to crotonaldehyde, even at very low
exposure levels.
Since crotonaldehyde is known to be irritating, you might
experience chemical burns of the lips, mouth, throat,
esophagus, and stomach if you were to ingest
crotonaldehyde.
We do not know if exposure to crotonaldehyde will result in

birth defects or other developmental effects in people.

crotonaldehyde?
Families are not likely to be exposed to levels of
crotonaldehyde that would be high enough to cause
problems.
If you come into contact with liquid crotonaldehyde, it can

cause serious burns to your skin or eyes. Some people may
become allergic to crotonaldehyde upon skin contact.

exposed to crotonaldehyde?
We do not know if exposure to crotonaldehyde will result in

reproductive effects in humans. However, crotonaldehyde
has been shown to cause degeneration of sperm cells in
mice.
There are no specific blood or urine tests for

crotonaldehyde. If a severe exposure has occurred,
respiratory function tests and a chest x-ray may show
whether damage has been done to the lungs. These tests
could be performed in a doctors office, clinic, or hospital as
long as they have the proper test equipment.
How likely is crotonaldehyde to cause cancer?

The EPA considers crotonaldehyde to be a possible human
carcinogen. The International Agency for Research on
Cancer (IARC) concluded that crotonaldehyde is not
classifiable as to its carcinogenicity to humans.

sets a limit of 2 parts of crotonaldehyde per million parts of
workroom air (2 ppm) for an 8-hour work shift, 40-hour work
week.
CYANIDE
CAS # 74-90-8, 143-33-9, 151-50-8, 592-01-8,
544-92-3, 506-61-6, 460-19-5, 506-77-4
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about cyanide. For more information,
HIGHLIGHTS: Cyanide is a very poisonous chemical. Exposure to high levels

of cyanide harms the brain and heart, and may cause coma and death. Exposure
to lower levels may result in breathing difficulties, heart pains, vomiting, blood
changes, headaches, and enlargement of the thyroid gland. Cyanide has been
What is cyanide?
(Pronounced s-nd)
Cyanide is usually found joined with other chemicals to
form compounds. Examples of simple cyanide compounds are
hydrogen cyanide, sodium cyanide and potassium cyanide.
Cyanide can be produced by certain bacteria, fungi, and algae, and it is found in a number of foods and plants. In the
body, cyanide combines with a chemical to form Vitamin B12.
Cyanide occurs naturally in cassava roots, which are potatolike tubers of cassava plants grown in tropical countries.
Hydrogen cyanide is a colorless gas with a faint, bitter,
almond-like odor. Sodium cyanide and potassium cyanide are
both white solids with a bitter, almond-like odor in damp air.
Cyanide and hydrogen cyanide are used in electroplating, metallurgy, production of chemicals, photographic development,
making plastics, fumigating ships, and some mining processes.
What happens to cyanide when it enters the

environment?
q Cyanide enters the environment from both natural processes and human industrial activities.
q In air, cyanide is mainly found as gaseous hydrogen cyanide; a small amount is present as fine dust particles.
q It takes about 13 years for half of the hydrogen cyanide

to disappear from the air.
q Most cyanide in surface water will form hydrogen cyanide and evaporate.
q Cyanide in water does not build up in the bodies of fish.
q At high concentrations, cyanide becomes toxic to soil
microorganisms and can pass through soil into underground water.
How might I be exposed to cyanide?

q Breathing air, drinking water, touching soil, or eating
foods containing cyanide.
q Smoking cigarettes and breathing smoke-filled air during
fires are major sources of cyanide exposure.
q Breathing air near a hazardous waste site containing
cyanide.
q Eating foods containing cyanide compounds, such as
cassava roots, lima beans, and almonds.
q Working in an industry where cyanide is used or produced, such as electroplating, metallurgy, metal cleaning,
and photography.
How can cyanide affect my health?

In large amounts, cyanide is very harmful to people. Expo-

CYANIDE
Page 2
CAS # 74-90-8, 143-33-9, 151-50-8, 592-01-8,

544-92-3, 506-61-6, 460-19-5, 506-77-4
ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov:/toxfaq.html

sure to high levels of cyanide in the air for a short time harms
the brain and heart, and may cause coma and death.
after the exposure. An almond-like odor in the breath may alert

a doctor that a person was exposed to cyanide.
Exposure to lower levels of cyanide for a long time may

result in breathing difficulties, heart pains, vomiting, blood
changes, headaches, and enlargement of the thyroid gland.

People who eat large amounts of cyanide may have symptoms including deep breathing and shortness of breath, convulsions, and loss of consciousness, and may die. Use of cassava roots as a primary food source in tropical Africa has led to
high blood cyanide levels.
People with high blood cyanide levels have also shown
harmful effects such as weakness of the fingers and toes, difficulty walking, dimness of vision, deafness, and decreased thyroid gland function, but chemicals other than cyanide may
have contributed to these effects. Skin contact with cyanide
can produce irritation and sores.
It is not known whether cyanide can directly cause birth
defects in people. Birth defects were seen in rats that ate diets
of cassava roots. Effects on the reproductive system were seen
in rats and mice that drank water containing sodium cyanide.
The EPA has set a maximum contaminant level of cyanide

in drinking water of 0.2 milligrams cyanide per liter of water
(0.2 mg/L). The EPA requires that spills or accidental releases
into the environment of 1 pound or more of hydrogen cyanide,
potassium cyanide, sodium cyanide, calcium cyanide or copper cyanide be reported to the EPA.
(OSHA) and (other recommendations) the American Conference of Governmental Industrial Hygienists (ACGIH) have
set a permissible exposure limit of 5 milligrams of cyanide
per cubic meter of air (5 mg/m3) in the workplace during an
Glossary
How likely is cyanide to cause cancer?
The EPA has determined that cyanide is not classifiable as

to its human carcinogenicity. There are no reports that cyanide
can cause cancer in people or animals.

exposed to cyanide?
There are medical tests to measure blood and urine levels
of cyanide; however, small amounts of cyanide are always
detectable in blood and urine. Tissue levels of cyanide can be
measured if cyanide poisoning is suspected, but cyanide is
rapidly cleared from the body, so the tests must be done soon
This ToxFAQs information is taken from the 1997 Toxicological Profile for Cyanide (update) produced by the Agency
DDT, DDE, AND DDD

CAS # 50-29-3, 72-55-9, 72-54-8
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about DDT, DDE, and
DDD. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is
one in a series of summaries about hazardous substances and their health effects. It is important you
HIGHLIGHTS: Exposure to DDT, DDE, and DDD occurs mostly from eating
foods containing small amounts of these compounds, particularly meat, fish and
poultry. High levels of DDT can affect the nervous system causing excitability,
tremors and seizures. In women, DDE can cause a reduction in the duration of
lactation and an increased chance of having a premature baby. DDT, DDE,
and DDD have been found in at least 441 of the 1,613 National Priorities List
What are DDT, DDE, and DDD?
DDT (dichlorodiphenyltrichloroethane) is a pesticide once
widely used to control insects in agriculture and insects that
carry diseases such as malaria. DDT is a white, crystalline
solid with no odor or taste. Its use in the U.S. was banned
in 1972 because of damage to wildlife, but is still used in
some countries.
DDE (dichlorodiphenyldichloroethylene) and DDD
(dichlorodiphenyldichloroethane) are chemicals similar to
DDT that contaminate commercial DDT preparations. DDE
has no commercial use. DDD was also used to kill pests,
but its use has also been banned. One form of DDD has
been used medically to treat cancer of the adrenal gland.
What happens to DDT, DDE, and DDD when

they enter the environment?
DDT entered the environment when it was used as a
pesticide; it still enters the environment due to current use
in other countries.
DDE enters the environment as contaminant or breakdown
product of DDT; DDD also enters the environment as a
breakdown product of DDT.
DDT, DDE, and DDD in air are rapidly broken down by
sunlight. Half of whats in air breaks down within 2 days.
They stick strongly to soil; most DDT in soil is broken
down slowly to DDE and DDD by microorganisms; half the
DDT in soil will break down in 2-15 years, depending on the
type of soil.
Only a small amount will go through the soil into

groundwater; they do not dissolve easily in water.
DDT, and especially DDE, build up in plants and in fatty
tissues of fish, birds, and other animals.
How might I be exposed to DDT, DDE, and

DDD?
Eating contaminated foods, such as root and leafy
vegetables, fatty meat, fish, and poultry, but levels are very
low.
Eating contaminated imported foods from countries that
still allow the use of DDT to control pests.
Breathing contaminated air or drinking contaminated water
near waste sites and landfills that may contain higher levels
of these chemicals.
Infants fed on breast milk from mothers who have been
exposed.
Breathing or swallowing soil particles near waste sites or
landfills that contain these chemicals.
How can DDT, DDE, and DDD affect my health?

DDT affects the nervous system. People who accidentally
swallowed large amounts of DDT became excitable and had
tremors and seizures. These effects went away after the
exposure stopped. No effects were seen in people who took
small daily doses of DDT by capsule for 18 months.
A study in humans showed that women who had high
amounts of a form of DDE in their breast milk were unable to

DDT, DDE, AND DDD
Page 2
CAS # 50-29-3, 72-55-9, 72-54-8

breast feed their babies for as long as women who had little
DDE in the breast milk. Another study in humans showed
that women who had high amounts of DDE in breast milk
had an increased chance of having premature babies.
In animals, short-term exposure to large amounts of DDT in
food affected the nervous system, while long-term exposure
to smaller amounts affected the liver. Also in animals, shortterm oral exposure to small amounts of DDT or its
breakdown products may also have harmful effects on
reproduction.
How likely are DDT, DDE, and DDD to cause

cancer?
Studies in DDT-exposed workers did not show increases in
cancer. Studies in animals given DDT with the food have
shown that DDT can cause liver cancer.
determined that DDT may reasonable be anticipated to be a
human carcinogen. The International Agency for Research
on Cancer (IARC) determined that DDT may possibly cause
cancer in humans. The EPA determined that DDT, DDE, and
DDD are probable human carcinogens.
How can DDT, DDE, and DDD affect children?

exposed to DDT, DDE, or DDD. We can assume that
children exposed to large amounts of DDT will have health
effects similar to the effects seen in adults. However, we do
not know whether children differ from adults in their
susceptibility to these substances.
There is no evidence that DDT, DDE, or DDD cause birth
defects in people. A study showed that teenage boys whose
mothers had higher DDE amounts in the blood when they
were pregnant were taller than those whose mothers had
lower DDE levels. However, a different study found the
opposite in preteen girls. The reason for the discrepancy
between these studies is unknown.
Studies in rats have shown that DDT and DDE can mimic
the action of natural hormones and in this way affect the
development of the reproductive and nervous systems.
Puberty was delayed in male rats given high amounts of DDE
as juveniles. This could possibly happen in humans.
A study in mice showed that exposure to DDT during the

first weeks of life may cause neurobehavioral problems later
in life.

DDT,DDE, and DDE?
Most families will be exposed to DDT by eating food or
drinking liquids contaminated with small amounts of DDT.
Cooking will reduce the amount of DDT in fish.
Washing fruit and vegetables will remove most DDT from
their surface.
Follow health advisories that tell you about consumption
of fish and wildlife caught in contaminated areas.

exposed to DDT, DDE, and DDD?
Laboratory tests can detect DDT, DDE, and DDD in fat,
blood, urine, semen, and breast milk. These tests may show
low, moderate, or excessive exposure to these compounds,
but cannot tell the exact amount you were exposed to, or
whether you will experience adverse effects. These tests are
not routinely available at the doctors office because they
require special equipment.

sets a limit of 1 milligram of DDT per cubic meter of air (1
mg/m3) in the workplace for an 8-hour shift, 40-hour
workweek.
The Food and Drug Administration (FDA) has set limits for
DDT, DDE, and DDD in foodstuff at or above which the
agency will take legal action to remove the products from the
market.
(ATSDR). 2002. Toxicological Profile for DDT/DDE/DDD
DIAZINON
CAS # 333-41-5
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about diazinon. For more
HIGHLIGHTS: Exposure to diazinon is most significant in people who work

in the manufacture and professional application of this insecticide. Very high
levels of exposure to diazinon have resulted in death. Some mild symptoms of
exposure include headache, dizziness, weakness, feelings of anxiety, constriction
of the pupils of the eye, and not being able to see clearly. Diazinon has been found
What is diazinon?
(Pronounced d-z-nn)
Diazinon is the common name of an organophosphorus
insecticide used to control pest insects in soil, on ornamental
plants, and on fruit and vegetable field crops. It is also used to
control household pests such as flies, fleas, and cockroaches.
This chemical is manufactured and does not occur naturally in
the environment.
The pure chemical is a colorless and practically odorless
oil. Preparations used in agriculture and by exterminators
contain 8590% diazinon and appear as a pale to dark-brown
liquid. Diazinon preparations available for home and garden
use contain 15% diazinon in a liquid or as solid granules.
Most of the diazinon used is in liquid form, but it is possible to be exposed to the chemical in a solid form. Diazinon
does not burn easily and does not dissolve easily in water.
q It is often sprayed on crops and plants, so small particles

of the chemical may be carried away from the field or yard
before falling to the ground.
q After diazinon has been applied, it may be present in the
soil, surface waters, and on the surface of the plants.
q Diazinon on soil and plant surfaces may be washed into
surface waters by rain.
q In the environment, diazinon is rapidly broken down into
a variety of other chemicals. It can move through the soil
and contaminate ground water.
q Diazinon is not likely to build up to high or dangerous
levels in animal or plant foods that you might eat.
How might I be exposed to diazinon?

q People who work in the manufacture and professional
application of diazinon have the most significant exposure to this insecticide.
q Exposure may occur by contact with contaminated soils
or contaminated runoff water or groundwater.
What happens to diazinon when it enters the

environment?
q Small amounts have been detected in foods, but the levels

in food are far below the levels that might cause any
harmful health effects.
q Most environmental diazinon contamination comes from

agricultural and household application to control insects.
How can diazinon affect my health?
q Diazinon may also enter the environment during the

manufacturing process.
Most cases of unintentional diazinon poisoning in people

have resulted from short exposures to very high concentra-

DIAZINON
CAS # 333-41-5
Page 2

tions of the material. Very high levels of exposure to diazinon
have resulted in death in people accidentally exposed and in
those who have swallowed large amounts of the chemical to
commit suicide.
urine. These tests aren't routinely available at most doctors'

offices, but can be done at special laboratories that have the
right equipment.
Diazinon affects the nervous system. Some mild symptoms Has the federal government made
include headache, dizziness, weakness, feelings of anxiety,
constriction of the pupils of the eye, and not being able to see
The EPA has developed 1- and 10-day health advisories
clearly. More severe symptoms include nausea and vomiting,
(maximum
recommended drinking water concentrations) for
abdominal cramps, slow pulse, diarrhea, pinpoint pupils, diffiadults and children of 20 micrograms per liter of water
culty breathing, and coma.
(20 mg/L).
Damage to the pancreas has developed in some people and
in laboratory animals exposed to large amounts of diazinon. In
Glossary
animal studies, high doses of diazinon produced effects on the
nervous system similar to those seen in people.
There is no evidence that long-term exposure to low levels
of diazinon causes any harmful health effects in people.
How likely is diazinon to cause cancer?

Cholinesterase: An enzyme found in the blood.

Diazinon has not been shown to cause cancer in people or
animals. The Department of Health and Human Services
Microgram (mg): One millionth of a gram.
Organophosphate: Chemicals made of phosphorus, carbon,
(IARC), and the EPA have not classified diazinon as to its carciand other compounds.
nogenicity.
exposed to diazinon?
This ToxFAQs information is taken from the 1996 Toxicological Profile for Diazinon produced by the Agency for Toxic
The most common test for exposure to diazinon is to deter- Substances and Disease Registry, Public Health Service, U.S.
Department of Health and Human Services, Public Health Sermine the level of cholinesterase activity in the red blood cells
or plasma. This test requires only a small amount of blood and vice in Atlanta, GA.
is routinely available in your doctors office; however, this test
does not specifically show exposure to diazinon.
Specific tests are available to determine the presence of
diazinon or its breakdown products in blood, body tissue, and
DIBORANE
CAS #19287-45-7
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about diborane. For more
HIGHLIGHTS: Diborane is a manufactured, toxic, flammable gas. Exposure

can occur primarily during manufacture or use in industry. The general
population is not exposed to diborane. Exposure to diborane can cause
irritation of the eyes, nose, throat, and respiratory airway. It can also cause
skin irritation. This substance has been found in at least 3 of the 1,585 National
What is diborane?
Diborane is a colorless gas at room temperature with a
repulsive, sweet odor. It mixes well with air and easily forms
explosive mixtures. Diborane will ignite spontaneously in
moist air at room temperature.
Diborane is used in rocket propellants, as a reducing agent,
as a rubber vulcanizer, as a catalyst for hydrocarbon
polymerization, as a flame-speed accelerator, and as a doping
agent. It is also used in electronics to impart electrical
properties in pure crystals.
What happens to diborane when it enters the

environment?
Diborane is a gas that can spontaneously burn or explode
in air at normal room temperatures.
Diborane is slightly soluble in water, but it will decompose
rapidly when in contact with water producing boric acid and
hydrogen gas which is very flammable.
Diborane is a gas that is not found in soil. If released to

soil it is likely that it would react violently and
spontaneously combust.
Diborane does not accumulate in the food chain.
How might I be exposed to diborane?

Diborane is a very dangerous gas that is only used in
chemical laboratories by experienced professionals. The
general population will not be exposed to diborane.
Diborane is a very toxic, flammable, gas used by chemists
to make other compounds. Workers employed in
occupations that manufacture or use diborane may be
exposed to this compound by breathing in its vapors.
How can diborane affect my health?

The toxic effects of diborane are primarily due to its irritant
properties. Short-term exposure to diborane can cause a
sensation of tightness of the chest, shortness of breath,

DIBORANE
Page 2
CAS #19287-45-7
cough, and wheezing. These signs and symptoms can occur

immediately or be delayed for up to 24 hours. Skin and eye
irritation can also occur. Studies in animals have shown that
diborane causes the same type of effects observed in
humans.
People exposed for a long time to low amounts of diborane
have experienced respiratory irritation, seizures, fatigue,
drowsiness, confusion, and occasional transient tremors.
There is no information to determine whether exposure to
diborane affects the reproductive system in humans or in
animals.
How likely is diborane to cause cancer?

There are no studies of carcinogenicity of diborane in
humans or in animals. The Department of Health and Human
Services (DHHS), the International Agency for Research on
Cancer (IARC), and the EPA have not classified diborane as
to its carcinogenicity.
How can diborane affect children?

diborane?
diborane.

exposed to diborane?
There are no tests for measuring diborane levels in the body.
If you suspect that you have been exposed to diborane, a
chest x-ray and pulmonary function tests may be appropriate
to determine if your lungs have been damaged. These tests
are usually not available in the doctors office, but can be
done in a hospital or clinic.

sets a limit for diborane in workplace air of 0.1 parts of
diborane per million parts of air (0.1 ppm) for an 8-hour
workday, 40-hour work week.

exposed to diborane. Although exposure of children to
diborane is unlikely, it is reasonable to assume that it will
cause health effects similar to those seen in adults.
We do not know if exposure to diborane will result in birth
1,2-DIBROMO-3-CHLOROPROPANE
CAS # 96-12-8
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2-dibromo-3chloropropane. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact
sheet is one in a series of summaries about hazardous substances and their health effects. This information
is important because this substance may harm you. The effects of exposure to any hazardous substance
SUMMARY: Exposure to 1,2-dibromo-3-chloropropane occurs mainly from

drinking water or eating food that contains the chemical. At high levels, this chemical
may cause damage to the male reproductive system. This chemical has been found
Protection Agency.
What is 1,2-dibromo-3-chloropropane?
(Pronounced 1,2-dbrm-3-klr prpn)
q In soil, some evaporates into the air, while small amounts

may stay in the soil for several years.
1,2-Dibromo-3-chloropropane is a manufactured chemical

and is not found naturally in the environment. It is a colorless
liquid with a sharp smell. It can be tasted in water at very low
concentrations.
How might I be exposed to 1,2-dibromo3-chloropropane?
Some industries use it to make another chemical that is

used to make materials that resist burning.
Large amounts of 1,2-dibromo-3-chloropropane were used
in the past on certain farms to kill pests that harmed crops.
Farmers in all states other than Hawaii stopped using this
chemical in 1979. Hawaii stopped using it in 1985.
We do not know exactly how much of it is currently made
or used by industry, but it is probably a small amount.
What happens to 1,2-dibromo-3-chloropropane when it enters the environment?

q Most of it that enters surface water evaporates into the air
within several days or a week.
q It takes several months for it to break down in air.
q It doesn't stick to soil at the bottom of rivers, lakes, or
ponds.
q Drinking water or eating food that contains the chemical.

q Breathing air or touching soil at or near agricultural areas
where 1,2-dibromo-3-chloropropane was used in the past.
q Breathing air at hazardous waste sites where improper
disposal methods were used.
q Working in an industry that uses 1,2-dibromo-3chloropropane.
How can 1,2-dibromo-3-chloropropane affect

my health?
The main effect from breathing high levels of
1,2-dibromo-3-chloropropane is damage to the male's ability
to reproduce.
Studies on workers have shown that men may produce
fewer sperm, produce sperm that results in more girl than boy
babies, and eventually become unable to father children. It
can also cause headaches, nausea, lightheadedness, and
weakness in workers.
Animals breathing high levels of the chemical were not

Page 2
1,2-DIBROMO-3-CHLOROPROPANE
CAS # 96-12-8

able to reproduce and had damaged stomachs, livers, kidneys,
brains, spleens, blood, and lungs. Breathing low to moderate
levels also caused damage to the reproductive system.
The ability of people to reproduce was not affected by
drinking water contaminated with low levels of 1,2-dibromo3-chloropropane and there was no increase in the number of
birth defects. Rats exposed to high levels did, however, have
an increase in birth defects. It can also cause skin and eye
damage from direct contact.
How likely is 1,2-dibromo-3-chloropropane to

cause cancer?
determined that 1,2-dibromo-3-chloropropane may reasonably be anticipated to be a carcinogen.
Animal studies found cancer of the nose in animals
exposed by breathing the chemical, cancer of the stomach and
kidney in animals that ingested the chemical, and cancer of
the stomach and skin in animals who had skin contact with
the chemical.
We do not know if these same cancers would occur in
people.
Because exposure to this chemical lowers the number of

sperm, we can count the number of sperm and blood levels of
certain hormones in exposed men to determine whether
harmful effects have occurred. However, these changes
cannot tell the level or length of exposure to the chemical.

The Environmental Protection Agency (EPA) has set a
limit of 0.2 parts of 1,2-dibromo-3-chloropropane per billion
parts of drinking water (0.2 ppb). EPA requires that discharges or spills into the environment of 1 pound or more of
1,2-dibromo-3-chloropropane be reported. EPA banned the
use of 1,2-dibromo-3-chloropropane as a pesticide in the
United States in the early 1980s.
(OSHA) has set an occupational exposure limit of 1 part of
1,2-dibromo-3-chloropropane in one billion parts of air
(1 ppb) for an 8-hour workday over a 40-hour workweek.
Health (NIOSH) currently recommends that workers breathe
as little 1,2-dibromo-3-chloropropane as possible.
Glossary
been exposed to 1,2-dibromo-3-chloropropane?

Tests are available that measure the amount of

1,2-dibromo-3-chloropropane in exhaled air, blood, and
samples of tissues from the body. These tests may require
special equipment and they may not be available in your
doctors office.
References
1992. Toxicological profile for 1,2-dibromo3-chloropropane. Atlanta, GA: U.S. Department of Health and
1,2-DIBROMOETHANE
CAS # 106-93-4
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2-dibromoethane.
For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one
in a series of summaries about hazardous substances and their health effects. This information is
important because this substance may harm you. The effects of exposure to any hazardous substance
SUMMARY: Exposure to 1,2-dibromoethane can result from drinking groundwater

or breathing air that is contaminated. This is most likely to occur in the workplace
or from living near a hazardous waste site. 1,2-Dibromoethane can affect the brain,
damage skin, damage sperm in males, and even cause death if exposure is very high.
This chemical has been found in at least 27 of 1,416 National Priorities List sites
identified by the Environmental Protection Agency.
What is 1,2-dibromoethane?
(Pronounced 1,2-dbrm thn)
1,2-Dibromoethane is a manufactured chemical. It also
occurs naturally in small amounts in the ocean where it is
formed, probably by algae and kelp. It is a colorless liquid
with a mild, sweet odor. Other names for 1,2-dibromoethane
are ethylene dibromide, EDB, and glycol bromide. Trade
names include Bromofume and Dowfume.
1,2-Dibromoethane has been used as a pesticide in soil,
and on citrus, vegetable, and grain crops. Most of these uses
have been stopped by the Environmental Protection Agency
(EPA) since 1984. Another major use was as an additive in
leaded gasoline; however, since leaded gasoline is now
banned, it is no longer used for this purpose. Uses today
include treatment of logs for termites and beetles, control of
moths in beehives, and as a preparation for dyes and waxes.
What happens to 1,2-dibromoethane when it

q It moves into the environment from manufacturing use
and leaks at waste sites.
q When released, it quickly moves to air and will evaporate
from surface water and soil to the air.
q It dissolves in water and will move through soil into the
groundwater.
q Small amounts remain attached to soil particles.

q It breaks down slowly in air (over 45 months), more
quickly in surface water (2 months), and hardly at all in
groundwater.
q It is not expected to build up in plants or animals.
How might I be exposed to 1,2-dibromoethane?

q Drinking contaminated water, especially well water near
farms or waste sites.
q Touching it while bathing or swimming in contaminated
water.
q Playing in contaminated soils at waste sites.
How can 1,2-dibromoethane affect my

health?
Your exposure to 1,2-dibromoethane is generally much,
much lower than levels that can harm you. We don't know the
effects on people of breathing high levels, but animal studies
with short-term exposures to high levels caused depression
and collapse, indicating effects on the brain.
Redness and inflammation, including skin blisters and
mouth and stomach ulcers, can occur if large amounts are

1,2-DIBROMOETHANE
CAS #106-93-4
Page 2

swallowed. One accidental swallowing caused death in a
woman. It is highly unlikely that there would be a risk of
death to people from low-level exposure.
ion, a breakdown product of 1,2-dibromoethane, in blood.

These tests cannot be done at your doctor's office, but your
doctor may be able to send samples to a special laboratory.
Although very little is known about the effects from

breathing 1,2-dibromoethane over a long period of time, some
male workers had reproductive effects including damage to
their sperm. No other long-term effects are known in people.

In rats, death occurred from breathing high levels for a

short time. Lower levels caused liver and kidney damage.
When rats breathed air or ate food containing 1,2-dibromoethane for short or long periods of time, they were less fertile
or had abnormal sperm.
Changes in the brain and behavior were also seen in
young rats whose male parents had breathed 1,2-dibromoethane, and birth defects were observed in the young of
animals that were exposed while pregnant. 1,2-Dibromoethane is not known to cause birth defects in people.
How likely is 1,2-dibromoethane to cause

cancer?
determined that 1,2-dibromoethane may reasonably be
There are no reports of cancer in workers or other people
exposed to 1,2-dibromoethane for several years. However, rats
and mice that breathed, swallowed, or touched it for long
periods had cancer in many organs.

been exposed to 1,2-dibromoethane?
There is no reliable medical test to determine whether
you have been exposed to 1,2-dibromoethane. Experimental
methods exist to measure 1,2-dibromoethane or the bromide
The EPA has set a limit of 0.05 parts of 1,2-dibromoethane per billion parts of drinking water (0.05 ppb). EPA
requires that spills into the environment of 1,000 pounds or
more of 1,2-dibromoethane be reported.
The Occupational Health and Safety Administration
(OSHA) has limited workers' exposure to an average of 20
parts of 1,2-dibromoethane per million parts of air (ppm) for
an 8-hour workday over a 40-hour workweek.
Health (NIOSH) has limited workers' exposure to
1,2-dibromoethane in air to an average of 0.045 ppm for up
to a 10-hour workday over a 40-hour workweek.
Glossary
References
1992. Toxicological profile for 1,2-dibromoethane. Atlanta,
Health Service.
1,4-DICHLOROBENZENE
CAS # 106-46-7
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 1,4-dichlorobenzene. For
of summaries about hazardous substances and their health effects. Its important you understand this
are present.
HIGHLIGHTS: Exposure to 1,4-dichlorobenzene happens mostly from

breathing high levels in indoor air or workplace air. Extremely high exposures
can cause dizziness, headaches, and liver problems. 1,4-Dichlorobenzene has
been found in at least 281 of 1,467 National Priorities List sites identified by
What is 1,4-dichlorobenzene?
(Pronounced 1,4-d klr bn zn)
q It evaporates easily from water and soil, so most is found

in the air.
q It is taken up and retained by plants and fish.
1,4-Dichlorobenzene is a chemical used to control moths,

molds, and mildew, and to deodorize restrooms and waste containers. It is also called para-DCB or p-DCB. Other names include Paramoth, Para crystals, and Paracide reflecting its widespread use to kill moths.
How might I be exposed to 1,4-dichlorobenzene?
At room temperature, p-DCB is a white solid with a

strong, pungent odor. When exposed to air, it slowly changes
from a solid to a vapor. It is the vapor that acts as a deodorizer
or insect killer. Most people recognize the odor as the smell of
mothballs, and can smell p-DCB in the air at very low levels.
Most p-DCB in our environment comes from its use in moth
repellent products and in toilet deodorizer blocks.
q Drinking contaminated water around hazardous waste

sites.
What happens to 1,4-dichlorobenzene when it

There is no evidence that moderate use of common

household products that contain p-DCB will result in harmful
effects to your health. Harmful effects, however, may occur
from high exposures. Very high usage of p-DCB products in
the home can result in dizziness, headaches, and liver problems. Some of the patients who developed these symptoms
had been using the products for months or even years after
q In air, it breaks down to harmless products in about a

month.
q It does not dissolve easily in water.
q It is not easily broken down by soil organisms.
q Breathing indoor air in public restrooms and homes that

use p-DCB as a deodorizer.
q Breathing air around some mothballs (check the label).
q Breathing workplace air where p-DCB is manufactured.
q Eating foods such as pork, chicken, and eggs that are

contaminated with p-DCB from its use as an odor control
product in animal stalls.
q Eating fish from contaminated waters.
How can 1,4-dichlorobenzene affect my health?

1,4-DICHLOROBENZENE
CAS # 106-46-7
Page 2

they first began to feel ill.
Workers breathing high levels of p-DCB (1,000 times more
than levels in deodorized rooms) have reported painful irritation of the nose and eyes. There are cases of people who have
eaten p-DCB products regularly for months to years because of
its sweet taste. These people had skin blotches and lower numbers of red blood cells.
How likely is 1,4-dichlorobenzene to cause

cancer?
has determined that p-DCB may reasonably be anticipated to
be a carcinogen. There is no direct evidence that p-DCB can
cause cancer in humans. However, animals given very high
levels in water developed liver and kidney tumors.
How can 1,4-dichlorobenzene affect children?

Children are exposed to p-DCB in many of the same ways
that adults are. Children may be at higher risk, due to accidental exposures such as swallowing p-DCB used in the home in
mothballs or toilet bowl deoderant blocks. There is very little
information on how children react to p-DCB exposure, but
children would probably show the same effects as adults.
No studies in people or animals show that p-DCB crosses
the placenta or can be found in fetal tissues. Based on other
similar chemicals, it is possible that this could occur. There is
no credible evidence that p-DCB causes birth defects. One
study found dichlorobenzenes in breast milk, but p-DCB has
not been specifically measured.

1,4-dichlorobenzene?
You should not let children play with or drink toilet bowl
water because it may contain p-DCB. Do not let children rub
mothballs or cleaners containing p-DCB on their skin. Pesti-
cides, bathroom deoderizers, and mothballs containg p-DCB

should be stored out of reach of young children. Always store
household chemicals in their original containers. Never store
them in containers children would find attractive to eat or
drink from, such as old soda bottles.

exposed to 1,4-dichlorobenzene?
Tests are available to measure your exposure to p-DCB.
The most common test measures a breakdown product of pDCB called 2,5-dichlorophenol in urine and blood. If there is
2,5-dichlorophenol in the urine, it indicates that the person
was exposed to p-DCB within the previous day or two. The test
that measures p-DCB in your blood is less common.

The EPA has set a maximum contaminant level of 75 micrograms of p-DCB per liter of drinking water (75 g/L).
p-DCB is also an EPA-registered pesticide. Manufacturers
must provide certain information to EPA for it to be used as a
pesticide.
(OSHA) has set a maximum level of 75 parts of p-DCB per million parts air in the workplace (75 ppm) for an 8-hour day,
40-hour workweek.
(ATSDR). 1998. Toxicological profile for 1,4-dichlorobenzene.
3,3'-DICHLOROBENZIDINE
CAS # 91-94-1
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 3,3'-dichlorobenzidine. For
HIGHLIGHTS: Exposure to 3,3'-dichlorobenzidine may cause sore throat,

respiratory infections, stomach upset, headache, dizziness, burns, and dermatitis.
It has been found to cause tumors in a variety of organs in animals. This substance
What is 3,3'-dichlorobenzidine?
(Pronounced 3,3-d klr bn z dn)
3,3'-Dichlorobenzidine is a gray-to-purple colored crystalline solid. It changes from a solid to a gas very slowly.
3,3'-Dichlorobenzidine salt is the major form in actual
use. It is a stable, off-white colored crystalline solid that does
not evaporate. Neither 3,3'-dichlorobenzidine nor its salt are
found naturally in the environment. They are manufactured
for pigments for printing inks, textiles, plastics and enamels,
paint, leather, and rubber.
What happens to 3,3'-dichlorobenzidine when it

q
q
q
q
3,3'-Dichlorobenzidine breaks down rapidly when exposed to natural sunlight.

About half of the chemical breaks down within 10 hours
in air and sunlight.
In water exposed to natural sunlight, it will break down
even more rapidly.
In soil, where no sunlight is present, it may last for several
months.
Under certain conditions, 3,3'-dichlorobenzidine in soil

can break down to form another chemical, benzidine.
How might I be exposed to 3,3'-dichlorobenzidine?
q
q
q
q
It is used to make pigments to color various substances.

You may be exposed if you work in a place where it is
manufactured or used.
The most common ways to be exposed are by breathing
dust or getting it on your skin.
You could be exposed through dirt or water if you lived
near a plant that uses it, or a hazardous waster site that
contains it.
How can 3,3'-dichlorobenzidine affect my health?

The salt form of 3,3'-dichlorobenzidine may have caused
sore throat, respiratory infections, stomach upset, headache,
dizziness, caustic burns, and dermatitis (an inflammation of
the skin) in workers exposed to the chemical. However, with
the exception of dermatitis, it is not certain that 3,3'-dichlorobenzidine caused these effects because the workers were exposed to other chemicals at the same time.

3,3'-DICHLOROBENZIDINE
CAS # 91-94-1
Page 2

How likely is 3,3'-dichlorobenzidine to cause
cancer?

exposed to 3,3'-dichlorobenzidine?
Studies show that 3,3'-dichlorobenzidine caused cancer of

the liver, skin, breast, bladder, and tissues that form blood (leukemia) and other organs in laboratory animals that ate it in
their food. Studies in people are inconclusive.
There are tests that can determine the presence of

3,3'-dichlorobenzidine in your urine. These tests are not commonly available to the general population, but are available to
workers who may have been exposed to potentially harmful
levels of the chemical in the workplace.

has determined that 3,3'-dichlorobenzidine and its salt form
may reasonably be expected to be a carcinogen.
How can 3,3'-dichlorobenzidine affect children?

There are no studies on the health effects of children exposed to 3,3'-dichlorobenzidine. In studies in which pregnant
mice were injected with high amounts of 3,3'-dichlorobenzidine under the skin, the kidneys of their babies did not develop properly and some babies developed kidney tumors.
However, it is very unlikely that people will encounter such
exposure conditions.
There is some evidence that 3,3'-dichlorobenzidine and its
breakdown products can cross the placenta. We do not know if
it can be transferred to babies by breast milk.
The tests are accurate, but because 3,3'-dichlorobenzidine

does not stay in the body for very long, they must be done as
soon as possible after exposure.

environment of 1 pound or more of 3,3'-dichlorobenzidine be
(NIOSH) considers 3,3'-dichlorobenzidine a "potential occupational carcinogen" and recommends workplace practices and
controls to reduce exposures to the lowest possible level.
3,3'-dichlorobenzidine?
Adults who work with 3,3'-dichlorobenzidine should be
careful not to bring home contaminated clothing or tools. If
you live near a plant that uses 3,3'-dichlorobenzidine or a hazardous waste site that contains it, you and your children
should be careful to wash your hands frequently, especially
before eating and children should be prevented from putting
their dirty hands in their mouths.

(ATSDR). 1998. Toxicological profile for
3,3'-dichlorobenzidine. Atlanta, GA: U.S. Department of
1,1-DICHLOROETHANE
CAS # 75-34-3
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 1,1-dichloroethane. For
of summaries about hazardous substances and their health effects. This information is important because
this substance may harm you. The effects of exposure to any hazardous substance depend on the dose, the
HIGHLIGHTS: 1,1-Dichloroethane is used to make other chemicals and to dissolve

and remove grease. Breathing very high levels can affect your heart and animal
studies have seen kidney disease from long-term exposure to high levels in air.
1,1-Dichloroethane has been found in at least 248 of the 1,430 National Priorities
What is 1,1-dichloroethane?
q 1,1-Dichloroethane does not dissolve easily in water.
(Pronounced 1,1-d klr th n)
q Small amounts of 1,1-dichloroethane released to soil can

evaporate into the air or move into groundwater.
1,1-Dichloroethane is a colorless, oily liquid with a sweet

odor. It evaporates easily at room temperature and burns easily.
It does not occur naturally in the environment.
q It is not known how long it stays in soil.
In the past, 1,1-dichloroethane was used as a surgical

anesthetic, but it is no longer used this way. Today it is used
primarily to make other chemicals, to dissolve substances
such as paint, varnish, and finish removers, and to remove
grease.
q 1,1-Dichloroethane is not expected to build up in the

body tissues of animals.
How might I be exposed to 1,1-dichloroethane?

q Breathing air containing it from industrial releases or
q Drinking contaminated tap water.
q Touching soil containing it.
What happens to 1,1-dichloroethane when it

q Touching contaminated materials in the workplace.
q 1,1-Dichloroethane is released from industrial processes

primarily to the air.
How can 1,1-dichloroethane affect my health?
q 1,1-Dichloroethane evaporates from water rapidly into

the air.
q It can also be found in the air as a breakdown product of
another chemical, 1,1,1-trichloroethane.
Very limited information is available on the effects of

1,1-dichloroethane on peoples health. The chemical was discontinued as a surgical anesthetic when effects on the heart,
such as irregular heart beats, were reported.

1,1-DICHLOROETHANE
Page 2
CAS # 75-34-3
Studies in animals have shown that 1,1-dichloroethane

can cause kidney disease after long-term exposure to high
levels in air. Delayed growth was seen in the offspring of animals who breathed high concentrations of the chemical during
pregnancy.
How likely is 1,1-dichloroethane to cause cancer?

the EPA have not classified 1,1-dichloroethane for carcinogenicity.
1,1-Dichloroethane caused cancer in one study in which
rats and mice were fed large doses of the chemical for their
lifetimes.

exposed to 1,1-dichloroethane?
Tests are available that measure 1,1-dichloroethane in
urine, blood, breath, and body tissues. These tests aren't available at most doctors' offices, but can be done at a special laboratory that has special equipment.
The tests must be done soon after exposure occurs, because most of the 1,1-dichloroethane that is taken into the
body leaves within 2 days. In addition, these tests cannot
tell you when you were exposed, or whether health effects
will occur.

environment of 1,000 pounds or more of 1,1-dichloroethane be

(OSHA) has set an occupational exposure limit of 400 milligrams of 1,1-dichloroethane per cubic meter of air (400 mg/m3)
for an 8-hour workday, 40-hour workweek.
(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) recommend the same exposure limit
in air.
NIOSH currently recommends that a level of 12,150
mg/m3 be considered immediately dangerous to life and
health. This is the exposure level of 1,1-dichloroethane that
is likely to cause permanent health problems or death.
The federal recommendations have been uipdated as of
July 1999.
Glossary
Anesthetic: A substance used to cause numbness.
Evaporate: To change into a vapor or gas.
Agency for Toxic Substances and Disease Registry. 1990.
Toxicological profile for 1,1-dichloroethane. Atlanta, GA: U.S.
Department of Health and Human Services, Public Health Service.
toxic substances might harm people or to treat those who have
been exposed. Laws today protect the welfare of research animals and scientists must follow strict guidelines.
1,2-DICHLOROETHANE
CAS #107-06-2
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2-Dichloroethane.
HIGHLIGHTS: Exposure to 1,2-dichloroethane usually occurs by breathing

contaminated air in workplaces that use 1,2-dichloroethane. Breathing or
ingesting high levels of 1,2-dichloroethane can cause damage to the nervous
system, liver, kidneys, and lungs and may cause cancer. This substance has
been found in at least 570 of the 1,585 National Priorities List sites identified
What is 1,2-dichloroethane?
1,2-Dichloroethane, also called ethylene dichloride, is a
manufactured chemical that is not found naturally in the
environment. It is a clear liquid and has a pleasant smell
and sweet taste.
1,2-Dichloroethane released in soil will either evaporate

into the air or travel down through the soil and enter
underground water.
How might I be exposed to 1,2-dichloroethane?
The most common use of 1,2-dichloroethane is in the

production of vinyl chloride which is used to make a variety
of plastic and vinyl products including polyvinyl chloride
(PVC) pipes, furniture and automobile upholstery, wall
coverings, housewares, and automobile parts. It is also
used to as a solvent and is added to leaded gasoline to
remove lead.
The general population may be exposed to

1,2-dichloroethane by breathing air or drinking water that
contains 1,2-dichloroethane.
People who work or live near a factory where
1,2-dichloroethane is used, may be exposed to higher than
usual levels.
also be exposed to higher than usual levels of
1,2-dichloroethane.
What happens to 1,2-dichloroethane when it

How can 1,2-dichloroethane affect my health?
Most of the 1,2-dichloroethane released to the

environment is released to the air. In the air,
1,2-dichloroethane breaks down by reacting with other
compounds formed by sunlight. It can stay in the air for
more than 5 months before it is broken down.
1,2-Dichloroethane can also be released into rivers and
lakes. It breaks down very slowly in water and most of it
will evaporate to the air.
Nervous system disorders, liver and kidney diseases, and

lung effects have been reported in humans ingesting or
inhaling large amounts of 1,2-dichloroethane.
In laboratory animals, breathing or ingesting large amounts
of 1,2-dichloroethane have also caused nervous system
disorders and liver, kidney, and lung effects. Animal studies
also suggest that 1,2-dichloroethane may damage the

1,2-DICHLOROETHANE
Page 2
CAS #107-06-2
immune system. Kidney disease has also been seen in

animals ingesting low doses of 1,2-dichloroethane for a long
time. Studies in animals indicate that 1,2-dichloroethane does
not affect reproduction.
How likely is 1,2-dichloroethane to cause cancer?

Human studies examining whether 1,2-dichloroethane can
cause cancer have been considered inadequate. In animals,
increases in the occurrence of stomach, mammary gland, liver,
lung, and endometrium cancers have been seen following
inhalation, oral, and dermal exposure.
determined that 1,2-dichloroethane may reasonably be
expected to cause cancer. The EPA has determined that
1,2-dichloroethane is a probable human carcinogen and the
International Agency for Cancer Research (IARC) considers
it to be a possible human carcinogen.
How can 1,2-dichloroethane affect children?

We do not know if exposure to 1,2-dichloroethane will result
in birth defects or other developmental effects in people.
Studies in animals suggest that 1,2-dichloroethane does not
produce birth defects.
high levels of 1,2-dichloroethane will be similar to the effects
seen in adults.

1,2-dichloroethane?
amounts of 1,2-dichloroethane. In the past, it was used in
small amounts in household products such as cleaning
agents, pesticides, and wallpaper and carpet glue. Risk of
exposure from this source could be eliminated if these older

products were immediately discarded.
hazardous waste sites where 1,2-dichloroethane may have
been discarded.

exposed to 1,2-dichloroethane?
Tests are available to measure 1,2-dichloroethane in breath,
blood, breast milk, and urine of exposed people. Because
1,2-dichloroethane leaves the body fairly quickly, these tests
need to be done within a couple of days of exposure. These
tests cannot be used to predict the nature or severity of
toxic effects. These tests are not usually done in the
doctors office.

The EPA allows 0.005 milligrams of 1,2-dichloroethane per
liter of drinking water (0.005 mg/L).
The Occupational Safety and Health Administration has set a
limit of 50 parts of 1,2-dichloroethane per million parts of air
(50 ppm) in workplace air for 8 hour shifts and 40 hour work
weeks.
(ATSDR). 2001. Toxicological Profile for 1,2-Dichloroethane.
1,1-DICHLOROETHENE
CAS # 75-35-4
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 1,1-dichloroethene. For
SUMMARY: Exposure to 1,1-dichloroethene occurs mainly in the workplace.

Breathing high levels of 1,1-dichloroethene can affect the liver, kidney, and central
nervous system. This chemical has been found in at least 515 of 1,416 National Priorities
What is 1,1-dichloroethene?
(Pronounced 1,1-dklr thn)
1,1-Dichloroethene is an industrial chemical that is not
found naturally in the environment. It is a colorless liquid
with a mild, sweet smell. It is also called vinylidene chloride.
1,1-Dichloroethene is used to make certain plastics, such
as flexible films like food wrap, and in packaging materials. It
is also used to make flame retardant coatings for fiber and
carpet backings, and in piping, coating for steel pipes, and in
adhesive applications.
What happens to 1,1-dichloroethene when it

q 1,1-Dichloroethene enters the environment from industries that make or use it.
q 1,1-Dichloroethene evaporates very quickly from water
and soil to the air.
q In the air, it takes about 4 days for it to break down.
q 1,1-Dichloroethene breaks down very slowly in water.
q It does not accumulate very much in fish or birds.
q In soil, 1,1-dichloroethene is slowly transformed to other
less harmful chemicals.
How might I be exposed to

1,1-dichloroethene?
q Workers may be exposed in industries that make or use
1,1-dichloroethene (these industries are mainly in Texas
and Louisiana).
q Food that is wrapped in plastic wrap may contain very
low levels of 1,1-dichloroethene. The government
controls these levels to prevent harm to your health.
q A small percentage (3%) of the drinking water supplies
may contain very low levels of 1,1-dichloroethene.
q Air near factories that make or use 1,1-dichloroethene and
air near hazardous waste sites may contain low levels of it.
How can 1,1-dichloroethene affect my health?

The main effect from breathing high levels of 1,1dichloroethene is on the central nervous system. Some people
lost their breath and fainted after breathing high levels of the
chemical.
Breathing lower levels of 1,1-dichloroethene in air for a
long time may damage your nervous system, liver, and lungs.
Workers exposed to 1,1-dichloroethene have reported a loss in
liver function, but other chemicals were present.

1,1-DICHLOROETHENE
CAS # 75-35-4
Page 2
ATSDR Internet home page via WWW is http://www.atsdr.cdc.gov/toxfaq.html
Animals that breathed high levels of 1,1-dichloroethene

had damaged livers, kidneys, and lungs. The offspring of
some of the animals had a higher number of birth defects. We
do not know if birth defects occur when people are exposed to
1,1-dichloroethene.
Because 1,1-dichloroethene leaves the body fairly

quickly, these methods are useful only for finding exposures
that have occurred within the last few days. These tests can't
tell you if adverse health effects will occur from exposure to
1,1-dichloroethene.
Animals that ingested high levels of 1,1-dichloroethene

had damaged livers, kidneys, and lungs. There were no birth
defects in animals that ingested the chemical.

Spilling 1,1-dichloroethene on your skin or in your eyes

can cause irritation.
How likely is 1,1-dichloroethene to cause

cancer?
The EPA has set a limit in drinking water of 0.007 parts

of 1,1-dichloroethene per million parts of drinking water
(0.007 ppm). EPA requires that discharges or spills into the
environment of 5,000 pounds or more of 1,1-dichloroethene
be reported.
The Environmental Protection Agency (EPA) has determined that 1,1-dichloroethene is a possible human carcinogen.

(OSHA) has set an occupational exposure limit of 1 ppm of
1,1-dichloroethene in workplace air for an 8-hour workday,
40-hour workweek.
Studies on workers who breathed 1,1-dichloroethene

have not shown an increase in cancer. These studies, however,
are not conclusive because of the small numbers of workers
and the short time studied.

Health (NIOSH) currently recommends that workers breathe
as little 1,1-dichloroethene as possible.
Animal studies have shown mixed results. Several

studies reported an increase in tumors in rats and mice, and
other studies reported no such effects.
Glossary

been exposed to 1,1-dichloroethene?
Tests are available to measure levels of 1,1-dichloroethene in breath, urine, and body tissues. These tests are not
usually available in your doctors office. However, a sample
taken in your doctors office can be sent to a special laboratory if necessary.

References
1994. Toxicological profile for 1,1-dichloroethene. Atlanta,
Health Service.
1,2-DICHLOROETHENE
CAS # 540-59-0, 156-59-2, and 156-60-5
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2-dichloroethene. For
HIGHLIGHTS: Exposure to 1,2-dichloroethene occurs mainly in workplaces where

it is made or used. Breathing high levels of 1,2-dichloroethene can make you feel
nauseous, drowsy, and tired. cis-1,2-Dichloroethene has been found in at least 146
of the 1,430 National Priorities List sites identified by the Environmental Protection
Agency (EPA). trans-1,2-Dichloroethene was found in at least 563 NPL sites. 1,2Dichloroethene was found at 336 sites, but the isomer (cis- or trans-) was not specified.
What is 1,2-dichloroethene?
(Pronounced 1,2-d-klr -thn)
1,2-Dichloroethene, also called 1,2-dichloroethylene, is a
highly flammable, colorless liquid with a sharp, harsh odor. It is
used to produce solvents and in chemical mixtures. You can
smell very small amounts of 1,2-dichloroethene in air (about 17
parts of 1,2-dichloroethene per million parts of air [17 ppm]).
There are two forms of 1,2-dichloroethene; one is called
cis-1,2-dichloroethene and the other is called trans-1,2-dichloroethene. Sometimes both forms are present as a mixture.
What happens to 1,2-dichloroethene when it

q 1,2-Dichloroethene evaporates rapidly into air.
q In the air, it takes about 5-12 days for half of it to break
down.
q Most 1,2-dichloroethene in the soil surface or bodies of
water will evaporate into air.
q 1,2-Dichloroethene can travel through soil or dissolve in
water in the soil. It is possible that it can contaminate
groundwater.
q In groundwater, it takes about 13-48 weeks to break down.
q There is a slight chance that 1,2-dichloroethene will

break down into vinyl chloride, a different chemical
which is believed to be more toxic than 1,2-dichloroethene.
How might I be exposed to 1,2-dichloroethene?

q Breathing 1,2-dichloroethene that has leaked from hazardous waste sites and landfills.
q Drinking contaminated tap water or breathing vapors
from contaminated water while cooking, bathing, or
washing dishes.
q Breathing 1,2-dichloroethene, touching it, or touching
contaminated materials in the workplace.
How can 1,2-dichloroethene affect my health?

Breathing high levels of 1,2-dichloroethene can make
you feel nauseous, drowsy, and tired; breathing very high
levels can kill you.
When animals breathed high levels of trans-1,2dichloroethene for short or longer periods of time, their livers
and lungs were damaged and the effects were more severe
with longer exposure times. Animals that breathed very high

Page 2
1,2-DICHLOROETHENE
CAS # 540-59-0, 156-59-2, and 156-60-5
levels of trans-1,2-dichloroethene had damaged hearts.

Animals that ingested extremely high doses of cis- or
trans-1,2-dichloroethene died.
Lower doses of cis-1,2-dichloroethene caused effects on
the blood, such as decreased numbers of red blood cells, and
also effects on the liver.
The long-term (365 days or longer) human health effects
after exposure to low concentrations of 1,2-dichloroethene
arent known. One animal study suggested that an exposed
fetus may not grow as quickly as one that hasnt been exposed.
Exposure to 1,2-dichloroethene hasnt been shown to
affect fertility in people or animals.
How likely is 1,2-dichloroethene to cause cancer?

The EPA has set the maximum allowable level of cis-1,2dichloroethene in drinking water at 0.07 milligrams per liter of
water (0.07 mg/L) and trans-1,2-dichloroethene at 0.1 mg/L.
The EPA requires that any spills or accidental release of
1,000 pounds or more of 1,2-dichloroethene must be reported
to the EPA.
The Occupational Health Safety and Health Administration (OSHA) has set the maximum allowable amount of
1,2-dichloroethene in workroom air during an 8-hour workday
in a 40-hour workweek at 200 parts of 1,2-dichloroethene per
million parts of air (200 ppm).
Glossary
The EPA has determined that cis-1,2-dichloroethene is not

classifiable as to its human carcinogenicity.
No EPA cancer classification is available for trans-1,2dichloroethene.
Fertility: Ability to reproduce.


exposed to 1,2-dichloroethene?
Tests are available to measure concentrations of the breakdown products of 1,2-dichloroethene in blood, urine, and tissues. However, these tests arent used routinely to determine
whether a person has been exposed to this compound. This is
because after you are exposed to 1,2-dichloroethene, the
breakdown products in your body that are detected with these
tests may be the same as those that come from exposure to
other chemicals. These tests aren't available in most doctors'
offices, but can be done at special laboratories that have the
right equipment.
Solvent: A chemical that can dissolve other substances.
This ToxFAQs information is taken from the 1996 Toxicological Profile for 1,2-Dichloroethene produced by the Agency
1,2-DICHLOROPROPANE
CAS # 78-87-5
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2-dichloropropane. For
HIGHLIGHTS: 1,2-Dichloropropane is primarily used to make other

chlorinated chemicals. Exposure to high levels of 1,2-dichloropropane can
damage the liver, kidneys, blood, and lungs, and affect the brain. It has been
found at 26 of the 1,177 National Priorities List sites identified by the
What is 1,2-dichloropropane?
(Pronounced 1,2-d-klr-prpn)
1,2-Dichloropropane is a colorless, flammable liquid with
a chloroform-like odor. It is moderately soluble in water and
readily evaporates into air. It does not occur naturally in the
environment.
1,2-Dichloropropane production in the United States has
declined over the past 20 years. It was used in the past as a
soil fumigant, chemical intermediate, and industrial solvent
and was found in paint strippers, varnishes, and furniture finish removers. Most of these uses were discontinued. Today,
almost all of the 1,2-dichloropropane is used as a chemical
intermediate to make perchloroethylene and several other
related chlorinated chemicals.
What happens to 1,2-dichloropropane when it

q 1,2-Dichloropropane released to air can spread to areas far
from where it was released because it is not rapidly broken down by reactions with other chemicals and sunlight.
q Most of the 1,2-dichloropropane in water will evaporate
to the air.
q When released to soil, it is not easily broken down by

bacteria, but will easily evaporate to the air and filter into
the groundwater.
q 1,2-Dichloropropane does not build up in the food chain.
How might I be exposed to 1,2-dichloropropane?

q Most people are not likely to be exposed to
1,2-dichloropropane because of its limited use.
q If you work where 1,2-dichloropropane is made or used,
you could be exposed by breathing air that contains its
vapors or by spilling or splashing it on your skin.
q People who live near a waste site containing
1,2-dichloropropane could be exposed by drinking contaminated groundwater, breathing vapors released to the
air, or getting contaminated soil on their skin.
How can 1,2-dichloropropane affect my health?

People who intentionally or accidentally breathe high
levels of 1,2-dichloropropane have experienced difficulty
breathing, coughing, vomiting, nosebleed, fatigue, and damage to blood cells, liver, and kidneys. People who accidently
drank cleaning solutions containing 1,2-dichloropropane
experienced headaches, dizziness, nausea, liver and kidney
damage, anemia, coma, and death.

1,2-DICHLOROPROPANE
CAS # 78-87-5
Page 2

Animal studies indicate that breathing low levels of
1,2-dichloropropane over short- or long-term periods causes
damage to the liver, kidney, and respiratory system. Breathing
high levels causes death. Similar effects have been reported
when animals were given 1,2-dichloropropane by mouth.
Some studies indicate that ingesting 1,2-dichloropropane may
cause reproductive effects. One study reported a delay in bone
formation of the skull in fetal rats following exposure of the
mother rats to 1,2-dichloropropane.
How likely is 1,2-dichloropropane to cause

cancer?
It is not known whether 1,2-dichloropropane causes cancer in people. The carcinogenicity of 1,2-dichloropropane has
been evaluated in animal studies with rats and mice. Liver
tumors have been observed in mice, and mammary gland
tumors have been found in rats. The International Agency for
Research on Cancer (IARC) has determined that 1,2-dichloropropane is unclassifiable as to human carcinogenicity.

exposed to 1,2-dichloropropane?
Urine and blood tests can be used to find out if you have
been exposed to 1,2-dichloropropane. Levels measured in the
urine can be used to predict the levels in the air. These tests
cannot predict whether you will suffer harmful effects. Because
special equipment is needed, these tests are not usually done
in the doctor's office.

of 0.005 parts per million (0.005 ppm) for 1,2-dichloropropane
in drinking water. The EPA recommends that the level of 1,2-
dichloropropane in lakes and streams should be limited to 0.52

parts per billion (0.52 ppb) to prevent possible human health
effects from drinking contaminated water or eating contaminated fish. Any release to the environment greater than 1,000
pounds of 1,2-dichloropropane must be reported to the EPA.
(OSHA) has set a workplace air concentration limit of 75 ppm
over an 8-hour workday, 40-hour workweek.
The federal recommendations have been updated as of July
1999.
Glossary
oxygen.
(ATSDR). 1989. Toxicological profile for 1,2-dichloropropane. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
Animal testing is sometimes necessary to find out how toxic
substances might harm people and how to treat people who
have been exposed. Laws today protect the welfare of research
animals and scientists must follow strict guidelines.
1,3-DICHLOROPROPENE
CAS # 542-75-6
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 1,3-dichloropropene.
present.
SUMMARY: Exposure to 1,3-dichloropropene occurs mainly on farms where it is

used to treat crops or in factories where it is made. When breathed at very high
levels, 1,3-dichloropropene may irritate the skin, eyes, nose, and throat, and other
effects. This chemical has been found in at least 94 of 1,416 National Priorities List
What is 1,3-dichloropropene?
(Pronounced 1,3-d klr prpn)
q It may travel deeper into the ground and reach underground water supplies; however, in states where it is often
used, very little has been found in the groundwater.
1,3-Dichloropropene is a manufactured chemical that

does not occur naturally in the environment. It is a colorless
liquid with a sweet smell.
q Other chemicals often found in hazardous waste sites may

slow the breakdown of 1,3-dichloropropene.
There are two forms of 1,3-dichloropropene: cis1,3-dichloropropene and trans-1,3-dichloropropene. These

forms are very similar to each other and are usually combined
in different amounts to form mixtures.
It is used mainly in farming to kill nematodes, which are
pests that eat the roots of crops. It is often sprayed undiluted
directly on the soils of vegetable and tobacco crops.
Much smaller amounts are used to dissolve or to make
other chemicals.
q We do not know if 1,3-dichloropropene accumulates in

fish. Studies with animals show that most of it leaves the
body within 2 days.
How might I be exposed to 1,3-dichloropropene?

q Breathing contaminated air or touching it during its use
to treat farm crops.
q Breathing contaminated workplace air or air around
hazardous waste sites that contain it.
q Drinking contaminated water near where it's produced or
used, or near hazardous waste sites that contain it.
What happens to 1,3-dichloropropene when

q 1,3-Dichloropropene rapidly evaporates from water and
soil into the air where it is broken down by sunlight.
q When in soil, it is likely to be broken down by small
organisms.
q It dissolves in water and breaks down slowly in water.
How can 1,3-dichloropropene affect my

health?
Most of the adverse health effects from 1,3-dichloropropene come from breathing or touching it when it's produced or used on farm crops. Workers who breathed high

1,3-DICHLOROPROPENE
CAS # 542-75-6
Page 2

levels of 1,3-dichloropropene had irritated skin, eyes, nose,
and throat, and coughing, nausea, headache, and fatigue.
Short-term high level and long-term lower level studies in
animals also show damage to the nose and lung tissues.
These tests are only accurate for recent exposures,

because 1,3-dichloropropene leaves the body within 1 to 2
days. These tests can't determine if adverse health effects will
occur from exposure to 1,3-dichloropropene.
The effects from ingesting 1,3-dichloropropene are not

known. Animal studies have reported damage to the stomach
lining, lung congestion, difficulty walking, and effects on the
liver and kidneys from ingesting high levels.

The skin of some workers who made a pesticide that

contained 1,3-dichloropropene became sensitive to further
exposure. When 1,3-dichloropropene was applied to the skin
of animals, irritation of the skin, hair loss, and bleeding from
the lungs and stomach occurred.
How likely is 1,3-dichloropropene to cause

cancer?
determined that 1,3-dichloropropene may reasonably be
Studies in animals show an increase in tumors of the
stomach, urinary bladder, and lungs from ingestion of
1,3-dichloropropene. Studies in people suggest that
1,3-dichloropropene may be carcinogenic, but no definite
conclusion can be made.
The Environmental Protection Agency (EPA) requires that

discharges or spills of 100 pounds or more of
1,3-dichloropropene into the environment be reported.
(NIOSH) and the American Conference of Governmental
Industrial Hygienists (ACGIH) have recommended an occupational exposure limit of 1 part 1,3-dichloropropene per
million parts of workplace air (1 ppm). These agencies advise
avoiding eye and skin contact because this may be a route of
significant exposure.
Glossary

been exposed to 1,3-dichloropropene?
Tests are available to measure the amount of 1,3dichloropropene or its breakdown products in blood and
urine. However, the presence of 1,3-dichloropropene or its
breakdown products could also mean that you were exposed
to some other chemical that breaks down into 1,3-dichloropropene.
References
1992. Toxicological profile for 1,3-dichloropropene. Atlanta,
Health Service.
DICHLORVOS
CAS # 62-73-7
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about dichlorvos. For more
HIGHLIGHTS: Dichlorvos is an insecticide which is used to control insects

primarily in storage areas and barns. It can affect the nervous system where it
may cause nausea and vomiting, restlessness, sweating, and muscle tremors at
high levels. Dichlorvos been found in at least 3 of the 1,430 National Priorities
What is dichlorvos?
(Pronounced d-klr vs)
Dichlorvos is an insecticide that is a dense colorless liquid. It has a sweetish smell and readily mixes with water.
Dichlorvos used in pest control is diluted with other chemicals
and used as a spray. It can also be incorporated into plastic
that slowly releases the chemical.
q It takes about 2436 hours for half of the chemical to be

broken down in water.
q Dichlorvos does not appear to accumulate in plants, fish,
or animals.
How might I be exposed to dichlorvos?

q The general population is not likely to be exposed to
dichlorvos.
Dichlorvos is used for insect control in food storage areas,

green houses, and barns, and control of insects on livestock. It
is not generally used on outdoor crops. Dichlorvos is sometimes used for insect control in workplaces and in the home.
Veterinarians use it to control parasites on pets.
q It has been found on some fruits, vegetables, and grain,

but washing and processing destroys the dichlorvos.
What happens to dichlorvos when it enters the

environment?
q People whose homes have been sprayed with dichlorvos

could be exposed by breathing contaminated air or
touching surfaces where dichlorvos was applied.
q Dichlorvos enters the environment during its manufacture

and use, from landfills, and from accidental spills during
transport and leaks from storage containers.
How can dichlorvos affect my health?
q It evaporates easily into the air, where it is broken down

into less harmful chemicals.
q It will dissolve in water, where microorganisms can break
it down.
q People who live near a hazardous waste site containing

dichlorvos could be exposed by breathing contaminated
air or touching contaminated soil.
q Workers who manufacture the chemical or use it are likely
to be exposed.
The major effect of dichlorvos is on the nervous system.

Studies on people who were exposed to dichlorvos by breathing air in the workplace containing low levels of dichlorvos
have not shown any harmful effects. Animal studies have shown

DICHLORVOS
CAS # 62-73-7
Page 2

that breathing high levels can cause nervous system effects.
Ingesting large doses may cause nausea and vomiting,
restlessness, sweating, and muscle tremors, while very large
doses may cause coma, inability to breathe, and death. Animal
studies have also shown effects on the nervous system when
animals drank water or ate food containing dichlorvos.
It is not known whether dichlorvos can affect reproduction or cause birth defects in people.
Animal studies have not reported effects on reproduction
or birth defects when animals were exposed to dichlorvos.
How likely is dichlorvos to cause cancer?

It is not known whether dichlorvos causes cancer in
people. A study in rats and mice reported that rats had an increase in cancer of the pancreas and in leukemia, and female
mice had an increase in stomach cancer after they were fed
dichlorvos for 2 years.
has determined that dichlorvos may reasonably be anticipated
to be a carcinogen. The International Agency for Research on
Cancer (IARC) has determined that dichlorvos is possibly
carcinogenic to humans. The EPA has determined that dichlorvos is a probable human carcinogen.
breakdown products in your urine. These tests arent available

at most doctors offices, but can be done at special laboratories
that have the right equipment.

environment of 10 pounds or more of dichlorvos be reported to
the EPA.
(OSHA) has set a permissible exposure limit of 1 milligram
dichlorvos per cubic meter of air (1 mg/m3) for an 8-hour workday, 40 hour workweek.
Glossary
Leukemia: Cancer of the blood-forming organs.
This ToxFAQs information is taken from the 1997 Toxico-
Is there a medical test to show whether Ive been logical Profile for Dichlorvos produced by the Agency for
exposed to dichlorvos?
There is a general test that can be used to determine if you
have been exposed to a group of insecticides, including
dichlorvos. This test measures the activity of an enzyme called
acetylcholinesterase in the blood. However, it does not specifi- toxic substances might harm people and how to treat people
cally show exposure to dichlorvos.
Specific tests are available to identify dichlorvos or its
Di(2-ethylhexyl) phthalate (DEHP)

CAS # 117-81-7
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about di(2-ethylhexyl)
phthalate (DEHP). For more information, call the ATSDR Information Center at 1-888-422-8737. This
fact sheet is one in a series of summaries about hazardous substances and their health effects. It is
important you understand this information because this substance may harm you. The effects of
exposure to any hazardous substance depend on the dose, the duration, how you are exposed, personal
traits and habits, and whether other chemicals are present.
HIGHLIGHTS: Di(2-ethylhexyl) phthalate (DEHP) is found in many plastics.

Exposure to DEHP is generally very low. Increased exposures may come from
intravenous fluids delivered through plastic tubing, and from ingesting
contaminated foods or water. DEHP is not toxic at the low levels usually
present in the environment. In animals, high levels of DEHP damaged the liver
and kidney and affected the ability to reproduce. DEHP has been found in at
What is di(2-ethylhexyl) phthlate?
Di(2-ethylhexyl) phthlate (DEHP) is a manufactured chemical
that is commonly added to plastics to make them flexible.
DEHP is a colorless liquid with almost no odor.
DEHP is present in plastic products such as wall coverings,
tablecloths, floor tiles, furniture upholstery, shower curtains,
garden hoses, swimming pool liners, rainwear, baby pants,
dolls, some toys, shoes, automobile upholstery and tops,
packaging film and sheets, sheathing for wire and cable,
medical tubing, and blood storage bags.
What happens to DEHP when it enters the

environment?
DEHP is everywhere in the environment because of its
use in plastics, but it does not evaporate easily or dissolve
in water easily.
DEHP can be released in small amounts to indoor air from
plastic materials, coatings, and flooring.
It dissolves faster in water if gas, oil, or paint removers
are present.
It attaches strongly to soil particles.
DEHP in soil or water can be broken down by
microorganisms into harmless compounds.
DEHP does not break down easily when it is deep in the

soil or at the bottom of lakes or rivers.
It is in plants, fish, and other animals, but animals high on
the food chain are able to break down DEHP, so tissue levels
are usually low.
How might I be exposed to DEHP?

DEHP is usually present at very low levels in:
Medical products packaged in plastic such as blood
products.
Some foods packaged in plastics, especially fatty foods
like milk products, fish or seafood, and oils.
Well water near waste sites.
Workplace air or indoor air where DEHP is released, but
usually not at levels of concern.
Fluids from plastic intravenous tubing if used extensively
as for kidney dialysis.
How can DEHP affect my health?

At the levels found in the environment, DEHP is not
expected to cause harmful health effects in humans. Most of
what we know about the health effects of DEHP comes from
studies of rats and mice given high amounts of DEHP.

Di(2-ethylhexyl) phthalate (DEHP)
Page 2
CAS # 117-81-7
Harmful effects in animals generally occurred only with high

amounts of DEHP or with prolonged exposures. Moreover,
absorption and breakdown of DEHP in humans is different
than in rats or mice, so the effects seen in rats and mice may
not occur in humans.
Rats that breathed DEHP in the air showed no serious
harmful effects. Their lifespan and ability to reproduce were
not affected.
Brief oral exposure to very high levels of DEHP damaged
sperm in mice. Although the effect reversed when exposure
ceased, sexual maturity was delayed in the animals.
High amounts of DEHP damaged the liver of rats and mice.
Whether or not DEHP contributes to human kidney damage
is unclear.
Skin contact with products containing DEHP will probably
cause no harmful effects because it cannot be taken up
easily through the skin.
How likely is DEHP to cause cancer?

determined that DEHP may reasonably be anticipated to be a
human carcinogen. The EPA has determined that DEHP is a
probable human carcinogen. These determinations were
based entirely on liver cancer in rats and mice. The
stated that DEHP cannot be classified as to its
carcinogenicity to humans.
How can DEHP affect children?

