What is Aromatic Hydrocarbon Toxicity: Benzene and Toluene?
Hydrocarbons are compounds made up of carbon and hydrogen atoms. They come in three different structures:
- Aliphatic: built of straight or branched chains of carbon
- Aromatic: carbons forming a ring
- Halogenated: made up of carbons, hydrogens, and a halogen atom
Two types of aromatic hydrocarbons, toluene and benzene, are often misused for their mind-altering effects. Toluene is a clear, sweet-smelling liquid that doesn’t dissolve in water but can dissolve in certain compounds. This substance is used extensively in making other organic compounds like benzene, and it’s found in items like gasoline, nail polish, spray paint, glue, cleaning products, and paint thinners. Exposure to toluene and benzene can be harmful to multiple body systems, including the lungs, nervous system, stomach and intestines, heart, kidneys, liver, skin, and blood systems. Toluene can notably lead to a particular type of kidney damage while benzene is known to result in blood disorders. Both can occasionally lead to death.
Hydrocarbons are common because they are present in numerous everyday products like kerosene, gasoline, cleaning products, and various paint items. Some of the most harmful hydrocarbons come from oil products like gasoline and kerosene. Usually, exposure to these substances is accidental, and these products can be inhaled, accidentally swallowed, or absorbed through the skin. Children are especially at risk of death from unintended ingestion. The second major concern is a lung condition, followed by issues with the nervous system and heart.
What Causes Aromatic Hydrocarbon Toxicity: Benzene and Toluene?
Toluene and benzene toxicity, or poisoning by these harmful chemicals, is typically acquired when a person breathes them in.
There are three common ways that people inhale these chemicals:
* Huffing: in this method, a person soaks a cloth with the chemical and then covers their mouth and nose with it.
* Bagging: in this method, a person puts the chemical in a bag and inhales deeply from the bag over and over again.
* Sniffing: in this method, the chemical is inhaled directly through the nostrils.
Risk Factors and Frequency for Aromatic Hydrocarbon Toxicity: Benzene and Toluene
Toluene, a type of drug often inhaled, is most commonly misused by young adults and teenagers looking for a ‘high’. Data from the American Association of Poison Control shows that over half of those misusing these inhaled substances are teenagers, specifically aged 13 to 19. A smaller proportion, 15%, are children between 6 to 12. Interestingly, abuse of such substances tends to be more prevalent in rural areas and among lower-income groups.
- Toluene is a drug that is often inhaled and is widely misused.
- It is most frequently abused by teenagers and young adults who seek its euphoric effects.
- According to the American Association of Poison Control, 54% of abusers are teenagers aged 13 to 19.
- Children aged 6 to 12 make up 15% of the abusers.
- Abuse of this drug is more common in states with larger rural populations and in lower-income groups.
Signs and Symptoms of Aromatic Hydrocarbon Toxicity: Benzene and Toluene
When assessing a patient who may have been exposed to a harmful drug or substance, certain information is important. Key queries include:
- What drug or substance the patient came into contact with
- Whether the exposure was intentional or an accident
- How the substance entered the body (inhalation or ingestion)
- When the exposure occurred
- How long the patient was in contact with the substance
- If they used or were exposed to any other toxic substances
Exposure to hydrocarbons, a group of chemicals often found in fuel and industrial products, can result in a range of symptoms. These may differ depending on the part of the body affected.
- Pulmonary (related to lungs): fast breathing, grunting, wheezing, pulling in between the ribs or underneath the ribcage while breathing
- Cardiac (related to heart): irregular heart rhythms
- Central nervous system (related to brain and spine): slurred speech, uncontrolled movement, drowsiness, unconsciousness
- Gastrointestinal (related to stomach and digestion): nausea, vomiting, abdominal pain
Exposure to specific hydrocarbons can lead to unique symptoms. For example:
- Toluene: headache, dizziness, confusion, muscle weakness and paralysis
- Benzene: fatigue, shortness of breath
Testing for Aromatic Hydrocarbon Toxicity: Benzene and Toluene
If you are suspected of being exposed to harmful hydrocarbons, certain steps are typically taken to monitor your health. These include setting up a heart monitor, measuring the oxygen levels in your blood using a device called a pulse oximeter, and conducting an electrocardiogram (ECG) to check your heart’s rhythm and electrical activity.
