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Carbon Monoxide and Dioxins – Toxic Substances

by Pravin Shukle, MD
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    00:01 Carbon monoxide is a common toxic agent. It's usually culprit in suicide attempts where people will breath in exhaust fumes from a car.

    00:12 Carbon monoxide has an affinity for hemoglobin about two hundred times greater than oxygen.

    00:19 The threshold limit for a human is about 25 ppm in 8 hours. Now, consider that on a bad traffic day in LA, you're going to hit 100 ppm. In Mumbai India, you'll hit 400 ppm. And in Shanghai, you'll hit 800 ppm.

    00:37 So, you can see that there is a toxicity potential in terms of the environment.

    00:42 Carbon monoxide results in a significant amount of confusion. Sometimes, you can have decreased visual acuity.

    00:50 There is almost always tachycardia. There may be syncope, and eventually will result in coma and death.

    00:57 The classic sign of a carbon monoxide patient are those rose cheeks.

    01:03 You see a person come in, and they have those red rose cheeks, and they look like they're just a little bit hyperemic, almost always you can diagnose carbon monoxide just by looking at them.

    01:12 The first time you see a carbon monoxide poisoned patient, you'll almost never missed the next diagnosis.

    01:18 The treatment is always with hyperbaric oxygen, which is sometimes a problem in rural and remote areas.

    01:26 Sulphur dioxide is an agent that is in the air that sometimes can cause toxicity.

    01:32 It forms sulfurous acid on contact with some mucous membranes. 6 ppm will cause symptoms.

    01:39 Generally, it's irratation of those mucous membranes. So, you get conjunctival irritation and mucous membrane irritation.

    01:46 A classic picture is a person with red eyes and irritation of the nares or nasal cavity.

    01:53 Long term exposure may lead to pulmonary edema.

    01:56 And treatment is always supportive including anti-inflammatories and high levels of oxygen.

    02:02 Dioxin toxicity is an important consideration on the chemical industry.

    02:06 Many chemical agents rely on dioxin as an intermedia in manufacturing. They are very poorly metabolized.

    02:14 And why I mention it here today is because these dioxins are very persistent in the environment.

    02:21 They cause a wasting syndrome and they cause hepatotoxicity. And they cause immune dysfunction and teratogenicity.

    02:28 If you're practising it in an area, where you start to see high levels of immune dysfunctions, high levels of wasting and hepatotoxicity, and even teratogenicity in a community, the first thing you should be looking for are dioxin levels in the environment.


    About the Lecture

    The lecture Carbon Monoxide and Dioxins – Toxic Substances by Pravin Shukle, MD is from the course Toxicology. It contains the following chapters:

    • Carbon Monoxide
    • Sulphur Dioxide

    Included Quiz Questions

    1. Carbon monoxide
    2. Microparticles
    3. Heavy metals
    4. Oxygen displacement
    5. Respiratory acidosis

    Author of lecture Carbon Monoxide and Dioxins – Toxic Substances

     Pravin Shukle, MD

    Pravin Shukle, MD


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