Children can be exposed to DEHP in the same manner as
adults. In addition, small children can be exposed by
sucking on or skin contact with plastic toys and pacifiers
that contain DEHP, but there is no conclusive evidence of
adverse health effects after such exposures. Nonetheless,
because of concern for childrens health, many toy
manufacturers have discontinued use of DEHP in their

products. In pregnant rats and mice exposed to high
amounts of DEHP, researchers observed birth defects and
fetal deaths.

DEHP?
It is almost impossible to completely avoid contact with
some DEHP because it is commonly found in plastics.
Prevent babies and small children from chewing on plastic
objects not designed for that purpose.

exposed to DEHP?
There is a test available that measures a breakdown product
of DEHP called mono(2-ethylhexyl) phthalate (MEHP) in your
urine or blood. This test can only detect recent exposure
because DEHP is rapidly broken down and eliminated from
your body. This test is not routinely available at the
doctors office because it requires special equipment.

The EPA limits the amount of DEHP that may be present in
drinking water to 6 parts of DEHP per billion parts of water
(6 ppb).
sets a maximum average of 5 milligrams of DEHP per cubic
meter of air (5 mg/m3) in the workplace during an 8-hour
shift. The short-term (15-minute) exposure limit is 10 mg/m3.
(ATSDR). 2002. Toxicological Profile for Di(2-ethylhexyl)
phthlate (Update). Atlanta, GA: U.S. Department of Health
DIETHYL PHTHALATE
CAS # 84-66-2
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about diethyl phthlate. For more
SUMMARY: Exposure to diethyl phthalate occurs when you use plastics that
contain it, and when you eat food from plastic containers made with it. Health
effects have not been reported in people exposed to diethyl phthalate. This substance
What is diethyl phthalate?
(Pronounced d thl thlt)
How might I be exposed to diethyl phthalate?
Diethyl phthalate is a colorless liquid that has a bitter,

disagreeable taste. This synthetic substance is commonly used
to make plastics more flexible. Products in which it is found
include toothbrushes, automobile parts, tools, toys, and food
packaging.
q Eating contaminated fish and shellfish.
Diethyl phthalate can be released fairly easily from these

products, as it is not part of the chain of chemicals (polymers)
that makes up the plastic. Diethyl phthalate is also used in
cosmetics, insecticides, and aspirin.
What happens to diethyl phthalate when it

q Diethyl phthalate has been found in waste sites and landfills from discarded plastics.
q It may break down in the air.
q It can become attached to particles of dust in the air, and
can settle out.
q It is broken down to harmless products by microorganisms in soil and water.
q Small amounts of it can build up in fish and shellfish
living in water containing it.
q Eating food that was contained in plastic packaging.

q Drinking contaminated water near waste sites and landfills that contain diethyl phthalate.
q Using consumer products that contain it.
How can diethyl phthalate affect my health?

No information is available regarding possible effects
caused by diethyl phthalate if you breathe, eat, or drink it, or
if it touches your skin. Very high oral doses of diethyl phthalate have caused death in animals, but brief oral exposures to
lower doses caused no harmful effects.
Weight gain was decreased in animals that ate high doses
of diethyl phthalate for a long time. The liver and kidneys of
these animals were larger than normal, but not from any harmful effects of diethyl phthalate.
It is not known if diethyl phthalate causes birth defects in
humans. Fewer live babies were born to female animals that
were exposed to diethyl phthalate throughout their lives.

DIETHYL PHTHALATE
CAS # 84-66-2
Page 2

The presence of an extra rib has been noted in newborn
rats whose mothers were given very high dietary doses of
diethyl phthalate, but this effect is not considered harmful by
all scientists.
Some birth defects occurred in rats whose mothers received high doses of diethyl phthalate by injection during
pregnancy. Humans are not exposed to diethyl phthalate by
this route.
Diethyl phthalate can be mildly irritating when applied
to the skin of animals. It can also be slightly irritating when
put directly into the eyes of animals.
How likely is diethyl phthalate to cause cancer?

The EPA has determined that diethyl phthalate is not
classifiable as to its carcinogenicity in humans.
tests arent available at most doctors offices, but can be done

at special laboratories that have the right equipment.

environment of 1,000 pounds or more of diethyl phthalate be
(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) recommend a maximum concentration of 5 milligrams of diethyl phthalate per cubic meter of
air (5 mg/m3) in workplace air for an 8- to 10-hour workday,
40-hour workweek.
Diethyl phthalate placed directly on the skin of rats daily

for 2 years was not carcinogenic. Liver tumors were seen in
mice that had diethyl phthalate placed directly on their skin
daily for 2 years. This type of tumor is common in mice, and
the smallest dose resulted in a similar number of tumors as the
largest dose.
Glossary
It is not clear if diethyl phthalate will cause a similar

effect in humans. Other studies of cancer in humans or animals exposed to diethyl phthalate were not located.
Oral: Taken by mouth.

been exposed to diethyl phthalate?
Reference
There is no routine medical test to show if you have been

exposed to diethyl phthalate. However, it has been measured
in semen, fat, and kidney tissue in laboratory studies. These

Insecticide: Substance that kills insects.
Synthetic: Made by humans.

(ATSDR). 1995. Toxicological profile for diethyl phthalate
(update). Atlanta, GA: U.S. Department of Health and Human
DIISOPROPYL
METHYLPHOSPHONATE
CAS # 1445-75-6
August 1999
This fact sheet answers the most frequently asked health questions (FAQs) about diisopropyl methylphosphonate.
For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a
series of summaries about hazardous substances and their health effects. Its important you understand this
present.
HIGHLIGHTS: Exposure to diisopropyl methylphosphonate would only occur

if you live near the area where it was made and stored. Diisopropyl
methylphosphonate may cause skin rashes if your skin comes in contact with
it. This chemical has been found in at least 2 of the 1,416 National Priorities
What is diisopropyl methylphosphonate?

(Pronounced d-s-prpl mthl fs f nt)
Diisopropyl methylphosphonate is a chemical by-product
resulting from the manufacture of Sarin (GB), a nerve gas that
was produced by the Army in the 1950s. A chemical by-product is a chemical that is formed while making another substance. Sarin was produced and stored only in the Rocky
Mountain Arsenal outside of Denver, Colorado. Production of
Sarin in the United States was discontinued in 1957.
Diisopropyl methylphosphonate is not known to occur
naturally in the environment. It is not likely to be produced in
the United States in the future because of the signing of a
chemical treaty that bans the use, production, and stockpiling
of poison gases.
Diisopropyl methylphosphonate is a colorless liquid.
Other names for it are DIMP, diisopropyl methanephosphonate, phosphonic acid, and methyl-,bis-(1-methylethyl)ester.
What happens to diisopropyl methylphosphonate when it enters the environment?

q Most diisopropyl methylphosphonate enters the groundwater or surface water.
q Most will not enter the air since it does not easily
evaporate.
q It does not easily break down in the environment.

q It can stay in water and soil for years.
q Diisopropyl methylphosphonate can enter the soil
through the flow of irrigation water.
q Plants can store diisopropyl methylphosphonate.

q It may enter the food chain when animals eat the plants
containing it.
How might I be exposed to diisopropyl

methylphosphonate?
q Most people would not be exposed to diisopropyl
methylphosphonate.
q Living near the site (the Rocky Mountain Arsenal) where
Sarin was produced and stored.

DIISOPROPYL METHYLPHOSPHONATE
CAS # 1445-75-6
Page 2

q Eating vegetables irrigated by water contaminated with
diisopropyl methylphosphonate.
How can diisopropyl methylphosphonate affect

my health?
Little is known about the effects of diisopropyl methylphosphonate on peoples health. Skin rashes were seen in some
people who handled dead animals near a pond containing
diisopropyl methylphosphonate and other chemicals, but it is
not known whether diisopropyl methylphosphonate or another
chemical caused the effects.
Animal studies have not shown liver or kidneys problems,
infertility, or birth defects after the animals ate or drank
diisopropyl methylphosphonate. Some effects on the blood
and nervous system have been seen in animals who ate or
drank diisopropyl methylphosphonate at high levels.
(IMPA), which is rapidly cleared from the blood. Tests can

measure IMPA in the blood or urine. However, these tests are
useful only for recent exposure because IMPA leaves the body
rapidly.

The EPA advises that adults should not drink water containing more than 0.6 milligrams of diisopropyl methylphosphonate per liter (0.6 mg/L) of water for a lifetime. They also
advise that children should not drink water containing more
than 8 mg/L of diisopropyl methylphosphonate for a 1-day or
longer period.
Glossary
How likely is diisopropyl methylphosphonate to

cause cancer?
The EPA has concluded that diisopropyl methylphosphonate is not classifiable as to its carcinogenicity to
humans.
No carcinogenicity studies on diisopropyl

methylphosphonate are available in people or animals.

exposed to diisopropyl methylphosphonate?
Once inside the body, diisopropyl methylphosphonate is
rapidly converted to isopropyl methylphosphonic acid

(ATSDR). 1998. Toxicological profile for diisopropyl
methylphosphonate. Atlanta, GA: U.S. Department of Health
research animals, and scientists must follow strict guidelines.
DI-n-BUTYL PHTHALATE
CAS #84-74-2
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about di-n-butyl phthalate.
HIGHLIGHTS: Di-n-butyl phthalate is a manufactured chemical that is added

to plastics, paint, glue, hair spray, and other household products. It is
commonly found in the environment, and most people are exposed to low levels
in the air, water, and food. No harmful effects have been found in humans. In
laboratory animals, oral exposure to very high levels can cause impaired
reproduction and developmental effects. This substance has been found in at
What is di-n-butylphthalate?
(Pronounced di n byewtyl thalate)
Di-n-butyl phthalate is a manufactured chemical that does
not occur naturally. It is an odorless and oily liquid that is
colorless to faint yellow in color. It is slightly soluble in
water and does not evaporate easily.
Di-n-butyl phthalate is used to make plastics more flexible
and is also in carpet backings, paints, glue, insect repellents,
hair spray, nail polish, and rocket fuel.
What happens to di-n-butylphthalate when it

Di-n-butyl phthalate is released to air as a vapor. It can
react with other chemicals in the air and is usually broken
down within a few days. Di-n-butyl phthalate can also
attach to particles in the air and eventually settle to the land
and water.
Most of the di-n-butyl phthalate in water attaches to
sediment and settles out of the water or is broken down by
bacteria. Small amounts may evaporate to the air.
When released to the soil, it attaches to soil particles and
is broken down by bacteria.
There is no evidence that it builds up in the food chain.
How might I be exposed to di-n-butylphthalate?

Most people are probably exposed to low levels of di-nbutyl phthalate in the air because it is used in so many
household products.
People who use products which contain di-n-butyl
phthalate, such as nail polish, may be exposed by breathing
it in the air or getting it on their skin.
The general population may also be exposed by eating
food containing di-n-butyl phthalate, such as fish and
shellfish, or food which is packaged or stored in materials
containing di-n-butyl phthalate.
If you work or live near a factory where di-n-butyl
phthalate is made or used, you could be exposed to higher
than usual levels.
also be exposed to higher than usual levels of di-n-butyl
phthalate.
How can di-n-butylphthalate affect my health?

Di-n-butyl phthalate appears to have relatively low toxicity.
Adverse effects have not been reported in humans as a
result of exposure to di-n-butyl phthalate.
In laboratory animals, studies show that eating large
amounts of di-n-butyl phthalate can affect their ability to

DI-n-BUTYL PHTHALATE
Page 2
CAS #84-74-2
reproduce. Sperm production can decrease, but returns to

near normal levels when exposure stops. Large amounts of
di-n-butyl phthalate repeatedly applied to the skin for a long
time can cause mild irritation. We do not know if similar
effects would occur in humans.

hazardous waste sites where di-n-butyl phthalate may have
been discarded.

exposed to di-n-butylphthalate?
How likely is di-n-butylphthalate to cause cancer?

There have been no cancer studies in humans and the one
study in laboratory animals is inadequate. The EPA has
determined that di-n-butyl phthalate is not classifiable as to
human carcinogenicity based on inadequate evidence in both
humans and animals.
Tests are available to measure di-n-butyl phthalate in blood

and body tissues, and its major breakdown products in urine.
However, these tests cannot determine whether you will
experience health effects or be used to predict the nature or
severity of any effects. Because special equipment is
needed, these tests are not usually done in the doctors
office.
How can di-n-butylphthalate affect children?

high levels of di-n-butyl phthalate will be similar to the
effects seen in adults. We do not know whether children
differ from adults in their susceptibility to di-n-butyl
phthalate.
We do not know if exposure to di-n-butyl phthalate will
result in birth defects or other developmental effects in
people. Birth defects have been observed in laboratory
animals exposed to high levels of di-n-butyl phthalate during
development. Death, low body weights, skeletal effects, cleft
palate, and damage to the testes have been observed in
animals exposed during development.

di-n-butylphthalate?
Di-n-butyl phthalate is used in many household products.
The level of di -n-butyl phthalate in a product is higher when
the product is new than when the product is old. Because
di-n-butyl phthalate may be in some toys, children chewing
on such toys could be exposed; however, no measurements
have yet been made to show whether children are exposed in
this way.

The EPA recommends that levels of di-n-butyl phthalate in
lakes and streams should be limited to 34 parts of di-n-butyl
phthalate per million parts of water (34 ppm) to prevent
possible human health effects from drinking water or eating
fish contaminated with this chemical.
has set a limit of 5 milligrams of di-n-butyl phthalate per
cubic meter of workplace air (5 mg/m3) for 8 hour shifts and
40 hour work weeks.
(ATSDR). 2001. Toxicological Profile for Di-n-Butyl
Phthalate Atlanta, GA: U.S. Department of Health and
Disease Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333. Phone: 1-888-4228737, FAX: 404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/toxfaq.html ATSDR can
1,3-DINITROBENZENE and
1,3,5-TRINITROBENZENE
CAS # 99-65-0 and 99-35-4
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about 1,3-dinitrobenzene and
1,3,5-trinitrobenzene. For more information, call the ATSDR Information Center at 1-888-422-8737. This
fact sheet is one in a series of summaries about hazardous substances and their health effects. This information
SUMMARY: Exposure to 1,3-dinitrobenzene and 1,3,5-trinitrobenzene may occur

from contaminated water, food, air, and soil near an Army ammunitions plant or
other chemical manufacturer. High levels of 1,3-dinitrobenzene affect the ability of
blood to carry oxygen. Effects of 1,3,5-trinitrobenzene are expected to be similar.
These substances have been found in at least 19 of the 1,430 National Priorities List
What are 1,3-dinitrobenzene and 1,3,5-trinitrobenzene?
(Pronounced 1,3-d-ntr-bnzn and 1,3,5-trntr-bnzn)
1,3-Dinitrobenzene and 1,3,5-trinitrobenzene are synthetic
substances that are used in explosives. Both substances are
yellow crystal-like solids at room temperature. They may exist
in air in very small amounts as dust or a vapor, and can dissolve
in certain liquids. If either substance is put under very high
heat, it will explode. They have have no odor or taste.
What happens to 1,3-dinitrobenzene and 1,3,5trinitrobenzene when they enter the

environment?
q Both compounds are likely to break down in air, water,
and soil very slowly.
q Both compounds are slightly soluble in water.
q 1,3-Dinitrobenzene evaporates slowly from water; 1,3,5trinitrobenzene does not evaporate from water.
q Neither compound sticks to soil strongly, so they can
move through soil into groundwater.
q These compounds are not likely to build up in fish or
people.
How might I be exposed to 1,3-dinitrobenzene

and 1,3,5-trinitrobenzene?
If you live or work near an Army ammunitions plant or
other chemical manufacturer, you may be exposed to these
compounds by drinking contaminated water, eating contaminated food, breathing contaminated air, or touching or eating
contaminated soil.
How can 1,3-dinitrobenzene and 1,3,5-trinitrobenzene affect my health?

Waste discharges from Army ammunitions plants or other
chemical manufacturers are the primary sources for release of
both compounds to air, water, and soil.
1,3-Dinitrobenzene and 1,3,5-trinitrobenzene are suspected to cause similar health effects. Exposure to high concentrations of 1,3-dinitrobenzene can reduce the ability of
blood to carry oxygen and can cause your skin to become
bluish in color.
If you are exposed to 1,3-dinitrobenzene for a long time,
you can develop a reduction (or loss) in the number of red
blood cells (anemia). Other symptoms of 1,3-dinitrobenzene
exposure include headache, nausea, and dizziness.

Page 2
1,3-DINITROBENZENE and 1,3,5-TRINITROBENZENE

CAS # 99-65-0 and 99-35-4
We do not know if there are any long-term health effects

from exposure to 1,3-dinitrobenzene or 1,3,5-trinitrobenzene.
We also do not know if these chemicals cause birth defects in
humans.
The EPA requires that spills or accidental releases into

the environment of 100 pounds or more of 1,3-dinitrobenzene, and 10 pounds or more of 1,3,5-trinitrobenzene, must
Results of studies in animals show that effects of 1,3-dinitrobenzene and 1,3,5-trinitrobenzene on the blood are similar
to the effects seen in people. Results from animal studies also
show some other effects of 1,3-dinitrobenzene exposure, such as
behavioral changes and male reproductive system damage.

(OSHA) regulates levels of 1,3-dinitrobenzene in the workplace. The maximum allowable amount of 1,3-dinitrobenzene
in workroom air during an 8-hour workday, 40-hour workweek, is 1 milligram per cubic meter (1 mg/m3).
We do not know if these compounds can cause birth defects in animals. We do not know if the effects seen in animals
could also occur in people.

(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) also recommend an exposure
limit of 1 mg/m3 1,3-dinitrobenzene in workplace air over a
40-hour workweek.
How likely are 1,3-dinitrobenzene and 1,3,5trinitrobenzene to cause cancer?

The EPA has determined that these compounds are not
classifiable as to their carcinogenicity in humans. This is because the ability of these compounds to produce cancer has
not been studied in humans or animals.
Glossary
Breakdown product: A substance that is formed when a chemical breaks down in the body.

exposed to 1,3-dinitrobenzene or 1,3,5trinitrobenzene?

exposed to 1,3-dinitrobenzene or 1,3,5-trinitrobenzene. Tests
have been used to detect 1,3-dinitrobenzene and its breakdown products in blood and urine of exposed animals, but
these tests have not been used for people.
Reference


(ATSDR). 1995. Toxicological profile for 1,3-dinitrobenzene/1,3,5-trinitrobenzene (update). Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

DINITROCRESOLS
4,6-DNOC CAS # 534-52-1
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about dinitrocresols. For more
SUMMARY: Exposure to dinitrocresols occurs mainly from breathing air, drinking

water, or eating food that contains the chemicals. At high levels, these chemicals
may cause skin rashes or yellowing; increased heart and breathing rates; damage
to the liver, stomach, and kidneys; and even death. These chemicals have been
What are dinitrocresols?
q It dissolves slightly in water.
(Pronounced d-ntr-krslz)
q It can be broken down slowly in air, water, and soil by

small organisms.
Dinitrocresols are a class of manufactured chemicals that

do not occur naturally in the environment. There are 18
different dinitrocresols.
The most commercially important dinitrocresol,
4,6-dinitro-o-cresol (DNOC), is a yellow solid with no smell. It
is used primarily for insect control and crop protection. It may
be sold under several trade names, including Antinonnin, Detal,
and Dinitrol. Use of tradenames is for identification only and
does not imply endorsement by the Agency for Toxic Substances and Disease Registry, the Public Health Service, or the
U.S. Department of Health and Human Services.
DNOC was used in diet pills in the 1930s, but has since
been banned for this use.
What happens to dinitrocresols when they

q DNOC enters the air, water and soil during its manufacture and use, and may be formed from the reaction of
other chemicals in the air.
q DNOC may also enter the environment through landfill
and storage tank leaks, or accidental spills during
manufacture or transport.
q It does not easily evaporate into the air.

q DNOC sticks to particles in water, which will cause it to
eventually settle to the bottom sediment.
q It also sticks to soil particles, which prevents it from
moving very deep into the soil with rainwater.
q It probably does not build up significantly in fish.
How might I be exposed to dinitrocresols?

q Breathing contaminated workplace air where it is manufactured or used.
q Breathing contaminated air from DNOC-containing waste
sites, or during DNOC spraying or waste incineration.
q Touching contaminated soil or water near DNOC-containing waste sites.
q Ingesting contaminated soil or water near DNOC-containing waste sites.
How can dinitrocresols affect my health?

Most of the information on the health effects of dinitrocresols comes from old studies on patients who were prescribed
diet pills containing DNOC before it was banned for this use.

DINITROCRESOLS
4,6-DNOC CAS # 534-52-1
Page 2
Exposure to high levels of DNOC for short periods may cause

convulsions, unconsciousness, and death.

Exposure to lower levels may result in an increased basal

metabolic rate (the rate that you use energy at complete rest),
increased sweating, weight loss, and increased heart rate,
breathing rate, and body temperature.
The EPA lists DNOC as a hazardous air pollutant (HAP).

The EPA requires that discharges or spills into the environment of 10 pounds or more be reported.
Other effects from DNOC exposure may include difficulty

in breathing, headache, drowsiness, dizziness, a yellowing of
skin and the whites of the eyes, and mild damage to the
stomach, kidneys, and liver. Ingesting DNOC for long periods
may cause cataracts and skin rashes.
How likely are dinitrocresols to cause cancer?

(OSHA) has set an exposure limit of 0.2 milligrams of DNOC
per cubic meter of air (0.2 mg/m3) for an 8-hour workday, 40hour workweek.
(NIOSH) recommends that average workplace air levels not
exceed 1.5 mg of DNOC/m3 of air for a 10-hour workday, 40hour workweek.

the EPA have not classified dinitrocresols for carcinogenicity.
NIOSH has recommended that 5 mg of DNOC/m3 of air be

considered immediately dangerous to life or health. This is
the exposure level of a chemical that is likely to cause
There are no studies available in people or animals on the

carcinogenic effects of dinitrocresols.
Glossary

been exposed to dinitrocresols?
Yellow-stained skin and eyes may indicate that you have
been exposed to DNOC, but these symptoms could also be
caused by exposure to other chemicals.
Tests are available that measure the amount of DNOC in
blood, urine, and feces. However, since DNOC may remain in
your blood and urine for a long time after exposure, these tests
cannot reliably tell you the amount to which you have been
exposed.
These tests may require special equipment, and they may
not be available at your doctors office.

Cataract: A decrease in the transparency of eye lenses.
Sediment: Mud and debris that have settled to the bottom of a
body of water.
References
1995. Toxicological profile for dinitrocresols. Atlanta, GA:
Service.
DINITROPHENOLS
2,4-DNP CAS # 51-28-5
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about dinitrophenols. For
present.
SUMMARY: Exposure to dinitrophenols occurs mainly from breathing air, drinking

water, or eating food that contains the chemicals. At low levels, these chemicals may
cause cataracts, serious skin rashes, and decreases in white blood cells. At high
levels, these chemicals may cause increased heart and breathing rates, and even
death. These chemicals have been found in at least 61 of the 1,430 National Priorities
What are dinitrophenols?
q It may be formed from reaction of other chemicals in the

air.
(Pronounced d-ntr-fnlz)
Dinitrophenols are a class of manufactured chemicals that
do not occur naturally in the environment. There are six different dinitrophenols.
q DNP may also enter the environment through landfill and

storage tank leaks, or accidental spills during manufacture or transport.
The most commercially important dinitrophenol, 2,4-dinitrophenol (DNP), is a yellow solid with no smell. It is used
in making dyes, wood preservatives, explosives, insect control substances, and other chemicals, and as a photographic
developer.
It was used in diet pills in the 1930s but was banned for
this use in 1938. It may be sold under several trade names,
including Caswell No. 392, Sulfo Black B, and Nitro Kleenup.
Disease Registry, the Public Health Service, or the U.S. Department of Health and Human Services.
What happens to dinitrophenols when they

q DNP enters the air, water, and soil during its manufacture
and use.
q It dissolves slightly in water, and does not easily evaporate to air.

q It can be broken down slowly in water and soil by small
organisms or by reacting with other chemicals.
q DNP sticks to particles in water, which will cause it to
eventually settle to the bottom sediment.
q DNP also sticks to some types of soil particles, which may
prevent it from moving very deep into the soil with rainwater.
q DNP probably does not build up significantly in fish.
How might I be exposed to dinitrophenols?

q Breathing contaminated workplace air where it is manufactured or used.
q Breathing contaminated air from DNP-containing waste
sites, waste incineration, or automobile exhaust.
q Touching contaminated soil or water near DNP-containing waste sites.

DINITROPHENOLS
2,4-DNP CAS # 51-28-5
Page 2

q Ingesting contaminated soil or water near DNP-containing
waste sites.
How can dinitrophenols affect my health?

Most of the information on the health effects of dinitrophenols comes from old studies of patients who were prescribed diet
pills containing dinitrophenol before it was banned.
Deaths have occurred in people who ingested 346 milligrams of dinitrophenols per kilogram of body weight per day
(346 mg/kg/day) for short periods, or 14 mg/kg/day for long
periods. Also, people who breathed air containing 40 mg dinitrophenols per cubic meter of air (40 mg/m3) for long periods
have died.
The amount of dinitrophenols ingested that causes harmful effects varies among people. Increased basal metabolic rate
(the rate that you use energy at complete rest), increased sweating, a feeling of warmth, weight loss, and increased heart rate,
breathing rate, and body temperature have been observed in
people who swallowed as little as 1 mg/kg/day or as much as
46 mg/kg/day for short or long periods of time.
Ingesting 24 mg/kg/day DNP for short or long periods
has caused cataracts in some people, while ingesting
14 mg/kg/day for short or long periods has caused skin
rashes and decreases in white blood cells.

been exposed to dinitrophenols?
Tests are available that measure the amount of DNPs or
their breakdown products in blood, urine, and samples of tissue from the body. However, these tests may require special
equipment and may not be available in your doctors office.

The EPA recommends that not more than 70 parts of dinitrophenols per billion parts of water (70 ppb) be present in
lakes or streams used for swimming.
The EPA lists DNPs as hazardous air pollutants (HAP) under
the Clean Air Act. The EPA also requires that discharges or spills
into the environment of 10 pounds or more be reported.
Glossary
CAS: Chemical Abstract Service.
Cataract: A decrease in the transparency of eye lenses.
Ingest: Take food or drink into your body.
Kilogram (kg): One thousand grams.
How likely are dinitrophenols to cause

cancer?
the EPA have not classified dinitrophenols for carcinogenicity.
There are no studies available in people or animals on the
carcinogenic effects of dinitrophenols.

body of water.
References
1995. Toxicological profile for dinitrophenols. Atlanta, GA:
Service.
2,4- and 2,6-DINITROTOLUENE

CAS # 121-14-2 and 606-20-2
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 2,4- and 2,6-dinitrotoluene.
present.
HIGHLIGHTS: 2,4- and 2,6-Dinitrotoluene are used in a number of industries.

Exposure to high levels may affect the nervous system and the blood. Both
are known to cause cancer in laboratory animals. These substances have been
found in at least 69 (2,4-DNT) and 53 (2,6-DNT) of the 1,467 National Priorities
What are 2,4-dinitrotoluene (2,4-DNT) and
2,6-dinitrotoluene (2,6-DNT)?
(Pronounced 2,4- and 2,6-d n tr tl y n)
Both 2,4-DNT and 2,6-DNT are pale yellow solids with a
slight odor. They are two of the six forms of the chemical
called dinitrotoluene (DNT).
q In water, DNT tends to be more stable and less likely to

break down.
q DNT can be transferred to plants by root uptake from contaminated water or soil.
How might I be exposed to 2,4- and 2,6-DNT?

q Most people will not be exposed to 2,4- and 2,6-DNT.
DNT is not a natural substance. It is made by mixing toluene with nitric acid. DNT is usually used to make flexible
polyurethane foams used in the bedding and furniture industries. DNT is also used to produce explosives, ammunition,
and dyes. It is also used in the air bags of automobiles.
q Breathing contaminated air near manufacturing plants.
What happens to 2,4- and 2,6-DNT when they

How can 2,4- and 2,6-DNT affect my health?
q DNT has been found in the soil, surface and ground water,
and air.
q It has been found at hazardous waste sites that contain
buried ammunition wastes.
q DNT does not usually evaporate; it is found mostly in the
air of manufacturing plants.
q DNT does not stay in the environment because it is broken down by sunlight and by bacteria.
q Drinking contaminated water or eating contaminated

food.
q Breathing air near a hazardous waste site that contains
buried ammunition wastes.
Workers who have been exposed to 2,4-DNT showed a

higher than normal death rate from heart disease. However,
these workers were exposed to other chemical as well. 2,4and 2,6-DNT may also affect the nervous system and the
blood of exposed workers.
One study showed that male workers exposed to DNT
had reduced sperm counts, but other studies did not confirm
this finding.

Page 2
2,4- and 2,6-DINITROTOLUENE

CAS # 121-14-2 and 606-20-2

Animals exposed to high levels of DNT had lowered number of sperm and reduced fertility. Animals also showed a
reduction in red blood cells, nervous system disorders, and
liver and kidney damage.
How likely are 2,4- and 2,6-DNT to cause

cancer?
In animal studies, both 2,4- and 2,6-DNT caused liver
cancer in rats. There are no studies on the effects of 2,4- and
2,6-DNT on people. The International Agency for Research on
Cancer (IARC) has determined that 2,4- and 2,6-DNT are possible human carcinogens.
How can 2,4- and 2,6-DNT affect children?

It is unlikely that children would be exposed to 2,4- and
2,6-DNT unless they live near a manufacturing plant or a waste
site that contains these compounds. Children are at risk of
exposure if DNT has leached into a community's drinking
water supply from a nearby hazardous waste site, since they
drink more fluids in proportion to their body weight than
adults. Children playing in DNT-contaminated surface water
might be more exposed than adults, because of their larger
skin area in proportion to their body weight.
The health effects of DNT on children have not been studied. It is not known if DNT affects children differently than
adults, or what long-term effects might appear in adults exposed as children.

exposed to 2,4- and 2,6-DNT?
Both 2,4- and 2,6-DNT and the chemicals they change
into in the body can be measured in the blood and urine. The
urine must be collected within 24 hours of exposure. These
tests cannot show how much 2,4- or 2,6-DNT a person has
been exposed to. They are not usually available in a doctors
office, but they can be performed in special laboratories.

EPA requires that spills or accidental releases of more than
1,000 pounds of DNT be reported to the EPA.
(OSHA) requires that total DNT (all forms) in workplace air
should not exceed 1.5 mg per cubic meter (1.5 mg/m3) for an
(NIOSH) recommends a workplace limit of 1.5 mg/m3. This is
the average concentration for a 10-hour day over a 40-hour
workweek.

2,4- and 2,6-DNT?

(ATSDR). 1998. Toxicological profile for 2,4- and 2,6-dinitrotoluene. Atlanta, GA: U.S. Department of Health and Human
If your doctor finds that you have been exposed to significant amounts of 2,4- or 2,6-DNT, ask if children may also be
exposed. When necessary your doctor may need to ask your
state Department of Public Health to investigate.

1,2-DIPHENYLHYDRAZINE
CAS # 122-66-7
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2-diphenylhydrazine. For
HIGHLIGHTS: 1,2-Diphenylhydrazine is a man-made chemical that was once

used in fabric dyes but now is only used to make certain medicines. No harmful
effects on people have been reported. Animal studies indicate that it may affect
the liver, lungs, and digestive system. It has been found at 7 of the 1,177 National
What is 1,2-diphenylhydrazine?
(Pronounced 1,2-d-f-nl-hdr-zn)
1,2-Diphenylhydrazine is a white solid. There is no information on what it smells like or whether it will burn. It does
not dissolve easily in water, but when placed in water, it rapidly breaks down into other chemicals. These include the
toxic chemicals benzidine and azobenzene. It does not
evaporate easily but may be released to air when attached to
dust particles.
1,2-Diphenylhydrazine is a man-made chemical that was
used in the past to make benzidine, which was used to make
various fabric dyes. Benzidine dyes are no longer used in the
United States, but may still be used in other countries. The
only current use of 1,2-diphenylhydrazine in the United
States is in the production of medicines to treat inflammation
and a type of arthritis.
What happens to 1,2-diphenylhydrazine when it

q 1,2-Diphenylhydrazine rapidly breaks down to other
chemicals when released to the environment.
q Very little 1,2-diphenylhydrazine is likely to be released

to the air because it does not evaporate easily; however, if
released to the air, it would probably break down rapidly
to other chemicals such as azobenzene.
q 1,2-Diphenylhydrazine reacts rapidly with water to form
benzidine, azobenzene, and other chemicals.
q When released to soil, it will attach to soil particles but is
not expected to last very long.
q It is not likely to filter through the soil to groundwater.
q There is no information about its biomagnification
through the food chain, but it would not be expected to
bioaccumulate because it does not persist for long in the
environment.
How might I be exposed to 1,2-diphenylhydrazine?

q Most people are not likely to be exposed to 1,2-diphenylhydrazine because of its limited use and because it
doesn't last long once released to the environment.
q People who take medicines made from 1,2-diphenylhydrazine may be exposed to low levels.
q If you live near a waste site that contains 1,2-diphenylhydrazine you might be exposed if it was in dust you
breathed or dirt that got on your skin.

1,2-DIPHENYLHYDRAZINE
CAS # 122-66-7
Page 2

q If you work in a factory where 1,2-diphenylhydrazine is
made or used, you could be exposed to it by breathing
dust or getting it on your skin.
How can 1,2-diphenylhydrazine affect my

health?
No harmful effects on people exposed to 1,2-diphenylhydrazine have been reported.
Animal studies indicate that ingesting large amounts of
1,2-diphenylhydrazine can cause death. Ingesting smaller
amounts over a long period can cause damage to the lungs,
digestive tract (stomach and intestines), and liver, and can
cause death. We do not know if it can cause birth defects or
affect reproduction.
How likely is 1,2-diphenylhydrazine to cause

cancer?
No studies are available on whether 1,2-diphenylhydrazine causes cancer in people. The carcinogenicity of
1,2-diphenylhydrazine has been evaluated in rats and mice in
studies that showed it caused liver cancer. The EPA has determined that 1,2-diphenylhydrazine is a probable human
carcinogen based on adequate evidence in animals and inadequate data in humans.

exposed to 1,2-diphenylhydrazine?
There are no medical tests to determine if you have been
exposed to 1,2-diphenylhydrazine.

The EPA recommends that levels of 1,2-diphenylhydrazine in lakes and streams should be limited to 0.041 parts per
billion (0.041 ppb) to prevent possible human health effects
from drinking water or eating fish contaminated with this
chemical. Any release to the environment greater than
10 pounds of 1,2-diphenylhydrazine must be reported to the
EPA.
July 1999.
Glossary
(ATSDR). 1990. Toxicological profile for 1,2-diphenylhydrazine. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
DI-n-OCTYLPHTHALATE (DNOP)
CAS # 117-84-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about di-n-octylphthalate (DNOP).
present.
HIGHLIGHTS: Exposure to di-n-octylphthalate occurs mainly from eating food

or drinking water that is stored in plastic containers. The health effects of breathing,
ingesting, or touching di-n-octylphthalate are not known. This substance has
What is di-n-octylphthalate?
(Pronounced d-n-ktl thl t)
Di-n-octylphthalate is a colorless, odorless, oily liquid
that doesnt evaporate easily. It is a man-made substance used
to keep plastics soft or more flexible. This type of plastic can
be used for medical tubing and blood storage bags, wire and
cables, carpetback coating, floor tile, and adhesives. It is also
used in cosmetics and pesticides.
What happens to di-n-octylphthalate when it

q Di-n-octylphthalate can be released to water or air during
its manufacture, by leaking from plastics in landfills, or
from the burning of plastic products.
q If di-n-octylphthalate is released into the air, it may be
deposited on the ground or to surface water in rain or dust
particles.
q Di-n-octylphthalate sticks tightly to soil, sediment, and
dust particles.
q Di-n-octylphthalate is mainly broken down into other
substances by microorganisms.
q It can also be broken down in reactions with sunlight,

other chemicals in the atmosphere, or water.
q Small amounts of di-n-octylphthalate can build up in
animals that live in water, such as fish and oysters.
How might I be exposed to di-n-octylphthalate?

q Eating foods stored in containers made with di-noctylphthalate that has leaked into the food.
q Receiving blood transfusions, dialysis, or other medical
treatments in which the equipment is made of plastics
containing di-n-octylphthalate.
q Breathing contaminated air, drinking contaminated water, or touching contaminated soil near hazardous waste
sites or an industrial manufacturing facility that uses or
makes di-n-octylphthalate.
How can di-n-octylphthalate affect my health?

Little information is known about the health effects that
might be caused by di-n-octylphthalate. It is not known what
happens when you breathe or ingest the chemical.

Page 2
DI-n-OCTYLPHTHALATE (DNOP)
CAS # 117-84-0
Some rats and mice that were given very high doses of
di-n-octylphthalate by mouth died. Mildly harmful effects
have been seen in the livers of some rats and mice given
very high doses of di-n-octylphthalate by mouth for short
(14 days or less) or intermediate periods (15 to 365 days) of
time, but lower doses given for short periods of time generally caused no harmful effects.
No information is available on the health effects of having
di-n-octylphthalate in contact with human skin. It can be
mildly irritating when applied to the skin of animals.
It is not known whether or not di-n-octylphthalate could
affect the ability to have children, or if it could cause birth
defects.
This test is not part of a routine medical examination, but

it can be done by the doctor's request at special laboratories.

The EPA has recently determined that there is not enough
evidence to say that di-n-octylphthalate causes harmful effects
in humans or the environment.
environment of 5,000 pounds or more of di-n-octylphthalate
Glossary
How likely is di-n-octylphthalate to cause cancer?
Di-n-octylphthalate is not known to cause cancer in humans or animals.
Di-n-octylphthalate has not been classified as to its carcinogenicity by the Department of Health and Human Services
(IARC), or the EPA.

body of water.
exposed to di-n-octylphthalate?
Di-n-octylphthalate and its principal breakdown products
can be measured in urine, blood, and tissues. However, it is
not known if they are specific for di-n-octylphthalate or for
how long after exposure occurs the test is useful. These facts
cannot be used to determine how much di-n-octylphthalate
you were exposed to or predict whether harmful effects will
occur.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Di-n-octylphthalate produced by the
Health Service, U.S. Department of Health and Human Services, Public Health Service in Atlanta, GA.
DISULFOTON
CAS # 298-04-4
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about disulfoton. For more
SUMMARY: Exposure to disulfoton happens mostly from breathing

contaminated air, drinking contaminated water, and eating contaminated food.
High exposures can cause harmful effects on the nervous system. Disulfoton has
been found in at least 7 of the 1,430 National Priorities List sites identified by the
What is disulfoton?
q Natural chemical reactions and bacteria remove it from

soil and water.
(Pronounced d-slf-tn)
Disulfoton is a manufactured substance used as a pesticide
to control a variety of harmful pests that attack many field and
vegetable crops. It does not occur naturally. Pure disulfoton is a
colorless oil with an unidentifiable characteristic odor and
taste. The technical product is dark yellowish, with an aromatic
odor. Common trade names are Di-syston, Disystox, Frumin
AL, and Soilvirex. Use of trade names is for identification only
and does not imply endorsement by the Agency for Toxic Substances and Disease Registry, the Public Health Service, or the
U.S. Department of Health and Human Services.
q Fish accumulate disulfoton in their bodies.
It is used to protect small grains, sorghum, corn, and other

field crops; some vegetables, fruit, and nut crops; and ornamental and potted plants against certain insects. Although it is
used mostly in agriculture, small quantities are used on home
and garden plants, and for mosquito control in swamps. The
use of disulfoton has decreased in recent years.
What happens to disulfoton when it enters

the environment?
q Disulfoton enters the environment when it is applied on
field crops, vegetables, potted plants, and home gardens.
q Disulfoton is found mainly in soil and water.
q Disulfoton binds moderately to soil and typically does

not travel deep into soil with rainwater.
q In water, it takes about 7 days for half of it to break down.
q In soil, it takes about 3.5290 days for half of it to break
down, depending on soil type, moisture, and temperature.
How might I be exposed to disulfoton?

q Breathing contaminated air, drinking contaminated water,
and eating contaminated food.
q Living near hazardous waste sites where it is found.
q For children, touching or eating soil at or near hazardous
waste sites that contain disulfoton.
q Working in fields where it is sprayed.
q Working in industries that manufacture and formulate it.
q Using it in your home or garden.
How can disulfoton affect my health?

In people, disulfoton mainly causes harmful effects to the
nervous system. Depending on the amount of disulfoton that
enters the body, effects on the nervous system, such as
narrowing of the pupils, vomiting, diarrhea, drooling,

DISULFOTON
CAS # 298-04-4
Page 2

difficulty in breathing, tremors, convulsions, and even death
may occur. These effects can occur if you breathe in, ingest, or
touch disulfoton. If you ingest disulfoton from food or water
for long periods, it may affect your eyes and you may become
nearsighted. You may become weak and tired after skin contact
with disulfoton.
Ingesting high levels of disulfoton can cause similar nervous system (neurologic) effects in animals. Animals that ingested disulfoton for long periods became nearsighted, and the
structures of their eyes were damaged.
We do not know whether disulfoton causes reproductive or
birth defects in people. Some animals that ingested disulfoton
during pregnancy had newborns with underdeveloped bones,
damaged livers and kidneys, and underdeveloped testes.
How likely is disulfoton to cause cancer?

the EPA have not classified disulfoton as to its ability to cause
cancer.
We don't know whether disulfoton will cause cancer in
people. No studies in people are available, and animals that
ingested disulfoton for long periods did not develop cancer.
you were exposed to. Your doctor can send samples of your
blood or urine to special laboratories that perform these tests.

The EPA recommends that no more than 10 parts of disulfoton per billion parts of water (10 ppb) be present in water
that children drink for periods of up to 10 days. They also recommend that disulfoton should not exceed 3 ppb for children
or 9 ppb for adults if they drink water for longer periods of
time, and it should not exceed 0.3 ppb for adults who drink the
water for a lifetime. The EPA requires that spills or accidental
releases of disulfoton into the environment of 1 pound or more
must be reported.
Hygienists (ACGIH) has set a limit of 0.1 milligram of disulfoton per cubic meter of air (0.1 mg/m3) for an 8-hour workday,
40-hour workweek.
(NIOSH) recommends an exposure limit of 0.1 mg disulfoton/m3
of air for a 10-hour workday, 40-hour workweek.
Glossary

been exposed to disulfoton?
Disulfoton and its breakdown products can be measured
in the blood, urine, feces, liver, kidney, or body fat of exposed
people. Inhibition of blood cholinesterase (an enzyme in the
blood) may also suggest exposure to disulfoton. However, this
test is not specific for disulfoton. The measurement of blood
cholinesterase and the amount of disulfoton breakdown products in the urine cannot always predict how much disulfoton

Testes: Male reproductive glands that produce sperm.
References
1995. Toxicological profile for disulfoton. Atlanta, GA: U.S.
ENDOSULFAN
CAS # 33213-65-9
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about endosulfan. For more
HIGHLIGHTS: Exposure to endosulfan happens mostly from eating

contaminated food, but may also occur from skin contact, breathing
contaminated air, or drinking contaminated water. Endosulfan affects the
function of the central nervous system. Endosulfan has been found in at least
164 of 1,577 National Priorities List sites identified by the Environmental
What is endosulfan?
(Pronounced en!do-sul-f|n)
Endosulfan does not dissolve easily in water. Endosulfan

in surface water is attached to soil particles floating in water
or attached to soil at the bottom.
Endosulfan is a pesticide. It is a cream- to brown-colored

solid that may appear in the form of crystals or flakes. It
has a smell like turpentine, but does not burn. It does not
occur naturally in the environment.
Endosulfan can build up in the bodies of animals that live

in endosulfan-contaminated water;
How might I be exposed to endosulfan?

Endosulfan is used to control insects on food and non-food
crops and also as a wood preservative.
What happens to endosulfan when it enters the

environment?
Endosulfan enters the air, water, and soil during its
manufacture and use. It is often sprayed onto crops and the
spray may travel long distances before it lands on crops,
soil, or water.
Endosulfan on crops usually breaks down in a few weeks,
but endosulfan sticks to soil particles and may take years to
completely break down.
Eating food contaminated with endosulfan, but levels in

foods are very low.
People working in industries involved in making
endosulfan or as pesticide applicators.
Skin contact with soil containing endosulfan.
How can endosulfan affect my health?

Endosulfan affects the central nervous system and prevents
it from working properly. Hyperactivity, nausea, dizziness,
headache, or convulsions have been observed in adults
exposed to high doses. Severe poisoning may result in
death.

ENDOSULFAN
Page 2
CAS # 33213-65-9
Studies of the effects of endosulfan on animals suggest that

long-term exposure to endosulfan can also damage the
kidneys, testes, and liver and may possibly affect the bodys
ability to fight infection. However, it is not known if these
effects also occur in humans.
How likely is endosulfan to cause cancer?

We do not know if endosulfan can cause cancer in humans.
Studies in animals have provided inconclusive results.
How can endosulfan affect children?

We do not know if children are more sensitive to endosulfan
than adults. We do not know if endosulfan can affect the
ability of people to have children or if it causes birth defects.
Large amounts of endosulfan damaged the testes of animals,
but it is not known if this damaged their ability to reproduce.
Some birth defects have been seen in the offspring of
animals ingesting endosulfan during pregnancy.

endosulfan?
Fresh fruits and vegetables should be washed before
being eaten.
Children should not play on grasses that were recently
treated with endosulfan. Carefully follow the directions on
the pesticide label about how long to wait before re-entering
the treated area.
People working in a factory making endosulfan and people
using endosulfan should wash clothing, skin, and hair before
going home.
Pesticides should be used according to the directions on

the label and stored in the original container in a place that
children cannot reach.

exposed to endosulfan?
Endosulfan and its breakdown products can be detected in
your blood, urine, and body tissues if you have been
exposed to a large amount. These tests are not usually
the samples to a laboratory that can perform the tests.
Because endosulfan leaves the body fairly quickly, these
methods are useful only for finding exposures that have
occurred within the last few days.

The EPA recommends that the amount of endosulfan in
rivers, lakes, and streams should not be more than 74 parts
per billion (74 ppb).
The Food and Drug Administration (FDA) allows no more
than 24 parts per million (24 ppm) endosulfan on dried tea.
EPA allows no more than 0.1 to 2 ppm endosulfan on other
raw agricultural products.
(ATSDR). 2000. Toxicological Profile for Endosulfan.
ENDRIN
CAS # 72-20-8
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about endrin. For more information,
hazardous substances and their health effects. This information is important because this substance may
harm you. The effects of exposure to any hazardous substance depend on the dose, the duration, how you
are exposed, personal traits and habits, and whether other chemicals are present.
HIGHLIGHTS: Exposure to endrin can cause various harmful effects including

death and severe central nervous system injury. Swallowing very large amounts
of endrin may cause convulsions and kill you in a few minutes or hours. Exposure
to high doses may result in headaches, dizziness, nervousness, confusion, nausea,
vomiting, and convulsions. No long-term health effects have been noted in workers.
Endrin has been found in at least 120 of the 1,430 National Priorities List sites
What is endrin?
(Pronounced n drn)
Endrin is a solid, white, almost odorless substance that
was used as a pesticide to control insects, rodents, and birds.
Endrin has not been produced or sold for general use in the
United States since 1986.
Little is known about the properties of endrin aldehyde
(an impurity and breakdown product of endrin) or endrin
ketone (a product of endrin when it is exposed to light).
q Endrin may also be broken down by exposure to high

temperatures or light to form primarily endrin ketone and
endrin aldehyde.
q It is not known what happens to endrin aldehyde or endrin ketone once they are released to the environment.
However, the amount of endrin broken down to endrin
aldehyde or endrin ketone is very small.
How might I be exposed to endrin?

q You may be exposed to endrin in air, water, or soil if you
live near a hazardous waste site.
q You may be exposed by eating foods that contain endrin.
What happens to endrin when it enters the

environment?
q Endrin does not dissolve very well in water. It has been
found in groundwater and surface water, but only at very
low levels. It is more likely to cling to the bottom sediments of rivers, lakes, and other bodies of water.
q Children living near hazardous waste sites could be exposed to endrin in contaminated soils if they eat dirt.
q Endrin levels can build up in the tissues of organisms that
live in water.
q Human breast milk may be a route of exposure for nursing
infants.
q Endrin is generally not found in the air except when it

was applied to fields during agricultural applications.
How can endrin affect my health?
q The persistence of endrin in the environment depends

highly on local conditions. Some estimates indicate that
endrin can stay in soil for over 10 years.
Exposure to endrin can cause various harmful effects including death and severe central nervous system (brain and
spinal cord) injury. Swallowing large amounts of endrin may

ENDRIN
CAS # 72-20-8
Page 2

cause convulsions and kill you in a few minutes or hours.
Symptoms that may result from endrin poisoning are headaches, dizziness, nervousness, confusion, nausea, vomiting,
and convulsions.
No long-term health effects have been noted in workers
who have been exposed to endrin by breathing or touching it.
Studies in animals confirm that endrins main target is the
nervous system.
tests to predict the type or severity of any health effects that

might occur.

The EPAs maximum contaminant level (MCL) for endrin in
drinking water is 0.0002 milligrams per liter (0.0002 mg/L).
Birth defects, especially abnormal bone formation, have

been seen in some animal studies.

(OSHA) has established a limit of 0.1 mg endrin per cubic
meter of air (0.1 mg/m3) for an 8-hour day in a 40-hour workweek.
How likely is endrin to cause cancer?
Glossary
In studies using rats, mice, and dogs, endrin did not produce cancer. However, most of these studies did not accurately
evaluate the ability of endrin to cause cancer.
No significant excess of cancer has been found in exposed

factory workers.
The EPA has determined that endrin is not classifiable as

to its human carcinogenicity because there is not enough information to allow classification.

exposed to endrin?
If you are exposed to endrin, it can be detected in your
blood, breast milk, or fatty tissue. Tests can measure endrin
in the blood or fat of people recently exposed. These tests
arent available at most doctors offices, but can be done at
special laboratories that have the right equipment.
Although these tests can be used to confirm that a person
has been exposed to endrin, it is not yet possible to use these

Sediments: Mud and debris that have settled to the bottom of a
body of water.
This ToxFAQs information is taken from the 1996 Toxicological Profile for Endrin produced by the Agency for Toxic
Substances and Disease Registry, Public Health Service, U.S.
Department of Health and Human Services, Public Health Service in Atlanta, GA.
ETHION
CAS # 563-12-2
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about ethion. For more information,
HIGHLIGHTS: Exposure to ethion happens mostly from skin contact or breathing

contaminated air, but may also occur from eating contaminated food or drinking
contaminated water. Ethion affects the function of the central nervous system
and at high doses can cause nausea, blurring or dimness of vision, muscle tremors,
and labored breathing. Ethion has been found in at least 9 of 1,577 National
What is ethion?
(Pronounced -thi!on)
Ethion is an organophosphate pesticide. Pure ethion is a
clear to yellowish liquid with an unpleasant sulfur-like smell.
It does not occur naturally in the environment.
move from soil to underground water. Ethion in soil breaks

down in 112 months.
It is not known if ethion levels can build up in plants or
fish.
How might I be exposed to ethion?

Ethion is used in agriculture, mainly to control insects on
citrus trees, but also on cotton, fruit and nut trees, and some
vegetables. It may also be used on lawns and turf grasses,
but it is not used in the home for pest control.
What happens to ethion when it enters the

environment?
Ethion enters the air, water, and soil during its
manufacture and use.
Ethion in air lasts a short time. It is slowly broken down
in water.
Ethion binds strongly to soil particles and it does not
Working in industries that make ethion or as a pesticide

applicator.
Eating raw fruits or vegetables that have been treated with
ethion, but levels are very low.
Skin contact with soil containing ethion.
How can ethion affect my health?

Ethion affects the nervous system. Exposure to high levels
of ethion can nausea, sweating, diarrhea, loss of bladder

ETHION
Page 2
CAS # 563-12-2
control, blurring or dimness of vision, muscle tremors, and

labored breathing. Severe poisoning may result in coma,
inability to breathe, and death.
How likely is ethion to cause cancer?
We do not know if ethion can cause cancer in humans. No

cancer was seen in animals that ate ethion over a long period
of time.
How can ethion affect children?
We do not know if children are more sensitive to ethion than

adults. We do not know if ethion can affect the ability of
people to have children or if it causes birth defects. Some
birth defects have been seen in the babies of animals that ate
ethion during pregnancy.

exposed to ethion?
The breakdown products of ethion can be measured in
your urine.
There are tests to measure the activity of the enzymes
(acetylcholinesterases) that are affected by ethion. These
tests cannot tell if you were exposed to ethion because a
number of chemicals also affect these enzymes.
Neither of these tests are routinely available in your
doctors office, but samples can be sent to a special
laboratory.

The EPA has established regulations for the maximum
limits of ethion on food products, ranging from 0.1 to 14
parts per million (0.1 to 14 ppm).

ethion?
Children should not play on grasses that were recently
treated with ethion. Carefully follow the directions on the
pesticide label about how long to wait for re-entering the
treated area.
People working in a factory making ethion and people
using ethion should wash clothing, skin, and hair before
going home.

(ATSDR). 2000. Toxicological Profile for Ethion. Atlanta,
Health Service.
ETHYLBENZENE
CAS # 100-41-4
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about ethylbenzene. For more
HIGHLIGHTS: Ethylbenzene is a colorless liquid found in a number of

products including gasoline and paints. Breathing very high levels can cause
dizziness and throat and eye irritation. Ethylbenzene has been found in at
What is ethylbenzene?
(Pronounced th l bn zn)
Ethylbenzene is a colorless, flammable liquid that smells
like gasoline. It is found in natural products such as coal tar
and petroleum and is also found in manufactured products
such as inks, insecticides, and paints.
Ethylbenzene is used primarily to make another chemical,
styrene. Other uses include as a solvent, in fuels, and to make
other chemicals.
What happens to ethylbenzene when it enters the

environment?
q Ethylbenzene moves easily into the air from water and
soil.
q It takes about 3 days for ethylbenzene to be broken down
in air into other chemicals.
q Ethylbenzene may be released to water from industrial
discharges or leaking underground storage tanks.
q In surface water, ethylbenzene breaks down by reacting
with other chemicals found naturally in water.
q In soil, it is broken down by soil bacteria.
How might I be exposed to ethylbenzene?

q Breathing air containing ethylbenzene, particularly in
areas near factories or highways.
q Drinking contaminated tap water.
q Working in an industry where ethylbenzene is used or
made.
q Using products containing it, such as gasoline, carpet
glues, varnishes, and paints.
How can ethylbenzene affect my health?

Limited information is available on the effects of ethylbenzene on peoples health. The available information shows
dizziness, throat and eye irritation, tightening of the chest,
and a burning sensation in the eyes of people exposed to high
levels of ethylbenzene in air.
Animals studies have shown effects on the nervous system,
liver, kidneys, and eyes from breathing ethylbenzene in air.
How likely is ethylbenzene to cause cancer?

The EPA has determined that ethylbenzene is not classifiable as to human carcinogenicity.

ETHYLBENZENE
CAS # 100-41-4
Page 2

No studies in people have shown that ethylbenzene exposure can result in cancer. Two available animal studies suggest
that ethylbenzene may cause tumors.
How can ethylbenzene affect children?
some body tissues of exposed people. The most common

way to test for ethylbenzene is in the urine. This test measures substances formed by the breakdown of ethylbenzene.
This test needs to be done within a few hours after exposure
occurs, because the substances leave the body very quickly.
Children may be exposed to ethylbenzene through inhalation of consumer products, including gasoline, paints, inks,
pesticides, and carpet glue. We do not know whether children
are more sensitive to the effects of ethylbenzene than adults.
These tests can show you were exposed to ethylbenzene,

but cannot predict the kind of health effects that might occur.
It is not known whether ethylbenzene can affect the

development of the human fetus. Animal studies have
shown that when pregnant animals were exposed to ethylbenzene in air, their babies had an increased number of
birth defects.


ethylbenzene?
Exposure to ethylbenzene vapors from household products and newly installed carpeting can be minimized by using
adequate ventilation.
Household chemicals should be stored out of reach of
children to prevent accidental poisoning. Always store household chemicals in their original containers; never store them in
containers children would find attractive to eat or drink from,
such as old soda bottles. Gasoline should be stored in a gasoline can with a locked cap.
Sometimes older children sniff household chemicals, including ethylbenzene, in an attempt to get high. Talk with
your children about the dangers of sniffing chemicals.

exposed to ethylbenzene?
Ethylbenzene is found in the blood, urine, breath, and
The EPA has set a maximum contaminant level of

0.7 milligrams of ethylbenzene per liter of drinking water
(0.7 mg/L).
environment of 1,000 pounds or more of ethylbenzene be reported to the EPA.
(OSHA) has set an occupational exposure limit of 100 parts of
ethylbenzene per million parts of air (100 ppm) for an 8-hour
(ATSDR). 1999. Toxicological profile for ethylbenzene.
toxic substances might harm people or to treat those who have
ETHYLENE OXIDE
CAS # 75-21-8
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about ethylene oxide. For more
HIGHLIGHTS: Large amounts of ethylene oxide are produced in the United

States. Most of it is used to make other chemicals such as ethylene glycol, but
smaller amounts are used as a pesticide or to sterilize medical equipment.
Exposure to ethylene oxide can cause irritation of the eyes, skin, nose, throat,
and lungs, and damage to the brain and nerves. It has been found at 3 of the
1,177 National Priorities List sites identified by the Environmental Protection
Agency (EPA).
What is ethylene oxide?
(Pronounced th-ln ksd)
Ethylene oxide is a flammable gas with a somewhat sweet
odor. It dissolves easily in water.
Ethylene oxide is a man-made chemical that is used primarily to make ethylene glycol (a chemical used to make antifreeze and polyester). A small amount (less than 1%) is used
to control insects in some stored agricultural products and a
very small amount is used in hospitals to sterilize medical
equipment and supplies.
What happens to ethylene oxide when it enters

the environment?
q When released to soil, most will evaporate to air and some

may be broken down by bacteria or by reacting with water
in the soil.
q Ethylene oxide does not persist long in the environment
and is not expected to build up in the food chain.
How might I be exposed to ethylene oxide?

q Most people are not likely to be exposed to ethylene
oxide because it is not commonly found in the environment.
q If you work where ethylene oxide is made or used, you
could be exposed to it by breathing it or getting it on
your skin.
q Although ethylene oxide has been measured in some
foods shortly after being sprayed as a pesticide, it is not
known if any ethylene oxide would remain on the food
by the time it is processed and eaten.
q Ethylene oxide rapidly breaks down when released to the

environment.
q Because ethylene oxide is a gas, most is expected to be
released to the air where it reacts with water vapor and
sunlight and breaks down within a few days.
q Ethylene oxide will dissolve in water, but most of it will
quickly evaporate to the air. The ethylene oxide remaining will be broken down by bacteria, or by reacting with
water and other chemicals.
How can ethylene oxide affect my health?

Breathing low levels of ethylene oxide for several months
to years has caused irritation of the eyes, skin, and respiratory
passages and affected the nervous system (headache, nausea,
vomiting, memory loss, numbness, etc.). At higher levels of

ETHYLENE OXIDE
CAS # 75-21-8
Page 2
exposure for shorter periods, effects are similar but may be

more severe. There is some evidence that exposure to ethylene
oxide can cause a pregnant woman to have a miscarriage.
Animal studies indicate that in addition to irritation of the
respiratory passages, nervous system effects, and reproductive
effects, the kidneys, adrenal gland, and skeletal muscles may
be affected from long-term exposure to ethylene oxide.
How likely is ethylene oxide to cause cancer?

Increased incidences of leukemia and stomach cancer
have been reported for workers exposed to ethylene oxide;
however, the data are not considered conclusive. The carcinogenicity of ethylene oxide has been evaluated in rats and mice
that breathed it. Leukemia, brain tumors, lung tumors, and
other cancers were observed. The Department of Health and
Human Services (DHHS) has determined that ethylene oxide
may reasonably be anticipated to be a human carcinogen.

exposed to ethylene oxide?
There are two kinds of tests that can determine if you have
been recently exposed to ethylene oxide. One test measures
ethylene oxide in blood and the other test measures it in your
breath. However, these tests cannot be used to predict how it
will affect your health. Because special equipment is needed,
these tests are not usually done in the doctors office.

The Food and Drug Administration (FDA) has set a tolerance limit of 50 parts per million (50 ppm) of ethylene oxide
in ground spices. Any release to the environment greater than

10 pounds must be reported to the EPA.
(OSHA) has set a limit of 1 ppm over an 8-hour workday, 40hour workweek with a short-term exposure limit (not to exceed
15 minutes) of 5 ppm.
(NIOSH) recommends that average workplace air should contain less than 0.1 ppm ethylene oxide averaged over a 10-hour
July 1999.
Glossary
(ATSDR). 1990. Toxicological profile for ethylene oxide.
ETHYLENE GLYCOL and

PROPYLENE GLYCOL
CAS # 107-21-1 and 57-55-6
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about ethylene glycol and propylene
glycol. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is
one in a series of summaries about hazardous substances and their health effects. This information is
important because this substance may harm you. The effects of exposure to any hazardous substance depend
on the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals
are present.
HIGHLIGHTS: Ethylene glycol and propylene glycol are clear liquids used in
antifreeze and deicing solutions. Exposure to large amounts of ethylene glycol
can damage the kidneys, heart, and nervous system. Propylene glycol is generally
regarded as safe for use in food. Ethylene glycol has been found in at least 34,
and propylene glycol in at least 5, of the 1,416 National Priorities List sites identified
What are ethylene glycol and propylene glycol?
(Pronounced th-ln and pr p-ln gl kl)
Both ethylene glycol and propylene glycol are clear, colorless, slightly syrupy liquids at room temperature. Either
compound may exist in air in the vapor form, although propylene glycol must be heated or briskly shaken to produce a
vapor. Ethylene glycol is odorless but has a sweet taste. Propylene glycol is practically odorless and tasteless.
Both compounds are used to make antifreeze and deicing
solutions for cars, airplanes, and boats; to make polyester compounds; and as solvents in the paint and plastics industries.
Ethylene glycol is also an ingredient in photographic developing solutions, hydraulic brake fluids and in inks used in
stamp pads, ballpoint pens, and print shops.
The Food and Drug Administration (FDA) has classified
propylene glycol as an additive that is generally recognized
as safe for use in food. It is used to absorb extra water and
maintain moisture in certain medicines, cosmetics, or food
products. It is a solvent for food colors and flavors.
Propylene glycol is also used to create artificial smoke
or fog used in fire-fighting training and in theatrical productions.
What happens to ethylene glycol and propylene

glycol when they enter the environment?
q Neither compound is likely to exist in large amounts in air.
q About half of the compounds that enter the air will break
down in 2450 hours.
q Both compounds break down within several days to a
week in water and soil.
How might I be exposed to ethylene glycol and

propylene glycol?
q You can be exposed to ethylene glycol when you use antifreeze, photographic developing solutions, coolants, and
brake fluid.
q You can be exposed to propylene glycol by eating food
products, using cosmetics, or taking medicine that contains it.
q If you work in an industry that uses ethylene glycol or
propylene glycol, you could be exposed by breathing or
touching these substances.
How can ethylene glycol and propylene glycol

affect my health?
Eating or drinking very large amounts of ethylene glycol
can result in death, while large amounts can result in nausea,

Page 2
ETHYLENE GLYCOL & PROPYLENE GLYCOL

CAS # 107-21-1 and 57-55-6
convulsions, slurred speech, disorientation, and heart and

kidney problems.
the body, they are very difficult to detect, even though symptoms may be present.
Female animals that ate large amounts of ethylene glycol

had babies with birth defects, while male animals had reduced
sperm counts. However, these effects were seen at very high
levels and would not be expected in people exposed to lower
levels at hazardous waste sites.

The EPA has set a drinking water guideline for ethylene
glycol of 7,000 micrograms (7,000 mg/L) in a liter of water for
an adult.
Ethylene glycol affects the body's chemistry by increasing the amount of acid, resulting in metabolic problems. Similar to ethylene glycol, propylene glycol increases the amount
of acid in the body. However, larger amounts of propylene
glycol are needed to cause this effect.

propylene glycol as generally recognized as safe, which
means that it is acceptable for use in flavorings, drugs, and
cosmetics, and as a direct food additive.
How likely are ethylene and propylene glycol to

cause cancer?

Hygienists (ACGIH) recommends a maximum level of
127 milligrams of ethylene glycol per cubic meter of air
(127 mg/m3) for a 15-minute exposure.

the EPA have not classified ethylene glycol and propylene
glycol for carcinogenicity. Studies with people who used ethylene glycol did not show carcinogenic effects. Animal studies also have not shown these chemicals to be carcinogens.

exposed to ethylene or propylene glycol?
Glossary
Acid: A sour substance.
Metabolic: Chemical changes in cells that provide energy to
the body.
Tests are available to determine if you have been exposed

to ethylene glycol. These tests are only used on people who are
showing symptoms of ethylene glycol poisoning (but they
could be used in other situations). The tests are most often used
on people who have intentionally consumed, or who suspect
they have consumed, large amounts of ethylene glycol.
Propylene glycol is generally considered to be a safe

chemical, and is not routinely tested for, unless specific exposure, such as to a medicine or cosmetic, can be linked with
symptoms. Since both chemicals break down very quickly in

This ToxFAQs information is taken from the 1997 Toxicological Profile for Ethylene Glycol and Propylene Glycol produced by the Agency for Toxic Substances and Disease Registry, Public Health Service, U.S. Department of Health and Human Services, Public Health Service in Atlanta, GA.
FLUORINE, HYDROGEN
FLUORIDE, AND FLUORIDES
CAS# Fluorine 7782-41-4, Hydrogen Fluoride 7664-39-3,

Sodium Fluoride 7681-49-4
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about fluorine, hydrogen
fluoride, and flourides. For more information, call the ATSDR Information Center at 1-888-422-8737.
This fact sheet is one in a series of summaries about hazardous substances and their health effects. It
is important you understand this information because this substance may harm you. The effects of
HIGHLIGHTS: Fluorine and hydrogen fluoride are naturally occurring gases

that are very irritating to the skin, eyes, and respiratory tract. Fluorides are
also naturally occurring compounds. Low levels of fluoride can help prevent
dental cavities. At high doses, fluoride can result in tooth and bone damage.
These substances have been found in at least 177 of the 1,585 National
What are fluorine, hydrogen fluoride, and
fluorides?
Fluorine, hydrogen fluoride, and fluorides are chemically
related. Fluorine is a naturally occurring, pale yellow-green
gas with a sharp odor. It combines with hydrogen to make
hydrogen fluoride, a colorless gas. Hydrogen fluoride
dissolves in water to form hydrofluoric acid. Fluorine also
combines with metals to make fluorides such as sodium
fluoride and calcium fluoride, both white solids. Sodium
fluoride dissolves easily in water, but calcium fluoride does
not.
Fluorine and hydrogen fluoride are used to make certain
chemical compounds. Hydrofluoric acid is used for etching
glass. Fluorides are used in making steel, chemicals,
ceramics, lubricants, dyes, plastics and pesticides (for ants
and roaches). Fluorides are often added to drinking water
supplies and to a variety of dental products, including
toothpaste and mouth rinses, to prevent dental cavities.
What happens to fluorine, hydrogen fluoride, and

fluorides when they enter the environment?
Fluorine can not be destroyed in the environment, it can
only change its form. Fluorine forms salts with minerals in
soil, and doesnt evaporate back into air as a gas.
Hydrogen fluoride gas will be absorbed by rain and into
clouds and fog to form hydrofluoric acid, which will fall to
the ground.
Fluorides if released to the air from volcanoes and
industry are carried by wind and rain to nearby water, soil,

and food sources.
Fluorides in water and soil will form strong associations
with sediment or soil particles.
Fluorides will accumulate in plants and animals. In
animals, the fluoride accumulates primarily in the bones or
shell rather than in edible meat.
How might I be exposed to fluorine, hydrogen

fluoride, and fluorides?
The general populations can be exposed to fluorides in
contaminated air, food, drinking water and soil.
People living in communities with fluoridated water or
high levels of naturally-occurring fluoride may be exposed to
higher levels.
People who work or live near industries where fluoridecontaining substances are used may be exposed to higher
levels.
How can fluorine, hydrogen fluoride, and fluorides

affect my health?
Fluorine and hydrogen fluoride are very irritating to the skin,
eyes, and respiratory tract. At high levels, hydrogen fluoride
can also damage the heart.
Small amounts of fluoride help prevent tooth cavities, but
high levels can harm your health. In adults, high fluoride
exposure over a long time can lead to skeletal fluorosis with
denser bones, joint pain, and a limited range of joint

Page 2
FLUORINE, HYDROGEN FLUORIDE, AND FLUORIDES

CAS# Fluorine 7782-41-4, Hydrogen Fluoride 7664-39-3, Sodium Fluoride 7681-49-4
movement. Although fluoride exposure results in denser

bones, the bone appears to be weaker than normal bone and
there may be a greater risk of breaking the bone. In animals,
exposure to high doses of fluoride can result in decreased
fertility and sperm and testes damage.
at most, a small pea size dab of toothpaste on the brush and

teach children not to swallow dental products.
How likely are fluorine, hydrogen fluoride, and

fluorides to cause cancer?
Tests are available to measure fluoride levels in urine; these

tests can determine if you have been exposed to higher-thannormal levels of fluorides. The urine test must be performed
soon after exposure because fluoride that is not stored in
bones leaves the body within a few days. The test can not
be performed in the doctors office, but can be done at most
laboratories that test for chemical exposure. The urine
fluoride test cannot be used to predict the nature or severity
of toxic effects. Bone sampling can be done in special cases
to measure long-term exposure to fluorides.
Most of the studies of people living in areas with fluoridated

water or naturally high levels of fluoride in drinking water did
not find an association between fluoride and cancer risk.
Two animal cancer studies were inconclusive. The
international Agency for Research on Cancer (IARC) has
determined that the carcinogenicity of fluoride to humans is
not classifiable.
How can fluorine, hydrogen fluoride, and fluorides

affect children?
When used appropriately, fluoride is both safe and effective
in preventing and controlling cavities. Drinking or eating
excessive fluoride during the time teeth are being formed
(before 6 years of age) can cause visible changes in teeth.
This condition is called dental fluorosis. At very high
concentrations of fluoride, the teeth can become more fragile
and sometimes develop a greater number of cavities.
No studies have addressed whether low levels of fluoride will
cause birth defects in humans. Birth defects have not been
found in most studies of animals.

fluorine, hydrogen fluoride, and fluorides?
Because fluorides are found naturally in the environment, we
cannot avoid being exposed to them.
Children may be exposed to high levels of fluorides if they
swallow dental products containing fluoridated toothpaste,
gels, or rinses. Parents should supervise brushing and place

exposed to fluorine, hydrogen fluoride, and
fluorides?