Many blood tests may be performed, including: checking your overall blood cell count; a complete metabolic panel, which examines the health of your kidneys and liver, as well as your blood sugar and electrolyte balance; an arterial blood gas test, which measures the oxygen and carbon dioxide levels in your blood; and a creatine kinase test, that checks for signs of damage to the heart or other muscles.
Imaging tests, such as a chest x-ray, can also be crucial. However, it’s important to note that an initial x-ray in a patient showing symptoms may seem perfectly normal. Changes suggestive of damage usually start showing up between 2 to 6 hours after exposure and are almost always there by 24 hours. The most commonly seen change is increased shadowing at the bottom of both lungs, suggesting damage in multiple areas.
Treatment Options for Aromatic Hydrocarbon Toxicity: Benzene and Toluene
There isn’t a specific cure or antidote for the poisonous effects of toluene or benzene.
If you come into contact with these substances, make these responses a priority:
* Call poison control immediately
* Ensure the person’s airway is clear
* If the person is wheezing, give them extra oxygen
* If wheezing persists, give B2-agonist medications (substances that help regulate breathing)
* Provide support for ventilation (breathing)
* If the person’s blood pressure drops (hypotension), aggressively administer fluids through an IV
* Treat heart rhythm disturbances caused by hydrocarbons with propranolol, esmolol, or lidocaine
* Gastric lavage (stomach pumping) and activated charcoal offer no benefit
* Correct any abnormalities in the person’s electrolyte levels
* If needed, administer blood products
What else can Aromatic Hydrocarbon Toxicity: Benzene and Toluene be?
When diagnosing a patient’s condition, a doctor might need to consider several possible causes for their symptoms. These could include:
- Severe lung condition (Acute Respiratory Distress Syndrome or ARDS)
- Alcohol poisoning
- Choking on or inhaling foreign objects (Aspiration)
- Poisoning from sleep or seizure medicine (Barbiturate Toxicity)
- Poisoning from medicine used for anxiety or sleep problems (Benzodiazepine Toxicity)
- Poisoning from exposure to large amounts of carbon monoxide gas
- Poisoning from two or more substances at the same time (Co-ingestions)
- Injuries from inhaling harmful gases or substances
- Suicidal thoughts or behaviors
- Poisoning from inhaling chemical vapors (Toluene Toxicity)
By checking for these possibilities, doctors can make sure they take all the necessary steps to identify the problem and come up with the right treatment plan.
Surgical Treatment of Aromatic Hydrocarbon Toxicity: Benzene and Toluene
Acute respiratory distress syndrome (ARDS) is a severe lung condition that can cause shortness of breath, fatigue, and headache.
Alcohol toxicity refers to the harmful effects of consuming too much alcohol, which can cause confusion, vomiting, slow or irregular breathing, and unconsciousness.
Aspiration is a condition where food, stomach acid, or saliva is breathed into the lungs or airways, leading to coughing, difficulty breathing, and possibly infection.
Barbiturate toxicity happens when there’s an overdose or misuse of barbiturate drugs, leading to symptoms like drowsiness, confusion, and life-threatening breathing problems.
Benzodiazepine toxicity, similar to barbiturate toxicity, happens when one takes too much of benzodiazepine drugs, resulting in dizziness, slurred speech, and potentially unconsciousness.
Carbon monoxide poisoning refers to inhaling too much carbon monoxide – a dangerous, odorless, and colorless gas. It can cause headaches, dizziness or loss of consciousness.
Co-ingestions are instances when multiple substances are taken at once, which can lead to unpredictable and potentially dangerous interactions.
Inhalation injury is damage to the respiratory system caused by breathing in harmful substances, like smoke or chemicals. This can cause difficulty breathing, cough, or even burns in the airway.
Suicidality refers to thoughts or behaviors related to ending one’s own life. It’s a critical situation that requires immediate medical attention and intervention.
Toluene toxicity refers to health problems caused by exposure to toluene, a colorless liquid with a distinctive smell, commonly used in various industrial processes. Symptoms may include irritation of the eyes and nose, weakness, confusion, and nausea.