The EPA has set a maximum amount of fluoride allowable in
drinking water of 4.0 milligrams per liter of water (4.0 mg/L).
For the prevention of dental decay, the Public Health Service
(PHS) has, since 1962, recommended that public water
supplies contain between 0.7 and 1.2 milligrams of fluoride
per liter of drinking water.
has set limits of 0.2 milligrams per cubic meter (0.2 mg/m3) for
fluorine, 2.0 mg/m3 for hydrogen fluoride, and 2.5 mg/m3 for
fluoride in workroom air to protect workers during an 8-hour
shift over a 40-hour work week.
(ATSDR). 2001. Toxicological Profile for Fluorine, Hydrogen
Fluoride, and Fluorides (Draft for Public Comment) Atlanta,
Health Service.
FORMALDEHYDE
CAS # 50-00-0
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about formaldehyde. For more
HIGHLIGHTS: Everyone is exposed to small amounts of formaldehyde in air

and some foods and products. Formaldehyde can cause irritation of the skin,
eyes, nose, and throat. High levels of exposure may cause some types of cancers.
This substance has been found in at least 26 of the 1,467 National Priorities List
What is formaldehyde?
(Pronounced fr-mld-hd)
At room temperature, formaldehyde is a colorless, flammable gas that has a distinct, pungent smell. It is also known
as methanol, methylene oxide, oxymethyline, methylaldehyde, and oxomethane. Formaldehyde is naturally produced
in small amounts in our bodies.
It is used in the production of fertilizer, paper, plywood,
and urea-formaldehyde resins. It is also used as a preservative
in some foods and in many products used around the house,
such as antiseptics, medicines, and cosmetics.
What happens to formaldehyde when it enters

the environment?
q Formaldehyde dissolves easily but does not last a long
time in water.
q Most formaldehyde in the air breaks down during the day.
q The breakdown products of formaldehyde are formic acid
and carbon monoxide.
q Formaldehyde does not build up in plants and animals.
How might I be exposed to formaldehyde?

q Smog is a major source of formaldehyde exposure.
q Cigarettes and other tobacco products, gas cookers, and
open fireplaces are sources of formaldehyde exposure.
q It is used in many industries and in hospitals and laboratories.
q Formaldehyde is given off as a gas from the manufactured
wood products used in new mobile homes.
q The amount of formaldehyde in foods is very small.
q Household sources, such as fiberglass, carpets, permanent
press fabrics, paper products, and some househould cleaners.
How can formaldehyde affect my health?

Low levels of formaldehyde can cause irritation of the
eyes, nose, throat, and skin. It is possible that people with
asthma may be more sensitive to the effects of inhaled formaldehyde.
Drinking large amounts of formaldehyde can cause severe
pain, vomiting, coma, and possible death.

FORMALDEHYDE
CAS # 50-00-0
Page 2

How likely is formaldehyde to cause cancer?
Some studies of people exposed to formaldehyde in workplace air found more cases of cancer of the nose and throat
than expected, but other studies did not confirm this finding.
In animal studies, rats exposed to high levels of formaldehyde in air developed nose cancer. The Department of Health
and Human Services (DHHS) has determined that formaldehyde may reasonably be anticipated to be a carcinogen.
How can formaldehyde affect children?

The most common route of exposure is by breathing it,
which is likely to cause nose and eye irritation (burning, itchy,
tearing, and sore throat) in children as well as in adults.
Animal studies suggest that formaldhyde will not cause
birth defects in humans. It is not likely to be transferred to a
child in breast milk.

formaldehyde?
Formaldehyde is usually found in the air, and levels are
usually higher indoors than outdoors. Opening windows and
using fans to bring fresh air indoors are the easiest ways to
lower levels in the house. Not smoking and not using
unvented heaters indoors can lower the formaldehyde levels.
Removing formaldehyde sources in the home can reduce
exposure. Formaldehyde is given off from a number of products used in the home. Providing fresh air, sealing unfinished
manufactured wood surfaces, and washing new permanent
press clothing before wearing can help lower exposure.
Is there a medical test to show whether I've been

exposed to formaldehyde?
Laboratory tests can measure formaldehyde in blood,
urine, and breath. These tests do not tell you how much formaldehyde you have been exposed to or if harmful effects will
occur. The tests are not routinely available at your doctor's
office.
What recommendations has the federal

government made to protect human health?
The EPA recommends that an adult should not drink water containing more than 1 milligram of formaldehyde per liter
of water (1 mg/L) for a lifetime exposure, and a child should
not drink water containing more than 10 mg/L for 1 day or
5 mg/L for 10 days.
(OSHA) has set a permissable exposure limit for formaldehyde
of 0.75 parts per million (ppm) for an 8-hour workday, 40-hour
workweek.
(NIOSH) recommends an exposure limit of 0.016 ppm.
(ATSDR). 1999. Toxicological profile for formaldehyde. Atlanta, GA: U.S. Department of Health and Human Services,
Public Health Services.
toxic substance might harm people and how to treat people
FUEL OILS
CAS # 8008-20-6, 70892-10-3, 68476-30-2,
68476-34-6, 68476-31-3
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about fuel oils. For more information,
SUMMARY: Fuel oils are liquid mixtures produced from petroleum, and their use
mostly involves burning them as fuels. Drinking or breathing fuel oils may cause
nausea or nervous system effects. However, exposure under normal use conditions
is not likely to be harmful. Fuel oils have been found in at least 26 of the 1,430
What are fuel oils?

(Pronounced fyl oilz)
Fuel oils are a variety of yellowish to light brown liquid
mixtures that come from crude petroleum. Some chemicals
found in fuel oils may evaporate easily, while others may
more easily dissolve in water.
Fuel oils are produced by different petroleum refining
processes, depending on their intended uses. Fuel oils may be
used as fuel for engines, lamps, heaters, furnaces, and stoves,
or as solvents.
Some commonly found fuel oils include kerosene, diesel
fuel, jet fuel, range oil, and home heating oil. These fuel oils
differ from one another by their hydrocarbon compositions,
boiling point ranges, chemical additives, and uses.
What happens to fuel oils when they enter the

environment?
q Some chemicals found in fuel oils may stick to particles

in water, which will eventually cause them to settle to the
bottom sediment.
q Some of the chemicals found in fuel oils may be broken
down slowly in air, water, and soil by sunlight or small
organisms.
q Some of the chemicals found in fuel oils may build up
significantly in plants and animals.
How might I be exposed to fuel oils?

q Using a home kerosene heater or stove, or using fuel oils
at work.
q Breathing air in home or building basements that has been
contaminated with fuel oil vapors entering from the soil.
q Drinking or swimming in water that has been contaminated with fuel oils from a spill or a leaking underground
storage tank.
q Touching soil contaminated with fuel oils.
q Using fuel oils to wash paint or grease from skin or equipment.
q Some chemicals found in fuel oils may evaporate into the

air from open containers or contaminated soil or water.
How can fuel oils affect my health?
q Some chemicals found in fuel oils may dissolve in water

after spills to surface waters or leaks from underground
storage tanks.
Little information is available about the health effects

that may be caused by fuel oils. People who use kerosene

Page 2
FUEL OILS
CAS # 8008-20-6, 70892-10-3, 68476-30-2, 68476-34-6, 68476-31-3

stoves for cooking do not seem to have any health problems
related to their exposure.
Breathing some fuel oils for short periods may cause nausea, eye irritation, increased blood pressure, headache, lightheadedness, loss of appetite, poor coordination, and difficulty
concentrating. Breathing diesel fuel vapors for long periods
may cause kidney damage and lower your bloods ability to
clot.
Drinking small amounts of kerosene may cause vomiting,
diarrhea, coughing, stomach swelling and cramps, drowsiness,
restlessness, painful breathing, irritability, and unconsciousness. Drinking large amounts of kerosene may cause convulsions, coma, or death. Skin contact with kerosene for short
periods may cause itchy, red, sore, or peeling skin.
How likely are fuel oils to cause cancer?

has determined that some fuel oils (heavy) may possibly cause
cancer in humans, but for other fuel oils (light) there is not
enough information to make a determination. IARC has also
determined that occupational exposures to fuel oils during petroleum refining are probably carcinogenic in humans.
Some studies with mice have suggested that repeated contact with fuel oils may cause liver or skin cancer. However,
other mouse studies have found this not to be the case. No
studies are available in other animals or in people on the carcinogenic effects of fuel oils.

exposed to fuel oils?
There is no medical test that shows if you have been exposed to fuel oils. Tests are available to determine if some of
the chemicals commonly found in fuel oils are in your blood.

However, the presence of these chemicals in blood may not
necessarily mean that you have been exposed to fuel oils.

(OSHA) and the Air Force Office of Safety and Health (AFOSH)
have set a permissible exposure level (PEL) of 400 parts of
petroleum distillates per million parts of air (400 ppm) for an
exceed 350 milligrams of petroleum distillates per cubic meter
of air (350 mg/m3) for a 40-hour workweek.
The Department of Transportation (DOT) lists fuel oils as
hazardous materials and, therefore, regulates their transportation.
Glossary
Carcinogenic: Able to cause cancer.
Hydrocarbon: Any compound made up of hydrogen and carbon.
body of water.
Reference
(ATSDR). 1995. Toxicological profile for fuel oils. Atlanta,
Health Service.
AUTOMOTIVE GASOLINE
CAS # 8006-61-9
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about automobile gasoline. For
SUMMARY: Exposure to automotive gasoline most likely occurs from breathing its
vapor at a service station while filling a cars fuel tank. At high levels, automotive
gasoline is irritating to the lungs when breathed in and irritating to the lining of the
stomach when swallowed. Exposure to high levels may also cause harmful effects
to the nervous system. Automotive gasoline has been found in at least 23 of the 1,430
What is automotive gasoline?
(Pronounced t-mtv gs-ln)
q Other chemicals in gasoline dissolve in water after spills

to surface waters or underground storage tank leaks into
the groundwater.
The gasoline discussed in this fact sheet is automotive used

as a fuel for engines in cars. Gasoline is a colorless, pale brown, or
pink liquid, and is very flammable.
q In surface releases, most chemicals in gasoline will probably evaporate; others may dissolve and be carried away
by water; a few will probably stick to soil.
Gasoline is a manufactured mixture that does not exist naturally in the environment. Gasoline is produced from petroleum in
the refining process.
Typically, gasoline contains more than 150 chemicals,
including small amounts of benzene, toluene, xylene, and
sometimes lead. How the gasoline is made determines which
chemicals are present in the gasoline mixture and how much
of each is present. The actual composition varies with the
source of the crude petroleum, the manufacturer, and the
time of year.
q The chemicals that evaporate are broken down by sunlight and other chemicals in the air.
q The chemicals that dissolve in water also break down
quickly by natural processes.
How might I be exposed to automotive gasoline?

q Breathing vapors at a service station when filling the cars
fuel tank is the most likely way to be exposed.
q Working at a service station.
q Using equipment that runs on gasoline, such as a lawn
mower.
What happens to automotive gasoline when it

q Small amounts of the chemicals present in gasoline
evaporate into the air when you fill the gas tank in your
car or when gasoline is accidentally spilled onto surfaces
and soils or into surface waters.
q Being close to a spot where gasoline has spilled or leaked

into the soil.
How can automotive gasoline affect my health?

Many of the harmful effects seen after exposure to gasoline are due to the individual chemicals in the gasoline mix-

AUTOMOTIVE GASOLINE
CAS # 8006-61-9
Page 2

ture, such as benzene and lead. Inhaling or swallowing large
amounts of gasoline can cause death.
Inhaling high concentrations of gasoline is irritating to
the lungs when breathed in and irritating to the lining of the
stomach when swallowed. Gasoline is also a skin irritant.
Breathing in high levels of gasoline for short periods or swallowing large amounts of gasoline may also cause harmful effects on the nervous system.
Serious nervous system effects include coma and the inability to breathe, while less serious effects include dizziness
and headaches.
There is not enough information available to determine if
gasoline causes birth defects or affects reproduction.
How likely is automotive gasoline to cause cancer?
ods are sensitive enough to measure background levels and

levels where health effects may occur. These tests aren't available in most doctors' offices, but can be done at special laboratories that have the right equipment.

The EPA has established many regulations to control air
pollution. These are designed to protect the public from the
possible harmful health effects of gasoline.
Hygienists (ACGIH) set a maximum level of 890 milligrams of
gasoline per cubic meter of air (890 mg/m3) for an 8-hour
Glossary

and the International Agency for Research on Cancer (IARC)
have not classified automotive gasoline for carcinogenicity.
Automotive gasoline is currently undergoing review by the
EPA for cancer classification.
Some laboratory animals that breathed high concentrations of unleaded gasoline vapors continuously for 2 years
developed liver and kidney tumors. However, there is no evidence that exposure to gasoline causes cancer in humans.

exposed to automotive gasoline?
Laboratory tests are available that can measure elevated

blood or urine levels of lead (as an indication of exposure to
leaded gasoline only), benzene, or other substances that may
result from exposure to gasoline or other sources. These meth-

(ATSDR). 1995. Toxicological profile for automotive gasoline. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

Crude petroleum: Petroleum that has not been processed.
Irritant: A substance that causes an abnormal reaction.
Mixture: A combination of two or more components.
Refining process: The process by which petroleum is purified
to form gasoline.
Reference
HEPTACHLOR/
HEPTACHLOR EPOXIDE
CAS # 76-44-8 and 1024-57-3
April 1993
This fact sheet answers the most frequently asked health questions (FAQs) about heptachlor/heptachlor
epoxide. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
is one in a series of summaries about hazardous substances and their health effects. Its important you
hazardous substance depend on the dose, the duration, how you are exposed, personal traits and habits,
and whether other chemicals are present.
SUMMARY: Exposure to heptachlor and heptachlor epoxide happens mostly

from eating contaminated foods and milk, or skin contact with contaminated
soil. At high levels, they can cause damage to your nervous system. Heptachlor
and heptachlor epoxide have been found in at least 129 and 87 sites, respectively,
of 1,300 National Priorities List sites identified by the Environmental Protection
Agency (EPA).
What are heptachlor/heptachlor epoxide?
(Pronounced hpt-klr/hpt-klr -pksd)
q Heptachlor epoxide can stay in the soil and water for

many years.
q Animals change heptachlor to the epoxide.
Heptachlor is a manufactured chemical and doesnt occur

naturally. Pure heptachlor is a white powder that smells like
camphor (mothballs).
q Plants can take up heptachlor from the soil.
The less pure grade is tan. Trade names include

Heptagran, Basaklor, Drinox, Soleptax, Termide, and
Velsicol 104.
How might I be exposed to heptachlor and

heptachlor epoxide?
Heptachlor was used extensively in the past for killing

insects in homes, buildings, and on food crops, especially
corn. Use slowed in the 1970s and stopped in 1988.
q Eating fish, dairy products, and fatty meats from animals

exposed to heptachlor in their food.
Heptachlor epoxide is also a white powder and is a breakdown product of heptachlor. The epoxide is more likely to be
found in the environment than heptachlor.
What happens to heptachlor and heptachlor

epoxide when they enter the environment?
q Heptachlor doesnt dissolve easily in water; heptachlor
epoxide dissolves more easily.
q They stick strongly to soil particles and evaporate slowly
to air.
q Levels build up in the tissues of fish and cattle.
q Eating crops grown in soil that contains heptachlor.
q Breathing air, drinking water, or skin contact with soil

near waste sites or landfills.
q Breast milk (from mothers who had high exposures).
How can heptachlor and heptachlor epoxide

affect my health?
Heptachlor and heptachlor epoxide are clearly toxic to
humans and animals and can damage the nervous system.
There are some human data on brief exposures to high levels.
A few reports showed that people who accidentally swallowed

Page 2
HEPTACHLOR/HEPTACHLOR EPOXIDE
CAS # 76-44-8 and 1024-57-3

pesticides containing heptachlor, or who spilled pesticides on
their clothes became dizzy, confused, or had convulsions.

Most of what we know about the health effects of these

pesticides comes from studies on mice and rats fed heptachlor
and heptachlor epoxide in the food or water. Very high levels
for short periods produce serious liver problems. Mice had
trouble walking and rats developed tremors. High levels of
heptachlor in the feed for several weeks damaged the livers of
rats and the livers and adrenal glands of mice.
The EPA banned the sale of all heptachlor products and

restricted the use of heptachlor to the control of fire ants in
power transformers. EPA recommends a maximum of 2.78 parts
of heptachlor and heptachlor epoxide per trillion parts of
drinking water or seafood (2.78 ppt) that you eat each day. For
longer exposures, a child should not drink water with greater
than 5,000 ppt heptachlor or 150 ppt heptachlor epopxide.
Quantities greater than 1 pound of heptachlor or heptachlor
epoxide that enter the environment must immediately be reported to the National Response Center.
We do not know if heptachlor or the epoxide affect the

ability of men or women to have children. Animals that ate
food containing heptachlor before and/or during pregnancy
had smaller litters or were unable to reproduce. Some of the
offspring had cataracts and some didnt live long after birth.
How likely are heptachlor and heptachlor

epoxide to cause cancer?
has determined that heptachlor and heptachlor epoxide are not
classifiable as to their carcinogenicity to humans because insufficient data are available to establish a clear assessment.
The Food and Drug Administration (FDA) limits the amount

of heptachlor and heptachlor epoxide on raw food crops and on
edible seafood to from 0-10 parts per billion (ppb), depending
on the type of food product. The limit on edible seafood is
300 ppb, and for the fat of food-producing animals is 200 ppb.
Hygienists (ACGIH) and the Occupational Safety and Health
Administration (OSHA) recommend a maximum in workplace
air over an 8-hour workday for a 40-hour work week of 0.5 milligrams of heptachlor per cubic meter (0.5 mg/m3).
Glossary
exposed to heptachlor and heptachlor epoxide?
Laboratory tests can measure heptachlor and heptachlor epoxide following exposure to high levels. The blood tests for these
chemicals must be done within a short period after exposure.
Levels in fat can be measured for a much longer period
after exposure. If heptachlor or heptachlor epoxide are found
in your fat, it isnt possible to tell exactly when you were exposed to these chemicals or if harmful health effects will occur.

Milligram (mg): One thousandths of a gram.
ppt: Parts per trillion.
References
(ATSDR). 1993. Toxicological profile for heptachlor and heptachlor epoxide. Atlanta, GA: U.S. Department of Health and
HEXACHLOROBENZENE
CAS # 118-74-1
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about hexachlorobenzene.
HIGHLIGHTS: Exposure to hexachlorobenzene occurs primarily from eating

low levels in contaminated food. Much lower exposures can occur from
drinking water and breathing air contaminated with hexachlorobenzene. The
main health effect from eating highly contaminated food is a liver disease.
Hexachlorobenzene has been found in at least 106 of the 1,613 National
What is hexachlorobenzene?
Hexachlorobenzene was widely used as a pesticide to
protect the seeds of onions and sorghum, wheat, and other
grains against fungus until 1965. It was also used to make
fireworks, ammunition, and synthetic rubber. Currently,
hexachlorobenzene is not used commercially in the United
States.
Hexachlorobenzene is a white crystalline solid, that does not
occur naturally in the environment. It is formed as a byproduct during the manufacture of other chemicals. Small
amounts can also be produced during combustion of
municipal waste.
What happens to hexachlorobenzene when it

Hexachlorobenzene can remain in the environment for a
long time. It breaks down very slowly.
It sticks strongly to soil. Half of the hexachlorobenzene
in soil will disappear in 3-6 years.
It does not dissolve easily in water. Once in water, it
binds to sediments and settles to the bottom.
Half of the hexachlorobenzene in surface water will
disappear in 3-6 years.
Under ordinary conditions not much evaporates into the
air. Once in air, it can be carried out long distances.
Hexachlorobenzene can build up in fish and other aquatic

animals.
How might I be exposed to hexachlorobenzene?

Eating low levels in contaminated food (e.g, fish, meat,
milk, dairy products) or drinking small amounts in
contaminated water.
Breathing low levels in contaminated air.
Eating or touching contaminated soil.
For babies, drinking contaminated breast milk from
exposed mothers.
Working in a factory that uses or produces it as a byproduct.
How can hexachlorobenzene affect my health?

A study of people in Turkey who ate, over a long time,
bread accidentally contaminated with hexachlorobenzene
suffered from a liver disease called porphyria cutanea tarda.
This disease can cause red-colored urine, skin sores, change
in skin color, arthritis, and problems of the liver, nervous
system, and stomach.
Studies in animals show that eating hexachlorobenzene for a
long time can damage the liver, thyroid gland, nervous
system, bones, kidneys, blood, and immune and endocrine
systems.

HEXACHLOROBENZENE
Page 2
CAS # 118-74-1
The immune system of rats that breathed hexachlorobenzene

for a few weeks was harmed.
How likely is hexachlorobenzene to cause cancer?

Studies in humans have provided inconclusive evidence of
carcinogenicity for hexachlorobenzene. The Department of
Health and Human Services (DHHS) has determined that
hexachlorobenzene may reasonable be anticipated to be a
human carcinogen. The International Agency for Research
on Cancer (IARC) has determined that hexachlorobenzene is
possibly carcinogenic to humans. The EPA haas concluded
that hexachlorobenzene is a probable human carcinogen.
Studies in animals suggest that eating this substance for
months or years can cause cancer of the liver, kidney, and
thyroid.
If hexachlorobenzene is produced in your place of work,

make sure you do not carry the chemical home in your
clothing, skin, hair, tools, or other objects from the
workplace.

exposed to hexachlorobenzene?
Blood, breast milk, urine, and feces may be tested to
determine if you have ever been exposed to
hexachlorobenzene. Because hexachlorobenzene can collect
and remain in breast milk, the test for this substance in
breast milk can tell you that you have been exposed, but not
when or to how much. The levels in blood, urine, and feces
indicate more recent exposure, but will not tell whether
harmful health effects will occur. The tests are not routinely
equipment.
How can hexachlorobenzene affect children?

Breast-fed infants of mothers known to have eaten bread
contaminated with hexachlorobenzene developed a disease
that produced skin lesions known as pink sore. Other
symptoms were weakness and convulsions. Many of the
sickened infants died from this disease. Young children older
than 2 years of age did not get pink sore, but they
developed numerous skin, nervous system, and bone
abnormalities later in life.
Studies in animals suggest that young animals are especially
sensitive to hexachlorobenzene. Effects on the liver, nervous
system, and immune system occurred at lower doses in the
young developing animals than in adults.

The EPA has set a maximum contaminant level of 0.001
milligram per liter (0.001 mg/L) of drinking water. The EPA
also recommends that hexachlorobenzene do not exceed 0.05
mg/L in water that children drink for periods of up 10 days.
(ATSDR). 2002. Toxicological Profile for Hexachlorobenzene

hexachlorobenzene?
The main way people are exposed to hexachlorobenzene is
through food, especially fatty foods (e.g., dairy products,
some fish).
HEXACHLOROBUTADIENE
CAS # 87-68-3
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about hexachlorobutadiene.
present.
SUMMARY: Most exposure to hexachlorobutadiene comes from breathing it in

workplace air. People living near hazardous waste sites may be exposed to it by
breathing air or by drinking contaminated water. Animal studies suggest that
hexachlorobutadiene can damage the kidneys and liver and may cause kidney
tumors. This chemical has been found in at least 47 of 1,416 National Priorities
What is hexachlorobutadiene?
(Pronounced hks klr byt-dn)
Hexachlorobutadiene is a colorless liquid with a turpentine-like odor. It is also called perchlorobutadiene. Hexachlorobutadiene is not found naturally in the environment. It
is formed when other chemicals are made.
Most hexachlorobutadiene used commercially in the
United States is imported from Germany. It is mainly used to
make rubber compounds. It is also used as a solvent, and to
make lubricants, in gyroscopes, as a heat transfer liquid, and
as a hydraulic fluid.
What happens to hexachlorobutadiene when

q Hexachlorobutadiene is released to the environment
mainly from its disposal following industrial uses.
q In air, half of it may be broken down to other chemicals
within 60 days.
q In water, half of it may be broken down to other chemicals
within about 30 days.
q Hexachlorobutadiene appears to readily break down in
soil.
q Hexachlorobutadiene can accumulate in fish and shellfish.

hexachlorobutadiene?
q Working in industries that make or use
hexachlorobutadiene.
q Breathing air around hazardous waste sites where it has
been disposed of.
q Drinking water contaminated with hexachlorobutadiene.
q Eating fish or other foods contaminated with it.
How can hexachlorobutadiene affect my

health?
There are no studies that have looked at the effects of
hexachlorobutadiene in people. All of our information has
come from studies in animals.
Studies in mice have shown irritation of the nose when
large amounts were breathed over a short time. The only other
effect noted in animals from breathing hexachlorobutadiene
was a reduction in the body weights of fetuses when their
mothers breathed high levels of the chemical.
There are no studies which looked at animals breathing
low levels of hexachlorobutadiene over a long time.
Rats and mice that drank low levels of hexachlorobutadiene over both short and long periods had kidney and

HEXACHLOROBUTADIENE
CAS #87-68-3
Page 2

liver damage. No effects on reproduction or on the developing fetuses were seen when rats and mice drank hexachlorobutadiene.
Studies in rabbits found kidney and liver damage from
contact with the chemical on the skin for a short time.
How likely is hexachlorobutadiene to cause

cancer?
that exposures in children should not exceed 0.3 milligrams

per liter (mg/L) for 10-day periods or more than 0.1 mg/L for
longer periods (7 years). Adults should not be exposed to
more than 0.4 mg/L for longer periods (7 years).
EPA requires that discharges or accidental spills into the
environment of 1 pound or more of hexachlorobutadiene be
reported.
The Environmental Protection Agency (EPA) has

determined that hexachlorobutadiene is a possible human
carcinogen.

Health (NIOSH) has recommended an occupational exposure
limit of 0.02 parts hexachlorobutadiene per million parts in
air (0.02 ppm) for an 8-hour workday over a 40-hour workweek.
An animal study found kidney tumors in rats exposed to

low levels of hexachlorobutadiene. It is not known whether
it may also cause cancer in people.

Hygienists (ACGIH) has established the same guidelines as
NIOSH for the workplace.

been exposed to hexachlorobutadiene?
These agencies advise avoiding eye and skin contact

because this may be a route of significant exposure.
Tests are available that measure levels of hexachlorobutadiene and its breakdown products in urine or fat. However, these tests must be performed within several days after
exposure because hexachlorobutadiene leaves the body fairly
quickly.
Glossary
These tests are not usually performed in most doctors

offices because special equipment is needed to conduct them.
In addition, these tests cannot determine if adverse health
effects will occur from the exposure to hexachlorobutadiene.

References
EPA has recommended guidelines for exposure to
hexachlorobutadiene in drinking water. EPA recommends

1992. Toxicological profile for hexachlorobutadiene.
HEXACHLOROCYCLOHEXANES
CAS # 319-84-6, 319-85-7, 319-86-8, 58-89-9
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about hexachlorocyclohexanes.
series of summaries about hazardous substances and their health effects. It's important you understand this
are present.
HIGHLIGHTS: Exposure to hexachlorocyclohexanes happens mostly from eating

contaminated foods or by breathing contaminated air in the workplace. Exposure
to high levels of hexachlorocyclohexanes can cause blood disorders, dizziness,
headaches; seizures, and changes in the levels of sex hormones. These substances
have been found in at least 144 of the 1,467 National Priorities List sites identified
What are hexachlorocyclohexanes?
(Pronounced hks-klr-sklhksn)
Hexachlorocyclohexanes (HCH) are a group of manufactured chemicals that do not occur naturally in the environment. HCH has eight chemical forms (called isomers). The
four most common are alpha-, beta-, gamma, and delta-HCH.
The most common of these is gamma-HCH (also known as
lindane). Lindane is a white solid substance that may evaporate into the air as a colorless vapor with a slightly musty odor.
It is the common form of hexachlorocyclohexane.
Lindane was used as an insecticide on fruit and vegetable
crops (including greenhouse vegetables and tobacco) and forest crops (including Christmas trees). It is still used in ointments to treat head and body lice, and scabies.
Lindane has not been produced in the United States since
1977. It is still imported to and formulated in the United
States.
What happens to hexachlorocyclohexanes when

q In air, HCH can be present as a vapor or attached to small
particles such as soil or dust.
q Lindane can remain in the air for up to 17 weeks and
travel long distances.
q Particles with attached HCH may be removed from the air

by rain.
q In soil, sediments, and water, it is broken down by algae,
fungi, and bacteria to less harmful substances.
q HCH isomers are broken down quickly in water; lindane
does not remain in water longer than 30 days.
q The length of time that HCH isomers remain in soil is not
known.
q It can accumulate in the fatty tissue of fish.
How might I be exposed to hexachlorocyclohexanes?

q Eating contaminated foods, such as plants, meat, and
milk.
q Breathing contaminated air in or near factories where
products using HCH are made.
q Through skin when applied as a lotion or shampoo to
control lice and scabies.
q Drinking contaminated water or breathing contaminated
air near waste sites or landfills.
How can hexachlorocyclohexanes affect my

health?
Some people who breathed contaminated workplace air
during the namufacturing of pesticides, including lindane,

Page 2
HEXACHLOROCYCLOHEXANES
CAS # 319-84-6, 319-85-7, 319-86-8, 58-89-9

had blood disorders, dizziness, headaches, and changes in the
levels of sex hormones. Some people who swallowed large
amounts had seizures and sometimes died.
Animals fed high levels of HCH had convulsions and
some became comatose. Liver and kidney effects and a reduced ability to fight infections occurred at moderate levels.
Animal showed a decreased ability to reproduce when
they were fed moderate to high levels of HCH.
How likely are hexachlorocyclohexanes to cause

cancer?
determined that HCH may reasonably be anticipated to be a
carcinogen. Liver cancer has been seen in laboratory rodents
that ate HCH for a long period of time.
How can hexachlorocyclohexanes affect

children?
There are no studies on the effects of HCH on children. It is
not known whether HCH can cause birth defects in people. Animal studies have not shown birth defects in the babies of animals
fed HCH during pregnancy. HCH has been detected in human
breast milk.

hexachlorocyclohexanes?
If you work with HCH, take all safety precautions to avoid
bringing the dust home on your clothing. If you use products
containing HCH, follow directions for use carefully. Make sure
that you keep it in tightly covered containers and store the containers safely where children cannot reach them. Always store
chemicals in the original labeled containers. Do not store HCH
in containers that children would find attractive to eat or drink
from, such as soda bottles.

exposed to hexachlorocyclohexanes?
Laboratory tests can measure HCH in blood, urine, and semen. These tests do not tell you how much HCH youve been
exposed to or if harmful effects will occur. The tests are not routinely available at your doctors office.

The EPA has set a limit in drinking water of 0.2 parts of
lindane per billion parts of water (0.2 ppb). The EPA requires
that spills or accidental discharges of lindane into the environment of 1 pound or more must be reported to the EPA.
(OSHA), the National Institute for Occupational Safety and Health
(NIOSH), and the American Conference of Governmental Industrial Hygienists (ACGIH) recommend a maximum level of 0.5
milligrams lindane per cubic meter (0.5 mg/m3) of workplace air
for an 8-hour workday, 40-hour workweek. These agencies advise avoiding eye and skin contact because this may be a route
of significant exposure.
1999. Toxicological profile for alpha-, beta-, gamma-, and deltahexachlorocyclohexane. Atlanta, GA: U.S. Department of Health
Animal testing is sometimes necessary to find out how toxic
substances might harm people and how to treat people who have
HEXACHLOROCYCLOPENTADIENE (HCCPD)
CAS # 77-47-4
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about hexachlorocyclopentadiene
(HCCPD). For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
are present.
HIGHLIGHTS: HCCPD is used in a group of related pesticides, but only two

of these are registered for use in the United States. Human data are limited,
but it can cause headaches and irritate the nose, throat, eye, and skin. Animal
tests suggests that very high levels of HCCPD can cause death. This substance
What is hexachlorocyclopentadiene (HCCPD)?
(Pronounced hks klr-skl pnt-dn)
q HCCPD that gets into soil binds to decaying plant and

animal matter. If the soil is sandy, HCCPD can move
through it to reach underground water.
HCCPD is a manufactured chemical that does not occur

naturally. It is a light, lemon-yellow liquid that has a sharp
musty odor. It easily evaporates into the air; the vapor looks
like a blue haze.
q About half of the HCCPD in the soil will be changed to

other chemicals by bacteria in 1 to 2 weeks.
HCCPD is used in the manufacture of certain pesticides.

Most of the HCCPD in the environment results from releases
during its production and disposal. It is also used to make
flame retardants, resins that wont burn, shock-proof plastics,
esters, ketones, fluorocarbons, and dyes.
How might I be exposed to HCCPD?
What happens to HCCPD when it enters the

environment?
q By touching it or something that has been contaminated

with it.
q HCCPD is released as vapor during manufacture and use.

q It is broken down quickly by sunlight and reactions with
other chemicals in the air.
q Small amounts of HCCPD can accumulate in fish.
q By breathing it when you are working with or producing

HCCPD.
q By applying pesticides that contain it.
q By contact with soils that have recently been treated with
the pesticides endosulfan or pentac.
q By eating or drinking foods contaminated with HCCPD,

but only a small amount will enter your blood stream.
q HCCPD doesnt dissolve readily in water.
How can HCCPD affect my health?
q HCCPD in water will evaporate from the surface.
If you breathe high levels of HCCPD vapors, you may get

a sore throat or have shortness of breath and chest discomfort.
You may get a headache from breathing HCCPD. Your liver
q About half the HCCPD in water will be changed to other

chemicals by light in only 4 minutes.

Page 2
HEXACHLOROCYCLOPENTADIENE (HCCPD)
CAS # 77-47-4

and kidneys could also be affected. If HCCPD comes in contact with your skin, it can cause a sore to form.

exposed to HCCPD?
Animal studies show that when HCCPD is inhaled, it

caused bleeding, swelling, and fluid buildup in the lungs.
Exposure to large amounts caused breathing difficulty and
death. Other studies found that swallowing HCCPD caused
lung, liver, kidney, brain and heart damage; most of the animals died during the exposure.
If you have been recently exposed to HCCPD, your blood

and urine can be tested for its presence. Doctors can collect the
specimens and send them to special laboratories for testing.
These tests can determine whether you have been exposed to
HCCPD, but can't determine how much you were exposed to
or whether your health will be affected.
How likely is HCCPD to cause cancer?

There is no information available to show whether
HCCPD causes cancer in people. A study in rats and mice did
not show an increase in tumors. The EPA has determined that
HCCPD is not classifiable as to human carcinogenicity.
How can HCCPD affect children?

Children are unlikely to be exposed to HCCPD. There is
no information on the effects in children or adults who were
exposed as children.
We do not know if HCCPD causes birth defects in people.
Animal studies suggest that it does not cause birth defects or
other developmental problems. We do not know if HCCPD can
cross the placenta to unborn babies or if it can accumulate in
breast milk.

EPA has a regulation on how much HCCPD can be present
in drinking water. The maximum contaminant level is 50 parts
per billion (50 ppb). EPA recommends that exposure in children should not exceed 2 ppm in water for 10-day periods or
no more than 0.7 ppm for up to 7 years. EPA requires that
spills or accidental releases of 10 pounds or more of HCCPD
(OSHA) has a permissable exposure limit of 0.01 parts per
million (0.01 ppm) in air for an 8-hour workday, 40-hour workweek.
HCCPD?
If your doctor finds that you have been exposed to significant amounts of HCCPD, ask if children may also be exposed.
When necessary, your doctor may need to ask your state public
health department to investigate.

(ATSDR). 1999. Toxicological profile for hexachlorocyclopentadiene (HCCPD). Atlanta, GA: U.S. Department of Health
HEXACHLOROETHANE
CAS # 67-72-1
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about hexachloroethane. For
HIGHLIGHTS: Hexachloroethane is a colorless solid that gradually evaporates

when it is exposed to air. It is used in the manufacture of aluminum and by the
military for smoke-producing devices. Exposure to hexachloroethane can be
irritating to the skin, nose, lungs, and eyes. Hexachloroethane has been found
What is hexachloroethane?
(Pronounced hks klr thn)
Hexachloroethane is a colorless solid that gradually
evaporates when it is exposed to air. It is also called HCE, perchloroethane, and carbon hexachloride. Its vapors smell like
camphor. In the United States, about half of the hexachloroethane is used by the military for smoke-producing devices. It is
also used to remove air bubbles in melted aluminum.
Hexachloroethane may be present as an ingredient in some
fungicides, insecticides, lubricants, and plastics.
Hexachloroethane does not occur naturally in the environment. It is no longer made in the United States, but it is formed
as a by-product in the production of some chemicals. Some
hexachloroethane can be formed by incinerators when materials containing chlorinated hydrocarbons are burned.
Hexachloroethane itself does not catch fire easily. Some
hexachloroethane can also be formed when chlorine reacts
with carbon compounds in drinking water.
What happens to hexachloroethane when it

q Hexachloroethane can be released to the environment
during its production, use, transport, or disposal.
q In air, hexachloroethane does not break down to other

compounds.
q Some hexachloroethane that is in lakes or streams and
surface soils will evaporate into the air.
q Microscopic organisms can break it down more easily
without oxygen than with oxygen.
q Hexachloroethane does not appear to build up in plants
or animals used for food.
How might I be exposed to hexachloroethane?

q If you work in an industry that uses hexachloroethane,
such as aluminum smelting, you could be exposed by
breathing it or touching it.
q If you live near a hazardous waste site, you might be exposed to hexachloroethane by breathing contaminated
air, by drinking contaminated water, or by touching contaminated soils.
q You might be exposed to it from the air near military installations where smoke pots and grenades that contain
hexachloroethane are used during training.
q You are not likely to be exposed to hexachloroethane
from your food.
How can hexachloroethane affect my health?

Mild skin irritation has been reported by workers at a muni-

HEXACHLOROETHANE
CAS # 67-72-1
Page 2

tions factory who were exposed to low levels of hexachloroethane. The workers were wearing protective clothing that greatly
reduced exposure. No other information is available concerning
health effects in people exposed to hexachloroethane.
Based on animal studies, hexachloroethane in air can irritate your nose and lungs and cause some buildup of mucus in
your nose, much like an allergy. It can also irritate your eyes
and make them tear.
If you breathe high levels of hexachloroethane vapor, your
facial muscles may twitch or you may have difficulty moving.
However, these effects have been seen in animals exposed to
levels far greater than those found during its use or those expected in areas near a hazardous waste site.
Hexachloroethane is not a very toxic substance. If you are
exposed to a large amount for a long time, your liver could be
affected. There is also a slight chance that your kidneys could
be damaged. Animal studies have not shown hexachloroethane
to cause birth defects or to affect reproduction.
you were exposed to hexachloroethane. These tests arent available at most doctors offices, but can be done at special laboratories that have the right equipment. They are useful only if you
were exposed 2448 hours before you saw the doctor and cannot predict whether you will experience any health effects.

(OSHA) has set a limit of 1 part hexachloroethane per million
parts of workplace air (1 ppm) over an 8-hour workday, 40hour workweek.
The EPA suggests that water consumed over a lifetime
contain no more than 1 part hexachloroethane per billion
parts water (1 ppb).
Glossary
How likely is hexachloroethane to cause cancer?

Liver tumors developed in mice that were orally exposed
to hexachloroethane for their whole lifetime. Hexachloroethane will not necessarily have the same effect on people. Male
rats that were exposed to hexachloroethane for their lifetime
developed kidney tumors. This type of tumor is not found in
people, so it is unlikely that exposure to hexachloroethane
would cause you to develop cancer of the kidney.
has determined that hexachloroethane may reasonably be anticipated to be a carcinogen.

exposed to hexachloroethane?
Samples of your blood, urine, or feces can be tested to see if
Evaporate: To enter the air as a vapor.

Fungicide: A substance that kills fungus.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Hexachloroethane produced by the Agency
HEXAMETHYLENE
DIISOCYANATE
CAS # 822-06-0
August 1999
This fact sheet answers the most frequently asked health questions (FAQs) about hexamethylene diisocyanate.
present.
HIGHLIGHTS: Exposure to hexamethylene diisocyanate occurs mainly in

the workplace, where it is used as a paint hardener. Hexamethylene diisocyanate
may cause an allergic, asthma-like syndrome, consisting of coughing, wheezing,
and shortness of breath. This chemical has been found in none of the 1,445
What is hexamethylene diisocyanate?
(Pronounced hex'uh-meth'el-een di i'so-si'an-ate)
Hexamethylene diisocyanate is a pale yellow liquid with
a strong odor. It is an industrial chemical that is not known to
occur naturally. It is also commonly known as HDI, 1,6-hexamethylene diisocyanate, 1,6-diisocyanatohexane, Mondur
HX, and Desmodur H.
Hexamethylene diisocyanate is mainly used to make
polyurethane foams and coatings. It is also used as a hardener
in automobile and airplane paints.
What happens to hexamethylene diisocyanate

when it enters the environment?
q Hexamethylene diisocyanate may be found in air near
areas where spray paints containing it as a hardening
agent are applied.
q It does not appear to be transported long distances in air.

q Hexamethylene diisocyanate does not easily evaporate
from water into air.
q Hexamethylene diisocyanate will break down very

quickly into other chemicals in water and soil.
q It does not build up in the food chain.
How might I be exposed to hexamethylene

diisocyanate?
q By spray-painting a car with a paint that contains it as a
hardening agent.
q Working in an industry or business in which

hexamethylene diisocyanate is used.
q Drinking tap water contaminated with it.

q Living near a hazardous waste site where hexamethylene
diisocyanate is disposed of.
How can hexamethylene diisocyanate affect my

health?
People exposed to hexamethylene diisocyanate for a long
time (a few months to a few years) have shown an allergic,
asthma-like syndrome. The symptoms consist of shortness of
breath, wheezing, bronchitis, and coughing. These symptoms
are not usually seen when the person is not using a product
that contains hexamethylene diisocyanate, but will start up
again when they begin to use hexamethylene diisocyanate
products again.
Laboratory animals exposed to very high concentrations of hexamethylene diisocyanate had pneumonia and
difficulty in breathing, and some died. Studies in animals

Page 2
HEXAMETHYLENE DIISOCYANATE
CAS # 822-06-0

have also shown that breathing high concentrations can
irritate the eyes, nose, and throat. When placed on the skin
of animals, hexamethylene diisocyanate caused redness,
irritation, and skin damage.
It is not known whether hexamethylene diisocyanate can
affect reproduction in people or animals.
How likely is hexamethylene diisocyanate to

cause cancer?
The Department of Health and Human Services, the International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified hexamethylene diisocyanate as to its human carcinogenicity.
No carcinogenicity studies are available in people. An
animal study showed no increase in cancer when rats breathed
air containing hexamethylene diisocyanate for 2 years.
exposed to low amounts of hexamethylene diisocyanate

over many months or years.

environment of 100 pounds or more of hexamethylene
diisocyanate be reported to the EPA.
Health and the American Conference of Governmental
Industrial Hygienists recommend that workers should not
breathe air containing more than 0.035 milligrams of hexamethylene diisocyanate per cubic meter of air (0.035 mg/
m3) during a 10-hour workday, 40-hour workweek.
Glossary
exposed to hexamethylene diisocyanate?
Antibodies: Substances produced by the body to fight agents

causing disease.
Tests are available that measure the antibodies in your

blood made by your body after you have been exposed to
hexamethylene diisocyanate. However, there are problems
with these tests: antibodies can react with other substances
that look like hexamethylene diisocyanate in your blood and
indicate that you have been exposed to hexamethylene
diisocyanate when you have not been. In addition, some
people do not develop antibodies to hexamethylene diisocyanate after they have been exposed.
A test is available that measures hexamethylene diisocyanate in your urine. However, this test only works if you
were exposed to the chemical within the last 12 to 15
hours. It is not a good test to find out if you have been

(ATSDR). 1998. Toxicological profile for hexamethylene
diisocyanate. Atlanta, GA: U.S. Department of Health and
n-HEXANE
CAS # 110-54-3
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about n-hexane. For more information,
HIGHLIGHTS: n-Hexane is mixed with solvents for a number of uses. Inhaling

n-hexane causes nerve damage and paralysis of the arms and legs. Some people
abuse products containing n-hexane by inhaling it to get "high." This substance
What is n-hexane?
(Pronounced n hk sn)
q It evaporates very easily into the air where it is broken

down in a few days.
n-Hexane is a chemical made from crude oil. Pure n-hexane is a colorless liquid with a slightly disagreeable odor. It is
highly flammable, and its vapors can be explosive.
q Most of n-hexane spilled in water will float on the surface

where it evaporates into the air.
Pure n-hexane is used in laboratories. Most of the n-hexane used in industry is mixed with similar chemicals called
solvents. The major use for solvents containing n-hexane is to
extract vegetable oils from crops such as soybeans.
q n-Hexane is not concentrated by plants, fish, or animals.
These solvents are also used as cleaning agents in the

printing, textile, furniture, and shoemaking industries. Certain
kinds of special glues used in the roofing and shoe and leather
industries also contain n-hexane. Several consumer products
contain n-hexane, such as gasoline, quick-drying glues used
in various hobbies, and rubber cement.
What happens to n-hexane when it enters the

environment?
q n-Hexane enters the environment during is manufacture
and use.
q It dissolves only slightly in water.
q If n-hexane is spilled on the ground, most of it will evaporate before it can soak into the soil.
How might I be exposed to n-hexane?

q You are most likely to be exposed to n-hexane by breathing in air contaminated with it.
q You may be exposed if you use products containing it at
work.
q Since it is in gasoline, nearly everyone is exposed to very
small amounts of n-hexane in the air.
q Exposure can occur at home if you use products containing n-hexane without proper ventilation.
How can n-hexane affect my health?

The only people known to have been affected by exposure to n-hexane used it at work. Breathing large amounts
caused numbness in the feet and hands, followed by muscle

n-HEXANE
CAS # 110-54-3
Page 2

weakness in the feet and lower legs. Continued exposure led to
paralysis of the arms and legs. If removed from the exposure,
the workers recovered in 6 months to a year.
q Maintain proper ventilation when using these products.
In laboratory studies, animals exposed to high levels of

n-hexane in air had signs of nerve damage. Some animals also
had lung damage. In other studies, rats exposed to very high
levels of n-hexane had damage to sperm-forming cells.

exposed to n-hexane?
How likely is n-hexane to cause cancer?

There is no evidence that n-hexane causes cancer in
people or animals.
q Never store household chemicals in containers, such as

old soda bottles, that children might find attractive.
If you have been exposed to harmful amounts of n-hexane, the amount of one of its breakdown products will probably be increased in your urine. Your doctor can send a sample
to a specialized laboratory. This test can only detect n-hexane
exposure that occurred within 2 to 3 days of testing.

International Agency for Research on Cancer (IARC) and the
EPA have not classified n-hexane for carcinogenicity.

How can n-hexane affect children?
The EPA requires that spills or accidental releases of

5,000 pounds or more of n-hexane be reported to the EPA.
Since most exposure occurs at work, children aren't likely

to be exposed to levels of n-hexane that cause problems. We
dont know if the effects seen in children would be different
than those seen in adults.
Sometimes older children inhale or sniff household
chemicals in an attempt to get high. This has caused paralysis of the arms and legs of teenagers in the U.S. and Europe.

n-hexane?
q Teach your children and teenagers the dangers of inhaling
products that contain n-hexane.
q Keep products containing n-hexane (quick-drying glues
and cements) out of the reach of children.

(NIOSH) recommends exposure to no more than 50 parts per
million (ppm) in workplace air. The Occupational Health and
Safety Administration (OSHA) has set a permissible exposure
limit of 500 ppm for n-hexane in workplace air.
(ATSDR). 1999. Toxicological profile for n-hexane. Atlanta,
Health Service.
2-HEXANONE
CAS # 591-78-6
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 2-hexanone. For more
SUMMARY: Exposure to 2-hexanone is most likely to occur from living near or

working in plants that make gas from coal, process oil shale, or produce wood pulp.
You may also be exposed if you live near a hazardous waste site where 2-hexanone
is found. In people, exposure to hexanone is most likely to affect the nervous system.
What is 2-hexanone?
(Pronounced 2-hks-nn)
2-Hexanone is also known as methyl n-butyl ketone,
MBK, or propyl acetone. It is a clear, colorless liquid with a
sharp odor. It dissolves very easily in water, and can evaporate easily into the air as a vapor.
q Half of the 2-hexanone in river water breaks down or

evaporates in about 1015 days.
q In the air, half of the 2-hexanone breaks down in about 36
hours.
q It is not known how long it takes to break down in soil.
How might I be exposed to 2-hexanone?
It was used in the past in paint and paint thinner, to make

other chemical substances, and to dissolve oils and waxes.
q Breathing contaminated air.
It is no longer made or used in the United States because

it has harmful health effects. It is formed as a waste product
resulting from industrial activities such as making wood pulp
and producing gas from coal, and in oil shale operations.
q Absorbing it through your skin if you touch liquid or soil

that contains it.
What happens to 2-hexanone when it enters

the environment?
q 2-Hexanone dissolves easily in water.
q Eating some foods that naturally contain low levels of

2-hexanone.
q Using products manufactured before 1982 that contain
2-hexanone (such as paint thinners).
q Working in coal gasification, oil shale processing, or
wood pulping operations.
q Living near hazardous waste sites where it is found.
q It evaporates quickly into the air.

q It may be broken down into other chemicals in the
atmosphere or may be removed by rain or snow.
q 2-Hexanone may be broken down by microorganisms in
water and soil.
q It doesn't usually attach to soils or sediment.
q It doesn't usually build up in plants and animals.
How can 2-hexanone affect my health?

Breathing 2-hexanone can harm your nervous system.
Workers who were exposed to 2-hexanone in the air for almost
a year felt weakness, numbness, and tingling in the skin of the
hands and feet.

2-HEXANONE
CAS # 591-78-6
Page 2

Similar effects were seen in different animals that ate or
breathed high levels of 2-hexanone.
In one study, pregnant rats that breathed 2-hexanone did
not gain as much weight during their pregnancy, had fewer
babies, and had babies that were smaller and less active than
the rats that were not exposed.
We do not know if breathing 2-hexanone affects human
reproduction or causes birth defects.
We do not know whether touching or ingesting 2-hexanone would affect your health. Animal studies have shown
that ingesting high levels of 2-hexanone harms the nervous
system. Also, animals that ingested 2-hexanone experienced
decreased body weight and effects on reproduction.
How likely is 2-hexanone to cause cancer?

classified 2-hexanone as to human carcinogenicity.
These tests are not routinely performed at your doctors

office, but your doctor can take blood or urine samples and

The Occupational Safety and Health Agency (OSHA) has
set a limit for exposure of workers to an average level of 100
parts of 2-hexanone per million parts of air (ppm) for an 8hour workday over a 40-hour workweek.
Hygienists (ACGIH) recommends an exposure limit of 5 ppm
for an 8-hour workday over a 40-hour workweek in workplace air.
Health (NIOSH) recommends that workers be exposed to no
more than an average of 1 ppm for up to a 10-hour workday
over a 40-hour workweek.
Also, the International Agency for Research on Cancer

and the Environmental Protection Agency (EPA) have not
classified 2-hexanone as to human carcinogenicity.
Glossary
There is no information available on the potential

carcinogenic effects of 2-hexanone in people or in experimental animals.
Gasification: Conversion of coal to gas.


been exposed to 2-hexanone?
Several tests are available to tell whether you have been
exposed to 2-hexanone. These tests can measure the levels of
2-hexanone, or its breakdown products, in your blood or
urine. This test only tells you if you have been exposed and
cannot predict whether your health will be affected.
References
1992. Toxicological profile for 2-hexanone. Atlanta, GA:
Health Service.
HMX
CAS # 2691-41-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about HMX. For more information,
HIGHLIGHTS: HMX is an explosive. People who work at facilities that make

HMX may be exposed to it. In one human study, no adverse effects were reported
in workers exposed to unknown concentrations of HMX. Animal studies indicate
that HMX may be harmful to the liver and central nervous system if it is swallowed
or gets on the skin. HMX has been found in at least 10 of the 1,416 National
What is HMX?
HMX is an acronym for High Melting eXplosive. It is
also known as octogen and cyclotetramethylenetetranitramine, as well as by other names. It is a colorless
solid that dissolves slightly in water. Only a small amount of
HMX will evaporate into the air; however, it can occur in air
attached to suspended particles or dust. The taste and smell of
HMX are not known.
HMX does not occur naturally in the environment. It is
made from other chemicals known as hexamine, ammonium
nitrate, nitric acid, and acetic acid. HMX explodes violently
at high temperatures. Because of this property, HMX is used
in various kinds of explosives, rocket fuels, and burster chargers. A small amount of HMX is also formed in making
cyclotrimethylene-trinitramine (RDX), another explosive
similar in structure to HMX.
What happens to HMX when it enters the

environment?
q Most of the HMX that entered the environment was released into waste water from places that made or used
HMX.
q A small amount of HMX can be released to the air as dust
or ash from facilities that burn waste contaminated with
HMX.
q Some HMX may be released to soil as a result of accidental spills, the settling of HMX-containing dust particles
from the air, or the disposal of waste that contains HMX
in landfills.
q Dust particles containing HMX may be carried by the
wind for some distance.
q In surface water, HMX does not evaporate or bind to sediments to any large extent. Sunlight breaks down most of
the HMX in surface water into other compounds, usually
in a matter of days to weeks.
q HMX is likely to move from soil into groundwater, particularly in sandy soils.
q It is not known if plants, fish, or animals living in contaminated areas build up levels of HMX in their tissues.
How might I be exposed to HMX?

There is no information on how often you might be exposed to HMX in the environment or to how much. Most
people, however, probably wont be exposed to HMX from
the environment.
People who work at facilities that make or use HMX or
RDX may be exposed to HMX. These workers may be exposed by inhaling dusts that contain HMX or by getting
HMX-containing liquids on their skin.

HMX
CAS # 2691-41-0
Page 2

People who live near facilities that make or use HMX, or
near hazardous waste sites that contain HMX may also be
exposed if a release occurs. For these residents, exposure (if
any) is most likely to occur from contaminated groundwater.
been exposed to or predict whether or not you will have any

health effects. This test isnt available at most doctors offices,
but can be done at special laboratories that have the right
equipment.
How can HMX affect my health?

Information on the adverse health effects of HMX is

limited. In one human study, no adverse effects were reported in workers who breathed HMX. However, the concentrations of HMX in the workplace air were not reported in
this study, and only a small number of workers and effects
were investigated.
Studies in rats, mice, and rabbits indicate that HMX may
be harmful to your liver and central nervous system if it is
swallowed or gets on your skin.
It is not known if HMX can affect the ability to have children, or if it can cause birth defects.
How likely is HMX to cause cancer?

There is no information available as to whether or not
HMX can cause cancer in animals or people. The Environmental Protection Agency (EPA) has determined that HMX is
not classifiable as to its human carcinogenicity.

exposed to HMX?
You can find out if you have been exposed to HMX by
having your blood, urine, or feces tested for HMX. Since
HMX is poorly absorbed after it is swallowed, the levels of
HMX in your blood and urine are likely to be lower than those
in your feces. For best results, tests for HMX should be done
within a few days after you are exposed.
These tests cannot tell you how much HMX you have
The EPA recommends that the concentration of HMX in an

adults drinking water be less than 0.4 milligrams per liter (0.4
mg/L) for a lifetime. EPA regulates waste containing HMX as
hazardous and has set restrictions on its disposal in landfills.
The Department of State regulates the exportation of
HMX, and the Department of Transportation (DOT) regulates
its transportation.
The Bureau of Alcohol, Tobacco, and Firearms (ATF)
regulates the importation, manufacture, distribution, and storage of HMX.
Glossary
This ToxFAQs information is taken from the 1997 Toxicological Profile for HMX produced by the Agency for Toxic
Substances and Disease Registry, Public Health Service, U.S.
HYDRAULIC FLUIDS
CAS # 55957-10-3; 68937-40-6; 50815-84-4; 55962-27-1;
66594-31-8; 63848-94-2; 107028-44-4; 28777-70-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about hydraulic fluids. For more
HIGHLIGHTS: Exposure to hydraulic fluids occurs mainly in the workplace.

Drinking certain types of hydraulic fluids can cause death in humans, and
swallowing or inhaling certain types of hydraulic fluids has caused nerve damage
in animals. Contact with some types of hydraulic fluids can irritate your skin
or eyes. These substances have been found in at least 10 of the 1,428 National
What are hydraulic fluids?
(Pronounced h-drlk fldz)
q If spilled on soil, some of the ingredients in hydraulic

fluids will stay on top and others will sink into the
groundwater.
Hydraulic fluids are a large group of liquids made of many

kinds of chemicals. They are used in automobile automatic
transmissions, brakes, and power steering; fork lift trucks; tractors; bulldozers; industrial machinery; and airplanes. The three
most common types of hydraulic fluids are mineral oil, organophosphate ester, and polyalphaolefin. Some of the trade names
for hydraulic fluids include Durad, Fyrquel, Skydrol,
Houghton-Safe, Pydraul, Reofos, Reolube, and
Quintolubric. (Use of trade names is for identification only
and does not imply endorsement by the Agency for Toxic Substances and Disease Registry, the Public Health Service, or the
U.S. Department of Health and Human Services.)
q In water, some hydraulic fluids' ingredients will transfer

to the bottom and can stay there for more than a year.
Some hydraulic fluids have a bland, oily smell and others

have no smell; some will burn and some will not burn. Certain
hydraulic fluids are produced from crude oil and others are
manufactured.
What happens to hydraulic fluids when they

q Hydraulic fluids can enter the environment from spills,
leaks in machines that use them, or from storage areas and
waste sites.
q Certain chemicals in hydraulic fluids may break down in

air, soil, or water, but how much breaks down isnt
known.
q Fish may contain some hydraulic fluids if they live in
contaminated water.
How might I be exposed to hydraulic fluids?

q Touching or swallowing hydraulic fluids.
q Breathing hydraulic fluids in the air near machines where
hydraulic fluids are used.
q Touching contaminated water or soil near hazardous
waste sites or industrial manufacturing facilities that use
or make hydraulic fluids.
How can hydraulic fluids affect my health?

Little is known about how hydraulic fluids can affect
your health. Since hydraulic fluids are actually mixtures of
chemicals, some of the effects seen may be caused by additives in the hydraulic fluids.

HYDRAULIC FLUIDS
Page 2
CAS # 55957-10-3; 68937-40-6; 50815-84-4; 55962-27-1;

66594-31-8; 63848-94-2; 107028-44-4; 28777-70-0
In people, the effects of breathing air with high levels of

hydraulic fluids are not known. Drinking large amounts of
some types of hydraulic fluids can cause pneumonia, intestinal
bleeding, or death in humans. Weakness of the hands was seen
in a worker who touched a lot of hydraulic fluids.
Rabbits that inhaled very high levels of one type of hydraulic fluid had trouble breathing, congested lungs, and
became drowsy. The nervous systems of animals that swallowed or inhaled other hydraulic fluids were affected immediately with tremors, diarrhea, sweating, breathing difficulty,
and sometimes several weeks later with weakness of the limbs,
or paralysis. The immediate effects are caused because hydraulic fluids stop the action of certain enzymes, called cholinesterases, in the body. There are no reports of people swallowing or breathing the types of hydraulic fluids that cause
these effects. When certain types of hydraulic fluids were put
into the eyes of animals or allowed to touch the skin of
people or animals for short periods of time, redness and swelling occurred. It is not known whether hydraulic fluids can
cause birth defects or reproductive effects.
How likely are hydraulic fluids to cause cancer?

the EPA have not classified hydraulic fluids as to their carcinogenicity.

exposed to hydraulic fluids?
Hydraulic fluids cant be measured in blood, urine, or feces,
but certain chemicals in the hydraulic fluids can be measured.
Some of the hydraulic fluids stop the activity of certain enzymes, called cholinesterases, in blood and this activity can be
measured. However, many other chemicals also cause this effect.
This test isnt available at most doctors offices, but can be done
at special laboratories that have the right equipment.

There are no federal government recommendations to
protect humans from the health effects of the major hydraulic
fluids. However, mineral oil, the major chemical ingredient of
one type of hydraulic fluid, is part of the petroleum distillate
class of chemicals and there are regulations for these chemicals.
(OSHA) has set an exposure limit of 2,000 milligram per cubic
meter (mg/m3 ) petroleum distillates for an 8-hour workday,
40-hour workweek. The National Institute for Occupational
Safety and Health (NIOSH) recommends an exposure limit of
350 mg/m3 petroleum distillates for a 10-hour workday,
40-hour workweek.
Glossary
Additive: Substance added to another in small amounts to
improve its properties.
Petroleum Distillate: A chemical fraction of petroleum.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Hydraulic Fluids produced by the Agency
HYDRAZINE CAS # 302-01-2

1,1-DIMETHYLHYDRAZINE CAS # 57-14-7
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about hydrazine,
1,1-dimethylhydrazine, and 1,2-dimethylhydrazine. For more information, call the ATSDR Information Center
at 1-888-422-8737. This fact sheet is one in a series of summaries about hazardous substances and their health
effects. Its important you understand this information because this substance may harm you. The effects
of exposure to any hazardous substance depend on the dose, the duration, how you are exposed, personal
HIGHLIGHTS: Hydrazines are colorless liquids that are used in rocket fuels,
chemical manufacturing, and as boiler water treatments. Exposure to hydrazines
may cause nervous system effects, as well as liver and kidney damage.
Hydrazines have been found in at least 8 of the 1,416 National Priorities List
What are hydrazines?
(Pronounced hdr znz)
Hydrazines are clear, colorless liquids with an ammonialike odor. There are many kinds of hydrazine compounds,
including hydrazine, 1,1-dimethylhydrazine, and 1,2-dimethylhydrazine. Small amounts of hydrazine occur naturally in
plants. Most hydrazines are manufactured for use as rocket
propellants and fuels, boiler water treatments, chemical reactants, medicines, and in cancer research. Hydrazines are
highly reactive and easily catch fire.
How might I be exposed to hydrazines?

q Breathing contaminated air in or near a facility that
makes, processes, or uses hydrazines.
q Eating fish contaminated with hydrazines.
q Drinking or swimming in water that has been contaminated with hydrazines.
q Touching soil contaminated with hydrazines, such as near
some military bases or hazardous waste sites.
q Breathing cigarette smoke indirectly or using tobacco
products may expose you to small amounts of hydrazine
or 1,1-dimethylhydrazine.
What happens to hydrazines when they enter

the environment?
q Working in greenhouses where the chemical Alar is used

may result in your being exposed to small amounts of 1,2dimethylhydrazine.
q Hydrazines can be released into the environment during

their production or use, or from accidental spills.
How can hydrazines affect my health?
q Hydrazines easily evaporate to the air, where they are

broken down by reactions within minutes or hours.
q Hydrazines can also dissolve in water, where they usually
break down into less toxic compounds within a few
weeks.
q Hydrazines may build up in some fish living in contaminated water, but are not expected to remain at high levels
over long periods of time.
q In soil, hydrazines may stick to particles and be changed
within a few days to less harmful compounds.
Breathing hydrazines for short periods may cause coughing and irritation of the throat and lungs, convulsions, tremors,
or seizures. Breathing hydrazines for long periods may cause
liver and kidney damage, as well as serious effects on reproductive organs.
Eating or drinking small amounts of hydrazines may
cause nausea, vomiting, uncontrolled shaking, inflammation
of the nerves, drowsiness, or coma.

Page 2
HYDRAZINE CAS # 302-01-2


How likely are hydrazines to cause cancer?
Tumors have been seen in many organs of animals that
were exposed to hydrazines by ingestion or breathing, but
most tumors have been found in the lungs, blood vessels, or
colon. 1,2-Dimethylhydrazine has caused colon cancer in
laboratory animals following a single exposure.

Health (NIOSH) recommends that the levels of hydrazine and
1,1-dimethylhydrazine in workplace air not exceed 0.03 and
0.6 parts of compound per million parts of air (0.03-0.6 ppm),
respectively, for a 2-hour period.

has determined that hydrazine and 1,1-dimethylhydrazine are
known carcinogens.

(OSHA) limits the amount of hydrazine and 1,1-dimethylhydrazine in workplace air to 1 and 0.5 ppm, respectively, for an
8-hour workday.

has determined that hydrazine, 1,1-dimethylhydrazine, and 1,2dimethylhydrazine are possible human carcinogens.
The Food and Drug Administration (FDA) has ruled that

hydrazine cannot be added to water used for making steam
which will contact food.
The EPA has determined that hydrazine, 1,1-dimethylhydrazine, and 1,2-dimethylhydrazine are probable human carcinogens.

the environment of 1 pound or more of hydrazine or
1,2-dimethylhydrazine, or more than 10 pounds of 1,1-dimethylhydrazine be reported to the EPA.

Hygienists (ACGIH) currently lists hydrazine and 1,1-dimethylhydrazine as suspected carcinogens, but has recently recommended that the listing of hydrazine be changed to that of
animal carcinogen, not likely to cause cancer to people under
normal exposure conditions.

exposed to hydrazines?
There are tests available to detect the presence of hydrazines or their breakdown products in the blood, urine, and
feces. These tests must be done soon after exposure, before the
compounds are broken down and eliminated from the body.
These tests arent available at most doctors offices, but can be
done at special laboratories that have the right equipment.
These tests cannot be used to tell how much hydrazines you
were exposed to or if any health effects will occur.

Glossary
This ToxFAQs information is taken from the 1997 Toxicological Profile for Hydrazines produced by the Agency for
Toxic Substances and Disease Registry, Public Health Service, U.S. Department of Health and Human Services, Public
HYDROGEN CHLORIDE
CAS #7647-01-0
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about hydrogen chloride. For
HIGHLIGHTS: People working in occupations in which hydrogen chloride is

used have the highest risk of being exposed to this compound. Exposure of the
general population is minimal. Hydrogen chloride gas can cause irritation of
the eyes, skin, and respiratory tract. Exposure to high levels can result in
corrosive damage to the eyes, skin, and respiratory tissues, and could lead to
pulmonary edema and even death in extreme cases. This substance has been
What is hydrogen chloride?
At room temperature, hydrogen chloride is a colorless to
slightly yellow, corrosive, nonflammable gas that is heavier
than air and has a strong irritating odor. On exposure to air,
hydrogen chloride forms dense white corrosive vapors.
Hydrogen chloride can be released from volcanoes.
Hydrogen chloride has many uses, including cleaning,
pickling, electroplating metals, tanning leather, and refining
and producing a wide variety of products.
Hydrogen chloride can be formed during the burning of
many plastics. Upon contact with water, it forms
hydrochloric acid. Both hydrogen chloride and hydrochloric
acid are corrosive.
What happens to hydrogen chloride when it

Hydrogen chloride released to the atmosphere will be
removed by rainfall.
Hydrogen chloride dissociates readily in water to chloride
and hydronium ions (an ion is an electrically charged atom
or molecule), which ultimately lowers the pH of the water

(makes it more acidic).
If released to soil, hydrogen chloride will evaporate from
dry soil surfaces and dissociate into chloride anions and
hydronium ions in moist soil.
Hydrogen chloride does not accumulate in the food chain.
How might I be exposed to hydrogen chloride?

You may breathe in air that contains very low levels of
hydrogen chloride gas. Naturally-occurring (i.e., from
volcanic eruptions) and other releases of hydrogen chloride
are removed by rainfall, limiting the chances of exposure to
high levels of this compound by breathing ambient air.
Hydrogen chloride is used to produce other chemicals, or
for applications such as a metal pickling, ore refining, food
processing, manufacture of fertilizers and dyes, and in the
rubber and textile industries. Workers in these occupations
may inhale hydrogen chloride or get it on their skin.
Soldering materials often contain hydrogen chloride and
you may be exposed if you use these products during
soldering.

HYDROGEN CHLORIDE
Page 2
CAS #7647-01-0
How can hydrogen chloride affect my health?

Hydrogen chloride is irritating and corrosive to any tissue it
contacts. Brief exposure to low levels causes throat
irritation. Exposure to higher levels can result in rapid
breathing, narrowing of the bronchioles, blue coloring of the
skin, accumulation of fluid in the lungs, and even death.
Exposure to even higher levels can cause swelling and spasm
of the throat and suffocation. Some people may develop an
inflammatory reaction to hydrogen chloride. This condition
is called reactive airways dysfunction syndrome (RADS), a
type of asthma caused by some irritating or corrosive
substances.
Depending on the concentration, hydrogen chloride can
produce from mild irritation to severe burns of the eyes and
skin. Long-term exposure to low levels can cause respiratory
problems, eye and skin irritation, and discoloration of the
teeth.
Swallowing concentrated hydrochloric acid will cause severe
corrosive injury to the lips, mouth, throat, esophagus, and
stomach.
We do not know if exposure to hydrogen chloride can result
in reproductive effects.
How likely is hydrogen chloride to cause cancer?

EPA have not classified hydrogen chloride as to its
carcinogenicity. IARC considers hydrochloric acid to be not
whether children differ from adults in their susceptibility to

hydrogen chloride. In general, children may be more
vulnerable to corrosive agents than adults because of the
smaller diameter of their airways.
We do not know if exposure to hydrogen chloride can result
in birth defects or other developmental effects.

hydrogen chloride?
hydrogen chloride gas.
Household products containing hydrochloric acid should
be stored in safe containers, in safe locations, out of the
reach of children.

exposed to hydrogen chloride?
Specific tests for the presence of hydrogen chloride in the
blood or urine are not generally useful. If a severe exposure
has occurred, blood and urine analyses and other tests may
show whether damage has occurred to the lungs or
gastrointestinal tract. Some of these tests can be performed
in a doctors office. Some testing may require hospital
facilities.

has set a ceiling limit of 5 parts of hydrogen chloride per
million parts of air (5 ppm) in workplace air.
How can hydrogen chloride affect children?

Children are probably affected by exposure to hydrogen
chloride in the same ways as adults. We do not know
HYDROGEN PEROXIDE
CAS #7722-84-1
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about hydrogen peroxicde. For
HIGHLIGHTS: Hydrogen peroxide is a manufactured chemical, although small

amounts of hydrogen peroxide gas may occur naturally in the air. Low
exposure may occur from use at home; higher exposures may occur from
industrial use. Exposure to hydrogen peroxide can cause irritation of the eyes,
throat, respiratory airway, and skin. Drinking concentrated liquid can cause
mild to severe gastrointestinal effects. This substance has been found in at
What is hydrogen peroxide?
Hydrogen peroxide is a colorless liquid at room temperature
with a bitter taste. Small amounts of gaseous hydrogen
peroxide occur naturally in the air. Hydrogen peroxide is
unstable, decomposing readily to oxygen and water with
release of heat. Although nonflammable, it is a powerful
oxidizing agent that can cause spontaneous combustion
when it comes in contact with organic material.
Hydrogen peroxide is found in many households at low
concentrations (3-9%) for medicinal applications and as a
clothes and hair bleach. In industry, hydrogen peroxide in
higher concentrations is used as a bleach for textiles and
paper, as a component of rocket fuels, and for producing
foam rubber and organic chemicals.
What happens to hydrogen peroxide when it

Hydrogen peroxide released to the atmosphere will react
very rapidly with other compounds found in air.
Hydrogen peroxide breaks down rapidly in water.
If released to soil, hydrogen peroxide will be broken down

by reacting with other compounds.
Hydrogen peroxide does not accumulate in the food chain.
How might I be exposed to hydrogen peroxide?

You can be exposed to hydrogen peroxide through its use
as a general disinfectant. Hydrogen peroxide solutions used
for this purpose are sold at almost all drugstores or
supermarkets.
Because hydrogen peroxide is used in many industries for
a variety of purposes, workers in such industries may be
exposed to this chemical through inhalation or contact with
the skin.
How can hydrogen peroxide affect my health?

Hydrogen peroxide can be toxic if ingested, inhaled, or by
contact with the skin or eyes. Inhalation of household
strength hydrogen peroxide (3%) can cause respiratory
irritation. Exposure to household strength hydrogen

HYDROGEN PEROXIDE
Page 2
CAS #7722-84-1
peroxide can cause mild ocular irritation. Inhalation of

vapors from concentrated (higher than 10%) solutions may
result in severe pulmonary irritation.
Ingestion of dilute solutions of hydrogen peroxide may result
in vomiting, mild gastrointestinal irritation, gastric distension,
and on rare occasions, gastrointestinal erosions or embolism
(blockage of blood vessels by air bubbles). Ingestion of
solutions of 10-20% strength produces similar symptoms, but
exposed tissues may also be burned. Ingestion of even more
concentrated solutions, in addition to the above, may also
induce rapid loss of consciousness followed by respiratory
paralysis.
Eye exposure to 3% hydrogen peroxide may result in pain
and irritation, but severe injury is rare. More concentrated
solution may result in ulceration or perforation of the cornea.
Skin contact can cause irritation and temporary bleaching of
the skin and hair. Contact with concentrated solutions may
cause severe skin burns with blisters.
We do not know if exposure to hydrogen peroxide may affect
reproduction in humans.
How likely is hydrogen peroxide to cause cancer?

determined that hydrogen peroxide is not classifiable as to its
How can hydrogen peroxide affect children?
children being accidently exposed to hydrogen peroxide have

described effects similar to those observed in adults.
We do not know if exposure to hydrogen peroxide may result

hydrogen peroxide?
Most families may be exposed to household strength
hydrogen peroxide.
Hydrogen peroxide should not be stored in containers that
may appear attractive to children, such as soda bottles.
Containers with hydrogen peroxide should be stored out of
the reach of children.

exposed to hydrogen peroxide?
There are no clinical tests that show that you have been
exposed to hydrogen peroxide. White foam from the mouth
immediately after ingestion of significant amounts may
provide a clue to emergency personnel.

sets a limit of 1 part of hydrogen peroxide in a million parts
of air (1 ppm) in the workplace for an 8-hour work shift, 40hour work week.

exposed to hydrogen peroxide. Documented cases of
HYDROGEN SULFIDE
CAS # 7783-06-4
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about hydrogen sulfide. For more
HIGHLIGHTS: Hydrogen sulfide occurs naturally and is also produced by

human activities. Just a few breaths of air containing high levels of hydrogen
sulfide gas can cause death. Lower, longer-term exposure can cause eye irritation,
headache, and fatigue. This substance has been found in at least 24 of the 1,467
(EPA).
What is hydrogen sulfide?
(Pronounced hdr-jn slfd)
Hydrogen sulfide occurs naturally in crude petroleum,
natural gas, volcanic gases, and hot springs. It can also result
from bacterial breakdown of organic matter. It is also produced by human and animal wastes.
Hydrogen sulfide can also result from industrial activities, such as food processing, coke ovens, kraft paper mills,
tanneries, and petroleum refineries.
Hydrogen sulfide is a colorless, flammable gas under normal conditions. It is commonly known as hydrosulfuric acid,
stink damp, and sewer gas. It smells like rotten eggs. People
can smell it at low levels.
What happens to hydrogen sulfide when it

q Hydrogen sulfide is released primarily as a gas and will
spread in the air.
q When released as a gas, it will form sulfur dioxide and
sulfuric acid in the atmosphere.
q Sulfur dioxide can be broken down further and is a major
component in acid rain.
q Hydrogen sulfide remains in the atmosphere for about

18 hours.
q In some instances, it may be released as a liquid waste
from an industrial facility.
How might I be exposed to hydrogen sulfide?

q You can be exposed by crude petroleum, natural gas, volcanic gases, and hot springs.
q You can be exposed at work if you work in the petroleum
refining, petrochemical, or natural gas industry; food
processing; wastewater treatment; coke oven plants; tanneries; or pulp and paper mills.
q A small amount of hydrogen sulfide is produced by bacteria in your mouth and gastrointestinal tract and by enzymes in your brain and muscle.
How can hydrogen sulfide affect my health?

Hydrogen sulfide is considered a broad-spectrum poison,
meaning it can poison several different systems in the body.
Breathing very high levels of hydrogen sulfide can cause
death within just a few breaths. There could be loss of consciousness after one or more breaths.

HYDROGEN SULFIDE
CAS # 7783-06-4
Page 2

Exposure to lower concentrations can result in eye irritation, a sore throat and cough, shortness of breath, and fluid in
the lungs. These symptoms usually go away in a few weeks.
Long-term, low-level exposure may result in fatigue, loss of
appetite, headaches, irritability, poor memory, and dizziness.
Animal studies showed that pigs that ate food containing
hydrogen sulfide had diarrhea after a few days and weight loss
after about 105 days.
How likely is hydrogen sulfide to cause cancer?

Hydrogen sulfide has not been shown to cause cancer in
humans. It's ability to cause cancer in animals has not been
studied fully. The Department of Health and Human Services
(IARC), and the EPA have not classified hydrogen sulfide for
carcinogenicity.
How can hydrogen sulfide affect children?

Because it is heavier than air, hydrogen sulfide tends to
sink, and because children are shorter than adults, they may be
more likely to be exposed to larger amounts than adults in the
same situations.
It is not known whether hydrogen sulfide can cause birth
defects in people. Some animal studies have shown developmental problems from exposure to hydrogen sulfide.

hydrogen sulfide?
Families may be exposed if they live near natural or industrial sources of hydrogen sulfide such as hot springs, or
pulp and paper mills. Families may want to restrict visits to
these places.

exposed to hydrogen sulfide?
In case of life-threatening hydrogen sulfide poisoning,
measurements of blood sulfide or urinary thiosulfate levels
may be used to confirm exposure. However, samples need to
be taken within two hours of exposure to be useful.

EPA has established that hydrogen sulfide is a regulated
toxic substance and is a hazardous substance as defined under
the Federal Water Pollution Control Act.
(OSHA) has established an acceptable ceiling concentration of
20 parts per million (20 ppm) in the workplace, with a maximum level of 50 ppm allowed for 10 minutes if no other measurable exposure occurs.
(NIOSH) recommends a maximum exposure level of 10 ppm.
Sources of Information
(ATSDR). 1999. Toxicological profile for hydrogen sulfide.
IODINE
CAS #7553-56-2
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about iodine. For more
HIGHLIGHTS: Iodine is a naturally occurring element that is required for

good health. Exposure to high levels of stable or radioactive iodine can cause
damage to the thyroid. This chemical has been found in at least 8 of the 1,585
(EPA).
What is iodine?
Iodine is a naturally occurring element found in sea water
and in certain rocks and sediments. There are
nonradioactive and radioactive forms of iodine.
Iodine is used as a disinfectant for cleaning surfaces and
storage containers and is used in skin soaps and bandages,
and for purifying water. Iodine is also added to some table
salt to ensure that all people in the United States have
enough iodine in their diet.
Radioactive iodine also occurs naturally. It is used in
medical tests and to treat certain diseases. Most radioactive
forms of iodine change very quickly (seconds to days) to
stable elements that are not radioactive. However, 129I (read
as iodine 129) changes very slowly (over millions of years).
What happens to iodine when it enters the

environment?
The primary source of non radioactive iodine is the ocean.
It enters the air from sea spray or as iodine gas. Once in the
air, iodine can combine with water or with particles in air and
can enter the soil and surface water, or land on vegetation
when these particles fall to the ground or when it rains.
Iodine can remain in soil for a long time. It can also be
taken up by some plants that grow in the soil but plants are
considered a poor source of dietary iodine.
Radioactive iodine forms naturally from chemical reactions
high in the atmosphere. Small amounts of radioactive iodine
can enter the air from nuclear power plants. Larger amounts
of radioactive iodine have been released to the air from
accidents at nuclear power plants and from explosions of
nuclear bombs.
How might I be exposed to iodine?

The general population is exposed to low levels of iodine
in air, some food and some beverages. Food (iodized salt,
bread, and milk ) is the largest sources of exposure to iodine.
The general population is rarely exposed to radioactive
iodine, unless they undergo certain medical tests or are
given it for the treatment of thyroid disease.
People who work at facilities using radioactive iodine may
be exposed to higher than normal levels.
How can iodine affect my health?

Iodine has both beneficial and harmful effects on human
health. Iodine is needed by your thyroid gland to produce
thyroid hormones. However, exposure to unnecessarily high
levels of nonradioactive and radioactive iodine can damage
the thyroid. Damage to the thyroid gland can result in
effects in other parts of your body, such as your skin, lung,
and reproductive organs.
How likely is iodine to cause cancer?

Some human studies have found an increased risk of thyroid
cancer in certain populations, particularly populations with
iodine deficient diets receiving iodine supplements. Other
human studies have not found an association between

IODINE
Page 2
CAS #7553-56-2
exposure to high levels of iodine and cancer risk. Neither the

EPA or the International Agency for Research on Cancer
(IARC) have reviewed the carcinogenicity of iodine.
Exposure to high levels of radioactive iodine may also
increase the risk of thyroid cancer. However, the evidence is
inconclusive.
How can iodine affect children?

Iodine is essential for the growth and development of
children. However, children are more sensitive to the harmful
effects of excessively high levels of stable and radioactive
iodine than adults because their thyroid glands are still
growing and they need a healthy thyroid gland for normal
growth. If babies and children receive too much iodine, they
can develop an enlarged thyroid gland (called a goiter),
which does not produce enough thyroid hormone for normal
growth. Too much iodine from the mother can cause a
babys thyroid gland to be so large that it makes breathing
difficult or impossible.
Radioactive iodine in food can be more harmful to babies and
children than to adults. Because a childs thyroid gland is
smaller than that of an adult, a childs thyroid gland will
receive a higher radiation dose than the adult exposed to the
same amount of iodine.

iodine?
The general population is exposed to iodine in some food
and beverages. We do not want to prevent exposure to
iodine, but we do want to try to prevent exposure to too
much iodine. Foods are not normally expected to have
enough iodine to harm your health. Unless you are exposed
to radioactive waste or emissions, you generally do not have
to worry about excessive exposure.

exposed to iodine?
There are reliable tests that can measure iodine in the blood,
urine, and saliva. These tests are not available at your
doctors office, but your doctor can send the samples to a
laboratory that can perform the tests. However, these tests
cannot predict whether you will experience any health
effects.
Radiation detectors can measured radioactive iodine inside
your body using the radiation coming from the thyroid gland
in your neck. Your body quickly eliminates iodine and
radioactive iodine, so tests should be done shortly after
exposure.

The National Research Council has established a
recommended dietary allowance (RDA) for iodine of 150
micrograms per day (150 g/day), with additional allowances
of 25 g/day during pregnancy and 50 g/day during
nursing. These dietary intake levels are sufficient to satisfy
the metabolic needs of the body.
The Nuclear Regulatory Commission (NRC), the National
Council of Radiation Protection and Measurement (NRCP),
and the International Commission of Radiological Protection
(ICRP) have established recommended limits for worker
exposures to radioactive iodine and for releases of
radioactive iodine to the environment.
(ATSDR). 2001. Toxicological Profile for Iodine (Draft for
IONIZING RADIATION
September 1999
This fact sheet answers the most frequently asked health questions (FAQs) about ionizing radiation. For
information because this material may harm you. The effects of exposure to any hazardous material depend
on the dose, the duration, how you are exposed, personal traits and habits, and whether other radioactive
materials are present.
HIGHLIGHTS: Ionizing radiation, like heat and light, is a form of energy. It includes particles
and rays given off by radioactive material, stars, and high-voltage equipment. Most of it
occurs naturally and some is produced by human activities. At very high doses, ionizing
radiation can cause illness or death. Any dose could possibly cause cancer, after a severalyear delay. It is not known how many of the 1,517 National Priorities List sites identified
by the Environmental Protection Agency give off ionizing radiation above background levels.
What is ionizing radiation?
(Pronounced -nzng rd-shn)
Ionizing radiation is any one of several types of particles
and rays given off by radioactive material, high-voltage equipment, nuclear reactions, and stars. The types that are normally
important to your health are alpha particles, beta particles,
x rays, and gamma rays.
Alpha and beta particles are small, fast-moving bits of
atoms that a radioactive atom gives off when it changes into
another substance. X rays and gamma rays are types of electromagnetic radiation. These radiation particles and rays carry
enough energy to knock out electrons from atoms and molecules (such as water, protein, and DNA) that they hit or pass
near. This process is called ionization, which is why this radiation is called "ionizing radiation."
What happens to ionizing radiation when it

Ionizing radiation, which travels as fast as the speed of
light, hits atoms and molecules in its path and loses some of its
energy with each hit. When all the energy is gone, there is essentially nothing left. Ionizing radiation does not make you
radioactive - it just leaves some of its energy inside you or
whatever else it hits.
When ionizing radiation from outer space hits the upper
atmosphere, it produces a shower of cosmic rays that constantly expose everything on earth. Some hit gases in the air
and change them into radioactive material (such as tritium and
carbon 14). Other radioactive materials are naturally part of the
environment, such as the uranium that has been here since the
earth was formed. Still other radioactive materials are made by
industry for smoke detectors, medical tests, and other uses.
These radioactive materials give off their ionizing radiation
over time until all of the radioactive atoms have decayed.
Whenever radioactive material enters the environment, it
behaves like other substances, getting into the air, water, soil,
plants, and animals, while also giving off radiation.
Some ionizing radiation is made on demand, such as when
doctors take x rays.
How might I be exposed to ionizing radiation?

You are exposed to low levels of ionizing radiation from
the sun, rocks, soil, natural sources in your body, fallout from
past nuclear weapons tests, some consumer products, and radioactive materials released from hospitals and from nuclear
and coal power plants.
You are exposed to more if you work as a pilot, flight attendant, astronaut, industrial and nuclear power plant worker,
or x ray or medical personnel.
You receive additional exposure with each x ray exam and

Page 2
IONIZING RADIATION
nuclear medicine test, and the amount depends on the type

and number of tests.
How can ionizing radiation affect my health?

Exposure to low levels of ionizing radiation from the environment has not been shown to affect human health. Exposure to high doses of ionizing radiation can result in skin
burns, hair loss, nausea, birth defects, illness, and death. How
you are affected depends on how much ionizing radiation you
received and over what period of time, and personal factors
such as sex, age at the time of exposure, and your health and
nutritional status. Increasing the dose results in a more severe
effect. Increased psychological stress has been shown in large
populations exposed to small doses of radiation from nuclear
accidents. Mental function has been affected in people exposed before birth to high doses of ionizing radiation.
How likely is ionizing radiation to cause cancer?

Exposure to ionizing radiation may increase your chance
of getting cancer. As with other health effects, how likely you
are to get cancer depends on how much ionizing radiation you
received, your age when exposed, and the type of cancer.
How can ionizing radiation affect children?
When you or your children receive an x ray, be sure to

correctly wear the protective garments that are provided. The
technician will make sure that only the area that needs to be
x rayed will be exposed to the x ray beam. If you or your children are treated with a chemical that has some amount of radioactive material in it to help a doctor diagnose or treat a
disease, be sure to follow the doctor's directions after you have
been treated.

exposed to ionizing radiation?
There are different kinds of tests to see if you have been
exposed to very high doses of ionizing radiation. One test
examines changes in blood cell counts, but only exposure to
high levels of ionizing radiation will produce detectable
changes in blood cell counts. Another test studies your chromosomes. This test is useful for doses several times the maximum permissible dose for radiation workers.
There are many ways to see if you have radioactive material in your body. Radioactive material can be measured in
your blood, feces, saliva, urine, and your entire body by specialized instruments. The instrument is chosen based on the
type of radiation that is to be measured. These tests are not
available at your doctor's office.
Like adults, children are exposed to small amounts of

ionizing radiation that comes from the soil where they live, the
food and water they eat and drink, the air they breathe, and
from sources that reach earth from space. There is no evidence
that exposure to normal background levels of ionizing radiation causes health effects in children or adults.

If a pregnant woman is exposed to high levels of ionizing

radiation, it is possible that her child may be born with some
brain abnormalities. There is an 8-week period during early
pregnancy when an unborn child is especially sensitive to the
effects of higher-than-normal levels of ionizing radiation. As
the levels of ionizing radiation increase, so does the chance of
brain abnormalities.
The current federal and state regulations limit workers'

doses to 5 rem/year; the limit for an unborn child of a female
radiation worker is 0.5 mrem/year; the limit for the general
public is 0.1 rem/year, with provisions for a limit of
0.5 rem/year under special circumstances.

ionizing radiation?
The EPA limits the dose from radionuclides released to

the air to 0.1 millirems (mrem)/year. The EPA has set a drinking water standard for radionuclides of 4 mrem/year for manmade sources of beta emitters.
(ATSDR). 1999. Toxicological profile for ionizing radiation.
ISOPHORONE
CAS # 78-59-1
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about isophorone. For more
HIGHLIGHTS: Isophorone is used in the printing industry. Exposure to high

levels causes irritation of the nose and throat, dizziness, and fatigue. This chemical
What is isophorone?
(Pronounced s-f'rn)
Isophorone is a clear liquid that smells like peppermint. It
can be dissolved in water and evaporates somewhat faster than
water. It is an industrial chemical used as a solvent in some
printing inks, paints, lacquers, and adhesives. It is also used as
an intermediate in the production of certain chemicals. Although isophorone is an industrial chemical, it also occurs
naturally in cranberries.
What happens to isophorone when it enters the

environment?
q Isophorone is released to the air from inks, paints, and
other products containing it.
q It disappears in air very quickly, half of it disappears in
less than 5 hours.
q Isophorone may be present in water from industrial releases.
q In water, it can be broken down by bacteria over a period
of several days to about a month.
q In soil, it may be be broken down by bacteria, filter to

groundwater, or evaporate to the air; however, there is not
much information on its presence in soil.
How might I be exposed to isophorone?

q Breathing low levels found in air.
q Drinking water contaminated with isophorone.
q Eating food that contains isophorone.
q Working in the printing, adhesives, and coatings industries where isophorone is used.
How can isophorone affect my health?

The only effects of isophorone reported by people who
have been exposed are irritation of the skin, eyes, nose, and
throat, and dizziness and fatigue. These effects have occurred
in workers who breathed vapors of isophorone and other
chemicals in the printing industry.
Short-term exposure of animals to high levels of
isophorone has caused inactivity and coma. Some animal
studies suggest that isophorone may cause birth defects and

ISOPHORONE
CAS # 78-59-1
Page 2

slower growth in the offspring of rats and mice that breathed
the vapors during pregnancy. These studies found some harmful health effects in adult female animals. When rats and mice
were given high doses of isophorone in food or water for a
long time, the male rats developed kidney disease.
ported to the EPA.
How likely is isophorone to cause cancer?

(NIOSH) recommends an occupational exposure limit of
23 mg/m3 for isophorone for a 10-hour workday in a 40-hour
workweek.
No studies are available on whether isophorone causes

cancer in people. In male rats, isophorone caused an increase
in tumors of the kidney, liver, and lymph and reproductive
glands when they were exposed to it by ingestion. There was
no increase in tumors in female rats or mice. The EPA has determined that isophorone is a possible human carcinogen,
based on adequate evidence in animals and inadequate evidence in people.

exposed to isophorone?
There is no medical test to determine whether you have
been exposed to isophorone. A few studies in rats and rabbits
have shown that isophorone and its breakdown products can
be found in the urine of these animals, so it may be possible to
find a method for testing the urine of people to determine exposure to isophorone. We do not know whether such a measurement would predict how much exposure had occurred or
the possible health effects.

should be limited to 8.4 parts of isophorone per billion parts of
water (8.4 ppb) to prevent possible health effects from drinking water or eating fish contaminated with isophorone.
The EPA requires that discharges, spills, or accidental
releases of 5,000 pounds or more of isophorone must be re-

(OSHA) has set a permissible exposure limit of 140 milligrams
of isophorone per cubic meter of air (140 mg/m3) for an 8-hour
workday in a 40-hour workweek.

July 1999.
Glossary
National Priorities List: A list of the nations worst hazardous
waste sites.
(ATSDR). 1990. Toxicological profile for isophorone.
JET FUELS JP-4 and JP-7

CAS # 50815-00-4
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about jet fuels JP-4 and JP-7. For
SUMMARY: JP-4 and JP-7 are liquid mixtures produced from petroleum and
used by the U.S. Air Force as aircraft fuels. Breathing large amounts of the vapors
from these fuels may cause nausea and nervous system effects. JP-4 has been
Environmental Protection Agency (EPA). JP-7 has not been found at any sites.
What are jet fuels JP-4 and JP-7?

(Pronounced jt fylz JP-4 and JP-7)
Jet fuels JP-4 and JP-7 (jet propellant-4 and jet propellant-7) are flammable, colorless to straw-colored liquid mixtures that come from crude petroleum. They smell like kerosene. Jet fuels are blends of other chemicals made according
to U.S. Air Force standards for use as aircraft fuels.
Although JP-4 and JP-7 are liquids at room temperature,
they also evaporate easily.
What happens to JP-4 and JP-7 when they

q JP-4 and JP-7 enter the environment when they are spilled
or leak into water or soil during their manufacture, storage, disposal, or release from jets during flight.
q Some chemicals found in JP-4 may dissolve in water,
while others may evaporate into the air.
q Some chemicals found in JP-4 may stick to particles in
water, which will eventually cause them to settle to the
bottom sediment.
q Some of the chemicals found in JP-4 may be broken
organisms.
q There is no information about what happens to JP-7 when

it enters the environment, but it probably acts similarly to
JP-4.
q There is no information on whether JP-4 and JP-7 build
up significantly in plants and animals.
q It is likely that some of the chemical components of JP-4
and JP-7 build up in plants and animals.
How might I be exposed to JP-4 and JP-7?

q Exposure to JP-4 occurs primarily in workers who manufacture, transport, or use jet fuels.
q Exposure to JP-4 is most likely to occur through skin
contact or breathing contaminated air.
q You may be exposed to JP-4 by breathing some of the
chemicals that evaporate from a spill or leak site.
q You may also be exposed through drinking or swimming
in water that has been contaminated with JP-4, or from
touching soil contaminated from a spill or leak.
q There is no information about how individuals may be
exposed to JP-7, but it is reasonable to assume that you
could be exposed in the same ways as for JP-4.
How can JP-4 and JP-7 affect my health?



CAS # 50815-00-4
Page 2

that may be caused by JP-4 and JP-7. Inhaling large amounts
of JP-4 vapor may cause painful breathing and a feeling of
suffocation, as well as headache, dizziness, nausea, depression, anxiety, memory loss, and irritability.
Animal studies have shown that inhaling extremely large
amounts of JP-4 or JP-7 vapor does not cause death. However,
animals breathing high levels of JP-4 vapor for short periods
exhibited poor coordination and convulsions. A depressed activity level has been seen in animals breathing low levels of
JP-4 vapor. Other effects seen in animals breathing JP-4 or JP-7
vapor have been skin and eye irritation, changes in liver cells,
and decreased numbers of white blood cells.
We do not know whether JP-4 or JP-7 can cause birth defects or if they affect reproduction in people.
How likely are JP-4 and JP-7 to cause cancer?

has stated there is not enough information to determine how
likely JP-4 and JP-7 are to cause cancer in humans.
Studies with mice and rats have suggested that skin contact with JP-4 may cause skin cancer, although this is not certain. There is also no clear evidence that breathing, eating, or
drinking JP-4 or JP-7 causes cancer in animals.

been exposed to JP-4 and JP-7?
There is no medical test that shows if you have been exposed to JP-4 and JP-7. Tests are available to determine if
some of the chemicals commonly found in jet fuels are in your
blood. However, the presence of these chemicals in blood may
not necessarily mean that you have been exposed to JP-4 or
JP-7.

(OSHA) has set an exposure limit of 500 parts of petroleum
distillates per million parts of air (500 ppm) for an 8-hour
The Air Force Office of Safety and Health (AFOSH) has set
an exposure limit of 400 ppm petroleum distillates for an
The Department of Transportation (DOT) lists JP-4 and
JP-7 as hazardous materials and, therefore, regulates their
transportation.
Glossary
Milligram: One thousandth of a gram.
body of water.
Reference
(ATSDR). 1995. Toxicological profile for jet fuels JP-4 and
JP-7. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

CAS # 8008-20-6
August 1999
This fact sheet answers the most frequently asked health questions (FAQs) about jet fuels JP-5 and JP-8. For
HIGHLIGHTS: Exposure to jet fuels JP-5 and JP-8 occurs mainly in the
workplace or from accidents or spills. Breathing in large amounts of JP-5 and
JP-8 may result in headaches, difficulty in concentrating, coordination problems,
and fatigue. These chemicals have been found in at least 22 of the 1,445 National
Priorities List sites identified by the Environmental Protection Agency.
What are jet fuels JP-5 and JP-8?
q Other chemicals in JP-5 and JP-8 will attach to particles in
(Pronounced jt fylz JP-5 and JP-8)
q Chemicals in JP-5 and JP-8 may be broken down by bac-
Jet fuels JP-5 and JP-8 are substances used as aircraft fuels
by the military. JP-5 and JP-8 is shorthand for jet propellants
5 and 8. JP-5 is the U.S. Navys primary jet fuel, and JP-8 is
one of the jet fuels used by the U.S. Air Force.
Both of the substances are composed of a large number of
chemicals, and both are colorless liquids that may change into
gas vapor. They smell like kerosene, since kerosene is the
primary component of both JP-5 and JP-8. They are made by
refining either crude petroleum oil deposits found underground or shale oil found in rock.
What happens to jet fuels JP-5 and JP-8 when

q Some chemicals in JP-5 and JP-8 will evaporate into air
from open containers or when they are spilled into water
or soil.
q JP-5 and JP-8 in air may break down by reacting with

sunlight or chemicals in air.
q Chemicals in JP-5 and JP-8 may slowly move from the

soil into groundwater.
water and may sink to the bottom sediments.

teria and other organisms in soil and water.
q JP-5 and JP-8 may stay in the soil for more than 10 years.
How might I be exposed to jet fuels JP-5 and
JP-8?
q Most people would not be exposed to jet fuels JP-5 and
JP-8 unless they work with these substances or live very

close to where they are used or spilled.
q Breathing air in an area where an accident or leak of jet

fuels JP-5 and JP-8 has occurred.
q Drinking water contaminated with JP-5 or JP-8.

q Touching soil contaminated with jet fuels JP-5 and JP-8.
q Working refueling military aircraft or transporting jet
fuels.
q Living near a hazardous waste site where jet fuels JP-5

and JP-8 are disposed of.
How can jet fuels JP-5 and JP-8 affect my

health?
Little is known about the effects of jet fuels JP-5 and JP-8
on peoples health. Breathing large amounts of JP-5 and JP-8

JET FUELS JP-5 AND JP-8

CAS # 8008-20-6
Page 2

for a short period may result in headaches, difficulty in concentrating, coordination problems, and fatigue. Breathing
lower levels of JP-5 and JP-8 for a longer period could result in
lack of initiative, sleep disturbances, and dizziness.
Much information is available on accidental poisonings
in children from drinking kerosene. Effects seen include vomiting, diarrhea, stomach cramps, coughing, drowsiness, and
loss of consciousness. Drinking very large amounts can result
in death. Skin exposure to kerosene results in skin irritation,
consisting of itchy, red, peeling, and sore skin.
It is not known whether jet fuels JP-5 and JP-8 can affect
reproduction or cause birth defects in people or animals.
How likely are jet fuels JP-5 and JP-8 to cause

cancer?
The International Agency for Research on Cancer has
concluded that jet fuels are not classifiable as to their carcinogenicity to humans.
However, tests can determine if your blood contains some of

the chemicals found in JP-5 and JP-8. However, the concentrations of these chemicals in JP-5 and JP-8 are very low, and if
they were detected in your blood, it would not necessarily
mean that you were exposed to JP-5 or JP-8.

Very few regulations or advisories are specific to jet
fuels JP-5 and JP-8. The following is a recommendation
for petroleum products, which are similar to jet fuels JP-5
and JP-8.
The Occupational Safety and Health Administration and
the Air Force Office of Safety and Health have set an exposure
limit of 400 milligrams of petroleum products per cubic meter
of air (400 mg/m3) for an 8-hour workday, 40-hour workweek.
Glossary
No carcinogenicity studies on jet fuels JP-5 and JP-8 are

available in people. A study on the use of kerosene stoves
found no association between their use and bronchial cancer,
while another study found an increase in oral cancer in men
who used kerosene stoves. Other studies in people are inconclusive. An animal study showed no increase in kidney tumors
when rats breathed air containing high levels of JP-5 or JP-8
for 90 days. Skin tumors were seen in mice when their skin was
exposed to jet fuel JP-5 for 60 weeks.

exposed to jet fuels JP-5 and JP-8?

No test shows if you have been exposed to JP-5 or JP-8.

(ATSDR). 1998. Toxicological profile for jet fuels (JP-5 and
JP-8). Atlanta, GA: U.S. Department of Health and Human
FUEL OILS
CAS # 8008-20-6, 70892-10-3, 68476-30-2,
68476-34-6, 68476-31-3
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about fuel oils. For more information,
SUMMARY: Fuel oils are liquid mixtures produced from petroleum, and their use
mostly involves burning them as fuels. Drinking or breathing fuel oils may cause
nausea or nervous system effects. However, exposure under normal use conditions
is not likely to be harmful. Fuel oils have been found in at least 26 of the 1,430
What are fuel oils?

(Pronounced fyl oilz)
Fuel oils are a variety of yellowish to light brown liquid
mixtures that come from crude petroleum. Some chemicals
found in fuel oils may evaporate easily, while others may
more easily dissolve in water.
Fuel oils are produced by different petroleum refining
processes, depending on their intended uses. Fuel oils may be
used as fuel for engines, lamps, heaters, furnaces, and stoves,
or as solvents.
Some commonly found fuel oils include kerosene, diesel
fuel, jet fuel, range oil, and home heating oil. These fuel oils
differ from one another by their hydrocarbon compositions,
boiling point ranges, chemical additives, and uses.
What happens to fuel oils when they enter the

environment?
q Some chemicals found in fuel oils may stick to particles

in water, which will eventually cause them to settle to the
bottom sediment.
q Some of the chemicals found in fuel oils may be broken
organisms.
q Some of the chemicals found in fuel oils may build up
significantly in plants and animals.
How might I be exposed to fuel oils?

q Using a home kerosene heater or stove, or using fuel oils
at work.
q Breathing air in home or building basements that has been
contaminated with fuel oil vapors entering from the soil.
q Drinking or swimming in water that has been contaminated with fuel oils from a spill or a leaking underground
storage tank.
q Touching soil contaminated with fuel oils.
q Using fuel oils to wash paint or grease from skin or equipment.
q Some chemicals found in fuel oils may evaporate into the

air from open containers or contaminated soil or water.
How can fuel oils affect my health?
q Some chemicals found in fuel oils may dissolve in water

after spills to surface waters or leaks from underground
storage tanks.

that may be caused by fuel oils. People who use kerosene

Page 2
FUEL OILS
CAS # 8008-20-6, 70892-10-3, 68476-30-2, 68476-34-6, 68476-31-3

stoves for cooking do not seem to have any health problems
related to their exposure.
Breathing some fuel oils for short periods may cause nausea, eye irritation, increased blood pressure, headache, lightheadedness, loss of appetite, poor coordination, and difficulty
concentrating. Breathing diesel fuel vapors for long periods
may cause kidney damage and lower your bloods ability to
clot.
Drinking small amounts of kerosene may cause vomiting,
diarrhea, coughing, stomach swelling and cramps, drowsiness,
restlessness, painful breathing, irritability, and unconsciousness. Drinking large amounts of kerosene may cause convulsions, coma, or death. Skin contact with kerosene for short
periods may cause itchy, red, sore, or peeling skin.
How likely are fuel oils to cause cancer?

has determined that some fuel oils (heavy) may possibly cause
cancer in humans, but for other fuel oils (light) there is not
enough information to make a determination. IARC has also
determined that occupational exposures to fuel oils during petroleum refining are probably carcinogenic in humans.
Some studies with mice have suggested that repeated contact with fuel oils may cause liver or skin cancer. However,
other mouse studies have found this not to be the case. No
studies are available in other animals or in people on the carcinogenic effects of fuel oils.

exposed to fuel oils?
There is no medical test that shows if you have been exposed to fuel oils. Tests are available to determine if some of
the chemicals commonly found in fuel oils are in your blood.

However, the presence of these chemicals in blood may not
necessarily mean that you have been exposed to fuel oils.

(OSHA) and the Air Force Office of Safety and Health (AFOSH)
have set a permissible exposure level (PEL) of 400 parts of
petroleum distillates per million parts of air (400 ppm) for an
The Department of Transportation (DOT) lists fuel oils as
hazardous materials and, therefore, regulates their transportation.
Glossary
Carcinogenic: Able to cause cancer.
Hydrocarbon: Any compound made up of hydrogen and carbon.
body of water.
Reference
(ATSDR). 1995. Toxicological profile for fuel oils. Atlanta,
Health Service.
LEAD
CAS # 7439-92-1
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about lead. For more information,
call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series of summaries
about hazardous substances and their health effects. Its important you understand this information because
HIGHLIGHTS: Exposure to lead can happen from breathing workplace air

or dust, eating contaminated foods, or drinking contaminated water. Children
can be exposed from eating lead-based paint chips or playing in contaminated
soil. Lead can damage the nervous system, kidneys, and reproductive system.
Lead has been found in at least 1,026 of 1,467 National Priorities List sites
What is lead?
(Pronounced ld)
Lead is a naturally occurring bluish-gray metal found in
small amounts in the earths crust. Lead can be found in all
parts of our environment. Much of it comes from human activities including burning fossil fuels, mining, and manufacturing.
Lead has many different uses. It is used in the production
of batteries, ammunition, metal products (solder and pipes),
and devices to shield X-rays.
Because of health concerns, lead from gasoline, paints
and ceramic products, caulking, and pipe solder has been dramatically reduced in recent years.
What happens to lead when it enters the

environment?
q Lead itself does not break down, but lead compounds are
changed by sunlight, air, and water.
q When lead is released to the air, it may travel long distances before settling to the ground.
q Once lead falls onto soil, it usually sticks to soil particles.
How might I be exposed to lead?

q Eating food or drinking water that contains lead.
q Spending time in areas where lead-based paints have
been used and are deteriorating.
q Working in a job where lead is used.
q Using health-care products or folk remedies that contain
lead.
q Engaging in certain hobbies in which lead is used (for
example, stained glass).
How can lead affect my health?

Lead can affect almost every organ and system in your
body. The most sensitive is the central nervous system, particularly in children. Lead also damages kidneys and the reproductive system. The effects are the same whether it is
breathed or swallowed.
At high levels, lead may decrease reaction time, cause
weakness in fingers, wrists, or ankles, and possibly affect the
memory. Lead may cause anemia, a disorder of the blood. It
can also damage the male reproductive system. The connection between these effects and exposure to low levels of lead
is uncertain.
q Movement of lead from soil into groundwater will depend

on the type of lead compound and the characteristics of
the soil.
How likely is lead to cause cancer?
q Much of the lead in inner-city soils comes from old

houses painted with lead-based paint.
The Department of Health and Human Services has determined that lead acetate and lead phosphate may reasonably
LEAD
CAS # 7439-92-1
Page 2

be anticipated to be carcinogens based on studies in animals.
There is inadequate evidence to clearly determine leads carcinogenicity in people.
How can lead affect children?

Small children can be exposed by eating lead-based paint
chips, chewing on objects painted with lead-based paint, or
swallowing house dust or soil that contains lead.
Children are more vulnerable to lead poisoning than
adults. A child who swallows large amounts of lead may develop blood anemia, severe stomachache, muscle weakness,
and brain damage. A large amount of lead might get into a
child's body if the child ate small pieces of old paint that contained large amounts of lead. If a child swallows smaller
amounts of lead, much less severe effects on blood and brain
function may occur. Even at much lower levels of exposure,
lead can affect a child's mental and physical growth.
Exposure to lead is more dangerous for young and unborn
children. Unborn children can be exposed to lead through their
mothers. Harmful effects include premature births, smaller babies, decreased mental ability in the infant, learning difficulties, and reduced growth in young children. These effects are
more common if the mother or baby was exposed to high levels
of lead.

lead?
Avoid exposure to sources of lead. Do not allow children
to chew or mouth painted surfaces that may have been painted
with lead-based paint (homes built before 1978). Run your
water for 15 to 30 seconds before drinking or cooking with it.
This will get rid of lead that may have leached out of pipes.
Some types of paints and pigments that are used as make-up or
hair coloring contain lead. Keep these kinds of products away
from children. Wash children's hands and faces often to remove
lead dusts and soil, and regularly clean the house of dust and
tracked in soil.

exposed to lead?
A blood test is available to measure the amount of lead in
your blood and to estimate the amount of your exposure to
lead. Blood tests are commonly used to screen children for
lead poisoning. Lead in teeth and bones can be measured with
X-rays, but this test is not as readily available. Medical treatment may be necessary in children if the lead concentration in
blood is higher than 45 micrograms per deciliter (45 g/dL).

The Centers for Disease Control and Prevention (CDC)
recommends that children ages 1 and 2 be screened for lead
poisoning. Children who are 3 to 6 years old should be tested
for lead if they have never been tested for lead before and if
they receive services from public assistance programs; if they
live in or regularly visit a building built before 1950; if they
live in or visit a home built before 1978 that is being remodeled; or if they have a brother, sister, or playmate who has had
lead poisoning. CDC considers children to have an elevated
level of lead if the amount in the blood is 10 g/dL.
The EPA requires lead in air not to exceed 1.5 micrograms
per cubic meter (1.5 g/m3) averaged over 3 months. EPA limits lead in drinking water to 15 g per liter.
(OSHA) develops regulations for workers exposed to lead. The
Clean Air Act Amendments of 1990 banned the sale of leaded
gasoline. The Federal Hazardous Substance Act bans children's
products that contain hazardous amounts of lead.
1999. Toxicological profile for lead. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
MALATHION
CAS #000121-75-5
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about malathion. For more
HIGHLIGHTS: The general population is probably not exposed to malathion

regularly. However, malathion is used to treat head lice on humans, to kill
fleas on pets, and to kill insects in gardens. Exposure to malathion may also
occur at farms where it has been sprayed on crops. Exposure to high
amounts of malathion can cause difficulty breathing, chest tightness,
vomiting, cramps, diarrhea, blurred vision, sweating, headaches, dizziness,
loss of consciousness, and possibly death. This chemical has been found in at
What is malathion?
How might I be exposed to malathion?
Malathion is an insecticide that does not occur naturally.

Pure malathion is a colorless liquid, and technical-grade
malathion, which contains >90% malathion and impurities in
a solvent, is a brownish-yellow liquid that smells like garlic.
Malathion is used to kill insects on farm crops and in
gardens, to treat lice on humans, and to treat fleas on pets.
Malathion is also used to kill mosquitos and Mediterranean
fruit flies (medflies) in large outdoor areas.
Most people are not exposed to malathion in the air they

breathe or on things they touch, unless they live next to
areas being sprayed.
factories that make malathion are most likely to be exposed.
People who use it around their homes and people living in
areas where malathion is sprayed to control medflies or
mosquitos may also be exposed.
People who live near landfills where it has been dumped
may be exposed.
Individuals may also be exposed by going into fields too
soon after spraying.
What happens to malathion when it enters the

environment?
Malathion enters the environment primarily through
spraying on farm crops.
Malathion does not stick to soil and is broken down
rapidly by bacteria in the soil, so it does not usually move
from the soil to groundwater.
In water, malathion is broken down by the action of the
water and bacteria in the water.
In air, malathion is broken down by sunlight.
Malathion is not expected to accumulate in the food chain
due to rapid metabolism in aquatic organisms.
How can malathion affect my health?

Malathion interferes with the normal way that the nerves and
brain function. Exposure to very high levels of malathion for
a short period in air, water, or food may cause difficulty
breathing, chest tightness, vomiting, cramps, diarrhea,
blurred vision, sweating, headaches, dizziness, loss of
consciousness, and death. If persons who are exposed to
high amounts of malathion are rapidly given appropriate
treatment, there may be no long-term harmful effects. If
people are exposed to levels of malathion below those that
affect nerve function, few or no health problems seem to
occur.

MALATHION
Page 2
CAS #000121-75-5
How likely is malathion to cause cancer?

There is no conclusive proof that malathion causes cancer in
humans, although some studies have found increased
incidence of some cancers in people who are regularly
exposed to pesticides, such as farmers and pesticide
applicators. Animal studies also fail to provide conclusive
evidence of carcinogenicity. The International Agency for
Research on Cancer (IARC) has determined that malathion is
unclassifiable as to carcinogenicity to humans.
How can malathion affect children?

high levels of malathion will be similar to the effects seen in
adults. It is not known whether children are more sensitive
to the effects of malathion than adults. There is some
indication that young rats may be more sensitive than adults
to nervous system effects.
Birth defects have not been observed in humans exposed to
malathion, but developmental effects have been seen in the
offspring of animals that ingested enough malathion while
pregnant to cause health effects in the mother. Animal
studies have shown that malathion can be transferred from a
pregnant mother to the developing fetus and from a nursing
mother to the newborns through the mothers milk.

malathion?
amounts of malathion. However, exposure may be reduced by
staying away from fields that have been recently sprayed, by
wearing protective clothing when applying malathion around
the home or in gardens, and by washing fruits and
vegetables grown in gardens treated with malathion before
eating.

exposed to malathion?
Malathion can be detected in your blood and its breakdown
products can be detected in your urine, but only within a
few days after your last exposure. If exposure is known or
suspected, a test can be done that measures cholinesterase
levels in your blood. Low levels of cholinesterase may be a
result of malathion exposure or may be caused by factors
other than malathion. These tests are not usually available
at your doctors office, but your doctor can send the samples
to a laboratory that can perform the tests. None of these
tests, however, can predict whether you will experience any
health effects.

The EPA has established a level of 0.1 milligrams of
malathion per liter of drinking water (0.1 mg/L) for lifetime
exposure of adults as a level that is not expected to cause
effects that are harmful to health.
The EPA allows a maximum of 0.1-135 parts (0.1-135 ppm)
malathion per million parts of certain types of food.
has set a limit of 15 milligrams of malathion per cubic meter
of workplace air (15 mg/m3) for 8-hour shifts and 40-hour
work weeks.
Sources of Information
(ATSDR). 2001. Toxicological Profile for Malathion (Draft
for Public Comment) Atlanta, GA: U.S. Department of Health

hazardous waste sites where malathion may have been
discarded.
MANGANESE
CAS # 127-18-4
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about manganese. For more
HIGHLIGHTS: Manganese is a trace element and eating a small amount from food
or water is needed to stay healthy. Exposure to excess levels of manganese may occur
from breathing air, particularly where manganese is used in manufacturing, and from
drinking water and eating food. At high levels, it can cause damage to the brain, liver,
kidneys, and the developing fetus. This chemical has been found in at least 603 of 1,467
What is manganese?
(Pronounced m|ng! gc-nz!)
Manganese is a naturally occurring metal that is found in many
types of rocks. Pure manganese is silver-colored, but does not
occur naturally. It combines with other substances such as
oxygen, sulfur, or chlorine. Manganese can also be combined with
carbon to make organic manganese compounds. Common organic
manganese compounds include pesticides, such as
maneb or mancozeb, and methylcyclopentadienyl manganese
tricarbonyl (MMT), a fuel additive in some gasolines.
Manganese is an essential trace element and is necessary for good
health. Manganese can be found in several food items, including
grains and cereals, and is found in high amounts in other foods,
such as tea.
What happens to manganese when it enters the

environment?
Manganese can enter the air from iron, steel, and power plants,
coke ovens, and from dust from mining operations.
It can enter the water and soil from natural deposits, disposal
of wastes or deposits from airborne sources.
Manganese exists naturally in rivers, lakes, and under-ground
water.
Plants in the water can take up some of the manganese from
water and concentrate it.
How might I be exposed to manganese?

Everyone is exposed to small amounts of manganese in air,
water, and food.
Individuals who work in occupations that mine or use
manganese are likely to be exposed to excess levels in their work
environment.
People who improperly use pesticides such as maneb and
mancozeb, may be exposed to excess levels.
How can manganese affect my health?

Some individuals exposed to very high levels of manganese for long
periods of time in their work developed mental and emotional
disturbances and slow and clumsy body movements.
This combination of symptoms is a disease called manganism.
Workers usually do not develop symptoms of manganism unless
they have been exposed to manganese for many months or years.
Manganism occurs because too much manganese injures a part of
the brain that helps control body movements.
Exposure to high levels of airborne manganese, such as in a
manganese foundry or battery plant, can affect motor skills such
as holding ones hand steady, performing fast hand movements,
and maintaining balance. Exposure to high levels of the metal may
also cause respiratory problems and sexual dysfunction.

MANGANESE
Page 2
CAS # 127-18-4
How likely is manganese to cause cancer?
near hazardous waste sites or in areas that may have increased

manganese levels in the soil.
There are no human cancer data available for manganese. Exposure

to high levels of manganese in food resulted in a slightly increased
incidence of pancreatic tumors in male rats and thyroid tumors in
male and female mice.
Manganese is also present in pesticides that may be used around

the home. These pesticides should be used in a manner consistent
with manufacturers instructions.
The EPA has determined that manganese is not classifiable as to

human carcinogenicity.

exposed to manganese?
How can manganese affect children?
Tests are available that show levels of manganese in different body

fluids. Measurements of manganese in blood, urine, feces, and
scalp hair can be used to determine exposure to excess
levels of manganese by testing whether levels of the metal in your
body tissues are greater than normal. However, these tests cannot
predict how the levels in your tissues will affect your health. Your
doctor can take samples and send them to a testing laboratory.
Daily intake of small amounts of manganese is needed for growth

and good health in children. Manganese is constantly present in the
mother and is available to the developing fetus during pregnancy.
Manganese is also transferred from a nursing mother to her infant
in breast milk at levels that are appropriate for proper
development.
Children, as well as adults, who lose the ability to remove excess
manganese from their bodies develop nervous system problems.
Because at certain ages children take in more than adults, there is
concern that children may be more susceptible to the toxic effects
of excess manganese.
Animal studies indicate that exposure to high levels of manganese
can cause birth defects in the unborn. There is no information on
whether mothers exposed to excess levels of manganese
can transfer the excess to their developing fetus during pregnancy
or to their nursing infant in breast milk.

manganese?

The EPA has set a non-enforceable guideline for the level of
manganese in drinking water at 0.05 milligrams per liter
(0.05 mg/L).
The Occupational Safety and Health Administration (OSHA) has
set a limit of 5 milligrams manganese per cubic meter (5 mg/m 3 )
of workplace air for the average amount of manganese during an 8hour workday, 40-hour workweek.
The National Research Council has recommended safe and adequate
daily intake levels for manganese that range from 0.3 to 1 mg/day
for children up to 1 year, 1 to 2 mg/day for children up to age 10,
and 2 to 5 mg/day for children 10 and older.
In most situations, there is no need to reduce ones exposure to

manganese because it is an essential nutrient for good health.
Excess levels of manganese may be present in soils, especially at or

near hazardous waste sites. Therefore, it is important to discourage
hand-to-mouth activity in young children, especially

2000. Toxicological profile for manganese. Atlanta, GA: U.S.
MERCURY
CAS # 7439-97-6
April 1999
This fact sheet answers the most frequently asked health questions (FAQs) about mercury. For more information,
HIGHLIGHTS: Exposure to mercury occurs from breathing contaminated air,

ingesting contaminated water and food, and having dental and medical treatments.
Mercury, at high levels, may damage the brain, kidneys, and developing fetus. This
What is mercury?
(Pronounced mrky-r)
Mercury is a naturally occurring metal which has several
forms. The metallic mercury is a shiny, silver-white, odorless
liquid. If heated, it is a colorless, odorless gas.
Mercury combines with other elements, such as chlorine,
sulfur, or oxygen, to form inorganic mercury compounds or
salts, which are usually white powders or crystals. Mercury
also combines with carbon to make organic mercury compounds. The most common one, methylmercury, is produced
mainly by microscopic organisms in the water and soil. More
mercury in the environment can increase the amounts of methylmercury that these small organisms make.
Metallic mercury is used to produce chlorine gas and
caustic soda, and is also used in thermometers, dental fillings,
and batteries. Mercury salts are sometimes used in skin lightening creams and as antiseptic creams and ointments.
What happens to mercury when it enters the

environment?
q Inorganic mercury (metallic mercury and inorganic mercury compounds) enters the air from mining ore deposits,
burning coal and waste, and from manufacturing plants.
q It enters the water or soil from natural deposits, disposal of
wastes, and volcanic activity.
q Methylmercury may be formed in water and soil by small

organisms called bacteria.
q Methylmercury builds up in the tissues of fish. Larger and
older fish tend to have the highest levels of mercury.
How might I be exposed to mercury?

q Eating fish or shellfish contaminated with methylmercury.
q Breathing vapors in air from spills, incinerators, and industries that burn mercury-containing fuels.
q Release of mercury from dental work and medical treatments.
q Breathing contaminated workplace air or skin contact during use in the workplace (dental, health services, chemical,
and other industries that use mercury).
q Practicing rituals that include mercury.
How can mercury affect my health?

The nervous system is very sensitive to all forms of mercury. Methylmercury and metallic mercury vapors are more
harmful than other forms, because more mercury in these forms
reaches the brain. Exposure to high levels of metallic, inorganic, or organic mercury can permanently damage the brain,
kidneys, and developing fetus. Effects on brain functioning
may result in irritability, shyness, tremors, changes in vision or
hearing, and memory problems.
Short-term exposure to high levels of metallic mercury
vapors may cause effects including lung damage, nausea,

MERCURY
CAS # 7439-97-6
Page 2

vomiting, diarrhea, increases in blood pressure or heart rate,
skin rashes, and eye irritation.
How likely is mercury to cause cancer?

There are inadequate human cancer data available for all
forms of mercury. Mercuric chloride has caused increases in
several types of tumors in rats and mice, and methylmercury
has caused kidney tumors in male mice. The EPA has determined that mercuric chloride and methylmercury are possible
human carcinogens.
How can mercury affect children?

Very young children are more sensitive to mercury than
adults. Mercury in the mothers body passes to the fetus and
may accumulate there. It can also can pass to a nursing infant
through breast milk. However, the benefits of breast feeding
may be greater than the possible adverse effects of mercury in
breast milk.
Mercurys harmful effects that may be passed from the
mother to the fetus include brain damage, mental retardation,
incoordination, blindness, seizures, and inability to speak.
Children poisoned by mercury may develop problems of their
nervous and digestive systems, and kidney damage.

mercury?
Carefully handle and dispose of products that contain
mercury, such as thermometers or fluorescent light bulbs. Do
not vacuum up spilled mercury, because it will vaporize and
increase exposure. If a large amount of mercury has been
spilled, contact your health department. Teach children not to
play with shiny, silver liquids.
Properly dispose of older medicines that contain mercury.
Keep all mercury-containing medicines away from children.
Pregnant women and children should keep away from
rooms where liquid mercury has been used.

Learn about wildlife and fish advisories in your area
from your public health or natural resources department.

exposed to mercury?
Tests are available to measure mercury levels in the body.
Blood or urine samples are used to test for exposure to metallic
mercury and to inorganic forms of mercury. Mercury in whole
blood or in scalp hair is measured to determine exposure to
methylmercury. Your doctor can take samples and send them to
a testing laboratory.

The EPA has set a limit of 2 parts of mercury per billion
parts of drinking water (2 ppb).
The Food and Drug Administration (FDA) has set a maximum permissible level of 1 part of methylmercury in a million
parts of seafood (1 ppm).
(OSHA) has set limits of 0.1 milligram of organic mercury per
cubic meter of workplace air (0.1 mg/m3) and 0.05 mg/m3 of
metallic mercury vapor for 8-hour shifts and 40-hour work
weeks.
(ATSDR). 1999. Toxicological profile for mercury. Atlanta,
Health Service.
METHOXYCHLOR
CAS # 72-43-5
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about methoxychlor. For
HIGHLIGHTS: Exposure to methoxychlor occurs mainly when workers,

farmers, and gardeners use this pesticide. Most people are not exposed to this
chemical on a regular basis. In animals, high levels of methoxychlor caused
tremors and convulsions, and affected fertility. Little is known about the effects
of methoxychlor on human health. Methoxychlor has been found in at least 58
What is methoxychlor?
How might I be exposed to methoxychlor?
Methoxychlor is a manufactured chemical that does not

occur naturally in the environment. Pure methoxychlor is a
pale-yellow powder with a slight fruity or musty odor.
Most people are not exposed to methoxychlor on a regular

basis.
Low levels are sometimes found in food, but it is not
usually detected in air or water.
People who work in factories that make methoxychlor or
products containing it may breathe it in the air or get it on
their skin.
People who work or live near farms that use methoxychlor
on crops or livestock may be exposed to above average
levels in air, soil, or water.
People who use pesticides containing methoxychlor for
home gardening or spraying pets may be exposed to aboveaverage levels in air and on their skin.
People living near a hazardous waste site that contains
methoxychlor may breathe it in air, swallow contaminated soil
or water, or get it on their skin.
Methoxychlor is used as an insecticide against flies,

mosquitoes, cockroaches, chiggers, and a wide variety of
other insects. It is used on agricultural crops and livestock,
and in barns, grain storage bins, home garden, and on pets.
Methoxychlor is also known as DMDT, Marlate, or
Metox.
What happens to methoxychlor when it enters the

environment?
Most methoxychlor enters the environment when it is
applied to agricultural crops, forests, and farm animals.
Methoxychlor released to the air eventually settles to the
ground. In the soil it sticks strongly to particles.
It does not dissolve easily in water. Once in water, it
binds to sediments and settles to the bottom.
Methoxychlor breaks down slowly in air, water and soil by
sunlight and microscopic organisms. It may take several
months.
Some breakdown products of methoxychlor can be as
harmful as methoxychlor.
Methoxychlor does not usually build up in the food
chain.
How can methoxychlor affect my health?

There is very little information on how methoxychlor can
affect peoples health. Animals exposed to very high
amounts of methoxychlor suffered tremors and convulsions
and seizures. Because methoxychlor is broken down quickly
in the body, you are not likely to experience these effects
unless you are exposed to very high levels.
Animal studies show that exposure to methoxychlor in food
or water harms the ovaries, uterus, and mating cycle in
females, and the testes and prostate in males. Fertility is

METHOXYCHLOR
Page 2
CAS # 72-43-5
decreased in both male and female animals. These effects
can occur both in adult and in developing animals and could
also occur following inhalation or skin contact. These
effects are caused by a breakdown product of methoxychlor
which acts as a natural sex hormone. These effects have not
been reported in humans, but they could happen.
Never store pesticides in containers that might appear

attractive to children, such as soda bottles.
Methoxychlor may occur at very low levels in some food.
Wash fruit and vegetables before consuming them.
Encourage children not to play at or near hazardous waste
sites.
How likely is methoxychlor to cause cancer?

exposed to methoxychlor?
Most of the information available from human and animal

studies suggests that methoxychlor does not cause cancer.
and the EPA have determined that methoxychlor is not
How can methoxychlor affect children?

Little information is available on the health effects of children
exposed to methoxychlor. Children exposed to large amounts
of methoxychlor may suffer tremors and convulsions, as
would probably occur in adults. However, we do not know
methoxychlor. The process of sexual maturation may be
altered in children born to women exposed to methoxychlor
during pregnancy or in children exposed shortly after birth.
This possibility is based on what we know from studies in
animals. There are no studies that examined whether
methoxychlor causes birth defects in humans.

methoxychlor?
Purchase an over-the-counter pesticide product containing
methoxychlor that is unopened, labeled, and contains an EPA
registration number.
Follow the instructions and any warning statements on the
label if you use over-the-counter pesticide products that
contain methoxychlor.
Prevent children from entering rooms or playing on lawns
too soon after a pesticide has been applied.
Prevent children from coming in contact with family pets
or farm animals that have been treated with the pesticide.
There are laboratory tests that can detect methoxychlor in

fat, blood, semen, and breast milk. These tests can only
detect exposure within 24 hours because methoxychlor
leaves your body quickly. These tests do not tell how much
methoxychlor you were exposed to or whether harmful health
effects will occur. The tests are not routinely available at the
doctors office because they require special equipment.

The EPA limits the amount of methoxychlor that may be
present in drinking water to 0.04 parts of methoxychlor per
million parts of water (0.04 ppm). The EPA also limits the
amount of methoxychlor present in agricultural products to
1-100 ppm.
sets a Permissible Exposure Limit (PEL) of 15 milligrams of
methoxychlor per cubic meter of air (15 mg/m3) in the
workplace during an 8-hour shift.
The Food and Drug Administration (FDA) limits the amount
of methoxychlor in bottled water to 0.04 ppm.
(ATSDR). 2002. Toxicological Profile for Methoxychlor
METHYL ISOCYANATE
CAS #624-83-9
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about methyl isocyanate. For
HIGHLIGHTS: People working in facilities that produce or use methyl

isocyanate have the highest risk of being exposed to this chemical. Exposure to
low levels of methyl isocyanate can cause eye and throat irritation. People
exposed to high levels of methyl isocyanate in the air have experienced severe
lung and eye damage. Methyl isocyanate has been found in at least 1 of the
Agency (EPA).
What is methyl isocyanate?
Methyl isocyanate does not accumulate in the food chain.
Methyl isocyanate is a colorless highly flammable liquid that

evaporates quickly when exposed to the air. It has a sharp,
strong odor.
How might I be exposed to methyl isocyanate?
Methyl isocyanate is used in the production of pesticides,

polyurethane foam, and plastics.
What happens to methyl isocyanate when it

When released to air, it will exist solely as a gas. Methyl
isocyanate gas is degraded rapidly in the air by reacting
with substances commonly found in the air. Methyl
isocyanate will also be broken down by moisture from
clouds and rainfall. It will only persist in the atmosphere a
few hours to a few days before being degraded.
Methyl isocyanate is rapidly (minutes to a few hours)
degraded in water into other compounds.
Most of the methyl isocyanate released to soil will be
broken down into other compounds upon contact with
moisture. Small amounts of methyl isocyanate may
evaporate into air.
Methyl isocyanate has been found in the smoke from

tobacco, so people who smoke or breathe second-hand
smoke may be exposed to this compound.
You can be exposed to methyl isocyanate by breathing or
touching it at workplaces where this compound is produced
or used.
People living near facilities which manufacture, store or
use the chemical may breathe in low levels of it.
How can methyl isocyanate affect my health?

Methyl isocyanate can be harmful if you breathe it. The
effects depend on how much you are exposed to and for
how long. Exposure to low levels might cause eye and
throat irritation that could cause you to cough or wheeze.
Higher concentrations of methyl isocyanate gas could cause
your lungs to swell, making it difficult to breathe. This
could happen quickly or might not be noticed for a day or
two. Exposure to high concentrations could result in severe
damage to your lungs that might be fatal. If you were to

METHYL ISOCYANATE
Page 2
CAS #624-83-9

survive severe damage to your lungs, they would probably
heal. But, some damage might not be completely repaired.
Long-term exposure to methyl isocyanate could result in
long-term lung damage.
If you were to get methyl isocyanate gas or liquid on your
skin or in your eyes, you could develop chemical burns. Eye
damage could be severe; in some cases, it could be
permanent.
You are not likely to come into skin contact with liquid
methyl isocyanate. You are also not likely to swallow methyl
isocyanate liquid, but if you did, your mouth, throat,
esophagus, and stomach could become damaged.
An increased rate of spontaneous abortion was seen in
women who were pregnant when they were exposed to
methyl isocyanate gas following the explosion of a tank
containing liquid methyl isocyanate. But it is not known
whether these effects were specifically linked to methyl
isocyanate exposure.
How likely is methyl isocyanate to cause cancer?

U.S. EPA have not classified methyl isocyanate as to its
carcinogenicity. There is no additional information to
determine whether exposure to methyl isocyanate might
cause cancer.
How can methyl isocyanate affect children?

exposed to methyl isocyanate. It is likely that the health
effects seen in children exposed to methyl isocyanate will be
similar to the effects seen in adults. We do not know

methyl isocyanate.
An increased rate of neonatal death was seen in babies
whose mothers had been exposed during pregnancy to
methyl isocyanate gas when a tank containing the chemical
exploded. But it is not known whether these effects were
specifically linked to methyl isocyanate exposure. Animal
studies indicate that fetal exposure to methyl isocyanate may
result in damage to the fetus.

methyl isocyanate?
methyl isocyanate.

exposed to methyl isocyanate?
Animal studies indicate that methyl isocyanate could be
detected in your blood or urine. However, specific tests for
the presence of methyl isocyanate in blood or urine are not
generally useful. If you suspect that you may have been
exposed to methyl isocyanate, chest x-rays, blood analyses,
and breathing tests might show whether the lungs have been
injured.

has set an exposure limit of 0.02 parts of methyl isocyanate
per million parts of workplace air (0.02 ppm) for an 8-hour
workday, 40-hour work week.
METHYL MERCAPTAN
CAS # 74-93-1
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about methyl mercaptan. For more
HIGHLIGHTS: Methyl mercaptan is a natural substance released from

decaying matter. Little is known about the health effects of this compound.
This chemical has been found in at least 2 of the 1,300 National Priorities List
What is methyl mercaptan?

(Pronounced mthl mr-kptn)
Methyl mercaptan is a colorless gas with a smell like
rotten cabbage. It is a natural substance found in the blood,
brain, and other tissues of people and animals. It is released
from animal feces. It occurs naturally in certain foods, such as
some nuts and cheese.
Methyl mercaptan is released from decaying organic
matter in marshes and is present in the natural gas of certain
regions in the United States, in coal tar, and in some crude
oils. It is manufactured for use in the plastics industry, in
pesticides, and as a jet fuel additive. It is also released as a
decay product of wood in pulp mills.
What happens to methyl mercaptan when it

q Methyl mercaptan is released to the air from both natural
and industrial sources.
q Most of the methyl mercaptan released to the environment goes into the air.
q Sunlight can break it down in the air to other substances.
q Methyl mercaptan may be formed in water from chemical

reactions.
q It occurs naturally in soil.
How might I be exposed to methyl mercaptan?

q Methyl mercaptan is always present in your body.
q You may breathe it in the air if you live near a natural
source of the gas, such as a marsh.
q You may eat it in certain foods, such as nuts and cheese.
q You may be exposed if you work at a wood-pulp mill or
sewage treatment plant.
q You could also be exposed if you work in a factory that
uses it to make other products such as jet fuel, pesticides,
or poultry feed.
How can methyl mercaptan affect my health?

Very little is known about the health effects of methyl
mercaptan. The only information available is about a worker
exposed to very high levels of this compound when he
opened and emptied tanks of this compound. He developed
anemia, went into a coma, and died about a month later.

METHYL MERCAPTAN
CAS # 74-93-1
Page 2

We do not know whether long-term exposure to low levels
of methyl mercaptan can result in harmful health effects.
How likely is methyl mercaptan to cause cancer?

There is no information available about whether methyl
mercaptan causes cancer in people or animals. The Department
of Health and Human Services (DHHS), the International
Agency for Research on Cancer (IARC), and the EPA have not
classified methyl mercaptan for carcinogenicity.

exposed to methyl mercaptan?
Methyl mercaptan is always present in your body. There is
a test that can be used to find out if it is present in your blood
at levels that are higher than normal. This test requires special
equipment and is not usually available in a doctors office. It
can be done in a special laboratory. However, this test cannot
be used to find out how much methyl mercaptan you were
exposed to or to predict whether harmful health effects will
occur.

releases of 100 pounds or more of methyl mercaptan must be
of methyl mercaptan per cubic meter of air (20 mg/m3) for an
8-hour workday in a 40-hour workweek.
The American Conference of Governmental and Industrial

Hygienists (ACGIH) and the National Institute for Occupational Safety and Health (NIOSH) recommend an occupational
exposure limit of 1 mg/m3 for methyl mercaptan.
July 1999.
Glossary
oxygen.
(ATSDR). 1992. Toxicological rofile for methyl mercaptan.
METHYL PARATHION
CAS #298-00-0
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about methyl parathion.
HIGHLIGHTS: The general population is probably not exposed to methyl

parathion. However, exposure to methyl parathion may occur at farms where it
has been used as a pesticide. Under certain exposure conditions, methyl
parathion can affect the central nervous system resulting in dizziness, headache,
difficulty breathing, vomiting, diarrhea, tremors, blurred vision, sweating, and
possibly death. This chemical has been found in at least 16 of the 1,585
(EPA).
What is methyl parathion?
(Pronounced methul parah-thieon)
Methyl parathion is an insecticide that does not occur
naturally in the environment. Pure methyl parathion exists
as white crystals. Impure methyl parathion is a brownish
liquid that smells like rotten eggs.
Methyl parathion is used to kill insects on farm crops,
especially cotton. The EPA now restricts how methyl
parathion can be used and applied; only trained people are
allowed to spray it. Methyl parathion can no longer be used
on food crops commonly consumed by children.
What happens to methyl parathion when it enters

the environment?
Methyl parathion enters the environment primarily
through spraying on farm crops.
Methyl parathion breaks down quickly to other chemical
compounds by interacting with water, bacteria in the water,
and sunlight.
Methyl parathion sticks to soil and generally does not
move from the soil to groundwater.
Methyl parathion does not appear to accumulate in fish or
plants.
How might I be exposed to methyl parathion?

Most people are not exposed to methyl parathion in the
air they breathe or on things they touch, unless they live
next to areas being sprayed.
factories that make methyl parathion are most likely to be
exposed.
People who live near farms where methyl parathion is
used or near landfills where methyl parathion has been
dumped may be exposed.
Individuals may also be exposed by going into fields too
soon after spraying.
How can methyl parathion affect my health?

Methyl parathion interferes with the normal way that the
nerves and brain function. Exposure to very high levels of
methyl parathion for a short period in air or water may cause
death, loss of consciousness, dizziness, confusion,
headaches, difficult breathing, chest tightness, wheezing,
vomiting, diarrhea, cramps, tremors, blurred vision, and
sweating. Changes in mental state may last several months
after exposure to high levels of methyl parathion has ended.
If people are exposed to levels of methyl parathion below
those that affect nerve function, few or no health problems

METHYL PARATHION
Page 2
CAS #298-00-0
seem to occur. A reduced ability to fight infections has also

been seen in some animal studies; we do not know if this
would also occur in humans.

exposed to methyl parathion?
How likely is methyl parathion to cause cancer?
Methyl parathion can be detected in your blood and its

breakdown product can be detected in your urine, but only
within about 24 hours after your last exposure. If exposure
is known or suspected, a test can be done that measures
cholinesterase levels in your blood. However, low levels of
cholinesterase may be a result of methyl parathion exposure
or it could be caused by factors other than methyl parathion.
These tests are not usually available at your doctors office,
but your doctor can send the samples to a laboratory that
can perform the tests. None of these tests, however, can
predict whether you will experience any health effects.
There is no evidence that methyl parathion causes cancer in

people who are regularly exposed, such as farmers and
pesticide applicators, or in animals. The EPA and
determined that methyl parathion is not classifiable as to
How can methyl parathion affect children?

high levels of methyl parathion will be similar to the effects
seen in adults. It is not known whether children are more
sensitive to the effects of methyl parathion than adults.
There is some indication that young rats may be more
sensitive than adults to nervous system effects.


methyl parathion or in the offspring of animals that ingested
methyl parathion while pregnant.
The NIOSH recommends that a person in the workplace not

be exposed to more than 0.2 milligram of methyl parathion per
cubic meter of air (0.2 mg/m3) for a 10-hour workday, 40-hour
workweek.

methyl parathion?
The EPA allows a maximum of 0.1-1 part methyl parathion per

million parts (0.1-1 ppm) of certain types of food.

amounts of methyl parathion. Some people living in the
areas where methyl parathion is used on crops may be
exposed to greater amounts of methyl parathion. Therefore,
staying away from fields that have been recently sprayed
may reduce exposure.
The EPA allows 0.002 milligrams of methyl parathion per liter

of drinking water (0.002 mg/L) for lifetime exposure of adults.
(ATSDR). 2001. Toxicological Profile for Methyl Parathion

hazardous waste sites where methyl parathion may have
been discarded.
METHYL TERT-BUTYL ETHER

(MTBE) CAS # 1634-04-4
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about methyl tert-butyl ether
(MTBE). For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
are present.
HIGHLIGHTS: Methyl tert-butyl ether (MTBE) is a flammable liquid which

is used as an additive in unleaded gasoline. Drinking or breathing MTBE may
cause nausea, nose and throat irritation, and nervous system effects. MTBE has
What is methyl tert-butyl ether?
(Pronounced mthl trsh-r bytl thr)
Methyl tert-butyl ether (MTBE) is a flammable liquid
with a distinctive, disagreeable odor. It is made from blending chemicals such as isobutylene and methanol, and has
been used since the 1980s as an additive for unleaded
gasolines to achieve more efficient burning.
MTBE is also used to dissolve gallstones. Patients
treated in this way have MTBE delivered directly to their
gall bladders through special tubes that are surgically inserted.
What happens to MTBE when it enters the

environment?
q MTBE may stick to particles in water, which will cause it

to eventually settle to the bottom sediment.
q MTBE may be broken down quickly in the air by sunlight.
q MTBE does not build up significantly in plants and animals.
How might I be exposed to MTBE?

q Touching the skin or breathing contaminated air while
pumping gasoline.
q Breathing exhaust fumes while driving a car.
q Breathing air near highways or in cities.
q Drinking, swimming, or showering in water that has been
contaminated with MTBE.
q Receiving MTBE treatment for gallstones.
q MTBE quickly evaporates from open containers and

surface water, so it is commonly found as a vapor in the
air.
How can MTBE affect my health?
q Small amounts of MTBE may dissolve in water and get

into underground water.
Breathing small amounts of MTBE for short periods may

cause nose and throat irritation. Some people exposed to
MTBE while pumping gasoline, driving their cars, or working
q It remains in underground water for a long time.

Page 2
METHYL TERT-BUTYL ETHER (MTBE)

CAS # 1634-04-4
in gas stations have reported having headaches, nausea, dizziness, and mental confusion. However, the actual levels of
exposure in these cases are unknown. In addition, these
symptoms may have been caused by exposure to other chemicals.
There are no data on the effects in people of drinking
MTBE. Studies with rats and mice suggest that drinking
MTBE may cause gastrointestinal irritation, liver and kidney
damage, and nervous system effects.

The EPA has issued guidelines recommending that, to
protect children, drinking water levels of MTBE not exceed
4 milligrams per liter of water (4 mg/L) for an exposure of 110 days, and 3 mg/L for longer-term exposures.
Hygienists (ACGIH) has recommended an exposure limit of
40 parts of MTBE per million parts of air (40 ppm) for an 8hour workday, 40-hour workweek.
How likely is MTBE to cause cancer?
Glossary
There is no evidence that MTBE causes cancer in

humans. One study with rats found that breathing high levels
of MTBE for long periods may cause kidney cancer. Another
study with mice found that breathing high levels of MTBE for
long periods may cause liver cancer.

the International Agency for Research on Cancer (IARC),
and the EPA have not classified MTBE as to its carcinogenicity.

been exposed to MTBE?
MTBE and its breakdown product, butyl alcohol, can
be detected in your breath, blood, or urine for up to 1 or 2
days after exposure. These tests arent available at most doctors offices, but can be done at special laboratories that have
the right equipment. There is no other test specific to determining MTBE exposure.

body of water.
This ToxFAQs information is taken from the 1996 Toxicological Profile for Methyl tert-Butyl Ether produced by the
4,4'-METHYLENEBIS(2-CHLOROANILINE) (MBOCA)
CAS # 101-14-4
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 4,4'-methylenebis(2chloroaniline (MBOCA). For more information, call the ATSDR Information Center at 1-888-4228737. This fact sheet is one in a series of summaries about hazardous substances and their health
effects. This information is important because this substance may harm you. The effects of exposure
to any hazardous substance depend on the dose, the duration, how you are exposed, personal traits
and habits, and whether other chemicals are present.
SUMMARY: Exposure to 4,4'-methylenebis(2-chloroaniline) (MBOCA) happens

mostly in the workplace by touching it or by breathing contaminated air. MBOCA
is suspected of causing bladder cancer in people and animals. This chemical has
been found in at least 4 of 1,416 National Priorities List sites identified by the
What is 4,4'-methylenebis(2-chloroaniline)
(MBOCA)?
(Pronounced 4,4-mth ln bs 2-klr nln)
MBOCA is a synthetic chemical used primarily to make
polyurethane products. Pure MBOCA is a colorless, crystalline solid, but the commonly used form is usually yellow, tan,
or brown pellets. It has no smell or taste.
Examples of these products include gears, gaskets, sport
boots, roller skate wheels, shoe soles, rolls and belt drives in
cameras, computers and copy machines, wheels and pulleys
for escalators and elevators, components in home appliances,
and various military applications. It is also used as a coating
in chemical reactions to set glues, plastics, and adhesives.
Because plastics have many uses, MBOCA is widely used.
Other names for MBOCA include 4,4'-methylenebis(2-chloroaniline), methylene-bis-ortho-chloro-aniline, bisamine, DACPM, MCA, and MOCA.
What happens to MBOCA when it enters

the environment?
q It enters the environment from the disposal of solid waste
from manufacturing plants that use MBOCA.
q It doesn't dissolve in water easily.
q MBOCA sticks strongly to soil particles.

q It is not likely to enter groundwater.
q MBOCA is not likely to evaporate from soil or water.
q It is broken down by sunlight in air and by microscopic
organisms in soil or water.
q Levels of MBOCA can build up in the roots of vegetables
grown in contaminated soil.
How might I be exposed to MBOCA?

q People who work with MBOCA may get it on their skin
and breathe it in air. Skin contact is the most common
way to be exposed.
q It is sometimes found in root crops (such as carrots and
beets) that people eat if the plants were grown in soil
containing MBOCA.
q People may be exposed through skin contact with soil
contaminated with MBOCA or near waste sites or
landfills.
q It is not usually found in drinking water.
How can MBOCA affect my health?

There is not much information on how MBOCA can
affect peoples health. Studies of human exposure suggest
that the small amounts of MBOCA usually found in the air or
on surfaces in or near factories do not cause toxic effects.

Page 2
4,4'-METHYLENEBIS(2-CHLOROANILINE)
(MBOCA) CAS # 101-14-4

Exposure to large amounts of MBOCA may cause harm, but
no such exposures have been reported. We do not know if
there are any other long-term health effects in people caused
by MBOCA, other than cancer.
One man was accidentally sprayed in his face with hot
MBOCA. He felt nauseated and his kidneys were affected, but
these effects lasted less than one day. MBOCA is harmful to
blood cells and the liver in dogs and rats.
Researchers do not know if MBOCA causes birth defects
in people.
How likely is MBOCA to cause cancer?

determined that MBOCA may reasonably be anticipated to
be a carcinogen.
MBOCA is suspected of causing bladder cancer in
people. Information is being gathered to determine whether
bladder cancer in people may result from short-, medium-, or
long-term exposures to MBOCA. A few studies have found
an above-normal number of bladder tumors in workers
exposed to MBOCA for several years. It caused lung, liver,
breast, and bladder cancer in rats, mice, and dogs that ate
MBOCA for over a year.

The Environmental Protection Agency (EPA) has
classified MBOCA as a hazardous waste that must meet
specific disposal requirements. The EPA requires that spills
or accidental releases of MBOCA into the environment of 10
pounds or more must be reported to EPA.
Hygienists (ACGIH) set a maximum level of 0.11 milligrams
of MBOCA per cubic meter (0.11 mg/m3) of workplace air for
Health (NIOSH) recommends an exposure limit of 3 micrograms of MBOCA per cubic meter of air (3 mg/m3) over a
10-hour day.
These agencies advise avoiding eye and skin contact
because this may be a route of significant exposure.
Glossary

been exposed to MBOCA?
Laboratory tests can measure MBOCA in urine. The test
must be done within a short period after you are exposed
because it is broken down quickly by your body. The test
does not tell how much MBOCA you've been exposed to or if
harmful effects will occur. The test is not routinely available
at your doctors office, but a sample taken in the doctor's
office can be shipped to a special laboratory if necessary.
References
1994. Toxicological profile for 4,4'-methylenebis(2chloroaniline) (MBOCA). Atlanta, GA: U.S. Department of
METHYLENE CHLORIDE
CAS # 75-09-2
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about methylene chloride. For
HIGHLIGHTS: Exposure to methylene chloride occurs mostly from breathing

contaminated air, but may also occur through skin contact or by drinking
contaminated water. Breathing in large amounts of methylene chloride can
damage the central nervous system. Contact of eyes or skin with methylene
chloride can result in burns. Methylene chloride has been found in at least 882
of 1,569 National Priorities List sites identified by the Environmental Protection
Agency (EPA).
What is methylene chloride?
How might I be exposed to methylene chloride?
Methylene chloride is a colorless liquid with a mild, sweet

odor. Another name for it is dichloromethane. Methylene
chloride does not occur naturally in the environment.
The most likely way to be exposed to methylene chloride

is by breathing contaminated air.
Methylene chloride is used as an industrial solvent and as a

paint stripper. It may also be found in some aerosol and
pesticide products and is used in the manufacture of
photographic film.
What happens to methylene chloride when it

Methylene chloride is mainly released to the environment
in air. About half of the methylene chloride in air disappears
in 53 to 127 days.
Methylene chloride does not easily dissolve in water, but
small amounts may be found in drinking water.
We do not expect methylene chloride to build up in plants
or animals.
Breathing the vapors given off by products containing

methylene chloride. Exposure to high levels of methylene
chloride is likely if methylene chloride or a product
containing it is used in a room with inadequate ventilation.
How can methylene chloride affect my health?

If you breathe in large amounts of methylene chloride you
may feel unsteady, dizzy, and have nausea and a tingling or
numbness of your finger and toes. A person breathing
smaller amounts of methylene chloride may become less
attentive and less accurate in tasks requiring hand-eye
coordination. Skin contact with methylene chloride causes
burning and redness of the skin.
How likely is methylene chloride to cause

cancer?
We do not know if methylene chloride can cause cancer in
humans. An increased cancer risk was seen in mice

METHYLENE CHLORIDE
Page 2
CAS # 75-09-2
breathing large amounts of methylene chloride for a long

time.
The World Health Organization (WHO) has determined that
methylene chloride may cause cancer in humans.
determined that methylene chloride can be reasonably
anticipated to be a cancer-causing chemical.
The EPA has determined that methylene chloride is a
probable cancer-causing agent in humans.
How can methylene chloride affect children?

high amounts of methylene chloride will be similar to the
effects seen in adults. We do not know if methylene chloride
can affect the ability of people to have children or if it
causes birth defects. Some birth defects have been seen in
animals inhaling very high levels of methylene chloride.

methylene chloride?
Families may be exposed to methylene chloride while using
products such as paint removers. Such products should
always be used in well-ventilated areas and skin contact
should be avoided.
Children should not be allowed to remain near indoor paint
removal activities.

exposed to methylene chloride?
These tests are not routinely available in your doctors

office.
Methylene chloride can be detected in the air you breathe
out and in your blood. These tests are only useful for
detecting exposures that have occurred within a few days.
It is also possible to measure carboxyhemoglobin (a
chemical formed in the blood as methylene chloride breaks
down in the body) in the blood or formic acid (a breakdown
product of methylene chloride) in the urine. These tests are
not specific for methylene chloride.

The EPA requires that releases of methylene chloride of
1,000 pounds or more be reported to the federal government.
The EPA recommends that exposure of children to
methylene chloride be limited to less than 10 milligrams per
liter of drinking water (10 mg/L) for 1 day or 2 mg/L for 10
days.
The Food and Drug Administration (FDA) has established
limits on the amounts of methylene chloride that can remain
after processing of spices, hops extract, and decaffeinated
coffee.
(OSHA) has set limits of 25 parts methylene chloride per
million parts of workplace air (25 ppm) for 8-hour shifts and
40-hour work weeks.
(ATSDR). 2000. Toxicological Profile for methylene chloride.
Several tests can measure exposure to methylene chloride.
4,4'-METHYLENEDIANILINE
CAS # 101-77-9
August 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 4,4'-methylenedianiline.
series of summaries about hazardous substances and their health effects. Its important you understand
HIGHLIGHTS: Exposure to 4,4'-methylenedianiline occurs mainly in the

workplace. Liver damage and skin irritation may occur from exposure to high
levels of 4,4'-methylenedianiline. This chemical has been found in none of the
Agency (EPA).
What is 4,4'-methylenedianiline?
(Pronounced mthl-n d nln)
4,4'-Methylenedianiline is an industrial chemical that is
not known to occur naturally. It is also commonly known as
diaminodiphenylmethane or MDA. It occurs as a colorless to
pale yellow solid and has a faint odor.
4,4'-Methylenedianiline is used mainly for making polyurethane foams, which have a variety of uses, such as insulating materials in mailing containers. It is also used for making
coating materials, glues, Spandex fiber, dyes, and rubber.
q 4,4'-Methylenedianiline becomes strongly attached to

soil and will not easily move into groundwater.
q It may take as long as 10 days for bacteria and microorganisms in soil to break down 4,4'-methylenedianiline.
How might I be exposed to 4,4'-methylenedianiline?

q Working in an industry that makes or uses 4,4'-methylenedianiline.
q Touching consumer goods such as polyurethane foams

that contain it.
q Living near a hazardous waste site where 4,4'-methyleneWhat happens to 4,4'-methylenedianiline when
q 4,4'-Methylenedianiline is found in tiny particles in air
dianiline is disposed of.
q Being treated by a kidney dialysis machine. Tiny
amounts are released from the polyurethane parts of the

machine when it is sterilized by radiation or heat.
which will settle to land or water in rain or snow.
q Most of the 4,4'-methylenedianiline in water will attach

itself to particles and sink to the bottom sediment.
q 4,4'-Methylenedianiline in water or sediment will be broken down by bacteria and other microorganisms.
How can 4,4'-methylenedianiline affect my

health?
Limited information is available on the effects of
4,4'-methylenedianiline on peoples health. The available

4,4'-METHYLENEDIANILINE
CAS # 101-77-9
Page 2

information shows that it can cause skin irritation and liver
damage. People who accidentally ate bread baked from flour
contaminated with 4,4'-methylenedianiline became ill with a
flu-like condition, consisting of stomach and chest pains.
They also exhibited jaundice, a yellowish coloring of the skin
or internal organs caused by abnormal functioning of the liver.
Animals that breathed very high levels of 4,4'-methylenedianiline showed eye damage, while animals that ate food or
drank water with moderate amounts of 4,4'-methylenedianiline
for months or years had liver damage and thyroid gland injuries. Exposure of the skin to high levels of the chemical also
resulted in liver damage in animals.
It is not known whether 4,4'-methylenedianiline can affect
the development of the fetus or the ability to fight disease in
people or animals.
How likely is 4,4'-methylenedianiline to cause

cancer?
determined that 4,4'-methylenedianiline is possibly carcinogenic to humans.
A study on people exposed to bread contaminated with
4,4'-methylenedianiline did not show an increased risk of cancer. An animal study showed cancer of the liver and thyroid
after animals drank water over their lifetimes containing
4,4'-methylenedianiline.

exposed to 4,4'-methylenedianiline?
4,4'-Methylenedianiline can be measured in your urine to
see if you have been recently exposed to the chemical. These
tests can show you were exposed to 4,4'-methylenedianiline,
but cannot predict the kind of health effects that might occur.
These tests are not routinely available in doctors offices and
hospitals because they require special equipment.

environment of 1 pound or more of 4,4'-methylenedianiline be
set an occupational exposure limit of 0.081 milligrams of
methylenedianiline per cubic meter of air (0.081 mg/m3) for an
recommends that workers should not breathe air containing
more than 0.03 mg/m3 of 4,4'-methylenedianiline during a
Glossary
(ATSDR). 1998. Toxicological profile for methylenedianiline. Atlanta, GA: U.S. Department of Health and Human
MIREX AND CHLORDECONE

CAS # 2385-85-5 and 143-50-5
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about mirex and chlordecone.
SUMMARY: Exposure to mirex and chlordecone occurs mainly from touching

or eating soil or food that contains the chemicals. At high levels, these chemicals
may cause damage to the skin, liver, or nervous and reproductive systems. Mirex
has been found in at least 7 of the 1,430 National Priorities List sites identified by
the Environmental Protection Agency (EPA); chlordecone has been found at 2 sites.
What are mirex and chlordecone?
q Mirex and chlordecone do not dissolve easily in water, but

they easily stick to soil and sediment particles.
(Pronounced mrks and klrd-kn)
q They are not likely to travel far through the soil and into
underground water.
Mirex and chlordecone are two separate, but chemically

similar, manufactured insecticides that do not occur naturally
in the environment. Mirex is a white crystalline solid, and
chlordecone is a tan-white crystalline solid. Both chemicals
are odorless.
Mirex and chlordecone have not been manufactured or
used in the United States since 1978. Mirex was used to control fire ants, and as a flame retardant in plastics, rubber, paint,
paper, and electrical goods from 1959 to 1972. Chlordecone
was used as an insecticide on tobacco, ornamental shrubs,
bananas, and citrus trees, and in ant and roach traps. Mirex
was sold as a flame retardant under the trade name
Dechlorane, and chlordecone was also known as Kepone. Use
of trade names is for identification only and does not imply
endorsement by the Agency for Toxic Substances and Disease
Registry, the Public Health Service, or the U.S. Department of
Health and Human Services.
What happens to mirex and chlordecone

q Mirex and chlordecone break down slowly in the environment, and they may stay for years in soil and water.
q They do not evaporate to any great extent from surface
water or surface soil.
q They can build up in fish or other organisms that live in

contaminated water or that eat other contaminated
animals.
How might I be exposed to mirex and

chlordecone?
q Touching or ingesting contaminated soil near hazardous
waste sites.
q Ingesting contaminated fish or other animals living near
q Nursing infants of mothers living near hazardous waste
sites may be exposed to mirex through their mothers' milk.
q Drinking water or breathing air is not likely to cause exposure because these compounds do not easily dissolve in
water or evaporate.
How can mirex and chlordecone affect my

health?
We do not know how mirex affects the health of people.
Workers who were exposed to high levels of chlordecone over
a long period (more than one year) showed harmful effects on
the nervous system, skin, liver, and male reproductive system.
These workers were probably exposed mainly through touch-

MIREX AND CHLORDECONE

CAS # 2385-85-5 and 143-50-5
Page 2

ing chlordecone, although they may have inhaled or ingested
some as well.
Animal studies with chlordecone have shown effects similar to those seen in people, as well as harmful kidney effects,
developmental effects, and effects on the ability of females to
reproduce. We do not know if these last three effects also occur
in people.
Animal studies have shown that ingesting high levels of
mirex can harm the stomach, intestine, liver, kidneys, eyes,
thyroid, and nervous and reproductive systems.
How likely are mirex and chlordecone to

cause cancer?
has determined that mirex and chlordecone may reasonably be
anticipated to be carcinogens.
There are no studies available on whether mirex and
chlordecone are carcinogenic in people. However, studies in
mice and rats have shown that ingesting mirex and chlordecone can cause liver, adrenal gland, and kidney tumors.
from harmful effects.

The EPA suggests that ingesting an amount of mirex equal
to 200 picograms (pg) per kilogram (kg) of your body weight
per day is not likely to cause significant harmful health effects.
The Food and Drug Administration (FDA) suggests that
eating fish and other foods with concentrations below 100 ppt
of mirex, or concentrations of chlordecone below 400 ppt, will
not cause harmful health effects in people.
The EPA requires that discharges or spills into the environment of 1 pound or more of chlordecone be reported.
(NIOSH) recommends that average workplace air levels not exceed 1 microgram per cubic meter (1 /gm3) of chlordecone
over a 10-hour period.
Glossary

been exposed to mirex and chlordecone?
Kilogram (kg): One thousand grams.
Tests are available that measure the amount of mirex in

blood, feces, fat, or milk, and the amount of chlordecone in
blood, saliva, feces, or bile. However, these tests may require
special equipment and they may not be available at your
doctors office.
Picogram (pg): One trillionth of a gram.


1995. Toxicological profile for mirex and chlordecone.
The EPA has set a limit of 1 part of mirex per trillion parts
of surface water (1 ppt) to protect fish and other aquatic life

body of water.
References
MUSTARD GAS
CAS #505-60-2
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about mustard gas. For
HIGHLIGHTS: The general population is not exposed to mustard gas.

Mustard gas can cause irritation and burns of the skin, eyes, and respiratory
tract, reproductive effects, and may cause cancer of the respiratory tract. This
chemical has been found in at least 3 of the 1,585 National Priorities List sites
What is mustard gas?
Mustard gas refers to several manufactured chemicals,
including sulfur mustard, that do not occur naturally in the
environment Mustard gas is actually a liquid and is not
likely to change into a gas immediately if it is released at
ordinary temperatures. As a pure liquid, it is colorless and
odorless, but when mixed with other chemicals, it looks
brown and has a garlic-like smell.
Mustard gas has been used in chemical warfare and was
made in large amounts during World Wars I and II. It was
reportedly used in the Iran-Iraq war in 19801988. It is not
presently used in the United States, except for research
purposes, and the U.S. Department of Defense must destroy
all remaining stocks of mustard gas by 2004.
What happens to mustard gas when it enters the

environment?
Mustard gas would primarily enter the environment
through an accidental release.
In soil and water, some mustard gas evaporates into the
air and the rest breaks down in minutes to days depending
on environmental conditions.
Mustard gas reacts with chemicals in the air to form other
compounds.
Mustard gas does not move from soil to groundwater, and
it does not build up in the tissues of animals because it
breaks down quickly.
How might I be exposed to mustard gas?

Mustard gas is no longer made in the United States and is
only stored at a few military storage sites; therefore, the
general public is not exposed to mustard gas.
Individuals working at or living near these military storage
sites may be exposed to mustard gas if there was an
accidental spill or unplanned release.
Occupational exposures are currently limited to soldiers in
some combat situations; those involved in its shipment,
storage, or disposal; and construction workers at storage
sites.
How can mustard gas affect my health?

Mustard gas can cause skin burns and blisters, especially
around sweaty parts of the body. It is more harmful to the
skin on hot, humid days, or in tropical climates. Mustard
gas makes your eyes burn, your eyelids swell, and causes
you to blink a lot. If you breathe mustard gas, it can cause
coughing, bronchitis, and long-term respiratory disease.
Exposure to a large amount of mustard gas can cause death.
Some men exposed to mustard gas during war have
experienced lower sperm counts.

MUSTARD GAS
Page 2
CAS #505-60-2
How likely is mustard gas to cause cancer?

Studies of people exposed during the production process or
during war, as well as animal studies, have shown that
mustard gas may cause respiratory cancer. The Department
of Health and Human Services (DHHS) and the International
Agency for Research on Cancer (IARC) have determined that
mustard gas is carcinogenic to humans.
How can mustard gas affect children?

Mustard gas causes the eyes and skin of children to burn
similarly to adults; however, the burns are more severe and
blisters appear sooner in children.
Limited human and animal data indicate that mustard gas may
cause birth defects or otherwise affect development.
It is not known if mustard gas can cross the placenta or be
passed to infants in breast milk.

mustard gas?

exposed to mustard gas?
Mustard gas or its breakdown products can be detected in
your blood and urine within a few weeks after your last
exposure. These tests are not usually available at your
laboratory that can perform the tests. None of these tests,
however, can predict whether you will experience any health
effects.

The Centers for Disease Control and Prevention (CDC) has
proposed a mustard gas 8-hour time-weighted average
(TWA) airborne exposure limit (AEL) of 0.003 milligrams per
cubic meter of air (0.003 mg/m3) for agent workers, and a
72-hour TWA AEL of 0.0001 mg/m3 for the general
population. A ceiling value indicating a maximum exposure
concentration at any time, for any duration, of 0.003 mg/m3
has also been proposed.
The risk of exposure to mustard gas is generally low, but may
be greater for those who live or work near Army bases and
facilities that store it. Mustard gas is currently being
destroyed at these facilities and the risk of exposure due to
accidents is minimal.

(ATSDR). 2001. Toxicological Profile for Mustard Gas (Draft
for Public Comment) Atlanta, GA: U.S. Department of Health
Children should avoid playing near uncontrolled hazardous

waste sites where mustard gas may have been discarded.
n-NITROSODIMETHYLAMINE
CAS #62-75-9
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about n-nitrosodimethylamine. For
HIGHLIGHTS: n-Nitrosodimethylamine is produced by industry in small

amounts but may be formed in the environment from chemical reactions. It
causes liver cancer in animals. This chemical has been found in at least 1 of
the 1,177 National Priorities List sites identified by the Environmental Protection
Agency (EPA).
What is n-nitrosodimethylamine?
(Pronounced n ntr-s d mth-l-mn)
q In water, it may break down when exposed to sunlight or

by natural biological processes.
n-Nitrosodimethylamine is produced by industry only in

small amounts for research. At room temperature, it is a yellow
liquid with no distinct odor. It was used to make rocket fuel,
but this use was stopped after unusually high levels of this
chemical were found in air, water, and soil samples collected
near a rocket fuel manufacturing plant. It is used in some cosmetic and toiletry products and in cleansers.
q It could also sink down into deeper soil.
n-Nitrosodimethylamine is unintentionally formed during various manufacturing processes and in air, water, and soil
from reactions involving other chemicals called alkylamines.
It is also found in some foods and may be formed in the body.
What happens to n-nitrosodimethylamine when

q n-Nitrosodimethylamine may be found in air, water, and
soil.
q When released to the air, it is broken down by sunlight in
a matter of minutes.
q When released to soil, it may evaporate into air.
How might I be exposed to n-nitrosodimethylamine?

q Eating food containing it, such as cured meats, fish, and
cheese.
q Using toiletry and cosmetic products such as shampoos
and cleansers that contain it.
q Breathing or inhaling cigarette smoke, which may contain low levels.
q Eating foods containing alkylamines, which can cause
n-nitrosodimethylamine to form in the stomach.
q Working in industries such as tanneries, pesticide manufacturing plants, and rubber and tire plants.

n-NITROSODIMETHYLAMINE
CAS # 62-75-9
Page 2
How can n-nitrosodimethylamine affect my

health?

When people were exposed to very high levels of n-nitrosodimethylamine, liver damage occurred. Little else is known
about the heath effects of n-nitrosodimethylamine in people.
Liver effects have also been seen in animals that ate food,
drank water, or breathed air containing high levels of
n-nitrosodimethylamine.

should be limited to 0.00069 parts of n-nitrosodimethylamine
per billion parts of water (0.00069 ppb) to prevent possible
health effects from drinking water or eating fish contaminated
with n-nitrosodimethylamine.
Mice that were fed n-nitrosodimethylamine during pregnancy had offspring that were born dead or died shortly after
birth.

10 pounds or more of n-nitrosodimethylamine be reported to
the EPA.
July 1999.
How likely is n-nitrosodimethylamine to cause

cancer?
Glossary
n-Nitrosodimethylamine exposure has been shown to

result in an increase in liver and lung cancer in animals. No
information is available on whether it causes cancer in people.
determined that n-nitrosodimethylamine may reasonably anticipated to be a human carcinogen.


exposed to n-nitrosodimethylamine?
Samples of your blood and urine can be tested to determine if you have been recently exposed to n-nitrosodimethylamine. These tests must be done soon after the exposure occurred. These tests will not tell you whether your health
will be affected by n-nitrosodimethylamine. They are not routinely available in hospitals and clinics because they require
special equipment.
(ATSDR). 1989. Toxicological profile for n-nitrosodimethylamine. Atlanta, GA: U.S. Department of Health and
n-NITROSODIPHENYLAMINE
CAS # 86-30-6
April 1993
This fact sheet answers the most frequently asked health questions (FAQs) about n-nitrosodiphenylamine. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
is one in a series of summaries about hazardous substances and their health effects. This information
is important because this substance may harm you. The effects of exposure to any hazardous
substance depend on the dose, the duration, how you are exposed, personal traits and habits, and
whether other chemicals are present.
SUMMARY: The general population and people in the workplace are probably
not exposed to n-nitrosodiphenylamine. People living near hazardous waste sites
may, however, be exposed to it by drinking contaminated water or by touching
or breathing contaminated soil and dust. Limited animal studies suggest that
n-nitrosodiphenylamine can damage the bladder and kidneys. It has been found
What is n-nitrosodiphenylamine?
(Pronounced n-n tr'-s d-fnl mn)
n-Nitrosodiphenylamine is an industrial compound. It is
an orange-brown or yellow solid that has been produced since
1945. n-nitrosodiphenylamine is used to make rubber products such as tires or to make other chemicals.
In the early 1980s, most U.S. rubber manufacturers replaced it with more efficient chemicals. Today, only one
manufacturer in the United States produces
n-nitrosodiphenylamine.
We do not know if it occurs naturally in the environment.
There is some evidence that microorganisms make it.
What happens to n-nitrosodiphenylamine when

q It evaporates slowly to the air or leaks into the ground
from waste sites.
q In air, n-nitrosodiphenylamine attaches to dust particles
and can move with the wind.
q It dissolves in water, but it binds to soil and does not

move quickly through soil.
q It breaks down in air, water, and soil within several weeks.
q We dont know what the breakdown substances are in
humans or whether they are harmful to you.
q We dont find it in our normal drinking water, foods, or
air.
q Water organisms take some into their bodies, but they
dont appear to build up high levels.
q We dont know if land animals or plants take it up and
store it in their bodies.
How might I be exposed to n-nitrosodiphenylamine?

q The likelihood of exposure is very low.
q Exposure in the workplace is not likely (only one company makes it today).
q Drinking water near hazardous waste sites may be contaminated.
q Touching or breathing contaminated waste or soils near
hazardous waste sites may result in higher exposures.

n-NITROSODIPHENYLAMINE
CAS # 86-30-6
Page 2

How can n-nitrosodiphenylamine affect my
health?
There is very little information on the effects of
n-nitrosodiphenylamine on human health. There is also not
enough information from animal studies to estimate how exposure to it will affect your health.
Animal studies have identified levels and exposures that
can cause death. Animals given high levels of
n-nitrosodiphenylamine in their diets for long periods of time
developed swelling, cancer of the bladder, and changes in body
weight.
We dont know if these effects would occur in humans. We
also dont know if it can affect pregnancy or cause birth defects.
How likely is n-nitrosodiphenylamine to cause

cancer?
The EPA has determined that n-nitrosodiphenylamine is a
probable human carcinogen. This is based on a long-term
study in rats showing an increase in bladder cancer in the
group exposed to high levels of n-nitrosodiphenylamine.
There is no evidence that it causes bladder cancer in people.
Although EPA has classified n-nitrosodiphenylamine as a
probable carcinogen, the animal data are limited. Other public
health agencies have concluded that no evaluation of n-nitrosodiphenylamines carcinogenicity in people is currently possible.
Additional research is needed.
n-nitrosodiphenylamine and its breakdown products in the

blood and urine of exposed animals, but these tests have not
been used for people.

The EPA recommends limits on how much n-nitrosodiphenylamine can be present in bodies of water such as lakes
and rivers. The recommended levels are 49,000 nanograms or
less of n-nitrosodiphenylamine per liter of water (49,000 ng/L).
At this level, EPA estimates that your risk of getting cancer is
very low.
For drinking water, the EPA set a limit of 700 micrograms
or less of n-nitrosodiphenylamine per liter of drinking water
(700 g/L).
n-Nitrosodiphenylamine is also considered to be a hazardous waste, and the EPA requires industry to immediately report
a spill of more than 100 pounds to the National Response Center of the federal government.
Glossary
Nanogram (ng): One billionth of a gram.
References
exposed to n-nitrosodiphenylamine?
No tests are available to determine if you have been exposed to n-nitrosodiphenylamine. There are tests to detect

(ATSDR). 1993. Toxicological profile for n-nitrosodiphenylamine. Atlanta: U.S. Department of Health and Human Services, Public Health Service.
n-NITROSODI-nPROPYLAMINE
CAS # 621-64-7
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about n-nitrosodi-n-propylamine.
present.
HIGHLIGHTS: N-Nitrosodi-n-propylamine is a chemical produced by industry

in small amounts for research. Evidence from animal studies indicates that
it may cause cancer. This chemical has been found in at least 1 of the 1,177
(EPA).
What is n-nitrosodi-n-propylamine?
(Pronounced n-n-trs-d'n-prpl-'mn)
n-Nitrosodi-n-propylamine is a chemical produced by
industry in small amounts for research. It is a yellow liquid at
room temperature. Small amounts of n-nitrosodi-n-propylamine are produced as a side reaction during some manufacturing processes, as a contaminant in some weed killers, and
during the manufacture of some rubber products.
What happens to n-nitrosodi-n-propylamine

q Low levels of n-nitrosodi-n-propylamine could be released to the environment from contaminated products or
from disposal of waste containing this chemical.
q If released to the air, it is broken down by sunlight within
a few hours.
q Low levels of n-nitrosodi-n-propylamine could occur in
water from use of weed killers containing it.
q It is broken down in water within a few hours.
q It evaporates from the soil surface or is broken down by
bacteria.
How might I be exposed to n-nitrosodi-npropylamine?

q People may be exposed to low levels by eating foods
treated with sodium-nitrite preservatives and by drinking
certain alcoholic beverages.
q Low levels may occur in cigarette smoke.
q Workers in the rubber industry could be exposed to
n-nitrosodi-n-propylamine.
q People applying contaminated weed killers could be
exposed to low levels of the chemical.
How can n-nitrosodi-n-propylamine affect my

health?
No information is available on the effects of n-nitrosodin-propylamine in people. Studies in animals have shown effects on the liver, lung, stomach, kidneys, and heart at very
high doses.

n-NITROSODI-n-PROPYLAMINE
CAS # 621-64-7
Page 2
How likely is n-nitrosodi-n-propylamine to cause

cancer?
No studies are available on whether or not n-nitrosodi-npropylamine causes cancer in people. Animal studies have
shown an increase in cancer of the liver, nose, and stomach
from n-nitrosodi-n-propylamine exposure. The Department of
Health and Human Services (DHHS) has determined that
n-nitrosodi-n-propylamine may reasonably be anticipated to
be a human carcinogen.

exposed to n-nitrosodi-n-propylamine?
Samples of your blood and urine can be tested to determine if you have been recently exposed to n-nitrosodi-npropylamine. These tests must be done soon after the exposure
occurred. These tests will not tell you whether your health will
be affected by n-nitrosodi-n-propylamine. The tests are not
routinely available in hospitals and clinics because they require special equipment.

should be limited to 0.005 parts n-nitrosodi-n-propylamine per
billion parts of water (0.005 ppb) to prevent possible health

effects from drinking water or ingesting fish contaminated
with n-nitrosodi-n-propylamine.
July 1999.
Glossary
(ATSDR). 1989. Toxicological profile for n-nitrosodi-npropylamine. Atlanta, GA: U.S. Department of Health and
NAPHTHALENE
CAS # 91-20-3
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about naphthalene. For more
SUMMARY: Exposure to naphthalene happens mostly from breathing air

contaminated from the burning of wood or fossil fuels, industrial discharges, tobacco
smoke, or moth repellents. Exposure to large amounts of naphthalene may damage
or destroy some of your red blood cells. Naphthalene has been found in at least
What is naphthalene?
q If dairy cows are exposed to naphthalene, some of it will

be in their milk.
(Pronounced nfth-ln)
Naphthalene is a white solid that is found naturally in
fossil fuels. Burning tobacco or wood produces naphthalene.
It has a strong, but not unpleasant smell.
q If laying hens are exposed, some of it will be in their

eggs.
The major products made from naphthalene are moth

repellents. It is also used for making dyes, resins, leather, tanning agents, and the insecticide, carbaryl.
What happens to naphthalene when it enters

the environment?
q Naphthalene enters the environment from industrial uses,
and from its use as a moth repellent.
How might I be exposed to naphthalene?

q Breathing low levels in outdoor air.
q Breathing air contaminated from industrial discharges or
from burning wood or fossil fuels.
q Breathing air in homes or businesses where cigarettes are
smoked, wood is burned, or moth repellents are used.
q Drinking water from contaminated wells.
q Touching clothing, blankets, or coverlets that are treated
with naphthalene.
q It also enters from the burning of wood or tobacco, and

from accidental spills.
q Naphthalene evaporates easily.
q In air, moisture and sunlight break it down, often within 1
day.
q Naphthalene in water is destroyed by bacteria or evaporates into the air.
q Naphthalene binds weakly to soils and sediment.
q It does not accumulate in animals or fish.
How can naphthalene affect my health?

Exposure to large amounts of naphthalene may damage
or destroy some of your red blood cells. This could cause you
to have too few red blood cells until your body replaces the
destroyed cells. People, particularly children, have developed this problem after eating naphthalene-containing mothballs or deodorant blocks. Some of the symptoms of this

NAPHTHALENE
CAS # 91-20-3
Page 2
problem are fatigue, lack of appetite, restlessness, and pale

skin. Exposure to large amounts of naphthalene may also
cause nausea, vomiting, diarrhea, blood in the urine, and a
yellow color to the skin.
Animals sometimes develop cloudiness in their eyes after
swallowing naphthalene. It is not clear if this also develops in
people.
When mice were repeatedly exposed to naphthalene vapors for 2 years, their noses and lungs became inflamed and
irritated.
How likely is naphthalene to cause cancer?

International Agency for Research on Cancer (IARC) and the
EPA have not classified naphthalene as to its human carcinogenicity.
No studies are available in people. Naphthalene has
caused cancer in studies in female mice, but not in male mice
or in rats of either sex.

The EPA recommends that children not drink water containing over 0.5 parts of naphthalene per million parts of water
(0.5 ppm) for more than 10 days, or 0.4 ppm for longer than
7 years. Adults should not drink water with more than 1 ppm
for more than 7 years. For water consumed over a lifetime, the
EPA suggests it contain no more than 0.02 ppm naphthalene.
The EPA requires that discharges or spills into the environment
of 100 pounds or more be reported.
(OSHA) has set a limit of 10 parts per million (10 ppm) for the
level of naphthalene in workplace air over an 8-hour workday,
40-hour workweek.
(NIOSH) considers more than 250 ppm of naphthalene in air to
be immediately dangerous to life or health. This is the exposure level of a chemical that is likely to cause permanent
health problems or death.
Glossary
been exposed to naphthalene?
Tests are available that measure levels of naphthalene and
its breakdown products in urine, stool, blood, or maternal
milk. A small sample of your body fat can also be removed and
analyzed for naphthalene. These tests are not routinely available in a doctors office. However, a sample taken in a doctors
office can be sent to a special laboratory, if needed.
These tests cannot determine exactly how much naphthalene you were exposed to or predict whether harmful effects
will occur.

body of water.
References
1995. Toxicological profile for naphthalene, 1-methylnaphthalene, and 2-methylnaphthalene (update). Atlanta, GA: U.S. Department of Health and Human Services, Public Health Services.
NERVE AGENTS (GA, GB, GD, VX)

TABUN (GA) CAS # 77-81-6
SOMAN (GD) CAS # 96-64-0
SARIN (GB) CAS # 107-44-8

VX CAS # 50782-69-9
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about nerve agents. For more
HIGHLIGHTS: Exposure to nerve agents can occur due to accidental release

from a military storage facility. Nerve agents are highly toxic regardless of the
route of exposure. Exposure to nerve agents can cause tightness of the chest,
excessive salivation, abdominal cramps, diarrhea, blurred vision, tremors, and
death. Nerve agents (GA, GB, GD, VX) have been identified at 5 of the 1,585
(EPA).
What are nerve agents GA, GB, GD, and VX?
Nerve agents GA(tabun), GB (sarin), GD(soman), and VX are
manufactured compounds. The G-type agents are clear,
colorless, tasteless liquids miscible in water and most
organic solvents. GB is odorless and is the most volatile
nerve agent. GA has a slightly fruity odor, and GD has a
slight camphor-like odor. VX is a clear, amber-colored
odorless, oily liquid. It is miscible with water and dissolves
in all solvents. VX is the least volatile nerve agent.
Most of the nerve agents were originally produced in a
search for insecticides, but because of their toxicity, they
were evaluated for military use. Nerve agents have been
used in wars and by terrorists. They are known to be stored
by several nations, including the United States.
What happens to nerve agents GA, GB, GD, and

VX when they enter the environment?
Nerve agents GA, GB, GD, and VX could enter the
When released to air, GA, GB, GD, and VX will be broken
down by compounds that are found in the air, but they may
persist in air for a few days before being broken down.
GA, GB, GD, and VX will be broken down in water quickly,

but small amounts may evaporate.
GA, GB, GD, and VX will be broken down in moist soil
quickly. Small amounts may evaporate into air or travel
below the soil surface and contaminate groundwater.
GA, GB, GD, and VX do not accumulate in the food chain.
How might I be exposed to nerve agents GA,

GB, GD, and VX?
The United States no longer produces nerve agents GA,
GB, GD, and VX.
The general population will not be exposed to nerve
agents GA, GB, GD, or VX unless there is an accidental
release from a military storage facility.
People who work at military sites where these compounds
are stored may be potentially exposed to nerve agents GA,
GB, GD, and VX.
How can nerve agents GA, GB, GD, and VX

affect my health?
Even in very small amounts, nerve agents are highly toxic if
you inhale or swallow them, or if they come in contact with
your skin or eyes. In general, the manifestation of toxic

Page 2
NERVE AGENTS (GA, GB, GD, VX)
TABUN (GA) CAS # 77-81-6

SOMAN (GD) CAS # 96-64-0
SARIN (GB) CAS # 107-44-8

VX CAS # 50782-69-9

effects is faster if you inhale or swallow nerve agents than if
they contact your skin. The initial effects also depend on
the amount you are exposed to. The onset of mild to
moderate effects after dermal exposure may be delayed for as
long as 18 hours.

susceptibility to nerve agents.
Regardless of the route of exposure, the manifestation of

nerve agent exposure includes runny nose, chest tightness,
pinpoint pupils, shortness of breath, excessive salivation and
sweating, nausea, vomiting, abdominal cramps, involuntary
defecation and urination, muscle twitching, confusion,
seizures, paralysis, coma, respiratory paralysis, and death.
Incapacitating effects occur within 1 to 10 minutes and fatal
effects can occur within 1 to 10 minutes for GA, GB, and GD,
and within 4 to 42 hours for VX.

nerve agents GA, GB, GD and VX?
Fatigue, irritability, nervousness, and memory defects may

persist for as long as 6 weeks after recovery from an
exposure episode.
There are medical tests available to determine whether you

have been exposed to nerve agents. There are tests to
measure degradation products of nerve agents in the urine,
but are not generally useful. A different kind of test
measures the levels of a substance called cholinesterase in
the blood. If these levels are less than half what they
should be, and you were exposed to nerve gases, you may
get symptoms of poisoning. Cholinesterase levels in the
blood can stay low for months after you have been exposed
to nerve agents. Measurement of cholinesterase levels in
blood is not specific for exposure to nerve agents.
We do not know if exposure to the nerve agents GA, GB,

GD, or VX might result in reproductive effects in humans.
How likely are nerve agents GA, GB, GD, and

VX to cause cancer?
The Department of Heath and Human Services (DHHS), the
EPA have not classified GA, GB, GD, and VX as to their
carcinogenicity to humans. Limited data in animals indicate
that nerve agents are not likely to be carcinogenic.
How can nerve agents GA, GB, GD, and VX

affect children?
Children exposed to nerve agents are likely to experience the
same toxic effects experienced by exposed adults. We do not
We do not know if exposure to the nerve agents GA, GB,

GD, or VX might result in developmental effects in humans.

nerve agents.

exposed to nerve agents GA, GB, GD, and VX?

and Human Services) of 0.003 micrograms of GA, GB, GD, or
VX per cubic meter of air (0.003 g/m3) has been established
as a time-weighted average (TWA) for the workplace.
NICKEL
CAS # 7440-02-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about nickel. For more information,
HIGHLIGHTS: Nickel is a hard, silvery-white metal used to make stainless

steel and other metal alloys. Skin effects are the most common effects in people
who are sensitive to nickel. Workers who breathed very large amounts of nickel
compounds have developed lung and nasal sinus cancers. Nickel has been found
What is nickel?
(Pronounced nkl)
q Nickel does not appear to collect in fish, plants, or animals used for food.
Nickel is a very abundant element. In the environment, it

is found primarily combined with oxygen (oxides) or sulfur
(sulfides). It is found in all soils and is emitted from volcanos.
How might I be exposed to nickel?
Pure nickel is a hard, silvery-white metal that is combined

with other metals to form mixtures called alloys. Some of the
metals that nickel can be alloyed with are iron, copper, chromium, and zinc. These alloys are used in the making of metal
coins and jewelry and in industry for making metal items.
q By breathing air or smoking tobacco containing nickel.

q By eating food containing nickel, which is the major
source of exposure for most people.
q By drinking water which contains small amounts of nickel.
q By handling coins and touching other metals containing
nickel, such as jewelry.
Nickel compounds are also used for nickel plating, to color

ceramics, to make some batteries, and as substances known as
catalysts that increase the rate of chemical reactions. Nickel
and its compounds have no characteristic odor or taste.
How can nickel affect my health?
What happens to nickel when it enters the

environment?
The most common adverse health effect of nickel in humans is an allergic reaction. People can become sensitive to
nickel when jewelry or other things containing it are in direct
contact with the skin. Once a person is sensitized to nickel,
further contact with it will produce a reaction. The most common reaction is a skin rash at the site of contact.
q Small nickel particles in the air settle to the ground or are

taken out of the air in rain.
q Much of the nickel in the environment is found with soil
and sediments because nickel attaches to particles that
contain iron or manganese, which are often present in soil
and sediments.
Nickel is required to maintain health in animals. A small

amount of nickel is probably essential for humans, although
a lack of nickel has not been found to affect the health of
humans.
Less frequently, some people who are sensitive to nickel

NICKEL
CAS # 7440-02-0
Page 2

have asthma attacks following exposure to nickel. People who
are sensitive to nickel have reactions when it is in contact with
the skin, and some sensitized persons react when they eat nickel
in food, drink it in water, or breathe dust containing it.
Lung effects, including chronic bronchitis and reduced
lung function, have been observed in workers who breathed
large amounts of nickel. Current levels of nickel in workplace
air are much lower than in the past, and today few workers
show symptoms of nickel exposure.
People who are not sensitive to it must eat very large
amounts of nickel to show adverse health effects. Workers
who accidently drank water containing very high levels of
nickel (100,000 times more than in normal drinking water) had
stomachaches and effects on their blood and kidneys.
Animal studies show that breathing high levels of nickel
compounds may result in inflammation of the respiratory tract.
Eating or drinking large amounts of nickel has been reported
to cause lung disease in dogs and rats and to affect the stomach, blood, liver, kidneys, immune system, and reproduction
and development in rats and mice.
Measurements of the amount of nickel in your blood,

feces, and urine can be used to estimate your exposure to
nickel. These measurements are most useful if the type of
nickel compound you have been exposed to is known. However, these tests cannot predict whether you will experience
any health effects.

The EPA recommends that children drink water containing no more than 0.04 milligrams of nickel per liter of water
(0.04 mg/L) for 1-10 days of exposure.
(OSHA) has set an occupational exposure limit of 1 milligram
of nickel per cubic meter of air (l mg/m3) for an 8-hour workday, 40-hour workweek.
Glossary
How likely is nickel to cause cancer?

has determined that nickel and certain nickel compounds may
reasonably be anticipated to be carcinogens. Cancers of the
lung and nasal sinus have resulted when workers breathed dust
containing high levels of nickel compounds while working in
nickel refineries or nickel processing plants.
When rats and mice breathed nickel compounds for a lifetime, nickel compounds that were hard to dissolve caused cancer, while a soluble nickel compound did not cause cancer.

exposed to nickel?
Sediments: Mud and debris that have settled to the bottom of

a body of water.
Soluble: Dissolves in water.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Nickel (update) produced by the Agency for
NITROBENZENE
CAS # 98-95-3
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about nitrobenzene. For more
HIGHLIGHTS: Nitrobenzene is used mainly as an intermediate to produce

another chemical. Repeated exposures to high levels result in a blood disorder
in people. This chemical has been found in at least 7 of the 1,177 National
What is nitrobenzene?
How might I be exposed to nitrobenzene?
(Pronounced ntr-bnzn)
q Breathing air containing it.
Nitrobenzene is an industrial chemical. It is an oily yellow liquid with an almond-like odor. It dissolves only slightly
in water and will evaporate to air.
q Living near a factory where it is used.
It is produced in large quantities for use in industry. Most

of the nitrobenzene produced in the United States is used to
manufacture a chemical called aniline. Nitrobenzene is also
used to produce lubricating oils such as those used in motors
and machinery. A small amount of nitrobenzene is used in the
manufacture of dyes, drugs, pesticides, and synthetic rubber.
What happens to nitrobenzene when it enters

the environment?
q Very low levels of nitrobenzene may be found in air.
q It may be present in water from industrial releases.
q In water, nitrobenzene will be broken down by sunlight.
q Nitrobenzene in soil can move into the groundwater, be
taken up by plants, evaporate to the air, and be broken
down by bacteria.
q It does not appear to concentrate in fish or other aquatic
animals.
q Working in a factory that produces nitrobenzene.

q Living near a hazardous waste site where it has been disposed of.
q Working as a chemist or in other occupations where nitrobenzene is used.
How can nitrobenzene affect my health?

A small amount of nitrobenzene may cause mild irritation
if it contacts the skin or eyes directly. Repeated exposures to a
high concentration of nitrobenzene can result in methemoglobinemia, a condition in which the bloods ability to carry
oxygen is reduced. If you have this condition, your skin may
turn a bluish color and you may have nausea, vomiting, and
shortness of breath. Effects such as headache, irritability, dizziness, weakness, and drowsiness may also occur. There is also
some evidence that breathing high concentrations of nitrobenzene may damage the liver.
Animal studies have reported effects on the blood and
liver from exposure to nitrobenzene. A single dose of nitro-

NITROBENZENE
CAS # 98-95-3
Page 2

benzene fed to male rats resulted in damage to the testicles and
decreased levels of sperm.
How likely is nitrobenzene to cause cancer?

No studies are available on whether nitrobenzene causes
cancer in people. In animals, breathing nitrobenzene resulted
in an increase in liver, thyroid, and kidney tumors.
has determined that nitrobenzene is possibly carcinogenic to
humans.

exposed to nitrobenzene?
ing water or eating fish contaminated with nitrobenzene.

releases of 1,000 pounds or more of nitrobenzene must be
nitrobenzene per cubic meter of air (5 mg/m3) for an 8-hour
workday in a 40-hour workweek.
Hygienists (ACGIH) and the National Institute for Occupational Safety and Health (NIOSH) also recommend an occupational exposure limit of 5 mg/m3 for nitrobenzene.
July 1999.
Nitrobenzene reacts with red blood cells in the body to

produce methemoglobin. If you have recently been exposed to
Glossary
nitrobenzene, the level of methemoglobin in your body may be
elevated, and this can be measured. However, since other toxic Carcinogenic: Able to cause cancer.
chemicals also produce methemoglobin, this method does not
definitely show that you were exposed to nitrobenzene.
In cases of long-term exposure to nitrobenzene, the presPesticide: A substance that kills pests.
ence of its breakdown products, p-nitrophenol and p-aminoppm: Parts per million.
phenol, in the urine indicates nitrobenzene exposure. These
tests require special equipment and cannot be routinely done
in a doctors office. The results of these tests cannot be used to
determine the level of nitrobenzene exposure or if harmful
health effects can be expected to occur.

should be limited to 17 parts of nitrobenzene per million parts
of water (17 ppm) to prevent possible health effects from drink-
(ATSDR). 1990. Toxicological profile for nitrobenzene.
NITROGEN OXIDES (nitric

oxide, nitrogen dioxide, etc.)
CAS #10102-43-9 (nitric oxide);

CAS #10102-44-0 (nitrogen dioxide)
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about nitrogen oxides (nitric
oxide, nitrogen dioxide, etc.). For more information, call the ATSDR Information Center at 1-888-422-8737.
This fact sheet is one in a series of summaries about hazardous substances and their health effects. It is
important you understand this information because this substance may harm you. The effects of exposure to
any hazardous substance depend on the dose, the duration, how you are exposed, personal traits and habits,
and whether other chemicals are present.
HIGHLIGHTS: Everybody is exposed to small amounts of nitrogen oxides in

ambient air. Higher exposure may occur by burning wood or kerosene or near
gas stoves or if you smoke. Exposure to high levels of nitrogen oxides can
damage the respiratory airways. Contact with the skin or eyes can cause
burns. Nitrogen dioxide and nitric oxide have been found in at least 9 and 6 of
the 1,585 National Priorities List sites identified by the Environmental
Protection Agency (EPA), respectively.
What are nitrogen oxides?
Nitrogen oxides are a mixture of gases that are composed of
nitrogen and oxygen. Two of the most toxicologically
significant nitrogen oxides are nitric oxide and nitrogen
dioxide; both are nonflammable and colorless to brown at
room temperature. Nitric oxide is a sharp sweet-smelling gas
at room temperature, whereas nitrogen dioxide has a strong,
harsh odor and is a liquid at room temperature, becoming a
reddish-brown gas above 70 EF.
Nitrogen oxides are released to the air from the exhaust of
motor vehicles, the burning of coal, oil, or natural gas, and
during processes such as arc welding, electroplating,
engraving, and dynamite blasting. They are also produced
commercially by reacting nitric acid with metals or cellulose.
Nitrogen oxides are used in the production of nitric acid,
lacquers, dyes, and other chemicals. Nitrogen oxides are
also used in rocket fuels, nitration of organic chemicals, and
the manufacture of explosives.
What happens to nitrogen oxides when they enter

the environment?
Nitrogen oxides are broken down rapidly in the
atmosphere by reacting with other substances commonly
found in the air. The reaction of nitrogen dioxide with

chemicals produced by sunlight leads to the formation of
nitric acid, which is a major constituent of acid rain.
Nitrogen dioxide also reacts with sunlight, which leads to the
formation of ozone and smog conditions in the air we
breathe.
Small amounts of nitrogen oxides may evaporate from
water, but most of it will react with water and form nitric acid.
When released to soil, small amounts of nitrogen oxides
may evaporate into air. However, most of it will be
converted to nitric acid or other compounds.
Nitrogen oxides do not build up in the food chain.
How might I be exposed to nitrogen oxides?

The general population is primarily exposed to nitrogen
oxides by breathing in air. People who live near combustion
sources such as coal burning power plants or areas with
heavy motor vehicle use may be exposed to higher levels of
nitrogen oxides.
Households that burn a lot of wood or use kerosene
heaters and gas stoves tend to have higher levels of
nitrogen oxides in them when compared to houses without
these appliances.
Nitric oxide and nitrogen dioxide are found in tobacco
smoke, so people who smoke or breathe in second-hand
smoke may be exposed to nitrogen oxides.

Page 2
NITROGEN OXIDES (nitric oxide, nitrogen dioxide, etc.)

CAS #10102-43-9 (nitric oxide); CAS #10102-44-0 (nitrogen dioxide)
Workers employed in facilities that produce nitric acid or

certain explosives like dynamite and trinitrotoluene (TNT), as
well as workers involved in the welding of metals may breath
in nitrogen oxides during their work.
How can nitrogen oxides affect my health?

Low levels of nitrogen oxides in the air can irritate your eyes,
nose, throat, and lungs, possibly causing you to cough and
experience shortness of breath, tiredness, and nausea.
Exposure to low levels can also result in fluid build-up in the
lungs 1 or 2 days after exposure. Breathing high levels of
nitrogen oxides can cause rapid burning, spasms, and
swelling of tissues in the throat and upper respiratory tract,
reduced oxygenation of body tissues, a build-up of fluid in
your lungs, and death.
If you were to come into skin or eye contact with high
concentrations of nitrogen oxide gases or nitrogen dioxide
liquid, you would likely experience serious burns.
We do not know if exposure to nitrogen oxides will result in
reproductive effects in humans.
How likely are nitrogen oxides to cause cancer?

EPA have not classified nitrogen oxides for potential
carcinogenicity.
How can nitrogen oxides affect children?

Children would probably be affected by exposure to nitrogen
oxides in the same ways as adults. But we do not know
nitrogen oxides.
also caused changes in the genetic material of animal cells.

But we do not know if exposure to nitrogen oxides might
cause developmental effects in humans.

nitrogen oxides?
Families with indoor gas stoves, space heaters, or indoor
cigarette smoke can minimize indoor exposure to nitrogen
oxides by periodically allowing fresh outdoor air into the
home. Farm families should not allow children to play near
silos that contain silage.

exposed to nitrogen oxides?
Specific tests for the presence of nitrogen oxides in blood or
urine are not generally useful to the doctor. If a severe
exposure has occurred, blood and urine analyses and other
tests may show whether damage has been done to your
respiratory airways. Some of these tests may be done at the
doctors office, others may require a clinic or hospital that
have specialized equipment.

The EPA has established that the average concentration of
nitrogen dioxide in ambient air in a calendar year should not
exceed 0.053 parts of nitrogen dioxide per million parts of air
(0.053 ppm).
has set a limit of 25 ppm of nitric oxide in workplace air
during an 8-hour workday, 40-hour work week. OSHA has
also set a 15-minute exposure limit of 5 ppm for nitrogen
dioxide in workplace air.
Exposure of pregnant animals to nitrogen oxides has resulted

in toxic effects in developing fetuses. Nitrogen oxides have
NITROPHENOLS
CAS # 88-75-5 and 100-02-07
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about nitrophenols. For more
summaries about hazardous substances and their health effects. This information is mportant because
SUMMARY: Everyone is exposed to very low levels of the nitrophenols in air,

water, and soil. Workers who make or process the chemicals may be exposed
to higher levels of them. Animal studies suggest that 4-nitrophenol may cause
a blood disorder. These chemicals have been found in at least 113 of 1,416
What are nitrophenols?
(Pronounced ntr f nolz)
q Very little is known about the fate of nitrophenols in air.
Nitrophenols include two chemicals, 2-nitrophenol and

4-nitrophenol, which are very similar to each other. They are
manufactured chemicals that do not occur naturally in the
environment. The manufacture of one almost always produces
a little of the other, so they are grouped together when
discussing their properties and harmful effects.
q It takes a long time for nitrophenols to break down in

deep soil and in groundwater.
2-Nitrophenol is a light yellow solid with a peculiar

sweet smell. 4-Nitrophenol is a colorless to light yellow solid
with very little odor.
2-Nitrophenol is used mainly to make dyes, paint
coloring, rubber chemicals, and substances that kill molds.
4-Nitrophenol is used mainly to make drugs, fungicides, dyes,
and to darken leather.
What happens to nitrophenols when they

q Most nitrophenols enter the environment during manufacturing and processing.
q Nitrophenols can be formed in the air as a result of the
breakdown of many other manufactured chemicals.
q Most goes to water and soil; little goes to the air.
q They readily break down in surface water.
q Nitrophenols have not been found in foods.

q They are a breakdown product of other pesticides
including parathion and fluoridifen. They are also formed
in auto exhaust.
How might I be exposed to nitrophenols?

q Exposure to very low levels of nitrophenols in air, water,
and soil.
q Breathing contaminated workplace air with higher levels
of the chemicals (especially during spills).
q Breathing contaminated air (during application) or
drinking contaminated water near farming areas where
certain fungicides are used.
q Breathing contaminated air or drinking contaminated
water near waste sites and landfills.
How can nitrophenols affect my health?

There are no studies that have looked at the effects of the
nitrophenols in people. All our information comes from
studies in animals. Some studies in animals have shown that

NITROPHENOLS
CAS # 88-75-5 and 100-02-7
Page 2

4-nitrophenol is more harmful than 2-nitrophenol when given
in high amounts over a short time, but we have very little
other information on the effects from longer time exposures at
lower levels.
Rats that breathed moderate levels of 4-nitrophenol for
two weeks developed a blood disorder that reduced the ability
of the blood to carry oxygen to tissues and organs. However,
these abnormalities disappeared a few days after exposure
stopped. No other harmful effects to other systems or organs
were seen.
Skin irritation has been noted in animals that had large
amounts of 4-nitrophenol applied to their skin, and eye
irritation when it was applied to the eye. These effects are
most likely due to the large amount used and not to a specific
harmful effect of nitrophenols.
No birth defects were seen in the offspring of animals that
ingested large quantities of 4-nitrophenol. There is no
information from animal studies on the effects of ingesting
low levels of nitrophenols.
The amounts given to animals that produce the harmful
effects are several hundred to several thousand times higher
than those people are generally exposed to.

been exposed to nitrophenols?
There is a medical test available to measure levels of
4-nitrophenol in urine and blood. However, this test will
only detect the chemical when exposure has been very recent
because 4-nitrophenol leaves the body through the urine
within a few hours.
Other chemicals can produce the same effects on the
blood as 4-nitrophenol, so it is not possible to tell from the
blood test whether the exposure was from 4-nitrophenol only.
No tests are available to measure exposure to
2-nitrophenol.

The EPA requires that discharges or accidental spills into
the environment of 100 pounds or more of the nitrophenols
be reported.
Glossary
How likely are nitrophenols to cause cancer?
Fungicide: Substance that kills molds.


International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified the
nitrophenols as to their human carcinogenicity.
An animal study found no evidence of cancer

when 4-nitrophenol was applied to the skin of mice, and no
studies in people are available.

1992. Toxicological profile for nitrophenols: 2-nitrophenol
and 4-nitrophenol. Atlanta, GA: U.S. Department of Health
References
OTTO FUEL II
AND ITS COMPONENTS
CAS # 106602-80-6
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about Otto Fuel II and its components.
present.
SUMMARY: Exposure to Otto Fuel II occurs in areas where Otto Fuel II is used
as a torpedo fuel or where it is made. Headaches are the most common effects from
overexposure. Other effects include loss of balance, poor eye-hand coordination,
eye irritation, nasal congestion, nausea, dizziness, and difficulty breathing. This
substance has been found in at least 2 of the 1,430 National Priorities List sites
What is Otto Fuel II?
(Pronounced t fyl 2)
Otto Fuel II is a distinct-smelling, reddish-orange, oily
liquid that the U.S. Navy uses as a fuel for torpedoes and other
weapon systems. It is a mixture of three synthetic substances:
propylene glycol dinitrate (the major component), 2nitrodiphenylamine, and dibutyl sebacate.
Propylene glycol dinitrate, a colorless liquid with an unpleasant odor, is explosive. 2-Nitrodiphenylamine is an orange solid used to control the explosion of propylene glycol
dinitrate. Dibutyl sebacate is a clear liquid used for making
plastics, many of which are used for food packaging. It is also
used to enhance flavor in some foods such as ice cream,
candy, baked goods, and nonalcoholic drinks, and is found in
some shaving creams.
What happens to Otto Fuel II and its components

q Otto Fuel II enters the environment mainly in waste water
from Naval facilities that produce it or are involved in
torpedo operations.
q All three components can be broken down by microorganisms in soil and water.
q Propylene glycol dinitrate evaporates rapidly; dibutyl

sebacate and 2-nitrodiphenylamine do not evaporate
easily.
q 2-Nitrodiphenylamine does not dissolve easily in water
and will be found associated with soil and sediments.
How might I be exposed to Otto Fuel II and its

components?
q Breathing contaminated air or touching fuel in areas
where Otto Fuel II is used or where it is made.
q Eating food that contains dibutyl sebacate.
How can Otto Fuel II and its components affect

my health?
Most of the effects of Otto Fuel II on peoples health are
believed to be caused by propylene glycol dinitrate. People
who work around Otto Fuel II report headaches, poor eye-hand
coordination, eye irritation, congested noses, nausea, dizziness, and difficulty breathing.
The most common effect of overexposure is headache.
The greater the overexposure, the larger the number of reported symptoms. People who have worked around Otto Fuel
II, but are no longer exposed to it, might feel chest pain or
rapid beating of the heart.

Page 2
OTTO FUEL II AND ITS COMPONENTS

CAS # 106602-80-6

We do not know if Otto Fuel II affects the ability of people
to have children or if it causes birth defects.
Animal studies show effects of propylene glycol dinitrate
that are similar to the effects seen in people. Exposure of animals to moderate-to-large amounts for several weeks causes
problems in the blood, such as a decreased ability of blood to
carry oxygen. The livers and kidneys of some animals exposed
to moderate levels of propylene glycol dinitrate 24 hours a
day for several months showed damage. We do not know if
these effects might also occur in persons exposed to sufficiently high concentrations.
Rats that had Otto Fuel II applied to their skin during
pregnancy gave birth to babies with low birth weights.
It is not known if propylene glycol dinitrate causes birth
defects in animals. The health of animals that ate large amounts of
dibutyl sebacate for long periods was not affected. The babies of
animals that ate large amounts of dibutyl sebacate grew more
slowly than babies of animals that did not eat it.
We do not know anything about the health effects of
2-nitrodiphenylamine in animals.
whether these compounds are carcinogenic. The carcinogenicity of 2-nitrodiphenylamine has not been studied in animals.

exposed to Otto Fuel II and its components?
No routine medical test shows if you have been exposed to
Otto Fuel II. Breakdown products of propylene glycol dinitrate
have been measured in blood and exhaled air, but these products leave your body within a day, so the tests must be given
within a few hours of exposure. No tests are known for measuring the other two components of Otto Fuel II in your body.

(NIOSH) recommends that workers not be exposed to air containing more than 0.05 parts propylene glycol dinitrate per
million parts of air (0.05 ppm) during a 10-hour workday, 40hour workweek.
Glossary
How likely are Otto Fuel II and its components
to cause cancer?
The International Agency for Research on Cancer (IARC),
the Department of Health and Human Services (DHHS), and
the EPA have not reviewed Otto Fuel II to determine whether it
is likely to cause cancer.
No human studies examine the carcinogenicity of Otto
Fuels II or any of its components. Animal studies of propylene
glycol dinitrate and dibutyl sebacate haven't determined

Reference
(ATSDR). 1995. Toxicological profile for Otto Fuel II. Atlanta, GA: U.S. Department of Health and Human Services,
PENTACHLOROPHENOL
CAS #87-86-5
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about pentachlorophenol.
HIGHLIGHTS: Pentachlorophenol is a manufactured chemical which is a

restricted use pesticide and is used industrially as a wood preservative for
utility poles, railroad ties, and wharf pilings. Exposure to high levels of
pentachlorophenol can cause increases in body temperature, liver effects,
damage to the immune system, reproductive effects, and developmental effects.
This substance has been found in at least 313 of the 1,585 National Priorities
What is pentachlorophenol?
How might I be exposed to pentachlorophenol?
Pentachlorophenol is a manufactured chemical that does not

occur naturally. Pure pentachlorophenol exists as colorless
crystals. Impure pentachlorophenol (the form usually found
at hazardous waste sites) is dark gray to brown and exists as
dust, beads, or flakes. Humans are usually exposed to
impure pentachlorophenol (also called technical grade
pentachlorophenol).
The general populations can be exposed to very low

levels of pentachlorophenol in contaminated indoor and
outdoor air, food, drinking water and soil.
People who work or live near a wood treatment facility or
in the production of utility poles, railroad ties, or wharf
pilings may be exposed to pentachlorophenol in the air or by
coming in contact with the treated wood.
People living near hazardous waste sites may also be
exposed to higher than usual levels of pentachlorophenol.
Pentachlorophenol was widely used as a pesticide and wood

preservative. Since 1984, the purchase and use of
pentachlorophenol has been restricted to certified
applicators. It is no longer available to the general public.
It is still used industrially as a wood preservative for utility
poles, railroad ties, and wharf pilings.
What happens to pentachlorophenol when it

Pentachlorophenol can be found in the air, water, and soil.
It enters the environment through evaporation from treated
wood surfaces, industrial spills, and disposal at uncontrolled
Pentachlorophenol is broken down by sunlight, other
chemicals, and microorganisms to other chemicals within a
couple of days to months.
Pentachlorophenol is found in fish and other foods, but
tissue levels are usually low.
How can pentachlorophenol affect my health?

Studies in workers show that exposure to high levels of
pentachlorophenol can cause the cells in the body to
produce excess heat. When this occurs, a person may
experience a very high fever, profuse sweating, and difficulty
breathing. The body temperature can increase to dangerous
levels, causing injury to various organs and tissues, and
even death. Liver effects and damage to the immune system
have also been observed in humans exposed to high levels
of pentachlorophenol for a long time. Damage to the thyroid
and reproductive system has been observed in laboratory
animals exposed to high doses of pentachlorophenol. Some
of the harmful effects of pentachlorophenol are caused by
the other chemicals present in technical grade
pentachlorophenol.

PENTACHLOROPHENOL
Page 2
CAS #87-86-5
How likely is pentachlorophenol to cause cancer?
them especially in the hot summer months.
Some studies have found an increase in cancer risk in

workers exposed to high levels of technical grade
pentachlorophenol for a long time, but other studies have
not found this. Increases in liver, adrenal gland, and nasal
tumors have been found in laboratory animals exposed to
high doses of pentachlorophenol.
Though pentachlorophenol has been found in some food, its

levels are low. You can minimize the risk of your familys
exposure by peeling and thoroughly washing fruits and
vegetables before cooking.
The EPA has determined that pentachlorophenol is a

probable human carcinogen and the International Agency for
Cancer Research (IARC) considers it possibly carcinogenic
to humans.
How can pentachlorophenol affect children?

Infants who were exposed to diapers and bedding which was
accidentally contaminated with pentachlorophenol had high
fevers, a large amount of sweating, difficulty breathing, and
harmful effects on the nervous system and liver, and some
died. Although these effects are similar to effects seen in
adults exposed to pentachlorophenol, we do not know
whether children and adults differ in their susceptibility to
pentachlorophenol.
We do not know if exposure to pentachlorophenol will result
Death, low body weights, decreased growth, and skeletal
effects have been observed in laboratory animals exposed to
high levels of pentachlorophenol during development.

pentachlorophenol?
Pentachlorophenol was a widely used pesticide for a long
time. Today its use is restricted and it can only be used by
certified applicators. You may have old containers of
pesticides in your attic, basement, or garage that contain
pentachlorophenol. Removing these old containers will
reduce your familys risk of exposure to pentachlorophenol.
If you live near utility poles and railroad tracks, you should
prevent your children from playing, climbing, or sitting on
Children should avoid playing in soils near hazardous waste

sites where pentachlorophenol may have been discarded.

exposed to pentachlorophenol?
Tests are available to measure pentachlorophenol and its
breakdown product in blood, urine, and body tissues.
These tests cannot be performed in the doctors office
because they require the use of special equipment. Because
pentachlorophenol leaves the body fairly quickly, these tests
are best for finding exposures that occurred within the last
several days. These tests do not tell you how much
pentachlorophenol you have been exposed to and cannot be
used to predict the occurrence, nature, or severity of toxic
effects.

The EPA has set a limit for drinking water of 1 part of
pentachlorophenol per billion parts of water (1 ppb).
has set a limit of 0.5 milligrams of pentachlorophenol per
cubic meter of workplace air (0.5 mg/m3) for 8 hour shifts and
40 hour work weeks.
(ATSDR). 2001. Toxicological Profile for Pentachlorophenol
Public Health Service. Atlanta, GA: U.S. Department of Health
PHENOL
CAS # 108-95-2
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about phenol. For more information,
HIGHLIGHTS: Phenol is a manufactured substance found in a number of

consumer products. Skin exposure to high levels of phenol has resulted in liver
damage, diarrhea, dark urine, and hemolytic anemia. Phenol has been found
What is phenol?
(Pronounced f nl)
q It can remain in water for longer than 9 days.
Phenol is a manufactured substance. It is a colorless-towhite solid when pure. The commercial product is a liquid. It
has sickeningly sweet and tarry odor.
q Small amounts of phenol may be found in organisms that

live in contaminated water.
You can taste and smell it at levels lower than those that
are associated with harmful effects. Phenol evaporates more
slowly than water, and a moderate amount can form a solution
with water. Phenol can catch fire.
How might I be exposed to phenol?
Phenol is used primarily in the formation of phenolic

resins. It is also used in the manufacture of nylon and other
synthetic fibers. It is also used in slimicides (chemicals that
kill bacteria and fungi in slimes), as a disinfectant, as an antiseptic, and in medicinal preparations, such as mouthwash and
sore throat lozenges.
What happens to phenol when it enters the

environment?
q Following small, single releases, phenol does not remain
in the air long (generally, half is removed from the air in
less than a day).
q It generally remains in the soil only about 2 to 5 days.
q Larger or repeated releases can remain in the air, water and

soil for much longer periods of time.
q You may be exposed to phenol if you work with or manufacture it.

q You may be exposed to very low levels in your home
because it is found in a number of products, including
some medicines, lotions, and ointments.
q Low levels of phenol are found in some foods, including
smoked summer sausage, fried chicken, mountain cheese,
and some species of fish.
q Phenol enters the lungs when you inhale tobacco smoke.
q It can be present in low levels in air and drinking water.
How can phenol affect my health?

In people, the effects of breathing phenol in air are not
known. People who had skin exposure to high levels had
liver damage, diarrhea, dark urine, and hemolytic anemia.
In animals, breathing air with high levels of phenol re-

PHENOL
CAS # 108-95-2
Page 2

sulted in irritation of the lungs. Repeated exposures led to
muscle tremors and loss of coordination. Exposure to high
levels of phenol for several weeks caused paralysis and severe
injury to the heart, liver, kidneys, and lungs, and in some
cases, death.
Phenol can have beneficial effects when used medically
as an antiseptic or anesthetic.

exposed to phenol?
There is a urine test that can tell if you have been exposed
to phenol recently (within 1 or 2 days). However, the test cannot tell if you were exposed only to phenol since many substances are converted to phenol in the body.
How likely is phenol to cause cancer?

It is not known if phenol causes cancer in people. Cancer

occured in mice when phenol was applied to the skin several
times each week for the lifetime of the animal. Phenol did not
cause cancer in mice or rats when they drank water containing
it for 2 years. The International Agency for Research on Cancer (IARC) has determined that phenol is not classifiable as to
EPA has a lifetime health advisory for adults for phenol in

drinking water of 4 milligrams per liter (4 mg/L). EPA also
recommends that the level of phenol in surface water (lakes,
streams) should be limited to 3.5 mg/L to protect people from
drinking contaminated water or eating contaminated fish.
How can phenol affect children?

Children are exposed to phenol in the same way adults
are. Children are at greater risk of accidently ingesting home
products that contain phenol. The effects of exposure to phenol on the human fetus are not known. Pregnant animals that
drank water containing high concentrations of phenol gave
birth to babies that had low birth weights and minor birth defects.

(OSHA) has set a limit of 5 parts per million (5 ppm) for workers during an 8-hour workshift in a 40-hour workweek.
(NIOSH) recommends that workroom air be limited to 5 ppm
over a 10-hour workday and that concentrations should not
exceed 16 ppm during a 15-minute period.

phenol?

(ATSDR). 1998. Toxicological profile for phenol. Atlanta,
Health Service.
If your doctor finds that you have been exposed to high

levels of phenol, ask if children may also be exposed. Your
doctor may need to ask your state department of health to investigate.

PHOSGENE
CAS #75-44-5
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about phosgene. For more
HIGHLIGHTS: Phosgene is a colorless, nonflammable gas at room

temperature. The general population is not exposed to significant amounts of
phosgene. Higher exposure may occur during manufacture or industrial use.
Exposure to phosgene in the air can cause eye and throat irritation. High
amounts in the air can cause severe lung damage. This substance has been
What is phosgene?
Phosgene is a colorless nonflammable gas that has the odor
of freshly cut hay. It is a manufactured chemical, but small
amounts occur naturally from the break down of chlorinated
compounds.
Phosgene is used in the manufacture of other chemicals
such as dyestuffs, isocyanates, polycarbonates and acid
chlorides; it is also used in the manufacture of pesticides
and pharmaceuticals. Phosgene can also be used to
separate ores.
Phosgene is a gas at room temperature, but is sometimes
stored as a liquid under pressure or refrigeration.
What happens to phosgene when it enters the

environment?
When released to air, phosgene will exist solely as a gas.
Phosgene gas is degraded in the atmosphere by reacting
with substances commonly found in the air, but this is a
very slow process. Phosgene in the air may also react with
moisture in clouds or rain and be broken down into other
compounds.
Phosgene will react with water and be broken down into

other products. Some of the phosgene that is not broken
down may evaporate into air.
When released to soil, phosgene will not stick to the soil.
Small amounts may evaporate into air or pass through the
soil surface and contaminate groundwater. Most of the
phosgene in soil will be broken down when it comes into
contact with moisture.
Phosgene does not accumulate in the food chain.
How might I be exposed to phosgene?

The general population may be exposed to very low levels
of phosgene by breathing in air.
Phosgene is released during the welding of metals that
have been cleaned up with chlorinated solvents, so welders
may be exposed to this compound.
Phosgene is used to produce a variety of other
compounds like dyes and pesticides, so workers employed in
these fields may be exposed to this compound.

PHOSGENE
Page 2
CAS #75-44-5
How can phosgene affect my health?

Phosgene can be harmful if you breathe it. Exposure to low
levels can cause eye and throat irritation making you to
cough or wheeze. Higher levels of phosgene gas can cause
your lungs to swell, making it difficult to breathe. This can
happen quickly or might not be noticed until the next day.
Even higher levels can result in severe damage to your lungs
that might lead to death.
Available studies of workers exposed for long periods of time
to low levels of phosgene gas have not shown increased
chances of developing lung problems.
If you get phosgene gas or liquid on your skin or in your
eyes, you may develop chemical burns. Phosgene liquid may
also cause frostbite. However, you are not likely to come
into contact with liquid phosgene. In the unlikely case that
you swallow phosgene liquid, your mouth, throat,
esophagus, and stomach could be damaged.
No information is available regarding the potential of
phosgene to cause reproductive effects.
How likely is phosgene to cause cancer?

EPA have not classified phosgene as to its carcinogenicity.
phosgene might cause cancer.
How can phosgene affect children?
in children exposed to phosgene will be similar to the effects

seen in adults. We do not know whether children differ from
adults in their susceptibility to phosgene.
We do not know if exposure to phosgene will result in birth
defects or other developmental effects in humans.

phosgene?
phosgene. However, the burning of materials such as certain
plastics that contain chlorinated hydrocarbons can produce
phosgene gas. You should stay away from fires or other
heat sources where such materials may be present.

exposed to phosgene?
There are no tests to positively determine whether you have
been exposed to phosgene. If you suspect that you may
have been exposed to phosgene, a chest X-ray may be the
quickest way to determine if your lungs have been damaged.
This can be done in a hospital, clinic, or doctors office that
has an X-ray machine.

sets a limit of 0.1 part of phosgene in a million parts of air
(0.1 ppm) in the workplace for an 8-hour work shift, 40-hour
work week.

exposed to phosgene. It is likely that the health effects seen
PHOSGENE OXIME
CAS #1794-86-1
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about phosgene oxime. For more
HIGHLIGHTS: Phosgene oxime was developed as a chemical warfare agent.

Only people working near where phosgene oxime has been stored are at risk of
being exposed to this substance. Exposure to high levels of phosgene oxime
vapors may cause severe lung damage, and even death. Contact with gaseous,
liquid, or solid phosgene oxime may result in severe skin or eye damage.
Phosgene oxime has been found in at least 1 of the 1,585 National Priorities
What is phosgene oxime?
Phosgene oxime is a manufactured chemical that was
developed as a potential chemical warfare agent, but its use
on the battlefield has never been documented. It has a
disagreeable penetrating odor. Pure phosgene oxime is a
colorless, crystalline solid; the munitions grade compound is
a yellowish-brown liquid. Both the liquid and the solid can
give off vapors at ambient temperatures.
What happens to phosgene oxime when it enters

the environment?
When released to air, phosgene oxime will exist solely in
the gas-phase. Phosgene oxime vapors are broken down in
the atmosphere by reacting with substances commonly
found in the air, but this is a very slow process. Phosgene
oxime in the air may also react with moisture in clouds or
rain and be broken down into other compounds.
Phosgene oxime will react with water or be broken down
into other products by bacteria. Some of the phosgene
oxime that is not broken down may evaporate into air.
Phosgene oxime will not stick to the soil. Small amounts

may evaporate into air or travel below the soil surface and
contaminate groundwater. Most of the phosgene oxime in
soil will be broken down upon contact with moisture or be
degraded by bacteria.
Phosgene oxime does not accumulate in the food chain.
How might I be exposed to phosgene oxime?

It is not likely that you would be exposed to phosgene
oxime; it has never been known to have been used in
chemical warfare.
How can phosgene oxime affect my health?

Breathing phosgene oxime vapors can cause severe
bronchitis and accumulation of fluid in the lungs. Skin
contact with phosgene oxime will cause swelling and itching
hives that can also result in immediate and painful skin
damage. Eye contact may result in severe pain and
conjunctivitis. Phosgene oxime is absorbed through the

PHOSEGENE OXIME
Page 2
CAS #1794-86-1
skin and eye; this can also result in pulmonary edema.

Inhaling or directly contacting significant amounts of
phosgene oxime can result in death.
We do not know what happens if you swallow phosgene
oxime liquid or solid. However, animal studies indicate that if
you did, you might suffer swelling and bleeding of the
gastrointestinal tract.
The effects of long-term exposure to phosgene oxime in
humans are not known.
We do not know if exposure to phosgene oxime might cause
reproductive effects in humans.
How likely is phosgene oxime to cause cancer?

EPA have not classified phosgene oxime for carcinogenicity.
phosgene oxime might cause cancer.
How can phosgene oxime affect children?

exposed to phosgene oxime. It is likely that the health
effects seen in children exposed to phosgene oxime would be
similar to the effects seen in adults. We do not know
phosgene oxime.
We do not know if exposure to phosgene oxime would result

in birth defects or other developmental effects in people and
no information exist from animal studies.

phosgene oxime?
Most families will not be exposed to phosgene oxime.

exposed to phosgene oxime?
There are no tests to positively determine whether you have
been exposed to phosgene oxime. If you suspect that you
may have been exposed to phosgene oxime, a chest X-ray
may be the quickest way to determine if your lungs have
been damaged. This can be done in a hospital, clinic, or
doctors office that has an X-ray machine.

No standards or recommendations are available for phosgene
oxime.
PHOSPHINE
CAS #7803-51-2
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about phosphine. For more
HIGHLIGHTS: The general population may be exposed to very small amounts

of phosphine in air, food or water. Workers who use this chemical may be
exposed to higher levels. Exposure to phosphine can cause abdominal pain,
nausea, and vomiting. High levels can cause weakness, bronchitis, pulmonary
edema, shortness of breath, convulsions, and death. Phosphine has been found
What is phosphine?
Phosphine does not accumulate in the food chain.
Phosphine is a colorless, flammable, and explosive gas at

ambient temperature that has the odor of garlic or decaying
fish. Small amounts occur naturally from the break down of
organic matter. It is slightly soluble in water.
How might I be exposed to phosphine?
Phosphine is used in semiconductor and plastics industries,

in the production of a flame retardant, and as a pesticide in
stored grain.
What happens to phosphine when it enters the

environment?
In the air, phosphine will exist solely as a gas. Phosphine
gas reacts with substances commonly found in the air. Half
of the phosphine in the air degrades in about 1 day. At high
concentrations, phosphine vapors may spontaneously
combust in air.
Phosphine is expected to react with water and be broken
down into other products. Some of the phosphine that is
not broken down may evaporate into air.
Phosphine breaks down rapidly in the environment so the

general population may only be exposed to small amounts of
this compound by inhaling air, drinking water and eating
foods.
Since phosphine is used to kill insects and rodents in
stored grain and tobacco, workers who use this product may
be exposed to it. People who live near where it is being
used may also breathe in small amounts of it.
How can phosphine affect my health?

Inhalation is the most likely route of exposure to phosphine.
Early symptoms of acute phosphine intoxication include
pain in the diaphragm, nausea, vomiting, excitement, and a
phosphorus smell on the breath. Higher levels can cause
weakness, bronchitis, pulmonary edema, shortness of breath,
convulsions, and death. Some effects, such as pulmonary
edema, convulsions, and liver injury, may appear or continue
to be present days after an exposure.
When released to soil, phosphine is broken down very

quickly.
PHOSPHINE
Page 2
CAS #7803-51-2

Long-term exposure to very low levels of phosphine can
result in anemia, bronchitis, gastrointestinal effects, and
visual, speech and motor problems.
with metal phosphide pesticide can produce phosphine

intoxication when the solid phosphide contacts acid in the
stomach.
Liquid phosphine on your skin can cause frostbite.

Ingestion of metal phosphides results in release of
phosphine in your stomach which can cause nausea,
vomiting, abdominal pain, and diarrhea.
Phosphine and metal phosphides are used to kill rats in

areas used for grain storage, but should not be used in
family dwellings.
No information is available regarding reproductive effects in

humans exposed to phosphine gas. Phosphine has not been
shown to cause reproductive effects in laboratory animals.
How likely is phosphine to cause cancer?

The EPA has determined that phosphine is not classifiable as
to its human carcinogenicity.
How can phosphine affect children?

Children appear to be affected by exposure to phosphine in
the same ways as adults. Accidental exposure of children
has resulted in vomiting, headache, fatigue, and damage to
the heart. In a fatal case, a 2-year-old child died with
congestive heart failure, pulmonary edema, congestion on the
membranes that surround the lungs, enlarged spleen, and
aspiration of the gastrointestinal contents.
We do not know if exposure to phosphine will result in birth
Always store pesticides in safe containers, in a safe place

out of the reach of children.

exposed to phosphine?
There are no specific blood or urine tests for phosphine
itself. Breakdown products of phosphine can be measured in
urine. If a severe exposure has occurred, blood and urine
analyses and other tests may show whether the lungs and
heart have been damaged. These tests would most likely be
performed in a hospital following severe exposure to
phosphine.

sets a limit of 0.3 parts of phosphine per million parts of
workroom air (0.3 ppm) for an 8-hour work shift, 40 hour
work week.

phosphine?
phosphine. However, consumption of food contaminated
WHITE PHOSPHORUS
CAS # 7723-14-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about white phosphorus. For more
HIGHLIGHTS: White phosphorus is a waxy solid which burns easily and is used
in chemical manufacturing and smoke munitions. Exposure to white phosphorus
may cause burns and irritation, liver, kidney, heart, lung, or bone damage, and
death. White phosphorus has been found in at least 77 of the 1,416 National
What is white phosphorus?
(Pronounced hwt fsfr-s)
White phosphorus is a colorless, white, or yellow waxy
solid with a garlic-like odor. It does not occur naturally, but is
manufactured from phosphate rocks.
White phosphorus reacts rapidly with oxygen, easily
catching fire at temperatures 10 to 15 degrees above room
temperature.
White phosphorus is used by the military in various types
of ammunition, and to produce smoke for concealing troop
movements and identifying targets.
It is also used by industry to produce phosphoric acid and
other chemicals for use in fertilizers, food additives, and cleaning compounds. Small amounts of white phosphorus were
used in the past in pesticides and fireworks.
What happens to white phosphorus when it

q White phosphorus can enter the environment when it is
made, used in manufacturing or by the military, or accidentally spilled during transport and storage.
q It can be found in the water and bottom sediment of rivers

and lakes near facilities that make or use it.
q In the air, white phosphorus reacts rapidly with oxygen to
produce relatively harmless chemicals within minutes.
q In water, white phosphorus reacts with oxygen within
hours or days.
q In water with low oxygen, white phosphorus may degrade
to a highly toxic compound called phosphine, which
eventually evaporates to the air and is changed to less
harmful chemicals.
q White phosphorus can build up slightly in the bodies of
fish that live in contaminated lakes or streams.
q In soil, white phosphorus may stick to particles and be
changed within a few days to less harmful compounds.
q In deep soil or sediments with little oxygen, white phosphorus may remain unchanged for many years.
How might I be exposed to white phosphorus?

q Breathing contaminated air near a facility that is using
white phosphorus.
q Eating contaminated fish or game birds from sites containing white phosphorus.
q Drinking or swimming in water that has been contaminated with white phosphorus.

WHITE PHOSPHORUS
CAS # 7723-14-0
Page 2

q Touching soil contaminated with white phosphorus.
q If you work in industries that use or manufacture white
phosphorus or munitions containing white phosphorus.
How can white phosphorus affect my health?

that may be caused by white phosphorus. Most of what is
known about the effects of breathing white phosphorus is from
studies of workers. Most of what is known about the effects of
eating white phosphorus is from reports of people eating rat
poison or fireworks that contained it.
Breathing white phosphorus for short periods may cause
coughing and irritation of the throat and lungs. Breathing
white phosphorus for long periods may cause a condition
known as phossy jaw which involves poor wound healing of
the mouth and breakdown of the jaw bone.
Eating or drinking small amounts of white phosphorus
may cause liver, heart, or kidney damage, vomiting, stomach
cramps, drowsiness, or death. We do not know what the effects
are from eating or drinking very small amounts of white phosphorus-containing substances over long periods of time. Skin
contact with burning white phosphorus may burn skin or
cause liver, heart, and kidney damage.
We do not know whether or not white phosphorus can
affect the ability to have children or cause birth defects in
people.
How likely is white phosphorus to cause cancer?

The EPA has determined that white phosphorus is not
classifiable as to its carcinogenicity in humans. There are no
studies available in people or animals that suggest white phosphorus causes cancer.

exposed to white phosphorus?
There is no medical test that shows if you have been ex-
posed to white phosphorus. However, the above health effects

may lead your doctor to suspect that you have been exposed, if
you have a history of exposure.

The EPA has listed white phosphorus as a Hazardous Air
Pollutant. The EPA requires that spills or accidental releases
into the environment of 1 pound or more of white phosphorus
Health (NIOSH), the Occupational Safety and Health Administration (OSHA), and the American Conference of Governmental Industrial Hygienists (ACGIH) have all set the inhalation exposure limit for white phosphorus in the workplace
during an 8-hour workday at 0.1 milligram of white phosphorus per cubic meter of air (0.1 mg/m3).
Glossary
body of water.
This ToxFAQs information is taken from the 1997 Toxicological Profile for White Phosphorous produced by the Agency
PLUTONIUM
CAS # 7440-07-5
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about plutonium. For more
HIGHLIGHTS: Plutonium is a radioactive material that does not occur

naturally to any extent, but is produced in nuclear reactors. It has been found
to cause lung, liver, and bone cancer in animals. This chemical has been found
What is plutonium?
(Pronounced pl-tn-m)
Plutonium is a silvery white metal that exists as a solid
under normal conditions. It is produced when uranium
absorbs an atomic particle. Trace amounts of plutonium occur
naturally, but large amounts have been produced in nuclear
reactors. Trace levels of plutonium can be found in the environment, from past nuclear bomb tests, in several forms called
isotopes. The most common plutonium isotopes are plutonium-238 and plutonium-239.
Plutonium undergoes radioactive decay. In this decay
process, energy is released and a new product is formed. The
energy released is called radiation. When plutonium decays,
it divides into two partsa small part that is called alpha
radiation and a large part called a daughter. The daughter is
also radioactive, and it, too, continues to decay until a nonradioactive daughter is formed. During these decay processes,
three types of radiation are releasedalpha, beta, and gamma.
Alpha particles can travel only a short distance and cannot
travel through your skin. Beta particles can penetrate through
your skin, but they cannot go all the way through your body.
Gamma radiation can go all the way through your body.
What happens to plutonium when it enters the

environment?
q Trace amounts of plutonium are found naturally in uranium-rich ores. Most is made in special nuclear reactors.
q It may also enter the environment from releases from
nuclear reactors, weapons production plants, and research
facilities.
q A major source of plutonium is releases from nuclear weapons testing.
q Plutonium may enter surface water from accidental releases
and disposal of radioactive wastes.
q Soil may become contaminated with plutonium from fallout from nuclear weapons testing.
q Plutonium can move slowly from soil into the groundwater.
q Low levels may be absorbed by plants.
How might I be exposed to plutonium?

q Everyone is exposed to very low levels of plutonium in air.
q Very low levels may be found in drinking water and food.
q Exposure to higher levels could occur from an accidental
release during its use, transport, or disposal.

PLUTONIUM
CAS # 7440-07-5
Page 2

q Workers at nuclear facilities using plutonium may be exposed to higher levels of it.
q People who live near facilities that use plutonium in their
operations may be exposed to it from releases to the air.

q It may also be found at radioactive waste disposal sites.
The EPA has set a drinking water limit of 15 picocuries

per liter (15 pCi/L) for gross alpha particle activity.
How can plutonium affect my health?
The EPA has also set a drinking water limit of 4 millirems

per year (4 mrem/yr) for beta and gamma radiation.
Plutonium has not been shown to cause adverse health

effects in people. Animal studies have shown lung diseases
from short-term exposure to high concentrations of plutonium.
Animal studies have also shown effects on the blood, liver,
bone, and immune system from plutonium exposure.
How likely is plutonium to cause cancer?

Studies in people have found no cancer from plutonium.
Animal studies have reported an increase in lung, liver, and
bone cancers from exposure to plutonium. The Department of
Health and Human Services (DHHS), the International Agency
for Research on Cancer (IARC), and the EPA have not classified plutonium for carcinogenicity.

exposed to plutonium?
There are tests available that can measure the amount of
plutonium in a urine sample, even at very low levels. These
measurements can be used to estimate the total amount of
plutonium that is in the body. However, these measurements
cannot be used to determine the levels to which the person was
exposed or to predict the potential for health effects. There are
also tests to measure plutonium in body organs, feces, bones,
and milk. These tests require special equipment and cannot be
routinely done in a doctors office.
The Nuclear Regulatory Commission (NRC) has set a

radiation dose limit for individual members of the public for
all sources of radiation of 0.5 rem per year (0.5 rem/yr).
July 1999.
Glossary
Millirem (mrem): A unit used to measure radiation dose (one
thousandth of a rem).
Picocurie (pCi): A unit used to measure the amount of
radioactive material.
rem: A unit used to measure radiation dose.
(ATSDR). 1990. Toxicological profile for plutonium.
POLYBROMINATED BIPHENYLS and

POLYBROMINATED DIPHENYL ETHERS
September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about polybrominated
biphenyls and polybrominated diphenyl ethers. For more information, call the ATSDR Information
Center at 1-888-422-8737. This fact sheet is one in a series of summaries about hazardous substances
and their health effects. It is important you understand this information because this substance may
harm you. The effects of exposure to any hazardous substance depend on the dose, the duration, how
you are exposed, personal traits and habits, and whether other chemicals are present.
HIGHLIGHTS: Polybrominated biphenyls (PBBs) and polybrominated diphenyl

ethers (PBDEs) are manmade chemicals found in plastics used in a variety of
consumer products to make them difficult to burn. Some people who ate food
contaminated with PBBs in the 1970s had skin problems. Almost nothing is known
about health effects of PBDEs in people. PBBs have been found in at least 9 of
the 1,613 National Priorities List sites identified by the Environmental Protection
Agency (EPA). PBDEs have not been identified in any of the 1,613 sites.
What are PBBs and PBDEs?
PBBs and PBDEs are manufactured chemicals found in plastics
used in a variety of consumer products (computer monitors,
televisions, textiles, plastic foams, etc.) to make them difficult to
burn. Because they are mixed into plastics rather than bound to
them, they can leave the plastic and find their way into the
environment. PBBs and PBDEs are similar, but not identical
compounds. Both are colorless to off-white solids. Both PBBs
and PBDEs are mixtures of up to 209 individual component
chemicals called congeners.
The manufacture of PBBs was discontinued in the United States
in 1976, while production of PBDEs has continued to the present.
Trade names of some commercial PBB mixtures include
FireMaster BP-6 and FireMaster FF-1. Trade names of some
PBDE commercial mixtures include Bromkal 70-5DE, Tardex
50L , and Saytex 115 .
What happens to PPBs and PBDEs when they

PBBs entered the air, water and soil during their manufacture
and use.
PBBs entered the environment when animal feed was
accidentally mixed with PBBs in lower Michigan in 1973.
PBBs entered the environment during the disposal of
contaminated animal feed and animal products, and during the
disposal of plastic products containing PBBs in waste sites.
Small amounts entered the environment from improper
incineration of plastics containing PBBs.
PBDEs entered air, water, and soil during their manufacture and
use in consumer products.
In air, PBDEs can be present as particles, but eventually settle
to soil or water.
Sunlight can degrade some PBDEs in air.

PBDEs do not dissolve easily in water, but stick to particles
and settle to the bottom of river or lakes.
Some PBDEs in water can build up in fish.
How might I be exposed to PBBs and PBDEs?

Exposure to PBBs by the general population will be mainly
from past releases.
Michigan residents who ate animal products contaminated with
PBBs were exposed to these chemicals.
Some people living in Michigans lower peninsula may still be
experiencing exposure to PBBs.
You can be exposed to PBBs in the air if you live near a waste
site that contains PBBs.
Low levels of PBDEs are found in air, sediments, animals, and
food.
Analyses of blood, breast milk, and body fat indicate that most
people are exposed to low levels of PBDEs.
Exposure to higher levels of PBDEs can occur in workers who
produce or manufacture PBDE-containing products.
Exposure to PBDEs can also occur if you work in a confined
place where plastics and foam products are recycled, and
computers are repaired.
How can PBBs and PBDEs affect my health?

Most of what we know about the health effects of PPBs in
people comes from studies of people in Michigan who ate PBBcontaminated animal products for several months. Some residents
complained of nausea, abdominal pain, loss of appetite, joint pain,
fatigue, and weakness. However, it could not be clearly
established that PBBs were the cause of these health problems.
There is stronger evidence that PBBs may have caused skin
problems, such as acne, in some people who ate contaminated

Page 2
POLYBROMINATED BIPHENYLS and

POLYBROMINATED DIPHENYL ETHERS
food. Some workers exposed to PBBs by breathing and skin

contact for days to months also developed acne.
Studies in animals exposed to large amounts of PBBs for a short
time or to smaller amounts for longer time show that PBBs can
cause weight loss, skin disorders, nervous and immune system
effects, and effects on the liver, kidneys, and thyroid gland.
There is no definite information on health effects of PBDEs in
people. Rats and mice that ate food with moderate amounts of
PBDEs for a few days had effects on the thyroid gland. Those
that ate smaller amounts for weeks or months had effects on the
thyroid and the liver. Preliminary evidence suggests that PBDEs
may cause neurobehavioral alterations and affect the immune
system in animals.
How likely are PBBs and PBDEs to cause

cancer?
We do not know whether PBBs can cause cancer in humans, but
we know that they can cause liver cancer in rats and mice. Based
on the findings in animals, the Department of Health and Human
Services (DHHS) determined that PBBs may reasonably be
anticipated to be carcinogens. The International Agency for
Research on Cancer (IARC) has determined that PBBs are possibly
carcinogenic to humans.
We do not know whether PBDEs can cause cancer in humans. Rats
and mice that ate food with decabromodiphenyl ether (one type of
PBDEs) throughout their lives, developed liver tumors. Based on
this evidence, the EPA has classified decabromodiphenyl ether as a
possible human carcinogen.
How can PBBs and PBDEs affect children?

Children are exposed to PBBs and PBDEs in generally the same
way as adults, mainly by eating contaminated food. Because PBBs
and PBDEs dissolve readily in fat, they can accumulate in breast
milk fat and be transferred to babies and young children. They can
also cross the placenta and reach the fetus.
No specific health effects attributed to PBBs were found in
children who ate contaminated food in the Michigan accident or in
children born to mothers who ate the contaminated food. No
studies are available of children exposed to PBDEs.
Neurobehavioral alterations have been found in animals that were
exposed to PBBs in the womb and by nursing. Such exposures also
caused changes in thyroid hormone levels in the newborn animals
and birth defects. Exposure to PBDEs in the womb and through
nursing has also caused thyroid effects and neurobehavioral
alterations in newborn animals, but not birth defects.

PBBs and PBDEs?
Since PBBs are no longer produced or used, the risk of exposure
to these compounds is limited.
Do not eat fish or wildlife caught in contaminated locations;
always follow posted health warnings.
Discourage children from playing in the dirt near waste sites.
Discourage children from eating dirt, from putting their hands in
their mouths or from doing other hand-to mouth activities.
If you are exposed to PBDEs at work, you may carry PBDEs
home on your skin, clothes, or tools. You can avoid this by
showering, and changing clothing before leaving work, and your
work clothes should be kept separate from other clothes and
laundered separately.

exposed PBBs and PBDEs?
There are tests that can detect PBBs and PBDEs in blood, body
fat, and breast milk. These tests can tell whether you have been
exposed to high levels of the chemicals, but cannot tell the exact
amount or type of PBB or PBDE you were exposed to, or
whether harmful effects will occur. Blood tests are the easiest and
safest for detecting recent exposures to large amounts of PBBs or
PBDEs. These tests are not routinely available at the doctors
office, but samples can be sent to laboratories that have the
appropriate equipment.

There are no federal guidelines or recommendations for protecting
human health from exposure to PBBs.
The EPA requires that companies that transport, store, or dispose
p-bromodiphenyl ether (a particular PBDE compound) follow the
rules and regulations of the federal hazardous waste management
program. The EPA requires that industry tell the National
Response Center each time 100 pounds or more of pbromodiphenyl ether are released to the environment.
2002. Toxicological Profile for Polybrominated Biphenyls and
Polybrominated Biphenyl Ethers (Draft for Public Comment).
POLYCHLORINATED
BIPHENYLS
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about polychlorinated biphenyls. For more information,
call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one in a series of summaries about hazardous substances
and their health effects. Its important you understand this information because this substance may harm you. The effects of
exposure to any hazardous substance depend on the dose, the duration, how you are exposed, personal traits and habits, and whether
HIGHLIGHTS: Polychlorinated biphenyls (PCBs) are a mixture of individual chemicals which are no longer produced
in the United States, but are still found in the environment. Health effects that have been associated with exposure
to PCBs include acne-like skin conditions in adults and neurobehavioral and immunological changes in children.
PCBs are known to cause cancer in animals. PCBs have been found in at least 500 of the 1,598 National Priorities
What are polychlorinated biphenyls?
Polychlorinated biphenyls are mixtures of up to 209
individual chlorinated compounds (known as congeners).
There are no known natural sources of PCBs. PCBs are
either oily liquids or solids that are colorless to light yellow.
Some PCBs can exist as a vapor in air. PCBs have no known
smell or taste. Many commercial PCB mixtures are known in
the U.S. by the trade name Aroclor.
PCBs have been used as coolants and lubricants in
transformers, capacitors, and other electrical equipment
because they dont burn easily and are good insulators.
The manufacture of PCBs was stopped in the U.S. in 1977
because of evidence they build up in the environment and
can cause harmful health effects. Products made before 1977
that may contain PCBs include old fluorescent lighting
fixtures and electrical devices containing PCB capacitors,
and old microscope and hydraulic oils.
What happens to PCBs when they enter the environment?
PCBs entered the air, water, and soil during their
manufacture, use, and disposal; from accidental spills and
leaks during their transport; and from leaks or fires in
products containing PCBs.
PCBs can still be released to the environment from
hazardous waste sites; illegal or improper disposal of
industrial wastes and consumer products; leaks from old
electrical transformers containing PCBs; and burning of
some wastes in incinerators.
PCBs do not readily break down in the environment and
thus may remain there for very long periods of time. PCBs
can travel long distances in the air and be deposited in areas
far away from where they were released. In water, a small
amount of PCBs may remain dissolved, but most stick to
organic particles and bottom sediments. PCBs also bind
strongly to soil.
PCBs are taken up by small organisms and fish in water.
They are also taken up by other animals that eat these
aquatic animals as food. PCBs accumulate in fish and marine

mammals, reaching levels that may be many thousands of
times higher than in water.
How might I be exposed to PCBs?
Using old fluorescent lighting fixtures and electrical
devices and appliances, such as television sets and
refrigerators, that were made 30 or more years ago. These
items may leak small amounts of PCBs into the air when they
get hot during operation, and could be a source of skin
exposure.
Eating contaminated food. The main dietary sources of
PCBs are fish (especially sportfish caught in contaminated
lakes or rivers), meat, and dairy products.
Breathing air near hazardous waste sites and drinking
contaminated well water.
In the workplace during repair and maintenance of PCB
transformers; accidents, fires or spills involving transformers,
fluorescent lights, and other old electrical devices; and
disposal of PCB materials.
How can PCBs affect my health?
The most commonly observed health effects in
people exposed to large amounts of PCBs are skin
conditions such as acne and rashes. Studies in exposed
workers have shown changes in blood and urine that may
indicate liver damage. PCB exposures in the general
population are not likely to result in skin and liver effects.
Most of the studies of health effects of PCBs in the general
population examined children of mothers who were exposed
to PCBs.
Animals that ate food containing large amounts of
PCBs for short periods of time had mild liver damage and
some died. Animals that ate smaller amounts of PCBs in
food over several weeks or months developed various kinds
of health effects, including anemia; acne-like skin conditions;
and liver, stomach, and thyroid gland injuries. Other effects

Page 2
POLYCHLORINATED BIPHENYLS
of PCBs in animals include changes in the immune system,

behavioral alterations, and impaired reproduction. PCBs are
not known to cause birth defects.
How likely are PCBs to cause cancer?
Few studies of workers indicate that PCBs were
associated with certain kinds of cancer in humans, such as
cancer of the liver and biliary tract. Rats that ate food
containing high levels of PCBs for two years developed liver
cancer. The Department of Health and Human Services
(DHHS) has concluded that PCBs may reasonably be
anticipated to be carcinogens. The EPA and the
International Agency for Research on Cancer (IARC) have
determined that PCBs are probably carcinogenic to humans.
How can PCBs affect children?
Women who were exposed to relatively high levels
of PCBs in the workplace or ate large amounts of fish
contaminated with PCBs had babies that weighed slightly
less than babies from women who did not have these
exposures. Babies born to women who ate PCBcontaminated fish also showed abnormal responses in tests
of infant behavior. Some of these behaviors, such as
problems with motor skills and a decrease in short-term
memory, lasted for several years. Other studies suggest that
the immune system was affected in children born to and
nursed by mothers exposed to increased levels of PCBs.
There are no reports of structural birth defects caused by
exposure to PCBs or of health effects of PCBs in older
children. The most likely way infants will be exposed to
PCBs is from breast milk. Transplacental transfers of PCBs
were also reported In most cases, the benefits of breastfeeding outweigh any risks from exposure to PCBs in
mothers milk.
How can families reduce the risk of exposure to PCBs?
You and your children may be exposed to PCBs by eating
fish or wildlife caught from contaminated locations. Certain
states, Native American tribes, and U.S. territories have
issued advisories to warn people about PCB-contaminated
fish and fish-eating wildlife. You can reduce your familys
exposure to PCBs by obeying these advisories.
Children should be told not play with old appliances,
electrical equipment, or transformers, since they may contain

PCBs.
Children should be discouraged from playing in the dirt
near hazardous waste sites and in areas where there was a
transformer fire. Children should also be discouraged from
eating dirt and putting dirty hands, toys or other objects in
their mouths, and should wash hands frequently.
If you are exposed to PCBs in the workplace it is possible
to carry them home on your clothes, body, or tools. If this is
the case, you should shower and change clothing before
leaving work, and your work clothes should be kept separate
from other clothes and laundered separately.
Is there a medical test to show whether Ive been exposed to
PCBs?
Tests exist to measure levels of PCBs in your blood,
body fat, and breast milk, but these are not routinely
conducted. Most people normally have low levels of PCBs
in their body because nearly everyone has been
environmentally exposed to PCBs. The tests can show if
your PCB levels are elevated, which would indicate past
exposure to above-normal levels of PCBs, but cannot
determine when or how long you were exposed or whether
you will develop health effects.
Has the federal government made recommendations to
protect human health?
The EPA has set a limit of 0.0005 milligrams of PCBs
per liter of drinking water (0.0005 mg/L). Discharges, spills or
accidental releases of 1 pound or more of PCBs into the
environment must be reported to the EPA. The Food and
Drug Administration (FDA) requires that infant foods, eggs,
milk and other dairy products, fish and shellfish, poultry and
red meat contain no more than 0.2-3 parts of PCBs per million
parts (0.2-3 ppm) of food. Many states have established fish
and wildlife consumption advisories for PCBs.
(ATSDR). 2000. Toxicological profile for polychlorinated
biphenyls (PCBs). Atlanta, GA: U.S. Department of Health
POLYCYCLIC AROMATIC
HYDROCARBONS (PAHs)
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about polycyclic aromatic
hydrocarbons (PAHs). For more information, call the ATSDR Information Center at 1-888-422-8737.
This fact sheet is one in a series of summaries about hazardous substances and their health effects. This
information is important because this substance may harm you. The effects of exposure to any hazardous
SUMMARY: Exposure to polycyclic aromatic hydrocarbons usually occurs by

breathing air contaminated by wild fires or coal tar, or by eating foods that have
been grilled. PAHs have been found in at least 600 of the 1,430 National Priorities
What are polycyclic aromatic hydrocarbons?
q PAHs enter water through discharges from industrial and

wastewater treatment plants.
(Pronounced pl-sklk r-mtk hdrkarbnz)
q Most PAHs do not dissolve easily in water. They stick to

solid particles and settle to the bottoms of lakes or rivers.
Polycyclic aromatic hydrocarbons (PAHs) are a group of

over 100 different chemicals that are formed during the
incomplete burning of coal, oil and gas, garbage, or other
organic substances like tobacco or charbroiled meat. PAHs
are usually found as a mixture containing two or more of
these compounds, such as soot.
q Microorganisms can break down PAHs in soil or water

after a period of weeks to months.
Some PAHs are manufactured. These pure PAHs usually

exist as colorless, white, or pale yellow-green solids. PAHs are
found in coal tar, crude oil, creosote, and roofing tar, but a few
are used in medicines or to make dyes, plastics, and pesticides.
What happens to PAHs when they enter the

environment?
q PAHs enter the air mostly as releases from volcanoes,
forest fires, burning coal, and automobile exhaust.
q PAHs can occur in air attached to dust particles.
q Some PAH particles can readily evaporate into the air
from soil or surface waters.
q PAHs can break down by reacting with sunlight and other
chemicals in the air, over a period of days to weeks.
q In soils, PAHs are most likely to stick tightly to particles;

certain PAHs move through soil to contaminate underground water.
q PAH contents of plants and animals may be much higher
than PAH contents of soil or water in which they live.
How might I be exposed to PAHs?

q Breathing air containing PAHs in the workplace of
coking, coal-tar, and asphalt production plants; smokehouses; and municipal trash incineration facilities.
q Breathing air containing PAHs from cigarette smoke,
wood smoke, vehicle exhausts, asphalt roads, or agricultural burn smoke.
q Coming in contact with air, water, or soil near hazardous
waste sites.
q Eating grilled or charred meats; contaminated cereals,
flour, bread, vegetables, fruits, meats; and processed or
pickled foods.
q Drinking contaminated water or cows milk.

POLYCYCLIC AROMATIC
HYDROCARBONS (PAHs)
Page 2

q Nursing infants of mothers living near hazardous waste
sites may be exposed to PAHs through their mother's milk.
How can PAHs affect my health?

Mice that were fed high levels of one PAH during
pregnancy had difficulty reproducing and so did their offspring. These offspring also had higher rates of birth defects
and lower body weights. It is not known whether these effects
occur in people.
Animal studies have also shown that PAHs can cause
harmful effects on the skin, body fluids, and ability to fight
disease after both short- and long-term exposure. But these
effects have not been seen in people.
How likely are PAHs to cause cancer?

has determined that some PAHs may reasonably be expected to
be carcinogens.
Some people who have breathed or touched mixtures of
PAHs and other chemicals for long periods of time have
developed cancer. Some PAHs have caused cancer in laboratory animals when they breathed air containing them (lung
cancer), ingested them in food (stomach cancer), or had them
applied to their skin (skin cancer).
health effects will occur or find out the extent or source of

your exposure to the PAHs. The tests arent usually available
in your doctors office because special equipment is needed to
conduct them.

(OSHA) has set a limit of 0.2 milligrams of PAHs per cubic
meter of air (0.2 mg/m3). The OSHA Permissible Exposure
Limit (PEL) for mineral oil mist that contains PAHs is 5 mg/m3
averaged over an 8-hour exposure period.
(NIOSH) recommends that the average workplace air levels for
coal tar products not exceed 0.1 mg/m3 for a 10-hour workday,
within a 40-hour workweek. There are other limits for workplace exposure for things that contain PAHs, such as coal, coal
tar, and mineral oil.
Glossary
References
been exposed to PAHs?
In the body, PAHs are changed into chemicals that can
attach to substances within the body. There are special tests
that can detect PAHs attached to these substances in body
tissues or blood. However, these tests cannot tell whether any

1995. Toxicological profile for polycyclic aromatic hydrocarbons. Atlanta, GA: U.S. Department of Health and Human
ETHYLENE GLYCOL and

PROPYLENE GLYCOL
CAS # 107-21-1 and 57-55-6
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about ethylene glycol and propylene
glycol. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is
one in a series of summaries about hazardous substances and their health effects. This information is
are present.
HIGHLIGHTS: Ethylene glycol and propylene glycol are clear liquids used in
antifreeze and deicing solutions. Exposure to large amounts of ethylene glycol
can damage the kidneys, heart, and nervous system. Propylene glycol is generally
regarded as safe for use in food. Ethylene glycol has been found in at least 34,
and propylene glycol in at least 5, of the 1,416 National Priorities List sites identified
What are ethylene glycol and propylene glycol?
(Pronounced th-ln and pr p-ln gl kl)
Both ethylene glycol and propylene glycol are clear, colorless, slightly syrupy liquids at room temperature. Either
compound may exist in air in the vapor form, although propylene glycol must be heated or briskly shaken to produce a
vapor. Ethylene glycol is odorless but has a sweet taste. Propylene glycol is practically odorless and tasteless.
Both compounds are used to make antifreeze and deicing
solutions for cars, airplanes, and boats; to make polyester compounds; and as solvents in the paint and plastics industries.
Ethylene glycol is also an ingredient in photographic developing solutions, hydraulic brake fluids and in inks used in
stamp pads, ballpoint pens, and print shops.
propylene glycol as an additive that is generally recognized
as safe for use in food. It is used to absorb extra water and
maintain moisture in certain medicines, cosmetics, or food
products. It is a solvent for food colors and flavors.
Propylene glycol is also used to create artificial smoke
or fog used in fire-fighting training and in theatrical productions.
What happens to ethylene glycol and propylene

glycol when they enter the environment?
q Neither compound is likely to exist in large amounts in air.
q About half of the compounds that enter the air will break
down in 2450 hours.
q Both compounds break down within several days to a
week in water and soil.
How might I be exposed to ethylene glycol and

propylene glycol?
q You can be exposed to ethylene glycol when you use antifreeze, photographic developing solutions, coolants, and
brake fluid.
q You can be exposed to propylene glycol by eating food
products, using cosmetics, or taking medicine that contains it.
q If you work in an industry that uses ethylene glycol or
propylene glycol, you could be exposed by breathing or
touching these substances.
How can ethylene glycol and propylene glycol

affect my health?
Eating or drinking very large amounts of ethylene glycol
can result in death, while large amounts can result in nausea,

Page 2
ETHYLENE GLYCOL & PROPYLENE GLYCOL

CAS # 107-21-1 and 57-55-6
convulsions, slurred speech, disorientation, and heart and

kidney problems.
the body, they are very difficult to detect, even though symptoms may be present.
Female animals that ate large amounts of ethylene glycol

had babies with birth defects, while male animals had reduced
sperm counts. However, these effects were seen at very high
levels and would not be expected in people exposed to lower
levels at hazardous waste sites.

The EPA has set a drinking water guideline for ethylene
glycol of 7,000 micrograms (7,000 mg/L) in a liter of water for
an adult.
Ethylene glycol affects the body's chemistry by increasing the amount of acid, resulting in metabolic problems. Similar to ethylene glycol, propylene glycol increases the amount
of acid in the body. However, larger amounts of propylene
glycol are needed to cause this effect.

propylene glycol as generally recognized as safe, which
means that it is acceptable for use in flavorings, drugs, and
cosmetics, and as a direct food additive.
How likely are ethylene and propylene glycol to

cause cancer?

Hygienists (ACGIH) recommends a maximum level of
127 milligrams of ethylene glycol per cubic meter of air
(127 mg/m3) for a 15-minute exposure.

the EPA have not classified ethylene glycol and propylene
glycol for carcinogenicity. Studies with people who used ethylene glycol did not show carcinogenic effects. Animal studies also have not shown these chemicals to be carcinogens.

exposed to ethylene or propylene glycol?
Glossary
Acid: A sour substance.
Metabolic: Chemical changes in cells that provide energy to
the body.
Tests are available to determine if you have been exposed

to ethylene glycol. These tests are only used on people who are
showing symptoms of ethylene glycol poisoning (but they
could be used in other situations). The tests are most often used
on people who have intentionally consumed, or who suspect
they have consumed, large amounts of ethylene glycol.
Propylene glycol is generally considered to be a safe

chemical, and is not routinely tested for, unless specific exposure, such as to a medicine or cosmetic, can be linked with
symptoms. Since both chemicals break down very quickly in

This ToxFAQs information is taken from the 1997 Toxicological Profile for Ethylene Glycol and Propylene Glycol produced by the Agency for Toxic Substances and Disease Registry, Public Health Service, U.S. Department of Health and Human Services, Public Health Service in Atlanta, GA.
PYRETHRINS AND
PYRETHROIDS
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about pyrethrins and
pyrethroids. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact
sheet is one in a series of summaries about hazardous substances and their health effects. It is
important you understand this information because this substance may harm you. The effects of
HIGHLIGHTS: Pyrethrins and pyrethroids are insecticides that are applied to

crops, garden plants, pets, and also directly to humans. High levels of
pyrethrins or pyrethroids can cause dizziness, headache, nausea, muscle
twitching, reduced energy, changes in awareness, convulsions and loss of
consciousness. Pyrethrins have been found in at least 5 of the 1,585 current or
former NPL sites identified by the Environmental Protection Agency (EPA), and
permethrin (a pyrethroid compound) has been found in at least 2 of the sites.
No other pyrethroids were detected at NPL sites.
What are pyrethrins and pyrethroids?
(Pronounced pI-rE-thren; pI-rE-throid)
How might I be exposed to pyrethrins and

pyrethroids?
Pyrethrins are naturally-occurring compounds with

insecticidal properties that are found in pyrethrum extract
from certain chrysanthemum flowers. The pyrethrins are
often used in household insecticides and products to
control insects on pets or livestock.
Pyrethrins and pyrethroids usually enter the body when

people eat foods contaminated by these chemicals.
They may also enter your body when you breathe air that
contains these compounds or when you get them on your
skin.
The use of products that contain pyrethrins and
pyrethroids, such as household insecticides, pet sprays and
shampoos, lice treatments that are applied directly to the
head, and mosquito repellents that can be applied to
clothing, may lead to exposure.
Pyrethroids are manufactured chemicals that are very similar

in structure to the pyrethrins, but are often more toxic to
insects as well as to mammals, and last longer in the
environment than the pyrethrins. More than 1,000 synthetic
pyrethroids have been developed, but less than a dozen of
them are currently used in the United States. Permethrin is
the most frequently used pyrethroid in the United States.
What happens to pyrethrins and pyrethroids when

Pyrethroids enter the environment primarily due to their
use as insecticides.
In air, all six of the pyrethrins and many of the pyrethroids
are broken down rapidly (12 days) by sunlight or other
compounds found in the atmosphere.
Pyrethrins and pyrethroids bind strongly to soil and are
eventually degraded by microorganisms in soil and water;
they generally do not move from the soil to groundwater.
How can pyrethrins and pyrethroids affect my

health?
Pyrethrins and pyrethroids interfere with the normal way that
the nerves and brain function. Exposure to very high levels
of these compounds for a short period in air, food, or water
may cause dizziness, headache, nausea, muscle twitching,
reduced energy, changes in awareness, convulsions and loss
of consciousness. Changes in mental state may last several
days after exposure to high levels of pyrethroids has ended.
There is no evidence that pyrethrins or pyrethroids affect
the ability of humans to produce children, but some animal
studies have shown reduced fertility in males and females.

PYRETHRINS AND
PYRETHROIDS
Page 2

How likely are pyrethrins and pyrethroids to
cause cancer?
There is no evidence that pyrethrins or pyrethroids causes
cancer in people or in animals. The International Agency for
Research on Cancer (IARC) has determined that the
carcinogenicity to humans for three pyrethroids
(deltamethrin, fenvalerate, permethrin) is not classifiable.
How can pyrethrins and pyrethroids affect

children?
high levels of pyrethrins or pyrethroids will be similar to the
effects seen in adults. We do not know whether children
differ from adults in their susceptibility to these chemicals.
pyrethrins or pyrethroids. Offspring of animals that ingested
pyrethrins or pyrethroids while pregnant showed signs of
possible damage to the immune system. Some animals that
were exposed to pyrethrins or pyrethroids right after birth
showed altered behavior as adults.

pyrethrins and pyrethroids?
Exposure to pyrethrins and pyrethroids can be reduced by
exercising care when using pesticides containing these
compounds around the house, on pets, and on children and
by storing them properly. Certain pyrethroids are sprayed to
control mosquitos during the spring and summer; remaining
indoors and closing your windows while your neighborhood
is being sprayed will lessen your exposure. Additional ways
to reduce possible exposure include thoroughly washing
fruits and vegetables before eating them, ensuring that
children wash their hands before eating, and discouraging
young children from eating dirt.

hazardous waste sites where pyrethrins and pyrethroids may
have been discarded.

exposed to pyrethrins or pyrethroids?
Pyrethrins, pyrethroids, and their breakdown products can be
detected in your blood and urine, but only within a few days
after your last exposure. These tests are not usually
the samples to a laboratory that can perform the tests. None
of these tests can predict whether you will experience any
related health effects.

has set a limit of 5 milligrams of pyrethrins per cubic meter of
workplace air (5 mg/m3) for 8-hour shifts and 40-hour work
weeks.
The EPA has recommended daily oral exposure limits for
10 different pyrethroids ranging from 0.005 to 0.05 mg per
kilogram of body weight per day (0.005-0.05 mg/kg/day).
The EPA has established tolerances for residues of
pyrethrins and various pyrethroids that range from 0.01 to
75 parts per million parts (0.01-75 ppm) of a variety of foods.
(ATSDR). 2001. Toxicological Profile for Pyrethrins and
Pyrethroids (Draft for Public Comment) Atlanta, GA: U.S.
Service.
PYRIDINE
CAS # 110-86-1
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about pyridine. For more
SUMMARY: Everyone is exposed to very low levels of pyridine in air, water,

and food. Workers who make or use the chemical may be exposed to higher
levels of it. Studies in people and animals suggest that pyridine may damage the
liver. This chemical has been found in at least 11 of 1,416 National Priorities List
What is pyridine?
(Pronounced pr-dn)
Pyridine is a colorless liquid with an unpleasant smell. It
can be made from crude coal tar or from other chemicals.
Pyridine is used to dissolve other substances. It is also
used to make many different products such as medicines,
vitamins, food flavorings, paints, dyes, rubber products,
adhesives, insecticides, and herbicides. Pyridine can also be
formed from the breakdown of many natural materials in the
environment.
What happens to pyridine when it enters the

environment?
q Pyridine is primarily released to the environment from
industries that make and use this chemical.
q Pyridine evaporates into the air very easily.
q In the air, it may take several months or years until it
breaks down into other compounds.
q Pyridine is very soluble in water.
q In water or soil, it may be broken down in a few days to a
few months by microscopic organisms.
q Pyridine sticks to soil particles.
q Pyridine probably doesn't build up in plants or animals.
How might I be exposed to pyridine?

q Everyone is exposed to very low levels of pyridine in air,
water, and food.
q Workers may be exposed in industries that make pyridine
or use it to make other products by breathing it in air or
by touching it.
q People may breathe pyridine when it is released into the
air from burning cigarettes and from hot coffee.
q People who live near hazardous waste sites or landfills
where pyridine exists may be exposed to it by breathing
contaminated air or by drinking contaminated water.
How can pyridine affect my health?

Very little information is available on the health effects
of pyridine. Animal studies and some limited case reports in
people have noted liver damage from exposure to pyridine.
Two patients with epilepsy had damage to the liver and
kidneys after ingesting some pyridine. We do not know if the
pyridine caused these effects because the patients were taking
several other medications at the same time. Harmful effects to
the liver were also seen in rats and mice that were given
pyridine for three months.
Headaches, giddiness, a desire to sleep, quickening of
the pulse, and rapid breathing occurred in adults who

PYRIDINE
CAS # 110-86-1
Page 2
breathed an unknown amount of pyridine for an unknown

length of time.
Mild skin irritation and eye irritation were seen in
rabbits when pyridine was placed on their skin or in their
eyes.
We do not know whether pyridine affects the ability of
men and women to have children or whether it causes birth
defects.
How likely is pyridine to cause cancer?

pyridine as to its human carcinogenicity.
No studies are available in people or animals on the
carcinogenic effects of pyridine.

been exposed to pyridine?
There are medical tests available to measure levels of
pyridine in urine and blood. However, these tests are not
usually performed in most doctors' offices because special
equipment is needed to conduct them.
These tests can't tell how much pyridine you were
exposed to or if harmful health effects will occur from the
exposure to pyridine.

the environment of 1,000 pounds or more of pyridine be
reported.
The Food and Drug Administration (FDA) allows
pyridine to be used as a flavoring agent in the preparation of
foods.
(OSHA) has set an occupational exposure limit of 5 parts of
pyridine per million parts of workplace air (5 ppm) for an
8-hour workday over a 40-hour workweek.
Health (NIOSH) and the American Conference of Governmental and Industrial Hygienists (ACGIH) have established the
same guidelines as OSHA for pyridine exposure levels in the
workplace.
NIOSH has recommended that 1,000 ppm be considered
immediately dangerous to life and health. This is the
exposure level of a chemical that is likely to cause permanent
Glossary
Herbicide: A chemical that kills weeds and other plants.
Insecticide: A chemical used to kill insects.
References
1992. Toxicological profile for pyridine. Atlanta, GA: U.S.
Service.
RADIUM
CAS # 7440-14-4
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about radium. For more information,
HIGHLIGHTS: Radium is a radioactive substance formed from the breakdown

of uranium and thorium. Exposure to high levels results in an increased risk
of bone, liver, and breast cancer. This chemical has been found in at least 18
What is radium?
(Pronounced rd-m)
Radium is a naturally occurring silvery-white radioactive
metal that can exist in several forms called isotopes. Radium
is formed when uranium and thorium break down in the environment. Uranium and thorium are found in small amounts in
most rocks and soil. Two of the main radium isotopes found in
the environment are radium-226 and radium-228.
metals as a neutron source for research and radiation instrument calibration. Until the 1960s, radium was a component of
the luminous paints used for watch and clock dials, intrument
panels in airplanes, military instruments, and compasses.
What happens to radium when it enters the

environment?
q Radium is constantly being produced by the radioactive
decay of uranium and thorium.
Radium undergoes radioactive decay. It divides into two

partsone part is called radiation and the other part is called
a daughter. The daughter, like radium, is not stable, and it also
divides into radiation and another daughter. The dividing of
daughters continues until a stable, nonradioactive daughter
is formed. During the decay process, alpha, beta, and gamma
radiation are released. Alpha particles can travel only a short
distance and cannot travel through your skin. Beta particles
can penetrate through your skin, but they cannot go all the
way through your body. Gamma radiation can go all the way
through your body.
q Radium is present at very low levels in rocks and soil and

may strongly attach to those materials.
Radium has been used as a radiation source for treating

cancer, in radiography of metals, and combined with other
q Everyone is exposed to low levels of radium in the air,

water, and food.
q Radium may also be found in air.

q High concentrations are found in water in some areas of
the country.
q Uranium mining results in higher levels of radium in
water near uranium mines.
q Radium in the soil may be absorbed by plants.
q It may concentrate in fish and other aquatic organisms.
How might I be exposed to radium?

RADIUM
CAS # 7440-14-4
Page 2

q Higher levels may be found in the air near industries that
burn coal or other fuels.
q It may be found at higher levels in drinking water from
wells.
q Miners, particularly miners of uranium and hard rock, are
exposed to higher levels of radium.
q It may also be found at radioactive waste disposal sites.
How can radium affect my health?

Radium has been shown to cause effects on the blood
(anemia) and eyes (cataracts). It also has been shown to affect
the teeth, causing an increase in broken teeth and cavities.
Patients who were injected with radium in Germany, from 1946
to 1950, for the treatment of certain diseases including tuberculosis were significantly shorter as adults than people who
were not treated.
How likely is radium to cause cancer?

Exposure to high levels of radium results in an increased
incidence of bone, liver, and breast cancer. The EPA and the
National Academy of Sciences, Committee on Biological Effects of Ionizing Radiation, has stated that radium is a known
human carcinogen.

exposed to radium?
Urine tests can determine if you have been exposed to
radium. Another test measures the amount of radon (a breakdown product of radium) in exhaled air. Both types of tests
require special equipment and cannot be done in a doctors
office. These tests cannot tell how much radium you were exposed to, nor can they be used to predict whether you will develop harmful health effects.

The EPA has set a drinking water limit of 5 picocuries per
liter (5 pCi/L) for radium-226 and radium-228 (combined).
The EPA has set a soil concentration limit for radium-226
in uranium and thorium mill tailings of 5 picocuries per gram
(5 pCi/g) in the first 15 centimeters of soil and 15 pCi/g in
deeper soil.
July 1999.
Glossary
oxygen.
Picocurie (pCi): A unit used to measure the quantity of
rem: A unit used to measure radiation dose.
(ATSDR). 1990. Toxicological profile for radium. Atlanta,
Health Service.
RADON
CAS # 14859-67-7
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about radon. For more information,
HIGHLIGHTS: Radon is an odorless, radioactive gas formed from the

breakdown of uranium. Exposure to high levels results in an increased risk
of lung cancer. This chemical has been found in at least 5 of the 1,177 National
What is radon?
(Pronounced rdn)
Radon is a naturally occurring radioactive gas that is
odorless and tasteless. It is formed from the radioactive decay
of uranium. Uranium is found in small amounts in most rocks
and soil. It slowly breaks down to other products such as radium, which breaks down to radon.
Radon also undergoes radioactive decay. It divides into
two partsone part is called radiation, and the other part is
called a daughter. The daughter, like radon, is not stable, and
it also divides into radiation and another daughter. The dividing of daughters continues until a stable, nonradioactive
daughter is formed. During the decay process, alpha, beta,
and gamma radiation are released. Alpha particles can travel
only a short distance and cannot travel through your skin.
Beta particles can penetrate through your skin, but they cannot go all the way through your body. Gamma radiation can
go all the way through your body.
Radon is no longer used in the treatment of various diseases including cancer, arthritis, diabetes, and ulcers. Radon is
used to predict earthquakes, in the study of atmospheric transport, and in exploration for petroleum and uranium.
What happens to radon when it enters the

environment?
q Radon enters the environment from the soil, from uranium
and phosphate mines, and from coal combustion.
q Radon has a radioactive half-life of about 4 days; this
means that one-half of a given amount of radon will decay
to other products every 4 days.
q Some of the radon produced in the soil will move to the
surface and enter the air.
q Radon daughters attach to dust and other particles in the
air.
q Most of the radon will remain in the soil.
q Radon also moves from the soil and enters the groundwater
How might I be exposed to radon?

q Radon is found at very low levels in outdoor air.
q It is found at higher levels in indoor air in homes, schools,
and office buildings.
q Cracks in the basement or foundation of a home may allow higher levels of radon inside the home.

RADON
CAS # 14859-67-7
Page 2

q Indoor radon levels are affected by the radium and uranium levels in soil, the porosity of the soil, the composition and condition of the foundation materials, and the
ventilation rate of the room.
q Miners, particularly those who mine uranium and hard
rock, are exposed to higher levels of radon.
q Radon is found in drinking water and may be higher in
well water.
How can radon affect my health?

Exposure to high levels of radon may result in an increased incidence of lung diseases, such as emphysema and
pulmonary fibrosis. These diseases have been seen at a higher
rate than normal among underground miners who were also
exposed to arsenic, silica dust, diesel fumes, and cigarette
smoke. Lung disease has been reported to increase with increasing exposure to radon and cigarette smoking.
Effects on the lung have also been seen in animals
exposed to radon.
How likely is radon to cause cancer?

People exposed to high levels of radon have an increased
incidence of lung cancer.

exposed to radon?
Radon in human tissues is not detectable by routine
medical testing. However, several of its decay products can be
detected in urine and in lung and bone tissue. These tests
cannot tell how much radon you were exposed to, nor can they
be used to predict whether you will develop harmful health
effects.

The EPA has set a guideline for radon in air inside homes
of 4 picocuries per liter (4 pCi/L) of air.
The EPA has also set a standard of 20 picocuries per
square meter per second (20 pCi/m2/sec) for emissions of radon-222 (a radon daughter) to the air from uranium mill tailings in non-operational piles.
July 1999.
Glossary
Emphysema: A lung disease.
Millirem (mrem): A unit used to measure radiation dose.
Picocurie (pCi): A unit used to measure the quantity of
Pulmonary fibrosis: Formation of fibrous tissue in the lung.
(ATSDR). 1990. Toxicological profile for radon. Atlanta, GA:
Service.
RDX
CAS # 121-82-4
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about RDX. For more information,
SUMMARY: RDX is an explosive. Few people will be exposed to RDX. Exposure

to large amounts can cause seizures. RDX has been found in at least 16 of the
Agency (EPA).
What is RDX?
(Pronounced RDX)
RDX stands for Royal Demolition eXplosive. It is also
known as cyclonite or hexogen. The chemical name for RDX
is 1,3,5-trinitro-1,3,5-triazine. It is a white powder and is very
explosive.
RDX is used as an explosive and is also used in combination with other ingredients in explosives. Its odor and taste are
unknown. It is a synthetic product that does not occur naturally in the environment. It creates fumes when it is burned
with other substances.
What happens to RDX when it enters the

environment?
q Particles of RDX can enter the air when it is disposed of
by burning.
q RDX can enter the water from disposal of waste water
from Army ammunitions plants, and it can enter water or
soil from spills or leaks from improper disposal at these
plants or at hazardous waste sites.
q RDX dissolves very slowly in water, and it also evaporates very slowly from water.
q It does not cling to soil very strongly and can move into
the groundwater from soil.
q RDX can be broken down in air and water in a few hours,
but it breaks down more slowly in soil.
q RDX does not build up in fish or in people.
How might I be exposed to RDX?

Few people will be exposed to RDX. Fewer than 500
people are known to work with RDX. These people can be
exposed by:
q Breathing dust with RDX in it.
q Getting RDX on their skin.
q Drinking contaminated water or touching contaminated
soil near factories that produce RDX.
How can RDX affect my health?

RDX can cause seizures (a problem of the nervous system)
in humans and animals when large amounts are inhaled or
eaten. The effects of long-term (365 days or longer), low-level
exposure on the nervous system are not known. Nausea and

RDX
CAS # 121-82-4
Page 2

vomiting have also been seen. No other significant health
effects have been seen in humans.

Rats and mice that ate RDX for 3 months or more had
decreased body weights and slight liver and kidney damage.
The Department of Transportation (DOT) has many regulations on the transportation of explosives.
It is not known whether RDX causes birth defects in humans; it did not cause birth defects in rabbits, but it did result
in smaller offspring in rats. It is not known whether RDX affects reproduction in people.
The EPA recommends a drinking water guideline of 2 micrograms (mg) RDX per liter for lifetime exposure for adults.
How likely is RDX to cause cancer?

The EPA has determined hat RDX is a possible human
carcinogen.
In one study, RDX caused liver tumors in mice that were
exposed to it in the food. However, carcinogenic effects were
not noted in rat studies and no human data are available.

exposed to RDX?
Medical tests are available that can measure RDX levels
in your blood or urine. However, these tests can only be used if
you have come in contact with RDX in the last few days.
These tests can determine if you have been exposed to RDX,
but they cannot be used to determine how much RDX entered
your body.
These tests arent available at most doctors offices, but
can be done at special laboratories that have the right equipment. However, they cannot be used to determine long-term
health effects from RDX.
The usual immediate health effects (seizures, muscle
twitching, or vomiting) from very high exposures would probably occur before you had the blood or urine test.

(NIOSH) has recommended an exposure limit of 1.5 milligrams
RDX per cubic meter of air (1.5 mg/m3) for a 10-hour workday,
40-hour workweek.
The NIOSH short-term exposure limit, which is the highest level of RDX that they recommend workers be exposed to
for 15 minutes, is 3 mg/m3.
Hygienists (ACGIH) also recommends an exposure limit of
1.5 mg/m3 in workplace air for an 8-hour workday, 40-hour
workweek.
Glossary
Reference
(ATSDR). 1995. Toxicological profile for RDX. Atlanta, GA:
Service.
SELENIUM
CAS #7782-49-2
September 2001
This fact sheet answers the most frequently asked health questions (FAQs) about selenium. For more
HIGHLIGHTS: People may be exposed to low levels of selenium daily through

food and water. Selenium functions as an antioxidant and is needed for good
health, but exposure to high levels can result in neurological effects and brittle
hair and deformed nails. Occupational inhalation exposure may cause
dizziness, fatigue, irritation of mucous membranes, and respiratory effects.
What is selenium?
Selenium is a naturally occurring mineral element that is
distributed widely in nature in most rocks and soils. In its
pure form, it exists as metallic gray to black hexagonal
crystals, but in nature it is usually combined with sulfide
minerals or with silver, copper, lead, and nickel minerals.
Most processed selenium is used in the electronics industry,
but it is also used: as a nutritional supplement; in the glass
industry; as a component of pigments in plastics, paints,
enamels, inks, and rubber; in the preparation of
pharmaceuticals; as a nutritional feed additive for poultry
and livestock; in pesticide formulations; in rubber
production; as an ingredient in antidandruff shampoos; and
as a constituent of fungicides. Radioactive selenium is used
in diagnostic medicine.
forms are very mobile and may enter surface water from
soils.
Selenium may accumulate up the food chain.
How might I be exposed to selenium?

The general population is exposed to very low levels of
selenium in air, food, and water.
People working in or living near industries where selenium
is produced, processed, or converted into commercial
products may be exposed to higher levels of selenium in the
air.
People living in the vicinity of hazardous waste sites or
coal burning plants may also be exposed to higher levels of
selenium.
How can selenium affect my health?

What happens to selenium when it enters the
environment?
Selenium occurs naturally in the environment and can be
released by both natural and manufacturing processes.
Selenium dust can enter the air from burning coal and oil.
This selenium dust will eventually settle over the land and
water.
It also enters water from rocks and soil, and from
agricultural and industrial waste. Some selenium compounds
will dissolve in water, and some will settle to the bottom as
particles.
Insoluble forms of selenium will remain in soil, but soluble
Selenium has both beneficial and harmful effects. Low doses

of selenium are needed to maintain good health. However,
exposure to high levels can cause adverse health effects.
Short-term oral exposure to high concentrations of selenium
may cause nausea, vomiting, and diarrhea. Chronic oral
exposure to high concentrations of selenium compounds can
produce a disease called selenosis. The major signs of
selenosis are hair loss, nail brittleness, and neurological
abnormalities (such as numbness and other odd sensations
in the extremities).
Brief exposures to high levels of elemental selenium or
selenium dioxide in air can result in respiratory tract irritation,

SELENIUM
Page 2
CAS #7782-49-2
bronchitis, difficulty breathing, and stomach pains. Longerterm exposure to either of these air-borne forms can cause
respiratory irritation, bronchial spasms, and coughing.
Levels of these forms of selenium that would be necessary to
produce such effects are normally not seen outside of the
workplace.
selenium; these should be used according to the

manufacturers directions.
Children living near selenium waste sites or coal burning
plants should be encouraged to wash their hands before
eating and to avoid putting their unwashed hands in their
mouths.
Animal studies have shown that very high amounts of

selenium can affect sperm production and the female
reproductive cycle. We do not know if similar effects would
occur in humans.

exposed to selenium?
How likely is selenium to cause cancer?

Studies of laboratory animals and people show that most
selenium compounds probably do not cause cancer. In fact,
studies in humans suggest that lower-than-normal selenium
levels in the diet might increase the risk of cancer.
determined that selenium and selenium compounds are not
classifiable as to their carcinogenicity to humans.
The EPA has determined that one specific form of selenium,
selenium sulfide, is a probable human carcinogen. Selenium
sulfide is not present in foods and is a very different
chemical from the organic and inorganic selenium compounds
found in foods and in the environment.
How can selenium affect children?
Low levels of selenium are normally found in body tissues

and urine. Blood and urine tests for selenium are most
useful for people who have recently been exposed to high
levels. Toenail clippings can be used to determine longerterm exposure. These tests are not usually available at your
laboratory that can perform the tests. None of these tests,
however, can predict whether you will experience any health
effects.

The EPA restricts the amount of selenium allowed in public
water supplies to 50 parts total selenium per billion parts of
water (50 ppb).
sets a limit of 0.2 mg selenium/m3 of workroom air for an
8-hour work shift.
It is likely that the health effects seen in children exposed to

selenium will be similar to the effects seen in adults.
However, one study found that children may be less
susceptible to the health effects of selenium than adults.
ATSDR and the EPA have determined that 5 micrograms of

selenium per kilogram of body weight taken daily would not
be expected to cause any adverse health effects over a
lifetime of such intake.
Selenium compounds have not been shown to cause birth

defects in humans or in other mammals.

selenium?
Certain dietary supplements and shampoos contain

(ATSDR). 2001. Toxicological Profile for Selenium (Draft for
Public Comment) Atlanta, GA: U.S. Department of Health and
SELENIUM HEXAFLUORIDE
CAS #7783-79-1
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about selenium hexafluoride. For
HIGHLIGHTS: Selenium hexafluoride is a corrosive gas. Significant exposure

may occur only if you work with selenium hexafluoride. It is unlikely that the
general population will be exposed to this substance. Exposure to selenium
hexafluoride can cause irritation of the respiratory airway, skin and eyes.
Exposure to high levels can cause severe skin and eye damage and
accumulation of fluid in the lungs, and even death. Selenium hexafluoride has
not been found in any of the 1,585 National Priorities List sites identified by the
What is selenium hexafluoride?
Selenium hexafluoride does not accumulate in the food

chain.
Selenium hexafluoride is a corrosive, colorless gas at room

temperature. Selenium hexafluoride is only slightly soluble
in water. It does not occur naturally in the environment.
How might I be exposed to selenium

hexafluoride?
Selenium hexafluoride is used as a gaseous electrical

insulator.
The general population is unlikely to be exposed to

selenium hexafluoride.
What happens to selenium hexafluoride when it

Workers that use selenium hexafluoride as a gaseous

electric insulator or use selenium hexafluoride to produce
other selenium containing compounds may be exposed to
this gas.
When released to air, selenium hexafluoride will react with

moisture, forming other compounds which are removed from
the atmosphere by rainfall.
Selenium hexafluoride is slightly soluble in water. It reacts
slowly with water to form other compounds. It may also
evaporate from water.
Because it is a gas, it is rarely found in soil. If released to
soil, selenium hexafluoride will react with moisture forming
other compounds or evaporate from the soil.
How can selenium hexafluoride affect my health?

Exposure to low levels of selenium hexafluoride gas can
cause irritation of the respiratory airway, skin, and eye.
Exposure to high levels can lead to severe skin and eye
damage, accumulation of fluid in the lungs, and eventually
death.

Page 2
SELENIUM HEXAFLUORIDE
CAS #7783-79-1
Exposure to the liquified gas can cause severe skin injury or

frostbite and also severe eye damage and blindness.
Long-term exposure to low concentrations of selenium
hexafluoride may cause effects similar to exposure to other
selenium or fluoride compounds, such as pale appearance,
nervousness, depression, gastrointestinal problems, lack of
appetite, weight loss, and dental defects.
There is no information on whether exposure to selenium
hexafluoride may affect the reproductive system in humans or
in animals.
How likely is selenium hexafluoride to cause

cancer?
EPA have not classified selenium hexafluoride as to its
carcinogenicity to humans. There are no studies of
carcinogenity of selenium hexafluoride in animals.
How can selenium hexafluoride affect children?

exposed to selenium hexafluoride. It is likely that the health
effects seen in children exposed to this chemical will be
similar to the effects seen in adults. In general, children may
be more vulnerable to corrosive agents because of the
smaller diameter of their airways.
We do not know if exposure to selenium hexafluoride will

result in birth defects or other developmental effects in
people. There are no developmental studies in laboratory
animals.

selenium hexafluoride?
Most families will not be exposed to selenium hexafluoride.

exposed to selenium hexafluoride?
There are no tests to determine whether you have been
exposed to selenium hexafluoride. If you suspect exposure, a
chest x-ray be an appropriate way to determine whether your
lungs have been damaged.

has set an exposure limit of 0.05 parts of selenium
hexafluoride per million parts of workroom air (0.05 ppm) for
an 8-hour work shift, 40 hour work week.
SILVER
CAS # 7440-22-4
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about silver. For more information,
HIGHLIGHTS: Silver is an element found naturally in the environment. At very

high levels, it may cause argyria, a blue-gray discoloration of the skin and other
organs. This chemical has been found in at least 27 of the 1,177 National Priorities
What is silver?
(Pronounced slvr)
Silver is a naturally occurring element. It is found in the
environment combined with other elements such as sulfide,
chloride, and nitrate. Pure silver is silver colored, but silver
nitrate and silver chloride are powdery white and silver sulfide and silver oxide are dark-gray to black. Silver is often
found as a by-product during the retrieval of copper, lead,
zinc, and gold ores.
Silver is used to make jewelry, silverware, electronic
equipment, and dental fillings. It is also used to make photographs, in brazing alloys and solders, to disinfect drinking
water and water in swimming pools, and as an antibacterial
agent. Silver has also been used in lozenges and chewing gum
to help people stop smoking.
What happens to silver when is enters the

environment?
q Silver may be released into the air and water through
natural processes such as the weathering of rocks.
q Human activities such as the processing of ores, cement

manufacture, and the burning of fossil fuel may release
silver into the air.
q It may be released into water from photographic processing.
q Rain may wash silver out of soil into the groundwater.

q Silver does not appear to concentrate to a significant
extent in aquatic animals.
How might I be exposed to silver?

q Breathing low levels in air.
q Swallowing it in food or drinking water.
q Carrying out activities such as jewelry-making, soldering, and photography.
q Using anti-smoking lozenges or other medicines containing it.
How can silver affect my health?

Exposure to high levels of silver for a long period of time
may result in a condition called arygria, a blue-gray discoloration of the skin and other body tissues. Lower-level exposures to silver may also cause silver to be deposited in the
skin and other parts of the body; however, this is not known
to be harmful. Argyria is a permanent effect, but it appears to
be a cosmetic problem that may not be otherwise harmful to
health.

SILVER
CAS # 7440-22-4
Page 2
ToxFAQs Internet home page via WWW is http://www.atsdr.cdc.gov/toxfaq.html

Exposure to high levels of silver in the air has resulted in
breathing problems, lung and throat irritation, and stomach
pains. Skin contact with silver can cause mild allergic reactions
such as rash, swelling, and inflammation in some people.
drinking water not exceed 0.10 milligrams per liter of water

(0.10 mg/L) because of the skin discoloration that may occur.
Animal studies have shown that swallowing silver results

in the deposit of silver in the skin. One study in mice found
that the animals exposed to silver in drinking water were less
active than unexposed animals.

(OSHA) limits silver in workplace air to 0.01 milligrams per
cubic meter (0.01 mg/m3) for an 8-hour workday, 40-hour
workweek. The National Institute of Occupational Safety and
Health (NIOSH) also recommends that workplace air contain
no more that 0.01 mg/m3 silver.
No studies are available on whether silver affects reproduction or causes developmental problems in people.
How likely is silver to cause cancer?

No studies are available on whether silver may cause cancer in people. The only available animal studies showed both
positive and negative results when silver was implanted under
the skin.
The EPA has determined that silver is not classifiable as to

exposed to silver?
Silver can be measured in the blood, urine, feces, and body
tissues of exposed people. Silver builds up in the body, and the
best way to learn if past exposure has occurred is to look for
silver in samples of skin. Tests for silver are not commonly
done at a doctors office because they require special equipment. Although doctors can find out if a person has been exposed to silver by doing these tests, they cannot tell whether
any health effects will occur.

The EPA recommends that the concentration of silver in

1,000 pounds or more of silver be reported to the EPA.

Hygienists (ACGIH) recommends that workplace air contain
no more than 0.1 mg/m3 silver metal and 0.01 mg/m3 soluble
silver compounds.
July 1999.
Glossary
CAS: Chemcial Abstracts Service.
National Priorities List: A list of the nation's worst hazardous
waste sites.
Soluble: Capable of being dissolved in water.
(ATSDR). 1990. Toxicological profile for silver. Atlanta, GA:
Service.
SODIUM HYDROXIDE
CAS #1310-73-2
April 2002
This fact sheet answers the most frequently asked health questions (FAQs) about sodium hydroxide. For
HIGHLIGHTS: Sodium hydroxide is a manufactured chemical. It is present in

several domestic cleaning products. Very low levels can produce irritation of
the skin and eyes. Exposure to the solid or concentrated liquid can cause severe
burns in the eyes, skin, and gastrointestinal tract which may ultimately lead to
death. This substance has been found in at least 49 of the 1,585 National
What is sodium hydroxide?
At room temperature, sodium hydroxide is a white crystalline
odorless solid that absorbs moisture from the air. It is a
manufactured substance. When dissolved in water or
neutralized with acid it liberates substantial heat, which may
be sufficient to ignite combustible materials. Sodium
hydroxide is very corrosive. It is generally used as a solid
or a 50% solution. Other common names include caustic
soda and lye.
Sodium hydroxide is used to manufacture soaps, rayon,
paper, explosives, dyestuffs, and petroleum products. It is
also used in processing cotton fabric, laundering and
bleaching, metal cleaning and processing, oxide coating,
electroplating, and electrolytic extracting. It is commonly
present in commercial drain and oven cleaners.
What happens to sodium hydroxide when it

Sodium hydroxide released to the atmosphere breaks
down readily by reacting with other chemicals.
Sodium hydroxide separates in water to sodium cations
(positively charged sodium atoms) and hydroxide anions
(negatively charged oxygen and hydrogen atoms), which
ultimately decrease the acidity of the water.
If released to soil, sodium hydroxide will separate into

sodium cations and hydroxide anions when it comes into
contact with moisture.
Sodium hydroxide does not accumulate in the food chain.
How might I be exposed to sodium hydroxide?

Small amounts of sodium hydroxide are sometimes used in
drain and oven cleaners. Using these products may expose
you to sodium hydroxide.
Workers employed in industries where sodium hydroxide
is produced or used may be exposed to this compound.
How can sodium hydroxide affect my health?

Sodium hydroxide is very corrosive and can cause severe
burns in all tissues that come in contact with it. Inhalation of
low levels of sodium hydroxide as dusts, mists or aerosols
may cause irritation of the nose, throat, and respiratory
airways. Inhalation of higher levels can produce swelling or
spasms of the upper airway leading to obstruction and loss
of measurable pulse; inflammation of the lungs and
accumulation of fluid in the lungs may also occur.
Ingestion of solid or liquid sodium hydroxide can cause
spontaneous vomiting, chest and abdominal pain, and
difficulty swallowing. Corrosive injury to the mouth, throat,
esophagus, and stomach is very rapid and may result in

SODIUM HYDROXIDE
Page 2
CAS #1310-73-2
perforation, hemorrhage, and narrowing of the

gastrointestinal tract. Case reports indicate that death results
from shock, infection of the corroded tissues, lung damage,
or loss of measurable pulse.
The cancer could have arisen during repair of the damaged

tissue.
Skin contact with sodium hydroxide can cause severe burns

with deep ulcerations. Pain and irritation are evident within 3
minutes, but contact with dilute solutions may not cause
symptoms for several hours. Contact with the eye may
produce pain and irritation, and in severe cases, clouding of
the eye and blindness.

exposed to sodium hydroxide. The effects seen in children
accidently exposed to sodium hydroxide are similar to the
effects observed in adults.
Long-term exposure to sodium hydroxide in the air may lead

to ulceration of the nasal passages and chronic skin
irritation.
We do not know if exposure to sodium hydroxide could
affect reproduction in humans.
How likely is sodium hydroxide to cause cancer?
How can sodium hydroxide affect children?
We do not know if exposure to sodium hydroxide can result


sodium hydroxide?
Products containing sodium hydroxide should be stored
out of the reach of children.
Cleaners containing sodium hydroxide should not be
stored in containers that may appear attractive to children,
such as soda bottles.
There have been reports of cancer of the esophagus 15 to 40

years after the formation of narrow points caused by
corrosion induced by sodium hydroxide. However, these
cancers were most likely the result of tissue destruction and
scar formation rather than a direct carcinogenic action of
sodium hydroxide itself.

exposed to sodium hydroxide?

EPA have not classified sodium hydroxide for carcinogenicity
in humans.

Some reports indicate that cancer of the esophagus may

develop many years after exposure to sodium hydroxide
levels that are high enough to cause tissue damage. But this
does not mean that sodium hydroxide itself is a cancer agent.
There are no clinical tests that show that you have been
exposed to sodium hydroxide.

sets a limit of 2 milligrams of sodium hydroxide per cubic
meter of air (2 mg/m3) in the workplace for an 8-hour work
shift, 40-hour work week.
The Food and Drug Administration (FDA) allows sodium
hydroxide as a food additive in levels not to exceed 1%.
STODDARD SOLVENT
CAS # 8052-41-3
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about Stoddard solvent. For more
SUMMARY: Exposure to Stoddard solvent occurs mainly in the workplace.

People who breathe Stoddard solvent can experience headaches; dizziness; and
eye, skin, or throat irritation. This substance has been found in at least 7 of the
1,430 National Priorities List Sites identified by the Environmental Protection
Agency (EPA).
What is Stoddard solvent?
(Pronounced stdrd slvnt)
Stoddard solvent is a colorless, flammable liquid that
smells and tastes like kerosene. It will turn into a vapor at
temperatures of 150200 C.
Stoddard solvent is a petroleum mixture that is also
known as dry cleaning safety solvent, petroleum solvent, and
varnoline; its registered trade names are Texsolve S and
Varsol 1. It is a chemical mixture that is similar to white
spirits.
Stoddard solvent is used as a paint thinner; in some types
of photocopier toners, printing inks, and adhesives; as a dry
cleaning solvent; and as a general cleaner and degreaser.
Disease Registry (ATSDR) the Public Health Service, or the
U.S. Department of Health and Human Services (DHHS).
What happens to Stoddard solvent when it

Because Stoddard solvent is a mixture of many chemi-
cals, these chemicals may react differently in the environment.

Some of these chemicals can:
q
Be broken down by sunlight or other chemicals in the air;
q Attach to particles in soil or water;

q Sink down to the sediment in water; and
q Be broken down by microorganisms in water, soil, or sediment.
It is not known whether Stoddard solvent will build up in
plants or animals living in contaminated soil or water, but
some of the chemicals that make up Stoddard solvent might
build up in these situations.
How might I be exposed to Stoddard solvent?

q Using products containing Stoddard solvent such as a
paint or paint thinner, and breathing the vapors, or getting
the vapors in your eyes.
q Breathing contaminated air where Stoddard solvent is
manufactured, used, or spilled.
q Breathing contaminated air at or near hazardous waste
sites.
q Drinking or bathing in contaminated water.
q Ingesting contaminated soil or water near waste sites containing Stoddard solvent.

STODDARD SOLVENT
CAS # 8052-41-3
Page 2

q Touching contaminated soil or water.
How can Stoddard solvent affect my health?

Most of the information on the health effects of Stoddard
solvent comes from studies in which it is breathed; there are
fewer studies of exposure to the eyes or skin.
Exposure to Stoddard solvent in the air can affect your
nervous system and cause dizziness, headaches, or a prolonged reaction time. It can also cause eye, skin, or throat irritation.
Rats, cats, and dogs that breathed in large amounts of
Stoddard solvent for several hours suffered seizures. Breathing
Stoddard solvent has caused bronchitis in guinea pigs, but
neither seizures nor bronchitis have been reported when humans breathed it. The effects of swallowing Stoddard solvent
are not known.
It is not known whether Stoddard solvent can cause birth
defects or affect reproduction.
is a mixture of many chemicals, some of these chemicals can

be detected in your breath, blood, urine, and fat. However, the
tests cannot tell you if you have been exposed to the specific
mixture of chemicals found in Stoddard solvent. They also
cannot tell whether you will suffer any health effects.

(OSHA) has set a maximum exposure limit of 500 parts of
Stoddard solvent per 1 million parts of air (500 ppm) for an 8hour workday, 40-hour workweek.
(NIOSH) recommends that the average workplace air levels not
be more than 60 ppm in workplace air for a 10-hour workday,
40-hour workweek.
Glossary
How likely is Stoddard solvent to cause cancer?

has determined that Stoddard solvent is not classifiable as to
Very few studies have been located that study the carcinogenic effects of Stoddard solvent in humans or animals.

Sediment: Mud and debris that have settled at the bottom of a
body of water.
Reference
Is there a medical test to show whether I've been
exposed to Stoddard solvent?
There is no routinely used test to show whether you have
been exposed to Stoddard solvent. Because Stoddard solvent

(ATSDR). 1995. Toxicological profile for Stoddard solvent.
STRONTIUM
CAS #7440-24-6
July 2001
This fact sheet answers the most frequently asked health questions (FAQs) about strontium. For more
HIGHLIGHTS: Exposure to stable or radioactive strontium occurs from

ingesting contaminated food or drinking water or breathing contaminated air.
In children, high levels of stable strontium can impair bone growth. High levels
of radioactive strontium can cause anemia or cancer. Strontium has been
found at 101 of the 1,585 National Priority List sites identified by the
What is strontium?
Strontium is a naturally occurring element found in rocks,
soil, dust, coal, and oil. Naturally occurring strontium is not
radioactive and is referred to as stable strontium. Stable
strontium in the environment exists in four stable isotopes,
84
Sr (read as strontium eighty-four), 86Sr, 87Sr, 88Sr.
Strontium compounds are used in making ceramics and glass
products, pyrotechnics, paint pigments, fluorescent lights,
and medicines.
Strontium can also exist as several radioactive isotopes, the
most common is 90Sr. 90Sr is formed in nuclear reactors or
during the explosion of nuclear weapons. Radioactive
strontium generate beta particles as they decay. One of the
radioactive properties of strontium is half-life, or the time it
takes for half of the isotope to give off its radiation and
change into another substance. The half-life of 90Sr is 29
years.
What happens to strontium when it enters the

environment?
In air, stable strontium is present as dust which eventually
settles over land and water.
Stable strontium dissolves in water
Stable strontium in soil can dissolve in water and move

deeper in the soil to underground water.
Radioactive decay is the only way of decreasing the
amount of 90Sr in the environment.
How might I be exposed to strontium?

You can be exposed to low levels of stable strontium and
radioactive strontium by breathing air, eating food, or
drinking water.
Food and drinking water are the largest sources of
exposure to strontium.
You can be exposed to radioactive strontium if you eat
food that was grown in contaminated soil.
Living near uncontrolled radioactive waste sites
containing strontium.
How can strontium affect my health?

Exposure to low levels of stable strontium has not been
shown to affect adult health, but may harm children (see
following section).
Breathing or ingesting high levels of radioactive strontium
can damage bone marrow and cause anemia and prevent the
blood from clotting properly.

STRONTIUM
Page 2
CAS #7440-24-6
How likely is strontium to cause cancer?

The only stable strontium compound that may cause cancer
is strontium chromate, but this is due to chromium not
strontium.
Exposure to high levels of radioactive strontium may cause
cancer. Leukemia has been seen in humans exposed to
relatively large amounts of strontium. Leukemia and cancers
of the bone, nose, lung, and skin have also been seen in
laboratory animals.
determined that radioactive strontium is a human carcinogen.
How can strontium affect children?

exposed to strontium?
All people have small amounts of stable strontium in their
bodies. There are tests to measure the level of strontium in
blood, hair, feces, and urine. These tests are most useful for
people exposed to high levels. These tests cannot determine
the exact levels of strontium you may have been exposed to
or predict how the levels in your tissues will affect your
health.
If a person has been exposed to radioactive strontium,
special tests can be used to measure levels of radiation in
blood, feces, or urine. These tests are most useful when
done soon after exposure, since radioactive strontium is
quickly incorporated into bone and its release from bone
occurs in very small amounts over a period of years.
We do not know if exposure to strontium will result in birth

defects have been observed in animals exposed to
radioactive strontium.

Exposure to high levels of stable strontium can result in

impaired bone growth in children.
EPA has set a limit of 4000 g strontium per liter of drinking

water (4000 g/L).
Children may be more susceptible than adults to the harmful

effects of radioactive strontium.

strontium?
Having a balanced diet with sufficient amounts of vitamin
D, calcium, and protein will reduce the amount of strontium
that is absorbed.
EPA has set a limit of 8 picocuries 90Sr per liter of drinking

water (8 pCi/L).
The Nuclear Regulatory Commission (NRC) has set a limit of
20 Ci per year for on-the-job exposure to 90Sr in air.
(ATSDR). 2001. Toxicological Profile for Strontium (Draft for
STYRENE
CAS # 100-42-5
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about styrene. For more
SUMMARY: Exposure to styrene is most likely to occur from breathing indoor air that
is contaminated with styrene vapors from building materials, tobacco smoke, and consumer
products. People who work where styrene is used or manufactured are likely to be exposed
by breathing workplace air. Breathing styrene is most likely to affect the nervous system.
Styrene has been found in at least 213 of 1,416 National Priorities List sites identified by
What is styrene?
(Pronounced strn)
Styrene is primarily a synthetic chemical. It is also
known as vinylbenzene, ethenylbenzene, cinnamene, or
phenylethylene. It's a colorless liquid that evaporates easily
and has a sweet smell. It often contains other chemicals that
give it a sharp, unpleasant smell.
It dissolves in some liquids but doesnt dissolve easily in
water. Billions of pounds are produced each year to make
products such as rubber, plastic, insulation, fiberglass, pipes,
automobile parts, food containers, and carpet backing.
Most of these products contain styrene linked together in
a long chain (polystyrene) as well as unlinked styrene. Low
levels of styrene also occur naturally in a variety of foods
such as fruits, vegetables, nuts, beverages, and meats.
It evaporates from shallow soils and surface water.

It doesnt stick easily to soils and sediments.
It's broken down by bacteria in the soil and water.
It's not expected to build up in animals.
Styrene breaks down to half the amount within a few days
in surface water; in groundwater, however, it takes between 6 weeks and 7.5 months.
How might I be exposed to styrene?

Breathing indoor air that is contaminated with styrene
vapors from building materials, consumer products, and
tobacco smoke.
Breathing contaminated workplace air.
Drinking contaminated water.
Living near industrial facilities or hazardous waste sites.
Smoking cigarettes or eating a lot of food packaged in
polystyrene containers.
What happens to styrene when it enters the

environment?
How can styrene affect my health?
Styrene enters the environment during the manufacture,

use, and disposal of styrene-based products. It can be
found in air, water, and soil.
It is quickly broken down in the air, usually within 1 to 2
days.
If you breathe high levels of styrene for a short time,

youre most likely to experience nervous system effects such
as depression, concentration problems, muscle weakness,
tiredness, and nausea, and possibly eye, nose, and throat
irritation.

STYRENE
CAS # 100-42-5
Page 2

When animals breathed styrene vapors in short-term studies, they damaged the lining of their noses. Long-term exposure damaged their livers, but there is no evidence that this will
occur in people because there is no information on human
health effects of breathing low levels for a long time.
The test for styrene and its breakdown products require

special equipment and are not usually available at your
doctors office, but may be ordered by the doctor. Your doctor
can take samples and send them to a testing laboratory.
There is also little information on human health effects from Has the federal government made
eating or touching styrene. Animal studies show that ingestion of recommendations to protect human health?
high levels of styrene over several weeks can cause damage to the
The EPA has determined that 0.1 part of styrene per milliver, kidneys, brain, and lungs. When styrene was applied to the
lion
parts of water (0.1 ppm) is the maximum amount that may
skin of rabbits, it caused irritation.
be present in drinking water. The EPA also requires that spills
There is no information as to whether breathing, ingesting, or accidental releases into the environment of 1,000 pounds or
or touching styrene affects fetal development or human repromore of styrene be reported.
duction.
In animal studies, short-term exposure to very high levels (OSHA) has limited workers' exposure to an average of
resulted in some reproductive and developmental effects.
100 ppm for an 8-hour workday, 40-hour workweek.
How likely is styrene to cause cancer?

has determined that styrene is possibly carcinogenic to humans.
Several studies of workers have shown that breathing styrene may cause leukemia. There is no information on the carcinogenicity of styrene in people who swallow it or get it on their
skin.
Studies in animals that breathed or ate styrene suggest that
it is weakly carcinogenic.
Glossary
Leukemia: Cancer of the blood-forming tissues.
Polystyrene: A long chain of styrene molecules joined
together.

exposed to styrene?
Styrene and its breakdown products can be measured in
your blood, urine, and body tissues. Styrene leaves your body
quickly. If you are tested within one day, the actual amount of
exposure can be estimated. However, it is difficult to predict if
the exposure will affect your health.
References
(ATSDR). 1992. Toxicological profile for styrene. Atlanta,
Health Service.
SULFUR DIOXIDE
CAS # 7446-09-5
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about sulfur dioxide. For more
HIGHLIGHTS: Exposure to sulfur dioxide occurs from breathing it in the air.

It affects the lungs and at high levels may result in burning of the nose and
throat, breathing difficulties, and severe airway obstructions. This chemical has
What is sulfur dioxide?
How might I be exposed to sulfur dioxide?
(Pronounced sl fr d k sd)
q Breathing air containing it or touching it.
Sulfur dioxide is a colorless gas with a pungent odor. It is

a liquid when under pressure, and it dissolves in water very
easily.
Sulfur dioxide in the air comes mainly from activities
such as the burning of coal and oil at power plants or from
copper smelting. In nature, sulfur dioxide can be released to
the air from volcanic eruptions.
What happens to sulfur dioxide when it enters

the environment?
q When released into the environment, sulfur dioxide
moves into the air.
q In the air, it can be converted to sulfuric acid, sulfur trioxide, and sulfates.
q Sulfur dioxide dissolves in water.
q Once dissolved in water, sulfur dioxide can form sulfurous acid.
q Sulfur dioxide can be absorbed into the soil, but we dont
know if or how it moves in soil.
q Working in industries where it occurs as a by-product,

such as copper smelting or power plants.
q Working in the manufacture of sulfuric acid, paper, food
preservatives, or fertilizers.
q Living near heavily industrialized activities where sulfur
dioxide occurs.
How can sulfur dioxide affect my health?

Exposure to very high levels of sulfur dioxide can be life
threatening. Exposure to 100 parts of sulfur dioxide per million parts of air (100 ppm) is considered immediately dangerous to life and health. Burning of the nose and throat, breathing difficulties, and severe airway obstructions occurred in
miners who breathed sulfur dioxide released as a result of an
explosion in a copper mine.
Long-term exposure to persistent levels of sulfur dioxide
can affect your health. Lung function changes were seen in
some workers exposed to low levels of sulfur dioxide for 20
years or more. However, these workers were also exposed to
other chemicals, so their health effects may not have been
from sulfur dioxide alone. Asthmatics have also been shown

SULFUR DIOXIDE
CAS # 7446-09-5
Page 2

to be sensitive to the respiratory effects of low concentrations
of sulfur dioxide.

sulfur dioxide?
Animal studies also show respiratory effects from breathing sulfur dioxide. Animals exposed to high concentrations of
sulfur dioxide showed decreased respiration, inflammation of
the airways, and destruction of areas of the lung.
Families living near heavily industrialized areas where

sulfur dioxide occurs should limit their outdoor activities
during times of high air pollution. By paying attention to
news bulletins and air pollution advisories, families can control the amount of their exposure. People with respiratory difficulties should pay special attention to these warnings, and
asthmatic childrens outdoor exercise should be limited when
high levels of sulfur dioxide are present in air.
How likely is sulfur dioxide to cause cancer?

There are no studies that clearly show carcinogenic effects
of sulfur dioxide in people or animals. Studies have investigated workers in the copper smelting and pulp and paper industries, but the results are inconclusive since the workers were
also exposed to arsenic and other chemicals. The one available
animal study suggests that sulfur dioxide may be a carcinogen
in mice. The International Agency for Research on Cancer
(IARC) has classified sulfur dioxide as Group 3, not classifiable as to human carcinogenicity.
How can sulfur dioxide affect children?

Children who live in or near heavily industrialized areas
where sulfur dioxide occurs may experience difficulty breathing, changes in the ability to breathe deeply, and burning of
the nose and throat. It is not known whether children are more
vulnerable to these effects than adults. However, children may
be exposed to more sulfur dioxide than adults because they
breathe more air for their body weight than adults do.
Long-term studies surveying large numbers of children
indicate that children who have breathed sulfur dioxide pollution may develop more breathing problems as they get older,
may make more emergency room visits for treatment of wheezing fits, and may get more respiratory illnesses than other children. Children with asthma may be especially sensitive even
to low concentrations of sulfur dioxide, but it is not known
whether asthmatic children are more sensitive than asthmatic
adults.

exposed to sulfur dioxide?
Sulfur dioxide in the body is changed into other sulfurcontaining chemicals in the body. These breakdown products
can be measured in blood and urine, but this requires special
equipment that is not routinely available in a doctors office.
Furthermore, exposure to chemicals other than sulfur dioxide
can also produce sulfate, so the presence of sulfate breakdown
products in your body does not necessarily mean you have
been exposed to sulfur dioxide.

EPA has set an air quality standard of 0.03 ppm for longterm, 1-year average concentrations of sulfur dioxide. Shortterm, 24-hour air concentrations should not exceed 0.14 ppm
more than once a year.
(OSHA) has set a limit of 2 ppm over an 8-hour workday, 40hour workweek.
(ATSDR). 1998. Toxicological profile for sulfur dioxide.
SULFUR TRIOXIDE (SO3)

and SULFURIC ACID
CAS # 7446-11-9 and 7664-93-9
June 1999
This fact sheet answers the most frequently asked health questions (FAQs) about sulfur trioxide (SO3) and
sulfuric acid. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet
is one in a series of summaries about hazardous substances and their health effects. Its important you
understand this information because this substance may harm you. The effects of exposure to any hazardous
HIGHLIGHTS: Sulfur trioxide (SO3) is formed from sulfur dioxide; SO3 forms
sulfuric acid when it comes in contact with water. Sulfuric acid can cause burns
to the skin, eyes, lungs, and digestive tract. Severe exposure can result in death.
q SO3 is formed when sulfur dioxide reacts with water in the
What are sulfur trioxide and sulfuric acid?
air.
(Pronounced slfr tr ksd and sl-fyrk sd)
Sulfur trioxide (SO3) is generally a colorless liquid. It can
also exist as ice- or fiber-like crystals or as a gas. When SO3 is
exposed to air, it rapidly takes up water and gives off white
fumes. It can react with water to form sulfuric acid.
SO3 is also called sulfuric oxide and sulfuric anhydride. It
is used in the production of sulfuric acid and other chemicals,
and explosives.
q Sulfuric acid dissolves in the water in air and can remain

suspended in air for varying periods of time.
q Sulfuric acid is removed from the air in rain.
q Sulfuric acid contributes to the formation of acid rain.
How might I be exposed to sulfur trioxide and

sulfuric acid?
Sulfuric acid is a clear, colorless, oily liquid that is very

corrosive. It is also called sulphine acid, battery acid, and hydrogen sulfate. It is used in the manufacture of fertilizers, explosives, other acids, and glue; in the purifiction of petroleum;
in the pickling of metal; and in lead-acid batteries (used in
most vehicles).
q Working in the chemical or metal plating industry; producing detergents, soaps, fertilizers, or lead-acid batteries;
or working in printing and publishing or photography
shops.
What happens to sulfur trioxide and sulfuric

acid when they enter the environment?
q Breathing air near a hazardous waste site where SO3 is

disposed of.
q Much of the sulfuric acid in the air is formed from sulfur

dioxide released when coal, oil, and gas are burned.
q Coming in contact with toilet bowl cleaners mixed with

water.
q Breathing outdoor air where coal, oil, or gas are burned.

q Touching the material that forms on the outside of your
car battery.

Page 2
SULFUR TRIOXIDE (SO3) AND SULFURIC ACID

CAS # 7446-11-9 and 7664-93-9

How can sulfur trioxide and sulfuric acid affect
my health?
Touching sulfuric acid will burn your skin, and breathing
sulfuric acid can result in tooth erosion and respiratory tract
irritation. Drinking sulfuric acid can burn your mouth, throat,
and stomach; it can result in death. If you get sulfuric acid in
your eyes, it will cause your eyes to water and will burn.
breathe more air per kilogram of body weight than adults.

sulfur trioxide and sulfuric acid?
q Keep household products like drain and toilet bowl cleaners containing sulfuric acid out of the reach of children.
q Wear protective gloves when using products that contain
sulfuric acid.
q Keep car batteries away from children.
How likely are sulfur trioxide and sulfuric acid

to cause cancer?
People who have breathed large quantities of sulfuric acid
at work have shown an increase in cancers of the larynx. However, most of the people were also smokers who were exposed
to other chemicals and acids as well.
The ability of sulfuric acid to cause cancer in laboratory
animals has not been studied. The International Agency for
Research on Cancer (IARC) has determined that occupational
exposure to strong inorganic acid mists containing sulfuric
acid is carcinogenic to humans. IARC has not classified pure
sulfuric acid for its carcinogenic effects.
How can sulfur trioxide and sulfuric acid affect

children?
Children may be exposed in the same ways as adults;
however, they may be more at risk due to accidental injuries
and accidents in the home. Teenagers may have jobs (such as
car repair) in which they have contact with sulfuric acid.
Children may have increased sensitivity to sulfuric acid in
air, due to their smaller airway diameters and the fact that they

exposed to sulfur trioxide and sulfuric acid?
There is no medical test to determine whether you have
been exposed to sulfur trioxide or sulfuric acid. Breathing in
acids, including sulfuric acid, will increase the acidity of your
saliva. Measuring the acidity of saliva may determine whether
you have been exposed to acid but cannot tell which acid.

EPA limits the amount of sulfur dioxide that can be released into the air. This limits the amount of sulfur trioxide
and sulfuric acid that form from sulfur dioxide in the air.
(OSHA) and the National Institute of Occupational Safety and
Health (NIOSH) limit the amount of sulfuric acid in workroom
air to 1 milligram per cubic meter of air (1 mg/m3).
(ATSDR). 1998. Toxicological profile for sulfur trioxide
(SO3) and sulfuric acid. Atlanta, GA: U.S. Department of
SYNTHETIC VITREOUS FIBERS

September 2002
This fact sheet answers the most frequently asked health questions (FAQs) about synthetic vitreous
fibers. For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is
one in a series of summaries about hazardous substances and their health effects. It is important you
HIGHLIGHTS: Synthetic vitreous fibers are manmade fibrous materials used

for thermal and sound insulating purposes. Short-term exposure can cause
reversible skin, eye, and lung irritation. Workers from factories making
synthetic vitreous fibers used in home insulation showed no increased rates of
lung problems. Some refractory ceramic fiber workers showed changes in
their chest x-rays, but these changes are not associated with breathing
problems. There is no clear association between exposure to synthetic vitreous
fibers and cancer in humans. Synthetic vitreous fibers have not been detected
in any of the 1,613 National Priorities List sites identified by the
What are synthetic vitreous fibers?
Synthetic vitreous fibers are a group of fibrous, inorganic
materials that contain aluminum or calcium silicates, and are
made from rock or stone, clay, slag, or glass. They do not
occur naturally in the environment, but are used widely for
thermal and sound insulating purposes and to reinforce
other materials. There are three categories of synthetic
vitreous fibers: 1) glass fibers (fiberglass), including glass
wool and continuous filament glass, 2) mineral wool, which
contains stone wool and slag wool, and 3) refractory ceramic
fibers.
Insulation that is used in homes and buildings is composed
of synthetic vitreous fibers. Refractory ceramic fibers are
not widely used for building insulation. They are used to
insulate furnaces, in replacement of asbestos.
What happens to synthetic vitreous fibers when

Synthetic vitreous fibers can enter the air, water, and soil
from the manufacture, use, and disposal of fiber-containing
materials.
They are generally not broken down to other compounds
in the environment and remain virtually unchanged over
long periods of time. They can eventually be broken down
if the water or soil is very acidic or very alkaline.
Most fibers suspended in air from insulation materials
settle quickly, but some smaller diameter fibers may remain
suspended and be carried some distance by wind before

settling.
Synthetic vitreous fibers do not move through soil.
How might I be exposed to synthetic vitreous

fibers?
When insulation materials containing synthetic vitreous
fibers are disturbed, fibers can be suspended in the air and
breathed in.
When installing or removing home insulation, fibers can
come in contact with the eyes and skin.
Workers who install or remove insulation or who are
involved in building maintenance or repair are expected to
have the highest levels of exposure to synthetic vitreous
fibers.
How can synthetic vitreous fibers affect my

health?
When synthetic vitreous fibers are suspended in air they
can cause irritation of the eyes, the nose and throat, and
parts of the lung. When these fibers contact the skin, they
may also cause irritation. These effects are reversible and
disappear shortly after exposure stops.
Animal studies show that repeatedly breathing dusty air
containing a lot of synthetic vitreous fibers can lead to
inflammation and fibrosis of the lung. Pulmonary
inflammation is part of a natural defense system to clear the
lung of deposited particles. If exposure stops, most

Page 2
SYNTHETIC VITREOUS FIBERS

deposited fibers are eventually cleared, and pulmonary

inflammation stops. However, if pulmonary inflammation
continues over a long period of time, a slow build up of scar
tissue may occur in the lungs and in the membrane encasing
the lungs called the pleura. This effect is called pulmonary
fibrosis or pleural fibrosis. Glass fibers commonly used in
home insulation materials did not cause fibrosis in animals,
but refractory ceramic fibers did.
You are unlikely to develop long-term pulmonary
inflammation or pulmonary fibrosis from synthetic vitreous
fibers, unless you are exposed to very dusty conditions daily
for many years. Studies of workers from factories that make
synthetic vitreous fibers used in home insulation materials
did not find abnormal numbers of cases of long-term
pulmonary inflammation, breathing problems, or changes in
chest x-rays. Some workers who made refractory ceramic
fibers showed changes in chest x-rays that are called pleural
plaques, but their ability to breathe was normal. Pleural
plaques are small areas of very mildly scarred pleural tissue.
How likely are synthetic vitreous fibers to cause

cancer?
You are unlikely to develop cancer from breathing in air with
small amounts of synthetic vitreous fibers. Studies of
workers from factories that make synthetic vitreous fibers
have not found increased rates of lung cancer or cancer of
the pleura, called mesothelioma. Animals exposed for life to
air containing refractory ceramic fibers showed increased
rates of lung cancer and mesothelioma, but animals exposed
to insulation glass wools and stone wools did not.
determined that insulation glass wool, stone wool, and slag
wool, and continuous filament glass are not classifiable as to
carcinogenicity to humans because of the inadequate
evidence of carcinogenicity in humans and the relatively low
biopersistence of these materials. IARC determined that
refractory ceramic fibers are possibly carcinogenic to humans
because of their relatively high biopersistence and the
findings of cancer in animals that repeatedly breathed in high
levels of refractory ceramic fibers. The EPA has classified
refractory ceramic fibers as a probable human carcinogen.
How can synthetic vitreous fibers affect children?

There are no unique exposure pathways to synthetic
vitreous fibers for children. It is likely that children exposed

to these types of fibers will experience the same effects as
adults, such as eye, skin, and upper respiratory tract
irritation.
There are no studies that examined whether exposure to
synthetic vitreous fibers affect the developments of the
fetus, infants, or young children.

synthetic vitreous fibers?
Insulating material in attics or walls is the most common
source of synthetic vitreous fibers in a home. Avoid
disturbing or contacting these materials.
If you install your own insulation, wear protective
clothing, respiratory protection, and eye protection, and
follow recommendations provided by the manufacturer for
installing this material.
If you are exposed to these fibers at work, you may carry
fibers home on your skin, clothes, or tools. You can avoid
this by showering, and changing clothing before leaving
work. Your work clothes should be kept separate from other
clothes and laundered separately.

exposed to synthetic vitreous fibers?
There are currently no tests specific for synthetic vitreous
fibers. A chest x-ray is a common method to determine if
you have certain conditions, such as pleural plaques, lung or
pleural fibrosis, or mesotheliomas.

has set a limit of 5 milligrams of synthetic vitreous fibers as
inert or nuisance dust per cubic meter (5 mg/m3) of air for the
respirable fraction and 15 mg/m3 for total dust. The
voluntary limit for fiberglass and mineral wool is 1 fiber per
cubic centimeter.
(ATSDR). 2002. Toxicological Profile for Synthetic Vitreous
Fibers (Draft for Public Comment). Atlanta, GA: U.S.
Service.
1,1,2,2-TETRACHLOROETHANE
CAS # 79-34-5
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about 1,1,2,2-tetrachloroethane.
HIGHLIGHTS: 1,1,2,2-Tetrachloroethane is a manufactured chemical that is no longer

used much in the United States. Breathing high levels of 1,1,2,2-tetrachloroethane
can cause fatigue, vomiting, dizziness, and possibly unconsciousness. Breathing,
drinking, or touching it for a long period of time can cause liver damage, stomachaches,
or dizziness. 1,1,2,2-Tetrachloroethane has been found in at least 273 of the 1,430
What is 1,1,2,2-tetrachloroethane?
(Pronounced tt r-klr -thn)
1,1,2,2-Tetrachloroethane is a manufactured, colorless
chemical that does not burn easily. It is volatile and has a
sweet odor.
In the past, it was used in large amounts to produce other
chemicals and as a solvent, to clean and degrease metals, and
in paints and pesticides. Commercial production of 1,1,2,2tetrachloroethane for these uses has stopped in the United
States. It presently is used only as a chemical intermediate in
the production of other chemicals.
What happens to 1,1,2,2-tetrachloroethane when

q 1,1,2,2-Tetrachloroethane eventually moves into the air
or ground water.
q It does not attach to soil particles when released to land.
q When released to surface water, much of it will evaporate to
the air while the rest may break down in the water.
q Breakdown of the chemical is slow; it takes about
13 months for half of the chemical to disappear in ground
water and 2 months in air.
q 1,1,2,2-Tetrachloroethane does not build up significantly

in the bodies of fish or other organisms.
How might I be exposed to 1,1,2,2-tetrachloroethane?

q 1,1,2,2-Tetrachloroethane can be found at low levels in
both indoor and outdoor air.
q It has rarely been found in public drinking water supplies,
although in a few instances it has been found in private
well water that may have been used for drinking.
q It has not been reported in food or soil.
q Since production of the chemical has stopped, most workers would not be exposed to it.
q Limited exposure could occur from breathing in vapors or
touching it due to spills or accidents in the workplace.
How can 1,1,2,2-tetrachloroethane affect my

health?
Breathing high levels of 1,1,2,2-tetrachloroethane in a
closed room can cause fatigue, vomiting, dizziness, and possibly unconsciousness. However, most people recover from these
effects once they are in fresh air. Breathing, drinking, or touching 1,1,2,2-tetrachloroethane can cause liver damage, stomach-

1,1,2,2-TETRACHLOROETHANE
CAS # 79-34-5
Page 2

aches, or dizziness if you are exposed to large amounts for a
long period of time.
The health effects from long-term (365 days or longer)
exposure to low levels of 1,1,2,2-tetrachloroethane are not
known. It is also not known whether 1,1,2,2-tetrachloroethane
will cause reproductive effects in people.
How likely is 1,1,2,2-tetrachloroethane to cause

cancer?
It is not known whether 1,1,2,2-tetrachloroethane causes
cancer in people. In a long-term study, 1,1,2,2-tetrachloroethane caused an increase in liver tumors in mice, but not in rats.

(OSHA) has set a permissible exposure limit of 5 parts of
1,1,2,2-tetrachloroethane per million parts of air (5 ppm) in
the workplace during an 8-hour workday, 40-hour workweek.
(NIOSH) recommends a maximum level of 1 ppm 1,1,2,2-tetrachloroethane for a 10-hour workday, 40-hour workweek.
Hygienists (ACGIH) recommends an exposure limit of 6.9 milligrams of 1,1,2,2-tetrachloroethane per cubic meter of air
(6.9 mg/m3) for an 8-hour workday, 40-hour workweek.

has determined that 1,1,2,2-tetrachloroethane cannot be classified as to its ability to cause cancer in humans, while the EPA
has determined that it is a possible human carcinogen.
Glossary

exposed to 1,1,2,2-tetrachloroethane?
There are no medical tests to determine if you have been

exposed to 1,1,2,2-tetrachloroethane. The symptoms of
1,1,2,2-tetrachloroethane poisoning, such as stomachaches,
fatigue, and dizziness are common to many diseases and are
not useful to determine if you were exposed to this chemical.
Solvent: A chemical that can dissolve other substances.
1,1,2,2-Tetrachloroethane can affect the liver and there are

medical tests to determine whether the liver is working properly. However, liver disease may have many causes and does
not only indicate exposure to 1,1,2,2-tetrachloroethane.

environment of 100 pounds or more of 1,1,2,2-tetrachloroethane be reported to the EPA.

Volatile: Easily changes into a vapor or a gas.
This ToxFAQs information is taken from the 1996 Toxicological Profile for 1,1,2,2-Tetrachloroethane produced by the
TETRACHLOROETHYLENE
CAS # 127-18-4
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about tetrachloroethylene. For
HIGHLIGHTS: Tetrachloroethylene is a manufactured chemical used for dry

cleaning and metal degreasing. Exposure to very high concentrations of
tetrachloroethylene can cause dizziness, headaches, sleepiness, confusion, nausea,
difficulty in speaking and walking, unconsciousness, and death.
Tetrachloroethylene has been found in at least 771 of the 1,430 National Priorities
What is tetrachloroethylene?
(Pronounced ttr-klr -th-ln)
Tetrachloroethylene is a manufactured chemical that is
widely used for dry cleaning of fabrics and for metal-degreasing. It is also used to make other chemicals and is used in
some consumer products.
Other names for tetrachloroethylene include perchloroethylene, PCE, and tetrachloroethene. It is a nonflammable
liquid at room temperature. It evaporates easily into the air
and has a sharp, sweet odor. Most people can smell tetrachloroethylene when it is present in the air at a level of 1 part
tetrachloroethylene per million parts of air (1 ppm) or more,
although some can smell it at even lower levels.
What happens to tetrachloroethylene when it

q Much of the tetrachloroethylene that gets into water or
soil evaporates into the air.
q Microorganisms can break down some of the tetrachloroethylene in soil or underground water.
q In the air, it is broken down by sunlight into other chemicals or brought back to the soil and water by rain.
q It does not appear to collect in fish or other animals that
live in water.
How might I be exposed to tetrachloroethylene?

q When you bring clothes from the dry cleaners, they will
release small amounts of tetrachloroethylene into the air.
q When you drink water containing tetrachloroethylene,
you are exposed to it.
How can tetrachloroethylene affect my health?

High concentrations of tetrachloroethylene (particularly
in closed, poorly ventilated areas) can cause dizziness, headache, sleepiness, confusion, nausea, difficulty in speaking and
walking, unconsciousness, and death.
Irritation may result from repeated or extended skin contact with it. These symptoms occur almost entirely in work (or
hobby) environments when people have been accidentally
exposed to high concentrations or have intentionally used
tetrachloroethylene to get a high.
In industry, most workers are exposed to levels lower than
those causing obvious nervous system effects. The health
effects of breathing in air or drinking water with low levels of
tetrachloroethylene are not known.
Results from some studies suggest that women who work
in dry cleaning industries where exposures to tetrachloroethyl-

TETRACHLOROETHYLENE
CAS # 127-18-4
Page 2

ene can be quite high may have more menstrual problems and
spontaneous abortions than women who are not exposed.
However, it is not known if tetrachloroethylene was responsible for these problems because other possible causes were
not considered.
Results of animal studies, conducted with amounts much
higher than those that most people are exposed to, show that
tetrachloroethylene can cause liver and kidney damage. Exposure to very high levels of tetrachloroethylene can be toxic
to the unborn pups of pregnant rats and mice. Changes in
behavior were observed in the offspring of rats that breathed
high levels of the chemical while they were pregnant.
How likely is tetrachloroethylene to cause

cancer?
has determined that tetrachloroethylene may reasonably be
anticipated to be a carcinogen. Tetrachloroethylene has been
shown to cause liver tumors in mice and kidney tumors in
male rats.
formed at special laboratories that have the right equipment.

Because exposure to other chemicals can produce the
same breakdown products in the urine and blood, the tests for
breakdown products cannot determine if you have been exposed to tetrachloroethylene or the other chemicals.

The EPA maximum contaminant level for the amount of
tetrachloroethylene that can be in drinking water is 0.005 milligrams tetrachloroethylene per liter of water (0.005 mg/L).
(OSHA) has set a limit of 100 ppm for an 8-hour workday over
a 40-hour workweek.
(NIOSH) recommends that tetrachloroethylene be handled as a
potential carcinogen and recommends that levels in workplace
air should be as low as possible.
Glossary

exposed to tetrachloroethylene?
One way of testing for tetrachloroethylene exposure is to

measure the amount of the chemical in the breath, much the
same way breath-alcohol measurements are used to determine
the amount of alcohol in the blood.
Nonflammable: Will not burn.
Because it is stored in the bodys fat and slowly released

into the bloodstream, tetrachloroethylene can be detected in
the breath for weeks following a heavy exposure.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Tetrachloroethylene (update) produced by
the Agency for Toxic Substances and Disease Registry, Public
Tetrachloroethylene and trichloroacetic acid (TCA), a

breakdown product of tetrachloroethylene, can be detected in
the blood. These tests are relatively simple to perform. These
tests aren't available at most doctors' offices, but can be per-

TETRYL (2,4,6-TRINITROPHENYLn-METHYLNITRAMINE)
CAS # 479-45-8
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about tetryl. For more information,
SUMMARY: Exposure to tetryl occurs around military installations where it was

made, used, or stored. Workers who breathed tetryl-laden dust complained of
coughs, fatigue, headaches, eye irritation, lack of appetite, nosebleeds, nausea, and
vomiting. This substance has been found in at least 12 of the 1,430 National Priorities
What is tetryl?
q It is not likely to evaporate from water or soil.
(Pronounced ttrl)
q It breaks down rapidly in sunlit rivers and lakes, but much

more slowly in groundwater.
The chemical name for tetryl is 2,4,6-trinitrophenyl-nmethylnitramine. Some commonly used names are nitramine,
tetralite, and tetril.
Tetryl is an odorless, synthetic, yellow crystal-like solid
that is not found naturally in the environment. Under certain
conditions, tetryl can exist as dust in air. It dissolves slightly
in water and in other liquids.
Tetryl was used to make explosives, mostly during
World Wars I and II. It is no longer manufactured or used in
the United States.
Stocks of tetryl are found in storage at military installations and are being destroyed by the Department of Defense
(DOD).
q Tetryl does not move easily from soil to groundwater.

q It is not known if tetryl builds up in fish, plants, or land
animals.
How might I be exposed to tetryl?

Most people are not exposed to tetryl because contamination is around military installations where it was made, used,
or stored. You may be exposed by:
q Drinking contaminated well water near a military installation site.
q Breathing contaminated dust near a military installation
site.
q Having skin contact with contaminated soil or water
near a military installation site.
What happens to tetryl when it enters the

environment?
How can tetryl affect my health?
q Tetryl may be released to the air, water, and soil when old
stores of the explosive are destroyed by exploding or
burning.
Workers at military facilities during World Wars I and II

who breathed tetryl-laden dust complained of coughs, fatigue,
headaches, eye irritation, lack of appetite, nosebleeds, nausea,

TETRYL (2,4,6-TRINITROPHENYLn-METHYLNITRAMINE)
CAS # 479-45-8
Page 2

and vomiting.
Workers who routinely handled tetryl developed a distinct yellow staining of the hands, neck, and hair. Many
workers who had skin contact with tetryl developed skin
rashes. Some also developed allergies with asthma-like reactions (severe coughing and wheezing) after breathing tetryl.
Rabbits fed high doses of tetryl every day for 69 months
developed effects on the kidneys and liver. Decreased bloodclotting capability and changes in the spleen were also noted.
We do not know if these effects would occur in humans exposed to similar doses of tetryl.

The Department of Transportation (DOT) has many regulations for the transportation of explosives including tetryl.
(OSHA) set a maximum level of 1.5 milligrams of tetryl per
cubic meter of workplace air (1.5 mg/m3) for an 8-hour workday, 40-hour workweek.
We do not know if tetryl causes birth defects, or if it affects reproduction in humans or animals.

(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) also recommend a maximum concentration of 1.5 mg/m3 in workplace air for an 8- to 10-hour
How likely is tetryl to cause cancer?
Glossary
The International Agency for Research on Cancer (IARC),

the Department of Health and Human Services (DHHS), and
the EPA have not reviewed tetryl to determine whether it is
likely to cause cancer.
Breakdown product: A substance that is formed when a

chemical breaks down in the body.
The carcinogenicity of tetryl in humans and animals has

not been studied.


exposed to tetryl?
exposed to tetryl. Breakdown products of tetryl have been
measured in the urine of animals, and similar measurements of
tetryl breakdown products in the urine of people could be
completed.
Reference
(ATSDR). 1995. Toxicological profile for tetryl (update).
THALLIUM
CAS # 7440-28-0
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about thallium. For more
SUMMARY: Exposure to thallium occurs mainly from eating food. Exposure to

higher levels of thallium may occur in the workplace. Breathing high levels of
thallium may result in effects on the nervous system, while ingesting high levels
of it results in vomiting, diarrhea, temporary hair loss, and other effects. This
chemical has been found in at least 210 of 1,416 National Priorities List sites
What is thallium?
(Pronounced thl-m)
q Some thallium compounds are removed from the atmosphere in rain and snow.
Pure thallium is a bluish-white metal that is found in trace

amounts in the earths crust. In the past, thallium was obtained as a by-product from smelting other metals; however, it
has not been produced in the United States since 1984.
Currently, all the thallium is obtained from imports and from
thallium reserves.
q It builds up in fish and shellfish.
In its pure form, thallium is odorless and tasteless. It can

also be found combined with other substances such as
bromine, chlorine, fluorine, and iodine. When it's combined,
it appears colorless-to-white or yellow.
Thallium is used mostly in manufacturing electronic
devices, switches, and closures, primarily for the semiconductor industry. It also has limited use in the manufacture of
special glass and for certain medical procedures.
What happens to thallium when it enters the

environment?
q Thallium enters the environment primarily from coalburning and smelting, in which it is a trace contaminant
of the raw materials.
q It stays in the air, water, and soil for a long time and is not
broken down.
q It's absorbed by plants and enters the food chain.
How might I be exposed to thallium?

q Eating food contaminated with thallium may be a major
source of exposure for most people.
q Breathing workplace air in industries that use thallium
q Smoking cigarettes.
q Living near hazardous waste sites containing thallium
(may result in higher than normal exposures).
q Touching or, for children, eating soil contaminated with
thallium.
q Breathing low levels in air and water.
How can thallium affect my health?

Exposure to high levels of thallium can result in harmful
health effects. A study on workers exposed on the job over
several years reported nervous system effects, such as numbness of fingers and toes, from breathing thallium.
Studies in people who ingested large amounts of thallium
over a short time have reported vomiting, diarrhea, temporary
hair loss, and effects on the nervous system, lungs, heart, liver,

THALLIUM
CAS # 7440-28-0
Page 2

and kidneys. It has caused death. It is not known what the
effects are from ingesting low levels of thallium over a long
time.
Birth defects were not reported in the children of mothers
exposed to low levels from eating vegetables and fruits
contaminated with thallium. Studies in rats, however,
exposed to high levels of thallium, showed adverse developmental effects.
It is not known if breathing or ingesting thallium affects
human reproduction. Studies showed that rats that ingested
thallium for several weeks had some adverse reproductive
effects. Animal data suggest that the male reproductive
system may be susceptible to damage by low levels of
thallium.
There is no information available on the health effects of
skin contact with thallium in people or animals.
How likely is thallium to cause cancer?

thallium as to its human carcinogenicity.
No studies are available in people or animals on the
carcinogenic effects of breathing, ingesting, or touching
thallium.
These tests require special equipment that is not usually

available in most doctors offices. In addition, these tests
cannot determine if adverse health effects will occur from the
exposure to thallium.

the environment of 1,000 pounds or more of thallium be
reported.
(OSHA) has set an exposure limit of 0.1 milligrams per cubic
meter (0.1 mg/m3) for thallium in workplace air. The American Conference of Governmental Industrial Hygienists
(ACGIH) has established the same guidelines as OSHA for the
workplace.
Health (NIOSH) has recommended that 15 mg/m3 of thallium
be considered immediately dangerous to life and health.
This is the exposure level of a chemical that is likely to cause
Glossary

been exposed to thallium?
References

thallium in urine and hair. In addition, thallium can also be
measured in blood; however, this is not a good indicator of
exposure since thallium only stays in blood a very short time.

1992. Toxicological profile for thallium. Atlanta, GA: U.S.
Service.
THORIUM
CAS # 7440-29-1
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about thorium. For more information,
HIGHLIGHTS: Thorium is a radioactive substance that occurs naturally in

the environment. It has been shown to cause an increase in cancers of the lung,
pancreas, and blood in workers exposed to high levels of it in the air. This
chemical has been found in at least 16 of the 1,177 National Priorities List sites
What is thorium?
Pronounced (thr-m)
Thorium is a naturally occurring, radioactive substance. In
the environment, thorium exists in combination with other
minerals, such as silica. Small amounts of thorium are present
in all rocks, soil, water, plants, and animals. Soil contains an
average of about 6 parts of thorium per million parts of soil
(6 ppm).
More than 99% of natural thorium exists in the form of
thorium-232. It breaks down into two partsa small part
called alpha radiation and a large part called the decay product. The decay product is also not stable and continues to
break down through a series of decay products until a stable
product is formed. During these decay processes, radioactive
substances are produced. These include radium and radon.
These substances give off radiation, including alpha and beta
particles, and gamma radiation.
Some rocks in underground mines contain thorium in a
more concentrated form. After these rocks are mined, thorium
is usually concentrated and changed into thorium dioxide or
other chemical forms. After most of the thorium is removed, the
rocks are called depleted ore or tailings.
Thorium is used to make ceramics, gas lantern mantles,
and metals used in the aerospace industry and in nuclear reac-
tions. Thorium can also be used as a fuel for generating

nuclear energy.
What happens to thorium when it enters the

environment?
q Thorium is a natural part of the environment.
q Thorium changes extremely slowly into other radioactive
substances.
q It takes about 14 billion years for half of the thorium-232
to change into new forms.
q As rocks are broken up by wind and water, the thorium
and all other components of the rocks become part of the
soil.
q Thorium in soil can be washed into rivers and lakes.
q Windblown dust and volcanic eruptions are natural
sources of thorium in the air.
q Burning coal may release small amounts of thorium into
the air.
q Mining thorium or making products that contain it may
also release thorium into the environment.
How might I be exposed to thorium?

q Just by being alive, everyone is exposed to small amounts
of thorium in air, water, and food.

THORIUM
CAS # 7440-29-1
Page 2

q Breathing air near facilities where uranium, phosphate, or
tin ore is processed.
q Living in homes built on soil with high levels of thorium.
q Working in the uranium, thorium, tin, and phosphate mining, and gas mantle production industries may expose you
to higher levels of thorium.
These tests are only useful if done within several days to a

week after exposure. The tests cannot tell you if your health
will be affected by the exposure. They require special equipment and are probably not available at your local clinic or
hospital.
q Living near radioactive waste disposal sites.
How can thorium affect my health?

Studies on thorium workers have shown that breathing

high levels of thorium dust results in an increased chance of
getting lung disease. Liver diseases and effects on the blood
were found in people injected with thorotrast, a thorium compound injected into the body as a radiographic contrast medium between the years 1928 and 1955. Animal studies have
shown that breathing thorium may result in lung damage.
The EPA has set a drinking water limit of 15 picocuries

per liter (15 pCi/L) of water for gross alpha particle activity
and 4 millirems per year for beta particles and photon activity
(for example, gamma radiation and x-rays).
Studies on exposed human populations have not reported

any birth defects or effects on a person's ability to have
children.
Glossary
How likely is thorium to cause cancer?

Workers who had high exposures to cigarette smoke, radon
gas, and thorium had cancers of the lung, pancreas, and blood.
People who had large amounts of thorium injected into their
blood for special x-ray tests had more than the usual number of
liver tumors, cancers of the blood, such as leukemia, and tumors of the bone, kidney, spleen, and pancreas.

exposed to thorium?
Special tests that measure the level of radioactivity from
thorium in your urine and feces, and radon gas in the air you
exhale can determine if you have been exposed to thorium.

July 1999.

Millirem (mrem): A unit used to measure radiation dose.
Picocurie (pCi): A unit used to measure the intensity of
radiation.
(ATSDR). 1990. Toxicological profile for thorium. Atlanta,
Health Service.
TIN
CAS # 7440-31-5
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about tin. For more information,
SUMMARY: Exposure to tin results mostly from eating food and breathing air
that contains tin. Breathing or swallowing large amounts of some compounds
that contain tin may cause stomachaches, anemia, and liver and kidney problems.
Tin has been found in at least 202 of 1,416 National Priorities List sites identified
What is tin?
(Pronounced tn)
Tin is a natural element in the earths crust. It is a soft,
white, silvery metal that doesn't dissolve in water. Tin is used
to make cans. It is present in brass, bronze, pewter, and some
soldering materials.
Tin can be combined with other chemicals to form compounds. When combined with chemicals like chlorine, sulfur,
or oxygen, it is called an inorganic tin compound. These are
used in toothpaste, perfumes, soaps, coloring agents, and
dyes. When tin is combined with materials that contain carbon, it is called an organotin compound and is used to make
plastics, food packages, plastic pipes, pesticides, paints, and
pest repellants.
Tin metal, as well as inorganic and organic tin compounds, can be found in the air, water, and soil near places
where they are naturally present in the rocks, or where they are
mined, manufactured, or used.
What happens to tin when it enters the

environment?
Tin is released into the environment by both natural processes and human activities such as mining, coal and oil
combustion, and the production and use of tin products.
The time that each type of tin compound stays in the air,
water, and soil differs for each compound.
In the atmosphere, tin exists as gases and fumes, and attaches to dust particles.
Some tin compounds dissolve in water.
In water, tin attaches to the soil and sediments.
Organotins build up in fish, other organisms, and plants.
How might I be exposed to tin?

Eating food or drinking juice or other liquids from tin
containers.
Breathing air that contains tin in the workplace or near
Touching substances that contain high levels of tin.
How can tin affect my health?

The inorganic tin compounds usually enter and leave
your body rapidly when you breathe or eat them, so they usually do not cause harmful effects.
Human and animal studies show that large amounts of
these tin compounds can cause stomachaches, anemia, and
liver and kidney problems.

TIN
CAS # 7440-31-5
Page 2

Breathing or swallowing organotin compounds can cause
breathing problems and eye irritation, and can interfere with
the way your brain and nervous system work. In severe cases,
it can cause death.
Some of the organotin compounds seemed to weaken rats
ability to protect themselves from disease. These effects have
not been observed in people.
Rats and mice exposed to organotin compounds had
problems with reproduction and with the development of normal babies. We do not know if this would happen to people.
Inorganic tin compounds do not affect reproduction or cause
birth defects.
There is very little information on the health effects
caused by touching tin compounds. When the skin and eyes
of people and animals were exposed to both organotin and
inorganic tin compounds, their skin and eyes became irritated.
How likely is tin to cause cancer?

The Department of Health and Human Services, the International Agency for Research on Cancer and the Environmental Protection Agency (EPA) have not classified tin for carcinogenicity.
your body. This test is only useful if you have been exposed
to food and air concentrations that result in much higher than
normal body levels. These tests are not routinely performed
at your doctors office, but your doctor can take samples and

The EPA has limited the use of certain organotin compounds in paints.
(OSHA) has set a maximum concentration limit of 0.1 milligrams per cubic meter of air (0.1 mg/m3) for organotin compounds, and 2.0 mg/m3 for tin and inorganic tin compounds.
The Food and Drug Administration (FDA) regulates the
use of some organotin compounds in coating and plastic
food packaging.
Glossary
oxygen.
There is no evidence that tin or tin compounds cause

cancer in humans. Animal studies show that inorganic tin
compounds do not cause cancer in rats and mice, but we do
not know if organotin compounds cause cancer in animals.

been exposed to tin?
References
Tin can be measured in your urine and feces. This can

tell you how much tin is in your body. It cannot tell you
when or how it got there because you always have some tin in

Organotin: Compound that contains both tin and carbon.

1992. Toxicological profile for tin. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
TITANIUM
TETRACHLORIDE
CAS # 7550-45-0
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about titanium tetrachloride. For
HIGHLIGHTS: Titanium tetrachloride is very irritating to the eyes, skin, mucous

membranes, and the lungs. Breathing in large amounts can cause serious injury
to the lungs. Contact with the liquid can burn the eyes and skin. The Environmental
Protection Agency (EPA) has identified 1,416 hazardous waste sites on its National
Priorities List (NPL) sites. Titanium tetrachloride has not been found in any of
the sites on the NPL. However, the number of NPL sites evaluated for titanium
tetrachloride is not known.
What is titanium tetrachloride?
(Pronounced t-tn-m ttr klrd)
Titanium tetrachloride is a colorless to pale yellow liquid
that has fumes with a strong odor. If it comes in contact with
water, it rapidly forms hydrochloric acid, as well as titanium
compounds.
Titanium tetrachloride is not found naturally in the environment and is made from minerals that contain titanium. It is
used to make titanium metal and other titanium-containing
compounds, such as titanium dioxide, which is used as a
white pigment in paints and other products and to produce
other chemicals.
What happens to titanium tetrachloride when it

q Titanium tetrachloride enters the environment primarily
in the air from factories that make or use it in various
chemical processes, or as a result of spills.
q If moisture is in the air, titanium tetrachloride reacts rapidly with it to form hydrochloric acid and other titanium
compounds, such as titanium hydroxide and titanium
oxychlorides.
q Some of the titanium compounds may settle out to soil or

water. In water, they sink into the bottom sediments.
q The titanium compounds may remain for a long time in
the soil or sediments.
q Some other titanium compounds, such as titanium dioxide, are also found in air and water.
How might I be exposed to titanium

tetrachloride?
q You are not likely to be exposed to titanium tetrachloride
in water, soil, food, or air.
q Because titanium tetrachloride breaks down rapidly in air,
you probably would not be exposed to it unless you
worked in an industry that made or used it.
q If you work in an industry that uses titanium tetrachloride, you could be exposed by breathing it or touching it.
q If titanium tetrachloride spills, you could get it on your
skin.
How can titanium tetrachloride affect my health?

Titanium tetrachloride can be very irritating to the skin,
eyes, mucous membranes, and the lungs. Breathing in large

TITANIUM TETRACHLORIDE
CAS # 7550-45-0
Page 2

amounts of titanium tetrachloride can injure the lungs seriously enough to cause death.
If you breathe in lower levels of titanium tetrachloride,
less serious respiratory system effects can include coughing
and tightness in the chest. More severe effects including
chemical bronchitis or pneumonia, and congestion of the mucous membranes of the upper respiratory tract can also occur.
These effects can cause long-term effects such as the narrowing
of the vocal cords, windpipe, and upper airways.
Accidental exposure to liquid titanium tetrachloride can
result in skin burns and can cause permanent damage to the
eyes, if they are not protected.
There is not enough information to determine if titanium
tetrachloride causes birth defects or affects reproduction.
for particles that contain titanium. This test is not specific for
titanium tetrachloride exposure, but it does indicate exposure
to some titanium-containing substances. Also, the test does
not indicate whether you may have potential health effects
resulting from such exposure or the amount of titanium compound to which you were exposed.

recommendations to protect humanhealth?
Releases of more than 100 pounds of titanium tetrachloride have been proposed as the release levels that must be
reported to the EPA. Maximum levels have not been established for titanium tetrachloride exposure in the workplace.
Glossary
How likely is titanium tetrachloride to cause
cancer?

EPA have not classified titanium tetrachloride for carcinogenicity. Some laboratory animals that breathed titanium tetrachloride fumes for 2 years developed lung tumors of a special
type. However, there is no evidence that long-term exposure to
titanium tetrachloride causes cancer in people.
Irritant: Abnormal reaction to a substance.

exposed to titanium tetrachloride?
There is no medical test to indicate whether you have
been exposed to titanium tetrachloride. However, you can be
tested for the presence of titanium dioxide or titanium metal,
which are breakdown products of titanium tetrachloride.
This test uses electron microscopes to examine lung tissue

body of water.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Titanium Tetrachloride produced by the
TOLUENE
CAS # 108-88-3
February 2001
This fact sheet answers the most frequently asked health questions (FAQs) about toluene. For more information,
HIGHLIGHTS: Exposure to toluene occurs from breathing contaminated

workplace air, in automobile exhaust, some consumer products paints, paint
thinners, fingernail polish, lacquers, and adhesives. Toluene affects the nervous
system. Toluene has been found at 959 of the 1,591 National Priority List sites
identified by the Environmental Protection Agency
What is toluene?
Toluene is a clear, colorless liquid with a distinctive smell.
Toluene occurs naturally in crude oil and in the tolu tree. It
is also produced in the process of making gasoline and
other fuels from crude oil and making coke from coal.
Toluene is used in making paints, paint thinners, fingernail
polish, lacquers, adhesives, and rubber and in some printing
and leather tanning processes.
What happens to toluene when it enters the

environment?
Toluene enters the environment when you use materials
that contain it. It can also enter surface water and
groundwater from spills of solvents and petrolieum products
as well as from leasking underground storage tanks at
gasoline stations and other facilities.
When toluene-containing products are placed in landfills
or waste disposal sites, the toluene can enter the soil or
water near the waste site.
Toluene does not usually stay in the environment long.

Toluene does not concentrate or buildup to high levels in
animals.
How might I be exposed to toluene?

Breathing contaminated workplace air or automobile
exhaust.
Working with gasoline, kerosene, heating oil, paints, and
lacquers.
Drinking contaminated well-water.
toluene products.
How can toluene affect my health?

Toluene may affect the nervous system. Low to moderate
levles can cause tiredness, confusion, weakness, drunkentype actions, memory loss, nausea, loss of appetite, and

TOLUENE
Page 2
CAS # 108-88-3
hearing and color vision loss. These symptoms usually

disappear when exposure is stopped.
When not in use, toluene-containing products should be

tightly covered to prevent evaporation into the air.
Inhaling High levels of toluene in a short time can make you

feel light-headed, dizzy, or sleepy. It can also cause
unconsciousness, and even death.

exposed to toluene?
High levels of toluene may affect your kidneys.
There are tests to measure the level of toluene or its

breakdown products in exhaled air, urine, and blood. To
determine if you have been exposed to toluene, your urine or
blood must be checked within 12 hours of exposure. Several
other chemicals are also changed into the same breakdown
products as toluene, so some of these tests are not specific
for toluene.
How likely is toluene to cause cancer?

Studies in humans and animals generally indicate that
toluene does not cause cancer.
The EPA has determined that the carcinogenicity of toluene
can not be classified.
How can toluene affect children?

toluene will be similar to the effects seen in adults.
Some studies in animals suggest that babies may be more
sensitive than adults.
Breathing very high levels of toluene during pregnancy can
result in children with birth defects and retard mental
abilities, and growth. We do not know if toluene harms the
unborn child if the mother is exposed to low levels of toluene
during pregnancy.

toluene?

EPA has set a limit of 1 milligram per liter of drinking water (1
mg/L).
Discharges, releases, or spills of more than 1,000 pounds of
toluene must be reported to the National Response Center.
The Occupational Safety and Health Administration has set a
limit of 200 parts toluene per million of workplace air (200
ppm).
(ATSDR). 2000. Toxicological Profile for Toluene. Atlanta,
Health Service.
Use toluene-containing products in well-ventilated areas.
TOTAL PETROLEUM
HYDROCARBONS (TPH)
August 1999
This fact sheet answers the most frequently asked health questions (FAQs) about total petroleum hydrocarbons
(TPH). For more information, call the ATSDR Information Center at 1-888-422-8737. This fact sheet is one
in a series of summaries about hazardous substances and their health effects. Its important you understand
are present.
HIGHLIGHTS: TPH is a mixture of many different compounds. Everyone is

exposed to TPH from many sources, including gasoline pumps, spilled oil on
pavement, and chemicals used at home or work. Some TPH compounds can affect
your nervous system, causing headaches and dizziness. TPH has been found in at
least 23 of the 1,467 National Priorities List sites identified by the Environmental
What are total petroleum hydrocarbons?
(Pronounced ttl p-trl-m hdr-krbnz)
Total petroleum hydrocarbons (TPH) is a term used to
describe a large family of several hundred chemical compounds that originally come from crude oil. Crude oil is used
to make petroleum products, which can contaminate the environment. Because there are so many different chemicals in
crude oil and in other petroleum products, it is not practical to
measure each one separately. However, it is useful to measure
the total amount of TPH at a site.
TPH is a mixture of chemicals, but they are all made
mainly from hydrogen and carbon, called hydrocarbons. Scientists divide TPH into groups of petroleum hydrocarbons
that act alike in soil or water. These groups are called petroleum hydrocarbon fractions. Each fraction contains many
individual chemicals.
Some chemicals that may be found in TPH are hexane,
jet fuels, mineral oils, benzene, toluene, xylenes, naphthalene,
and fluorene, as well as other petroleum products and gasoline
components. However, it is likely that samples of TPH will
contain only some, or a mixture, of these chemicals.
What happens to TPH when it enters the

environment?
q TPH may enter the environment through accidents, from
q
q
q
q
q
industrial releases, or as byproducts from commercial or

private uses.
TPH may be released directly into water through spills or
leaks.
Some TPH fractions will float on the water and form surface films.
Other TPH fractions will sink to the bottom sediments.
Bacteria and microorganisms in the water may break
down some of the TPH fractions.
Some TPH fractions will move into the soil where they
may stay for a long time.
How might I be exposed to TPH?

q Everyone is exposed to TPH from many sources.
q Breathing air at gasoline stations, using chemicals at
home or work, or using certain pesticides.
q Drinking water contaminated with TPH.

q Working in occupations that use petroleum products.
q Living in an area near a spill or leak of petroleum
products.
q Touching soil contaminated with TPH.

Page 2
TOTAL PETROLEUM HYDROCARBONS (TPH)

How can TPH affect my health?
Some of the TPH compounds can affect your central nervous system. One compound can cause headaches and dizziness at high levels in the air. Another compound can cause a
nerve disorder called peripheral neuropathy, consisting of
numbness in the feet and legs. Other TPH compounds can
cause effects on the blood, immune system, lungs, skin, and
eyes.
Animal studies have shown effects on the lungs, central
nervous system, liver, and kidney from exposure to TPH compounds. Some TPH compounds have also been shown to affect
reproduction and the developing fetus in animals.

There are no regulations or advisories specific to TPH.
The following are recommendations for some of the TPH fractions and compounds:
environment of 10 pounds or more of benzene be reported to
the EPA.
set an exposure limit of 500 parts of petroleum distillates per
million parts of air (500 ppm) for an 8-hour workday, 40-hour
workweek.
How likely is TPH to cause cancer?

has determined that one TPH compound (benzene) is carcinogenic to humans. IARC has determined that other TPH compounds (benzo[a]pyrene and gasoline) are probably and possibly carcinogenic to humans. Most of the other TPH compounds are considered not to be classifiable by IARC.

exposed to TPH?
There is no medical test that shows if you have been exposed to TPH. However, there are methods to determine if you
have been exposed to some TPH compounds. Exposure to
kerosene can be determined by its smell on the breath or clothing. Benzene can be measured in exhaled air and a breakdown
product of benzene can be measured in urine. Other TPH compounds can be measured in blood, urine, breath, and some
body tissues.
Glossary
Immune system: Body organs and cells that fight disease.
Pesticides: Chemicals used to kill pests.
(ATSDR). 1999. Toxicological profile for total petroleum
hydrocarbons (TPH). Atlanta, GA: U.S. Department of Health
TOXAPHENE
CAS # 8001-35-2
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about toxaphene. For more
HIGHLIGHTS: Toxaphene is an insecticide which is currently banned for all

uses in the United States. Breathing, eating, or drinking high levels of toxaphene
could damage the lungs, nervous system, and kidneys, and can even cause death.
Toxaphene has been found in at least 58 of the 1,430 National Priorities List sites
What is toxaphene?
(Pronounced tks-fn)
q It does not dissolve well in water, so it is more likely to

be found in air, soil, or sediment at the bottom of lakes or
streams, than in surface water.
Toxaphene is an insecticide containing over 670 chemicals. It is usually found as a solid or gas, and in its original
form it is a yellow to amber waxy solid that smells like turpentine.
q Toxaphene breaks down very slowly in the environment.
It does not burn and evaporates when in solid form or

when mixed with liquids. Toxaphene is also known as
camphechlor, chlorocamphene, polychlorocamphene, and
chlorinated camphene.
q People who breathe air near a hazardous waste site where

toxaphene was disposed could be exposed to it.
Toxaphene was one of the most heavily used insecticides

in the United States until 1982, when it was canceled for most
uses; all uses were banned in 1990. It was used primarily in the
southern United States to control insect pests on cotton and
other crops. It was also used to control insect pests on livestock and to kill unwanted fish in lakes.
What happens to toxaphene when it enters the

environment?
q Toxaphene may enter the environment from hazardous
waste sites.
q It may enter the air by evaporation.
q Toxaphene accumulates in fish and mammals.
How might I be exposed to toxaphene?
q Infants or toddlers could be exposed by eating contaminated soil.

q People who eat large quantities of fish and shellfish
which were contaminated with toxaphene could be exposed.
q People who drink water from wells containing toxaphene
could also be exposed.
How can toxaphene affect my health?

Breathing, eating, or drinking high levels of toxaphene
could damage the lungs, nervous system, and kidneys, and
can even cause death. However, since toxaphene is no longer
used in the United States, most people would not be exposed
to high levels of it.
People could be exposed to low levels of it; however,

TOXAPHENE
CAS # 8001-35-2
Page 2

there is no information on how low levels affect people.
Studies show that animals which ate food or drank water
containing toxaphene had effects on the liver, kidneys, adrenal glands, and immune system.
It is not known whether toxaphene can affect reproduction or cause birth defects in people. Animal studies have
reported that toxaphene affects the development of newborn
animals when their mothers are exposed during pregnancy.
How likely is toxaphene to cause cancer?
The EPA also requires spills or accidental releases into the

environment of 1 pound or more of toxaphene be reported.
(OSHA) has set a permissible exposure limit of 0.5 milligrams
toxaphene per cubic meter of air (0.5 mg/m3) for an 8-hour
workday, 40 hour workweek.
(NIOSH) recommends that toxaphene levels should be as low
as possible in the workplace due to its potential carcinogenicity.
It is not known whether toxaphene causes cancer in

people. An animal study reported that toxaphene caused cancer of the thyroid gland when the animals were exposed to
high levels over their lifetimes.

Hydienists (ACGIH) recommend 0.5 mg/m3 for an 8-hour
workday, 40-hour workweek. They also recommend that
1 mg/m3 be considered a level that should not be exceeded in
a 15-minute period.

has determined that toxaphene may reasonably be anticipated
to be a carcinogen.
Glossary

been exposed to toxaphene?
Toxaphene and its breakdown products can be detected

in blood, urine, breast milk, and body tissues. Urine and
blood tests are the most common tests used. These tests arent
available at most doctors offices, but can be done at special
laboratories that have the right equipment. However, these
tests cannot determine how much toxaphene you have been
exposed to, or whether you will experience any health effects.

body of water.

The EPA has set a drinking water standard of 0.003 milligrams of toxaphene per liter of drinking water (0.003 mg/L).
This ToxFAQs information is taken from the 1996 Toxicological Profile for Toxaphene produced by the Agency for
1,1,1-TRICHLOROETHANE
CAS # 71-55-6
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about 1,1,1-trichloroethane.
present.
SUMMARY: Exposure to 1,1,1-trichloroethane usually occurs by breathing

contaminated air. It is found in building materials, cleaning products, paints,
and metal degreasing agents. It can cause unconsciousness and other effects if
inhaled in large amounts, but usually the effects will disappear after exposure
ends. This substance has been found in at least 696 of the 1,430 National Priorities
What is 1,1,1-trichloroethane?
(Pronounced tr-klr-thn)
1,1,1-Trichloroethane is a colorless liquid with a sharp,
sweet odor. Even though it is usually found as a liquid, it
evaporates quickly and becomes a vapor. It is also known as
methyl chloroform, methyltrichloromethane, and trichloromethylmethane; its registered trade names are Chloroethene
NU and Aerothene TT. Use of trade names is for identification
only and does not imply endorsement by the Agency for Toxic
Substances and Disease Registry, the Public Health Service, or
the U.S. Department of Health and Human Services.
1,1,1-Trichloroethane does not occur naturally in the environment. It is found in many common products such as glue,
paint, industrial degreasers, and aerosol sprays. By 1996,
1,1,1-trichloroethane will no longer be made in the United
States due to its effects on the ozone layer.
What happens to 1,1,1-trichloroethane when

q Most of the 1,1,1-trichloroethane released into the environment is evaporated into the air, where it may last for
about 6 years.
q It may travel to the ozone layer, where sunlight can break
it down into chemicals that destroy the ozone layer.
q Contaminated water from hazardous waste sites may also

contaminate surrounding soil and nearby surface or
groundwater.
q From lakes and rivers, most of the 1,1,1-trichloroethane
evaporates quickly into the air.
q Water can carry 1,1,1-trichloroethane through the soil and
into the groundwater where it can evaporate and pass
through the soil as a gas, then be released to the air.
q Organisms living in soil or water may also break down
1,1,1-trichloroethane.
q It will not build up in plants or animals.
How might I be exposed to 1,1,1-trichloroethane?

q Breathing contaminated air; it is used in many building
materials, so you are likely to be exposed to higher levels
indoors than outdoors or near hazardous waste sites.
q Breathing contaminated air in the workplace while using
cleaning products, aerosol sprays, paint, and metal degreasing agents.
q Ingesting contaminated drinking water and food.
q Allowing liquids containing it to touch your skin.
How can 1,1,1-trichloroethane affect my health?

If you breathe air containing high levels of 1,1,1-trichloroethane for a short time you may become dizzy, lightheaded, and may lose your balance. These symptoms will dis-

CAS # 71-55-6
Page 2
appear if you stop breathing contaminated air. Breathing much

higher levels may cause unconsciousness, low blood pressure,
and loss of heartbeat. The effects of breathing
1,1,1-trichloroethane for a long time are not known. In animals
such as rats and dogs, exposure to high levels damages the
breathing passages, affects the nervous system, and causes mild
effects on the liver.
After pregnant rats or rabbits were exposed to 1,1,1-trichloroethane, effects on the offspring, such as delayed development and changes in the setting of the bone structure, were
usually only seen at levels that were toxic to the mother. It isnt
known whether this chemical affects human reproduction or
development.
There are no studies in people to tell whether harmful
health effects occur from eating food or drinking water contaminated with 1,1,1-trichloroethane. Placing large amounts of
it in an animals stomach has caused effects on the nervous
system, mild liver damage, unconsciousness, and even death.
If your skin comes into contact with 1,1,1-trichloroethane,
you might feel some irritation. Studies in animals have shown
that skin contact may affect the liver and very large amounts
may cause death.
ethane. These tests can sometimes estimate how much

1,1,1-trichloroethane has entered your body. Blood and
breath tests need to be taken within a few hours of exposure,
and urine tests need to be taken within 12 days. These tests,
however, cant tell whether your health will be affected as a
result of your exposure. The exposure tests arent routinely
available in hospitals and clinics because special equipment
is required to perform them.

The EPA has set a limit of 0.2 parts of 1,1,1-trichloroethane per million parts of drinking water (0.2 ppm). EPA has
recommended that the level of 1,1,1-trichloroethane in lakes
and streams shouldnt exceed 18 ppm to prevent possible
health effects from drinking water or eating contaminated
fish.
(OSHA) has set a workplace exposure limit of 350 ppm for an
Glossary
How likely is 1,1,1-trichloroethane to cause

cancer?
No information is available to show that 1,1,1-trichloroethane causes cancer. The International Agency for Research on
Cancer (IARC) has determined that 1,1,1-trichloroethane is not
classifiable as to its human carcinogenicity.

References
been exposed to 1,1,1-trichloroethane?
Breath, blood, and urine samples can be tested to determine if you have recently been exposed to 1,1,1-trichloro-

1995. Toxicological profile for 1,1,1-trichloroethane.
CAS # 79-00-5
July 1999
This fact sheet answers the most frequently asked health questions (FAQs) about 1,1,2-trichloroethane. For
HIGHLIGHTS: 1,1,2-Trichloroethane is primarily used as a solvent and a

chemical intermediate in industry. Breathing high levels of it caused effects on
the liver, kidney, and nervous system in animals. This chemical has been found
What is 1,1,2-trichloroethane?
(Pronounced 1,1,2-tr-klr-thn)
1,1,2-Trichloroethane is a colorless, sweet-smelling
liquid. It does not burn easily, can be dissolved in water, and
evaporates easily. It is used as a solvent (a chemical that
dissolves other substances) and as an intermediate in the production of the chemical, 1,1-dichloroethane. 1,1,2-Trichloroethane is sometimes present as an impurity in other chemicals,
and it may be formed when another chemical breaks down in
the environment under conditions where there is no air.
How might I be exposed to 1,1,2-trichloroethane?

q Breathing outdoor air that contains it from industrial releases.
q Touching it when used as a solvent in the workplace.
q Breathing air near a hazardous waste site that contains
1,1,2-trichloroethane.
How can 1,1,2-trichloroethane affect my health?

What happens to 1,1,2-trichloroethane when it
q Most 1,1,2-trichloroethane released into the environment
will go into the air.
q 1,1,2-Trichloroethane breaks down slowly in air; it takes
approximately 49 days for half of it to break down.
q 1,1,2-Trichloroethane may enter the groundwater by filtering through the soil.
q It appears to stay in water for a long time; it takes years
for it to break down.
No information is available on how breathing or swallowing 1,1,2-trichloroethane may affect your health. Applying
1,1,2-trichloroethane to the skin of a person resulted in stinging and burning of the skin.
When animals breathed high levels of 1,1,2-trichloroethane, it affected the liver and kidneys. Nervous system effects, such as excitation and sleepiness, were also seen. When
animals swallowed food or water containing 1,1,2-trichloroethane, effects on the stomach, blood, liver, kidneys, and nervous system were seen.

CAS # 79-00-5
Page 2

We do not know whether 1,1,2-trichloroethane can affect
reproduction in people. Animal studies have not shown the
chemical to affect normal reproduction and development.
How likely is 1,1,2-trichloroethane to cause

cancer?
No information is available on whether or not 1,1,2-trichloroethane will cause cancer in people. Only one study is
available on the ability of 1,1,2-trichloroethane to cause cancer in animals. This study found an increase in liver cancer in
mice, but not in rats, who were fed the chemical for their lifetime.
has determined that 1,1,2-trichloroethane is not classifiable as
to its carcinogenicity to humans.

exposed to 1,1,2-trichloroethane?
Samples of your breath, blood, and urine can be tested to
determine if you have been recently exposed to 1,1,2-trichloroethane. These tests must be done soon after the exposure
occurred. These tests will not tell you whether your health will
be affected by 1,1,2-trichloroethane and are not routinely
available in hospitals and clinics because they require special
equipment.

The EPA has set a limit of 0.005 milligrams of 1,1,2-trichloroethane per liter of drinking water (0.005 mg/L).
Discharges, spills, or accidental releases of 100 pounds or

more of 1,1,2-trichloroethane must be reported to the EPA.
1,1,2-trichloroethane per cubic meter of air (45 mg/m3) for an
8-hour workday in a 40-hour workweek.
Hygienists (ACGIH) and the National Institute for Occupational Safety and Health (NIOSH) also recommend an occupational exposure limit of 45 mg/m3 for 1,1,2-trichloroethane.
July 1999.
Glossary
(ATSDR). 1989. Toxicological profile for 1,1,2-trichloroethane. Atlanta, GA: U.S. Department of Health and Human
TRICHLOROETHYLENE
CAS # 79-01-6
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about trichloroethylene. For
HIGHLIGHTS: Trichloroethylene is a colorless liquid which is used as a solvent for

cleaning metal parts. Drinking or breathing high levels of trichloroethylene may
cause nervous system effects, liver and lung damage, abnormal heartbeat, coma, and
possibly death. Trichloroethylene has been found in at least 852 of the 1,430 National
What is trichloroethylene?
(Pronounced tr-klr-th-ln)
Trichloroethylene (TCE) is a nonflammable, colorless
liquid with a somewhat sweet odor and a sweet, burning taste.
It is used mainly as a solvent to remove grease from metal
parts, but it is also an ingredient in adhesives, paint removers,
typewriter correction fluids, and spot removers.
Trichloroethylene is not thought to occur naturally in the
environment. However, it has been found in underground
water sources and many surface waters as a result of the manufacture, use, and disposal of the chemical.
What happens to trichloroethylene when it

q Trichloroethylene dissolves a little in water, but it can
remain in ground water for a long time.
q Trichloroethylene quickly evaporates from surface water,
so it is commonly found as a vapor in the air.
q Trichloroethylene evaporates less easily from the soil than
from surface water. It may stick to particles and remain for
a long time.
q Trichloroethylene may stick to particles in water, which
will cause it to eventually settle to the bottom sediment.
q Trichloroethylene does not build up significantly in
plants and animals.
How might I be exposed to trichloroethylene?

q Breathing air in and around the home which has been
contaminated with trichloroethylene vapors from shower
water or household products such as spot removers and
typewriter correction fluid.
q Drinking, swimming, or showering in water that has been
contaminated with trichloroethylene.
q Contact with soil contaminated with trichloroethylene,
such as near a hazardous waste site.
q Contact with the skin or breathing contaminated air while
manufacturing trichloroethylene or using it at work to
wash paint or grease from skin or equipment.
How can trichloroethylene affect my health?

Breathing small amounts may cause headaches, lung
irritation, dizziness, poor coordination, and difficulty concentrating.
Breathing large amounts of trichloroethylene may cause
impaired heart function, unconsciousness, and death. Breathing it for long periods may cause nerve, kidney, and liver damage.
Drinking large amounts of trichloroethylene may cause
nausea, liver damage, unconsciousness, impaired heart function, or death.

TRICHLOROETHYLENE
CAS # 79-01-6
Page 2

Drinking small amounts of trichloroethylene for long
periods may cause liver and kidney damage, impaired immune
system function, and impaired fetal development in pregnant
women, although the extent of some of these effects is not yet
clear.

Skin contact with trichloroethylene for short periods may

cause skin rashes.
The EPA has also developed regulations for the handling

and disposal of trichloroethylene.
How likely is trichloroethylene to cause cancer?

(OSHA) has set an exposure limit of 100 parts of trichloroethylene per million parts of air (100 ppm) for an 8-hour workday,
40-hour workweek.
Some studies with mice and rats have suggested that high
levels of trichloroethylene may cause liver or lung cancer.
Some studies of people exposed over long periods to high
levels of trichloroethylene in drinking water or in workplace
air have found evidence of increased cancer. However, these
results are inconclusive because the cancer could have been
caused by other chemicals.
has determined that trichloroethylene is not classifiable as to

exposed to trichloroethylene?
If you have recently been exposed to trichloroethylene, it
can be detected in your breath, blood, or urine. The breath test,
if it is performed soon after exposure, can tell if you have been
exposed to even a small amount of trichloroethylene.
Exposure to larger amounts is assessed by blood and urine
tests, which can detect trichloroethylene and many of its
breakdown products for up to a week after exposure. However,
exposure to other similar chemicals can produce the same
breakdown products, so their detection is not absolute proof of
exposure to trichloroethylene. This test isnt available at most
doctors offices, but can be done at special laboratories that
have the right equipment.
The EPA has set a maximum contaminant level for trichloroethylene in drinking water at 0.005 milligrams per liter
(0.005 mg/L) or 5 parts of TCE per billion parts water.
Glossary
Carcinogenicity: The ability of a substance to cause cancer.
Nonflammable: Will not burn.
body of water.
Solvent: A chemical that dissolves other substances.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Trichloroethylene (update) produced by the
1,2,3-TRICHLOROPROPANE
CAS # 96-18-4
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about 1,2,3-trichloropropane.
a series of summaries about hazardous substances and their health effects. Its important you understand
SUMMARY: Exposure to 1,2,3-trichloropropane may occur from drinking water

or from breathing air that is contaminated. This is most likely to occur near facilities
that produce the chemical or near hazardous waste sites. People who are exposed
to 1,2,3-trichloropropane can have eye and throat irritation. This chemical has
What is 1,2,3-trichloropropane?
(Pronounced 1,2,3-tr klr prpn)
q There is very little evaporation from groundwater, so

1,2,3-trichloropropane can stay in groundwater for a long
time.
1,2,3-Trichloropropane is a synthetic chemical that is

also known as allyl trichloride, glycerol trichlorohydrin, and
trichlorohydrin.
q Very little sticks to soil particles.
It is a colorless, heavy liquid with a sweet but strong

odor. It evaporates very quickly and small amounts dissolve
in water.

1,2,3-trichloropropane?
It is mainly used to make other chemicals. Some of it is

also used as an industrial solvent, paint and varnish remover,
and cleaning and degreasing agent.
q Drinking low levels in water.
Very little information is available on the amounts

manufactured and the specific uses.
q Touching liquids or soil that contain 1,2,3-trichloropropane.
What happens to 1,2,3-trichloropropane

q It breaks down in the atmosphere when exposed to
sunlight.
q Every 15 days, half of the amount of 1,2,3-trichloropropane present in the air breaks down.
q It evaporates from surface water and surface soil.
q It leaches from deeper soil into the groundwater where it
slowly breaks down.
q It is not expected to build up in fish or plants.
q Breathing low levels in the air.

q Drinking contaminated well water from wells near
q Working in a facility where 1,2,3-trichloropropane is

used.
How can 1,2,3-trichloropropane affect my

health?
Exposure to high levels of 1,2,3-trichloropropane for a
short time causes eye and throat irritation. People exposed to
100 parts of 1,2,3-trichloropropane per million parts of air
(ppm) felt irritation, and some people exposed to 50 ppm for
an 8-hour workday also had throat and eye irritation. We

1,2,3-TRICHLOROPROPANE
CAS # 96-18-4
Page 2
dont know what would happen to someone who breathed low

levels for a long time. We also dont know what happens to
people who swallow it or get it on their skin.
Rats and mice died after breathing air containing
1,2,3-trichloropropane at levels higher than we have in the
environment. When rats breathed it at levels lower than those
that irritated humans, they developed eye, nose, and lung
irritation, and liver and kidney disease. The main health
effect in both animals and people is damage to the respiratory
system.
When rats swallowed 1,2,3-trichloropropane at high
levels, they died from liver and kidney damage. When
exposed to moderate levels that did not cause death, the rats
had minor liver and kidney damage, blood disorders, and
stomach irritation.
When it was applied to the skin of rabbits, it caused
severe irritation followed by injury to internal organs. This
happened only when large amounts were applied to the skin.
We do not know if 1,2,3-trichloropropane damages
people's ability to reproduce or if it causes birth defects.
When rats breathed low levels for several weeks or swallowed
a large amount for a few days there were no effects on their
ability to reproduce and there was no increase in birth defects.
How likely is 1,2,3-trichloropropane to cause

cancer?
International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified 1,2,3trichloropropane for carcinogenicity.
We do not know whether 1,2,3-trichloropropane causes
cancer in humans, but animals that swallowed low doses for
most of their lives developed tumors in several organs.

been exposed to 1,2,3-trichloropropane?
1,2,3-Trichloropropane can be measured in your blood,
urine, and breath. However, it breaks down quickly and
leaves your body in your breath, urine, and feces. The test
cannot measure how much you have been exposed to or
whether your health will be affected. The test requires
special methods and equipment and is not usually available
at your doctors office.

The Environmental Protection Agency (EPA) recommends that no more than 2 parts of 1,2,3-trichloropropane per
million parts (ppm) of water should be present in water that
adults drink over a long period of time (7 years). For children, the recommended level is 0.6 ppm.
(OSHA) has limited workers exposure to an average of
50 ppm in workplace air for an 8-hour workday, 40-hour
workweek.
Glossary
Leach: To be removed or washed away by water.
References
1992. Toxicological profile for 1,2,3-trichloropropane.
Disease Registry, Division of Toxicology, 1600 Clifton Road NE, Mailstop E-29, Atlanta, GA 30333.
Phone:1-888-422-8737, FAX: 404-498-0093. ToxFAQs Internet address via WWW is http://www.atsdr.cdc.gov/
toxfaq.html ATSDR can tell you where to find occupational and environmental health clinics. Their specialists
can recognize, evaluate, and treat illnesses resulting from exposure to hazardous substances. You can also contact
your community or state health or environmental quality department if you have any more questions or concerns.
1,3-DINITROBENZENE and
1,3,5-TRINITROBENZENE
CAS # 99-65-0 and 99-35-4
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about 1,3-dinitrobenzene and
1,3,5-trinitrobenzene. For more information, call the ATSDR Information Center at 1-888-422-8737. This
fact sheet is one in a series of summaries about hazardous substances and their health effects. This information
SUMMARY: Exposure to 1,3-dinitrobenzene and 1,3,5-trinitrobenzene may occur

from contaminated water, food, air, and soil near an Army ammunitions plant or
other chemical manufacturer. High levels of 1,3-dinitrobenzene affect the ability of
blood to carry oxygen. Effects of 1,3,5-trinitrobenzene are expected to be similar.
These substances have been found in at least 19 of the 1,430 National Priorities List
What are 1,3-dinitrobenzene and 1,3,5-trinitrobenzene?
(Pronounced 1,3-d-ntr-bnzn and 1,3,5-trntr-bnzn)
1,3-Dinitrobenzene and 1,3,5-trinitrobenzene are synthetic
substances that are used in explosives. Both substances are
yellow crystal-like solids at room temperature. They may exist
in air in very small amounts as dust or a vapor, and can dissolve
in certain liquids. If either substance is put under very high
heat, it will explode. They have have no odor or taste.
What happens to 1,3-dinitrobenzene and 1,3,5trinitrobenzene when they enter the

environment?
q Both compounds are likely to break down in air, water,
and soil very slowly.
q Both compounds are slightly soluble in water.
q 1,3-Dinitrobenzene evaporates slowly from water; 1,3,5trinitrobenzene does not evaporate from water.
q Neither compound sticks to soil strongly, so they can
move through soil into groundwater.
q These compounds are not likely to build up in fish or
people.
How might I be exposed to 1,3-dinitrobenzene

and 1,3,5-trinitrobenzene?
If you live or work near an Army ammunitions plant or
other chemical manufacturer, you may be exposed to these
compounds by drinking contaminated water, eating contaminated food, breathing contaminated air, or touching or eating
contaminated soil.
How can 1,3-dinitrobenzene and 1,3,5-trinitrobenzene affect my health?

Waste discharges from Army ammunitions plants or other
chemical manufacturers are the primary sources for release of
both compounds to air, water, and soil.
1,3-Dinitrobenzene and 1,3,5-trinitrobenzene are suspected to cause similar health effects. Exposure to high concentrations of 1,3-dinitrobenzene can reduce the ability of
blood to carry oxygen and can cause your skin to become
bluish in color.
If you are exposed to 1,3-dinitrobenzene for a long time,
you can develop a reduction (or loss) in the number of red
blood cells (anemia). Other symptoms of 1,3-dinitrobenzene
exposure include headache, nausea, and dizziness.

Page 2
1,3-DINITROBENZENE and 1,3,5-TRINITROBENZENE

CAS # 99-65-0 and 99-35-4
We do not know if there are any long-term health effects

from exposure to 1,3-dinitrobenzene or 1,3,5-trinitrobenzene.
We also do not know if these chemicals cause birth defects in
humans.

the environment of 100 pounds or more of 1,3-dinitrobenzene, and 10 pounds or more of 1,3,5-trinitrobenzene, must
Results of studies in animals show that effects of 1,3-dinitrobenzene and 1,3,5-trinitrobenzene on the blood are similar
to the effects seen in people. Results from animal studies also
show some other effects of 1,3-dinitrobenzene exposure, such as
behavioral changes and male reproductive system damage.

(OSHA) regulates levels of 1,3-dinitrobenzene in the workplace. The maximum allowable amount of 1,3-dinitrobenzene
in workroom air during an 8-hour workday, 40-hour workweek, is 1 milligram per cubic meter (1 mg/m3).
We do not know if these compounds can cause birth defects in animals. We do not know if the effects seen in animals
could also occur in people.

(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) also recommend an exposure
limit of 1 mg/m3 1,3-dinitrobenzene in workplace air over a
40-hour workweek.
How likely are 1,3-dinitrobenzene and 1,3,5trinitrobenzene to cause cancer?

The EPA has determined that these compounds are not
classifiable as to their carcinogenicity in humans. This is because the ability of these compounds to produce cancer has
not been studied in humans or animals.
Glossary

exposed to 1,3-dinitrobenzene or 1,3,5trinitrobenzene?

exposed to 1,3-dinitrobenzene or 1,3,5-trinitrobenzene. Tests
have been used to detect 1,3-dinitrobenzene and its breakdown products in blood and urine of exposed animals, but
these tests have not been used for people.
Reference


(ATSDR). 1995. Toxicological profile for 1,3-dinitrobenzene/1,3,5-trinitrobenzene (update). Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.

2,4,6-TRINITROTOLUENE
(TNT) CAS # 118-96-7
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about 2,4,6-trinitrotoluene. For
SUMMARY: Exposure to 2,4,6-trinitrotoluene occurs through eating, drinking,

touching, or inhaling contaminated soil, water, food, or air. Health effects reported
in people exposed to 2,4,6-trinitrotoluene include anemia, abnormal liver function,
skin irritation, and cataracts. This substance has been found in at least 20 of the
Agency.
What is 2,4,6-trinitrotoluene?
(Pronounced 2,4,6-tr ntr-tl y n)
2,4,6-Trinitrotoluene is a yellow, odorless solid that does
not occur naturally in the environment. It is commonly known
as TNT and is an explosive used in military shells, bombs, and
grenades, in industrial uses, and in underwater blasting.
2,4,6-Trinitrotoluene production in the United States
occurs solely at military arsenals.
How might I be exposed to 2,4,6-trinitrotoluene?

q Drinking contaminated water that has migrated from
chemical waste disposal sites.
q Eating contaminated foods such as fruits and vegetables.
q Eating contaminated soil.
How can 2,4,6-trinitrotoluene affect my health?

What happens to 2,4,6-trinitrotoluene when it
q 2,4,6-Trinitrotoluene enters the environment in waste
waters and solid wastes resulting from the manufacture of
the compound, the processing and destruction of bombs
and grenades, and the recycling of explosives.
q It moves in surface water and through soils to groundwater.
q In surface water, it is rapidly broken down into other
chemical compounds by sunlight.
q It is broken down more slowly by microorganisms in water and sediment.
Workers involved in the production of explosives who

were exposed to high concentrations of 2,4,6-trinitrotoluene
in workplace air experienced several harmful health effects,
including anemia and abnormal liver function.
Similar blood and liver effects, as well as spleen enlargement and other harmful effects on the immune system, have
been observed in animals that ate or breathed 2,4,6-trinitrotoluene.
Other effects in humans include skin irritation after prolonged skin contact, and cataract development after long-term
(365 days or longer) exposure.
q Small amounts of it can accumulate in fish and plants.

2,4,6-TRINITROTOLUENE (TNT)
CAS # 118-96-7
Page 2

It is not known whether 2,4,6-trinitrotoluene can cause
birth defects in humans. However, male animals treated with
high doses of 2,4,6-trinitrotoluene have developed serious
reproductive system effects.
The Department of Transportation (DOT) specifies that

when 2,4,6-trinitrotoluene is shipped, it must be wet with at
least 10% water (by weight) and it must be clearly labeled as a
flammable solid.
How likely is 2,4,6-trinitrotoluene to cause

cancer?

(OSHA) set a maximum level of 1.5 milligrams of 2,4,6-trinitrotoluene per cubic meter of workplace air (1.5 mg/m3) for
an 8-hour workday for a 40-hour workweek.
The EPA has determined that 2,4,6-trinitrotoluene is a

possible human carcinogen. This assessment was based on a
study in which rats that ate 2,4,6-trinitrotoluene for long periods developed tumors of the urinary bladder.

(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) recommend an exposure limit of
0.5 mg/m3 in workplace air for a 40-hour workweek.

exposed to 2,4,6-trinitrotoluene?
Glossary
Laboratory tests can detect 2,4,6-trinitrotoluene or its

breakdown products in blood or urine. Detection of its
breakdown products in urine is a clear indication of exposure. This test isnt available at most doctors offices, but can
be done at special laboratories that have the right equipment.
A simpler, but less specific test of 2,4,6-trinitrotoluene

exposure is a change in the color of urine to amber or deep red
due to the presence of its breakdown products. However, none
of these tests can predict whether a person will experience any
health effects.
Cataract: Clouding of the lens or capsule of the eye, causing

partial or total blindness.

Since 2,4,6-trinitrotoluene is explosive, flammable, and
toxic, EPA has designated it as a hazardous waste.

Reference
(ATSDR). 1995. Toxicological profile for 2,4,6-trinitrotoluene (update). Atlanta, GA: U.S. Department of Health and
URANIUM
CAS # 7440-61-1
September 1999
This fact sheet answers the most frequently asked health questions (FAQs) about uranium. For more information,
HIGHLIGHTS: Uranium is a naturally occurring chemical substance that is mildly

radioactive. Everyone is exposed to low amounts of uranium through food, air,
and water. Exposure to high levels of uranium can cause kidney disease. It is not
known to cause cancer, but can decay into other radioactive materials that may.
Uranium above background levels has been found in at least 54 of the 1,517 National
What is uranium?
(Pronounced y-rn-m)
Uranium is a common naturally occurring and radioactive
substance. It is a normal part of rocks, soil, air, and water, and it
occurs in nature in the form of minerals - but never as a metal.
Uranium metal is silver-colored with a gray surface and is
nearly as strong as steel. Natural uranium is a mixture of three
types or isotopes called U-234 (234U), U-235 (235U), and U-238
(238U). All three are the same chemical, but they have different
radioactive properties.
Typical concentrations in soil are a few parts per million
(ppm). Some rocks contain high enough mineral concentrations of uranium to be mined. The rocks are taken to a chemical plant where the uranium is taken out and made into uranium chemicals or metal. The remaining sand is called mill
tailings. Tailings are rich in the chemicals and radioactive
materials that were not removed, such as radium and thorium.
One of the radioactive properties of uranium is half-life, or
the time it takes for half of the isotope to give off its radiation
and change into another substance. The half-lives are very
long (around 200,000 years for 234U, 700 million years for 235U,
and 5 billion years for 238U. This is why uranium still exists in
nature and has not all decayed away.
The isotope 235U is useful as a fuel in power plants and
weapons. To make fuel, natural uranium is separated into two
portions. The fuel portion has more 235U than normal and is
called enriched uranium. The leftover portion with less 235U
than normal is called depleted uranium, or DU. Natural, de-
pleted, and enriched uranium are chemically identical. DU is

the least radioactive and enriched uranium is the most.
What happens to uranium when it enters the

environment?
q Uranium is already naturally present throughout the enviq
q
q
q
ronment. Human activities, wind, streams, and volcanoes

can move the uranium around and change the levels that
you are exposed to.
Uranium is found in soil where it may stay for billions of
years.
It exists as dust in the air and the dust settles onto surface
water, soil, and plants.
Uranium enters water by dissolving soil, eroding soil and
rocks, or in releases from processing plants. Larger particles settle into the bottom of lakes, rivers, and ponds and
join uranium that is there naturally.
Some plants may absorb uranium or it may stick to the
root surface.
How might I be exposed to uranium?

q Breathing air or drinking water in a place that has higher
than background levels of uranium.

q Eating food grown in areas with higher than background
levels of uranium.
q Working in factories that process uranium or with phosphate fertilizers, or living near any type of mine.
q Living near a coal-fired power plant.
How can uranium affect my health?

All uranium mixtures (natural, depleted, and enriched)
have the same chemical effect on your body. Large amounts of
uranium can react with the tissues in your body and damage

URANIUM
CAS # 7440-61-1
Page 2

your kidneys. The radiation damage from exposure to high
levels of natural or depleted uranium are not known to cause
cancer (see next section).
How likely is uranium to cause cancer?

Humans and animals exposed to high levels of uranium
did not have higher cancer rates. The Committee on the Biological Effects of Ionizing Radiation (BEIR IV) reported that
eating food or drinking water that has normal amounts of uranium will most likely not cause cancer.
Uranium can decay into other radioactive substances,
such as radium, which can cause cancer if you are exposed to
enough of them for a long enough period of time. Studies have
reported lung and other cancers in uranium miners; however,
the miners also smoked and were exposed to other substances
that cause cancer, such as radon and silica dust.
How can uranium affect children?

Like adults, children are exposed to small amounts of
uranium in air, food, and drinking water. If children were exposed to very large amounts of uranium, it is possible that they
might have kidney damage like that seen in adults. We do not
know whether children differ from adults in their susceptibility
to the health effects of uranium exposure.
It is not known if exposure to uranium can affect the developing human fetus. In laboratory animals, high doses of
uranium in drinking water resulted in birth defects and an increase in fetal deaths. Measurements of uranium have not
been made in pregnant women, so we do not know if uranium
can cross the placenta and enter the fetus. In an experiment
with pregnant animals, only a small amount of the injected
uranium reached the fetus.

uranium?
If your doctor finds that you have been exposed to significant amounts of uranium, ask whether your children might
also be exposed. Your doctor might need to ask your state
health department to investigate.
It is possible that higher-than-normal levels of uranium

may be in the soil at a hazardous waste site. If you live near
such a hazardous waste site, you should prevent your children
from eating dirt and make sure that they wash their hands frequently and before eating. You should also wash fruits and
vegetables grown in that soil well, and consider discarding the
outside portion of root vegetables.

exposed to uranium?
Uranium is in your normal diet, so there will always be
some level of uranium in all parts of your body. Uranium is
normally measured in a sample of urine collected and sent to a
laboratory. Blood, feces, and tissue samples are rarely used.
Because most uranium leaves the body within a few days,
higher than normal amounts in your urine shows whether you
have been exposed to larger-than-normal amounts within the
last week or so. Some highly sensitive radiation methods can
measure uranium levels for a long time after you take in a
large amount. Also, some radiation equipment can tell if uranium is on your skin.

The EPA requires that spills or accidental releases of uranium waste into the environment containing 0.1 curies or more
of radioactivity must be reported to the EPA.
The EPA is currently working to develop an appropriate
drinking water limit for uranium based on a broad range of
human and animal health studies.
set occupational exposure limits for uranium in breathing air
over an 8-hour workday, 40-hour workweek. The limits are
0.05 milligrams per cubic meter (0.05 mg/m3) for soluble uranium dust and 0.25 mg/m3 for insoluble uranium dust.
Agency for Toxic Substances and Disease Registry. 1999.
Toxicological profile for uranium. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
VANADIUM
CAS # 7440-62-2
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about vanadium. For more
SUMMARY: Everyone is exposed to low levels of vanadium in air, water, and

food; however, most people are exposed mainly from food. Breathing high levels
of vanadium may cause lung irritation, chest pain, coughing, and other effects.
What is vanadium?
(Pronounced v-nd-m)
Vanadium is a compound that occurs in nature as a whiteto-gray metal, and is often found as crystals. Pure vanadium
has no smell. It usually combines with other elements such as
oxygen, sodium, sulfur, or chloride. Vanadium and vanadium
compounds can be found in the earth's crust and in rocks, some
iron ores, and crude petroleum deposits.
Vanadium is mostly combined with other metals to make
special metal mixtures called alloys. Vanadium in the form of
vanadium oxide is a component in special kinds of steel that is
used for automobile parts, springs, and ball bearings. Most of
the vanadium used in the United States is used to make steel.
Vanadium oxide is a yellow-orange powder, dark-gray flakes,
or yellow crystals. Vanadium is also mixed with iron to make
important parts for aircraft engines.
Small amounts of vanadium are used in making rubber,
plastics, ceramics, and other chemicals.

It does not dissolve well in water.

It combines with other elements and particles.
It sticks to soil sediments.
Low levels have been found in plants, but it is not likely
to build up in the tissues of animals.
How might I be exposed to vanadium?

Exposure to very low levels in air, water, and food.
Eating higher levels of it in certain foods.
Breathing air near an industry that burns fuel oil or coal;
these industries release vanadium oxide into the air.
Working in industries that process it or make products
containing it.
Breathing contaminated air or drinking contaminated
water near waste sites or landfills containing vanadium.
Vanadium is not readily absorbed by the body from the
stomach, gut, or contact with the skin.
How can vanadium affect my health?

What happens to vanadium when it enters
the environment?
Vanadium mainly enters the environment from natural
sources and from the burning of fuel oils.
It stays in the air, water, and soil for a long time.
Exposure to high levels of vanadium can cause harmful

health effects. The major effects from breathing high levels of
vanadium are on the lungs, throat, and eyes. Workers who
breathed it for short and long periods sometimes had lung
irritation, coughing, wheezing, chest pain, runny nose, and a

VANADIUM
CAS # 7440-62-2
Page 2

sore throat. These effects stopped soon after they stopped
breathing the contaminated air. Similar effects have been
observed in animal studies. No other significant health effects
of vanadium have been found in people.
We do not know the health effects in people of ingesting
vanadium. Animals that ingested very large doses have died.
Lower, but still high levels of vanadium in the water of
pregnant animals resulted in minor birth defects. Some
animals that breathed or ingested vanadium over a long term
had minor kidney and liver changes.
Another indicator of high vanadium exposure in people

is that their tongues may have a green color on top.

The EPA requires discharges or spills of 1,000 pounds or
more of vanadium into the environment to be reported.
The amounts of vanadium given in these animal studies

that resulted in harmful effects are much higher than those
likely to occur in the environment.

(OSHA) has set an exposure limit of 0.05 milligrams per
cubic meter (0.05 mg/m3) for vanadium pentoxide dust and
0.1 mg/m3 for vanadium pentoxide fumes in workplace air for
How likely is vanadium to cause cancer?

Hygienists (ACGIH) has recommended an occupational
exposure limit of 0.05 mg/m3 for vanadium pentoxide.

vanadium as to its human carcinogenicity.
No human studies are available on the carcinogenicity of
vanadium. No increase in tumors was noted in a long-term
animal study where the animals were exposed to vanadium in
the drinking water.

Health (NIOSH) has recommended that 35 mg/m3 of vanadium be considered immediately dangerous to life and
health. This is the exposure level of a chemical that is likely
to cause permanent health problems or death.
Glossary

been exposed to vanadium?
vanadium in urine and blood. These tests are not routinely
performed at doctors' offices because they require special
equipment, but your doctor can take samples and send them
to a testing laboratory. These tests can't determine if harmful
health effects will occur from the exposure to vanadium.

References
1992. Toxicological profile for vanadium. Atlanta, GA: U.S.
Service.
VINYL ACETATE
CAS # 108-05-4
September 1995
This fact sheet answers the most frequently asked health questions about vinyl acetate. For more
information, you may call 404-639-6000. This fact sheet is one in a series of summaries about hazardous
substances and their health effects. This information is important because this substance may harm you.
The effects of exposure to any hazardous substance depend on the dose, the duration, how you are exposed,
personal traits and habits, and whether other chemicals are present.
SUMMARY: Exposure to vinyl acetate occurs mainly in the workplace. Breathing

high levels of it for a short time may irritate your eyes, nose, and throat. This
chemical has been found in at least 48 of 1,416 National Priorities List sites identified by the Environmental Protection Agency.
What is vinyl acetate?
(Pronounced vnl s-tt)
Vinyl acetate is an industrial chemical that is produced in
large amounts in the United States. It is a clear, colorless
liquid with a sweet, fruity smell. It is very flammable and may
be ignited by heat, sparks, or flames.
Vinyl acetate is used to make other industrial chemicals.
These chemicals are used mainly to make glues for the
packaging and building industries. They are also used to
make paints, textiles, and paper. Vinyl acetate is also used as a
coating in plastic films for food packaging and as a modifier
of food starch.
What happens to vinyl acetate when it enters

the environment?
Vinyl acetate enters the environment from industries that
make, use, or process it.
Vinyl acetate breaks down readily in the environment.
It takes about 6 hours for one-half of the chemical to
break down in the air.
It takes about 7 days for one-half of it to break down in
water.
It is not known how long vinyl acetate stays in the soil.
How might I be exposed to vinyl acetate?

Working in a factory that makes or uses it.
Breathing air near a factory that makes or uses vinyl
acetate.
Breathing air near a hazardous waste site containing
vinyl acetate.
Drinking contaminated water.
Touching products that were made with it, such as glues
and paints.
How can vinyl acetate affect my health?

The major effects experienced from breathing high levels
of vinyl acetate for a short time are irritated eyes, nose, and
throat.
We dont know what the effects are from breathing lower
levels of vinyl acetate for a long time. We also don't know
what happens if you ingest vinyl acetate.
Long-term animal studies show a reduced ability of
animals to fight infection when rats and mice ingested high
levels of the chemical.
Birth defects were not seen in the offspring of animals
that were exposed to vinyl acetate in drinking water during
their pregnancies.

VINYL ACETATE
CAS # 108-05-4
Page 2
Vinyl acetate has caused skin irritation and blisters in

workers who accidentally spilled it on their skin. Eye
irritation has also been seen when people were exposed to
vinyl acetate in the air or through accidents when the chemical went into their eyes.
5,000 pounds or more of vinyl acetate be reported to the

EPA.
How likely is vinyl acetate to cause cancer?

Hygienists (ACGIH) has established an exposure limit of
10 parts of vinyl acetate per million parts of workplace air
(10 ppm) for an 8-hour workday, 40-hour workweek.

determined that vinyl acetate is not classifiable as to its
There are no human studies on the carcinogenicity of
vinyl acetate. Animal studies have shown mixed results; one
study showed an increase in tumors of the noses of rats who
breathed vinyl acetate, while another study did not show an
increase in tumors in rats who drank water containing the
chemical.

been exposed to vinyl acetate?
No tests are available to measure vinyl acetate in the
blood, urine, or body tissues. Vinyl acetate breaks down very
quickly in the body to substances that are normally found in
the body; thus, measurement of these break down products is
not useful for determining whether you have been exposed to
vinyl acetate.

The Environmental Protection Agency (EPA) requires
that discharges or accidental spills into the environment of
The Food and Drug Administration (FDA) has determined that vinyl acetate may be safely used as a coating or
a part of a coating that is used in plastic films for food
packaging, and as a modifier of food starch.

Health (NIOSH) recommends that exposure to vinyl
acetate in the workplace not exceed 4 ppm over a 15minute period.
Glossary
Short-time: Lasting 14 days or less.
References
(ATSDR). 1992. Toxicological profile for vinyl acetate.
Atlanta, GA: U.S. Department of Health and Human
VINYL CHLORIDE
CAS # 75-01-4
September 1997
This fact sheet answers the most frequently asked health questions (FAQs) about vinyl chloride. For more
HIGHLIGHTS: Exposure to vinyl chloride occurs mainly in the workplace.

Breathing high levels of vinyl chloride for short periods of time can cause
dizziness, sleepiness, unconsciousness, and at extremely high levels can cause
death. Breathing vinyl chloride for long periods of time can result in permanent
liver damage, immune reactions, nerve damage, and liver cancer. This substance
What is vinyl chloride?
(Pronounced vnl klrd)
Vinyl chloride is a colorless, flammable gas at normal
temperatures with a mild, sweet odor. It is a manufactured
substance that is used to make polyvinyl chloride (PVC).
PVC is used to make a variety of plastic products, including
pipes, wire and cable coatings, and the furniture and automobile upholstery.
Vinyl chloride also results from the breakdown of other
substances, such as trichloroethane, trichloroethylene, and
tetrachloroethylene. Vinyl chloride is also known as chloroethene, chloroethylene, and ethylene monochloride.
What happens to vinyl chloride when it enters

the environment?
q Vinyl chloride is unlikely to build up in plants or animals.
How might I be exposed to vinyl chloride?

q Breathing vinyl chloride that has been released from plastics industries, hazardous waste sites, and landfills.
q Breathing vinyl chloride in air or during contact with
your skin or eyes in the workplace.
q Drinking water from contaminated wells.
How can vinyl chloride affect my health?

Breathing high levels of vinyl chloride can cause you to
feel dizzy or sleepy. Breathing very high levels can cause you
to pass out, and breathing extremely high levels can cause
death.
q Small amounts of vinyl chloride can dissolve in water.
Most of the studies on long-term exposure (365 days or

longer) to vinyl chloride are about workers that make or use
vinyl chloride. They were exposed to much higher levels of
vinyl chloride in the air than is the general population.
People who breathe vinyl chloride for long periods of time
can have changes to the structure of their livers.
q Vinyl chloride formed from the breakdown of other

chemicals can enter groundwater.
People who work with vinyl chloride have developed

nerve damage and immune reactions. Other workers have
q Liquid vinyl chloride evaporates easily into the air. Vinyl

chloride, if it is near the surface of soil or water, can also
evaporate.
q Vinyl chloride in the air can break down within a few
days to other substances, some of which can be harmful.

VINYL CHLORIDE
CAS # 75-01-4
Page 2

developed problems with the blood flow in their hands; the
tips of their fingers turn white and hurt when they are in cold
temperatures. Sometimes, the bones in the tips of their fingers
have broken down.
vinyl chloride, but this is not sensitive enough to determine

the effects resulting from exposure. These tests are not available at most doctors' offices, but can be done at special laboratories that have the right equipment.
Animal studies have shown that long-term (365 days or

longer) exposure to vinyl chloride can damage the sperm and
testes. It has not been proven that vinyl chloride causes birth
defects in humans, but animal studies have shown that breathing vinyl chloride can harm unborn offspring and may also
cause increases in early miscarriages.

The effects of drinking high levels of vinyl chloride are

unknown. If you spill vinyl chloride on your skin, it will
cause numbness, redness, and blisters.
How likely is vinyl chloride to cause cancer?
The EPA requires that the amount of vinyl chloride in

drinking water not exceed 0.002 milligrams of vinyl chloride
per liter of water (0.002 mg/L). The EPA requires that spills or
accidental releases into the environment of 1 pound or more of
vinyl chloride be reported to the EPA.
(OSHA) has set the maximum allowable level of vinyl chloride
in workroom air during an 8-hour workday in a 40-hour workweek at 1 part vinyl chloride per million parts of air (1 ppm).

has determined that vinyl chloride is a known human carcinogen. Vinyl chloride exposure results in liver cancer in
people.
Glossary

exposed to vinyl chloride?
The results of several tests can sometimes show if youve

been exposed to vinyl chloride. If breath samples are taken
just after exposure, vinyl chloride can be measured, but this is
not helpful for measuring very low levels of the chemical.
Better information is gotten by measuring a breakdown
product of vinyl chloride, thiodiglycolic acid, in the urine
shortly after exposure. However, this test will not give information on the level of exposure. Exposure to other chemicals
can produce the same breakdown product in the urine.
The binding of vinyl chloride to genetic material in your
blood or tissue can tell whether you have been exposed to

Immune reaction: Sensitizing response of the body to a
chemical.
Miscarriage: Pregnancy loss.
This ToxFAQs information is taken from the 1997 Toxicological Profile for Vinyl Chloride (update) produced by the
XYLENE
CAS # 1330-20-7
September 1996
This fact sheet answers the most frequently asked health questions (FAQs) about xylene. For more information,
SUMMARY: Exposure to xylene occurs in the workplace and when you use paint,
gasoline, paint thinners and other products that contain it. People who breathe
high levels may have dizziness, confusion, and a change in their sense of balance.
This substance has been found in at least 658 of the 1,430 National Priorities List
What is xylene?
q In the air, it is broken down by sunlight into other less

harmful chemicals.
(Pronounced zln)
q It is broken down by microorganisms in soil and water.
Xylene is a colorless, sweet-smelling liquid that catches

on fire easily. It occurs naturally in petroleum and coal tar and
is formed during forest fires. You can smell xylene in air at
0.083.7 parts of xylene per million parts of air (ppm) and
begin to taste it in water at 0.531.8 ppm.
q Only a small amount of it builds up in fish, shellfish, plants,

and animals living in xylene-contaminated water.
Chemical industries produce xylene from petroleum. Its

one of the top 30 chemicals produced in the United States in
terms of volume.
Xylene is used as a solvent and in the printing, rubber,
and leather industries. It is also used as a cleaning agent, a
thinner for paint, and in paints and varnishes. It is found in
small amounts in airplane fuel and gasoline.
How might I be exposed to xylene?

q Breathing xylene in workplace air or in automobile exhaust.
q Touching gasoline, paint, paint removers, varnish, shellac,
and rust preventatives that contain it.
q Breathing cigarette smoke that has small amounts of xylene
in it.
q Drinking contaminated water or breathing air near waste
sites and landfills that contain xylene.
q The amount of xylene in food is likely to be low.
What happens to xylene when it enters the

environment?
q Xylene has been found in waste sites and landfills when
discarded as used solvent, or in varnish, paint, or paint
thinners.
q It evaporates quickly from the soil and surface water into
the air.
How can xylene affect my health?

Xylene affects the brain. High levels from exposure for short
periods (14 days or less) or long periods (more than 1 year) can
cause headaches, lack of muscle coordination, dizziness,
confusion, and changes in ones sense of balance. Exposure of

XYLENE
CAS # 1330-20-7
Page 2

people to high levels of xylene for short periods can also cause
irritation of the skin, eyes, nose, and throat; difficulty in
breathing; problems with the lungs; delayed reaction time;
memory difficulties; stomach discomfort; and possibly changes
in the liver and kidneys. It can cause unconsciousness and
even death at very high levels.
Studies of unborn animals indicate that high concentrations of xylene may cause increased numbers of deaths, and
delayed growth and development. In many instances, these
same concentrations also cause damage to the mothers. We do
not know if xylene harms the unborn child if the mother is
exposed to low levels of xylene during pregnancy.
How likely is xylene to cause cancer?

The EPA has set a limit of 10 ppm of xylene in drinking
water.
The EPA requires that spills or accidental releases of xylenes
into the environment of 1,000 pounds or more must be reported.
has set a maximum level of 100 ppm xylene in workplace air for
(NIOSH) and the American Conference of Governmental Industrial Hygienists (ACGIH) also recommend exposure limits of
100 ppm in workplace air.

has determined that xylene is not classifiable as to its carcinogenicity in humans.
NIOSH has recommended that 900 ppm of xylene be

considered immediately dangerous to life or health. This is the
exposure level of a chemical that is likely to cause permanent
Human and animal studies have not shown xylene to be

carcinogenic, but these studies are not conclusive and do not
provide enough information to conclude that xylene does not
cause cancer.
Glossary
Evaporate: To change from a liquid into a vapor or a gas.
Carcinogenic: Having the ability to cause cancer.

been exposed to xylene?
Laboratory tests can detect xylene or its breakdown
products in exhaled air, blood, or urine. There is a high degree
of agreement between the levels of exposure to xylene and the
levels of xylene breakdown products in the urine. However, a
urine sample must be provided very soon after exposure ends
because xylene quickly leaves the body. These tests are not
routinely available at your doctors office.

Solvent: A liquid that can dissolve other substances.
References
1995. Toxicological profile for xylenes (update). Atlanta, GA:
Service.
evaluate, and treat illnesses resulting from exposure to hazardous substances. You can also contact your
community or state health or environmental quality department if you have any more questions or concerns.
ZINC
CAS # 7440-66-6
September 1995
This fact sheet answers the most frequently asked health questions (FAQs) about zinc. For more information,
SUMMARY: Exposure to high levels of zinc occurs mostly from eating food,
drinking water, or breathing workplace air that is contaminated. Exposure to
large amounts of zinc can be harmful. However, zinc is an essential element for
our bodies, so too little zinc can also be harmful. This chemical has been found
Protection Agency.
What is zinc?
(Pronounced zngk)
Zinc compounds can move into the groundwater and into

lakes, streams, and rivers.
Zinc is one of the most common elements in the earth's

crust. It's found in air, soil, and water, and is present in all
foods. Pure zinc is a bluish-white shiny metal.
It builds up in fish and other organisms, but it doesn't

build up in plants.
Zinc has many commercial uses as coatings to prevent

rust, in dry cell batteries, and mixed with other metals to make
alloys like brass and bronze. A zinc and copper alloy is used
to make pennies in the United States.
How might I be exposed to zinc?
Zinc combines with other elements to form zinc compounds. Common zinc compounds found at hazardous waste
sites include zinc chloride, zinc oxide, zinc sulfate, and zinc
sulfide. Zinc compounds are widely used in industry to make
paint, rubber, dye, wood preservatives, and ointments.
Drinking contaminated water or a beverage that has been

stored in metal containers or flows through pipes that
have been coated with zinc to resist rust.
What happens to zinc when it enters the

environment?
Some is released into the environment by natural processes, but most comes from activities of people like
mining, steel production, coal burning, and burning of
waste.
It attaches to soil, sediments, and dust particles in the air.
Rain and snow remove zinc dust particles from the air.
Most of the zinc in soil stays bound to soil particles.
Ingesting small amounts present in your food and water.

Drinking contaminated water near manufacturing or
waste sites.
Eating too many dietary supplements that contain zinc.

Breathing zinc particles in the air at manufacturing sites.
How can zinc affect my health?

Zinc is an essential element in our diet. Too little zinc
can cause health problems, but too much zinc is also harmful.
The recommended dietary allowance (RDA) for zinc is
15 milligrams a day for men (15 mg/day); 12 mg/day for
women; 10 mg/day for children; and 5 mg/day for infants.
Not enough zinc in your diet can result in a loss of appetite, a
decreased sense of taste and smell, slow wound healing and

ZINC
CAS # 7440-66-6
Page 2

skin sores, or a damaged immune system. Young men who
don't get enough zinc may have poorly developed sex organs
and slow growth. If a pregnant woman doesn't get enough
zinc, her babies may have growth retardation.
Too much zinc, however, can also be damaging to your
health. Harmful health effects generally begin at levels from
10-15 times the RDA (in the 100 to 250 mg/day range).
Eating large amounts of zinc, even for a short time, can cause
stomach cramps, nausea, and vomiting. Taken longer, it can
cause anemia, pancreas damage, and lower levels of high
density lipoprotein cholesterol (the good form of cholesterol).
Breathing large amounts of zinc (as dust or fumes) can
cause a specific short-term disease called metal fume fever.
This is believed to be an immune response affecting the lungs
and body temperature. We do not know the long-term effects
of breathing high levels of zinc.
also be measured in urine, saliva, and hair. The amount of

zinc in your hair tells us something about long-term exposure, but the relationship between levels in your hair and the
amount that you were exposed to is not clear. These tests are
not routinely performed at doctors' offices, but your doctor
can take samples and send them to a testing laboratory.

EPA recommends that there be no more than 5 parts of
zinc in 1 million parts of drinking water (5 ppm) because of
taste. EPA also requires that releases of more than 1,000 (or in
some cases 5,000) pounds of zinc or its compounds into the
environment be reported.
It is not known if high levels of zinc affect human

reproduction or cause birth defects. Rats that were fed large
amounts of zinc became infertile or had smaller babies.
Irritation was also observed on the skin of rabbits, guinea
pigs, and mice when exposed to some zinc compounds. Skin
irritation will probably occur in people.

(OSHA) has set a maximum concentration limit for zinc
chloride fumes in workplace air of 1 milligram of zinc per
cubic meter of air (1 mg/m3) for an 8-hour workday over a 40hour work week and 5 mg/m3 for zinc oxide fumes. The
(NIOSH) has set the same standards for up to a 10-hour
workday over a 40-hour workweek.
How likely is zinc to cause cancer?
Glossary

International Agency for Research on Cancer, and the Environmental Protection Agency (EPA) have not classified zinc for
carcinogenicity.

References
been exposed to zinc?
Zinc can be measured in your blood or feces. This can
tell you how much zinc you have been exposed to. Zinc can

(ATSDR). 1994. Toxicological profile for zinc. Atlanta, GA:
Service.

A Planning Guide For The Management of Contaminated Patients

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HIGHLIGHTS: ATSDR's Managing Hazardous Materials Incidents is a three volume

Emergency Medical Services: A Planning Guide for the Management of

Hospital Emergency Departments: A Planning Guide for the Management of

Medical Management Guidelines for Acute Chemical Exposures.

Community Challenge: Hazardous Materials Response and the Emergency Medical

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Public Health Service

MANAGING HAZARDOUS MATERIAL INCIDENTS

The ATSDR Internet address is < http://www.atsdr.cdc.gov >

General Information (synonyms, appearance, routes of exposure, potential for secondary

The general hazardous substances (35)

The DOD-related hazardous substances (5)

INTENDED AUDIENCE: HAZMAT Teams,

Where can I get more information?

For more information about the Managaing Hazardous Mateerial Incidents

Federal Recycling Program

Printed on Recycled Paper

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Emergency Medical Services: A Planning Guide for the Management of

Hospital Emergency Departments: A Planning Guide for the Management of

Medical Management Guidelines for Acute Chemical Exposures

Agency for Toxic Substances

Additional copies of this report are available from:

2 Printed on recycled paper

SPECIAL FOURTH-CLASS RATE

Volume I - Table of Contents

Systems Approach to Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Emergency Medical Services Response to Hazardous Materials Incidents . . . . . . . . .13

Decontamination of Emergency Medical Service Personnel . . . . . . . . . . . . . . . . . . . . 38

Response and Patient Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Hazardous Materials Classification Systems . . . . . . . . . . . . . . . . . . . . . . . . . A1

Types of Respiratory Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B1

2000 Revision of Volume II

Craig DeAtley, P.A.-C., C.C.T.

George C. Rodgers, Jr., M.D., Ph.D.

Associate Professor, Emergency Medicine

Peer Review Panel for revised (2000) Volumes I and II:1

Systems Approach To Planning

THE ROLE OF EMS IN A SYSTEMS APPROACH TO PLANNING

Incidents have been poorly managed on site by first responders.

PREHOSPITAL RESPONSE PLANNING

THE SPECTRUM OF HAZARDOUS MATERIALS INCIDENTS

Individual patient: A single individual is contaminated and must be transported to an emergency

Multi-casualty: This situation is usually limited to a single location:

Can occur in the workplace, in a public place, or at home.

Involves normal systems of transportation.

Mass-casualty: Disrupts a large segment of the community:

Involves several locations.

SARA TITLE III

Identification of facilities subject to planning provisions under Title III

Identification of transportation routes for extremely hazardous substances

Identification of risk-related facilities

Methods and procedures for response

Designated community and facility coordinators

Procedures for public notification

Methods for determining release occurrence and the area affected

Evacuation plans and training programs

THE STATE EMERGENCY MEDICAL SERVICES (EMS) AGENCY

Triage: Outline triage procedures to be utilized in prioritizing decontamination and transport of

Decontamination: Institute a regional standard for performing decontamination of ambulatory and

FEDERAL EMERGENCY RESPONSE ACTIVITIES

Focus communities on emergency preparedness and response.