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Basics of Toxicology
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Steven Fink

Director of the EHMT Program

West Los Angeles College

4800 Freshman Drive

Culver City, CA  90230

(213)836-7110, ext. 237

 ©1991 California Environmental Hazardous Materials Consortium

 Basics of Toxicology

 Module Description

 This module presents the basics of toxicology and its applications to Risk Assessment studies. Topics include a discussion on exposure and entry routes, fates of toxic substances in the body (toxicokinetics), concepts in experimental toxicology, the dose response relationship, actions of toxic substances, target organ effects, the actions and types of carcinogens, and a survey of the health effects of common classes of toxic substances is also presented. The principles of Risk Assessment, as well as sources of information on toxic substances is also presented.

 The competencies fulfilled by this course are:

 I. Hazardous Materials Handling and Sampling

A. Handles hazardous materials/wastes

1. Identifies, selects, and recommends safety equipment

 II. Procedures and Plans for Regulatory Compliance

A. Assists in development of organizational goals and prevention plans with relation to hazardous materials/wastes and safety

B. Tracks regulatory compliance

1. Procures current MSDS’s

2. Understands and utilizes information on MSDS’s

 Specific objectives are listed for each of the 12 lessons described in this module.

 Texts

 Suggested Student Text:

 Excerpts from the various sources described in the lessons.

 Instructor Resources and References are described within this document as well.

 Instructor Note

Note to Instructors:  It is suggested that the instructor using this module read through all lessons prior to starting the course. In this way, later concepts which are built on earlier activities can be better anticipated and planned for

Module

Description

Texts

Instructor

Note

Preface

 

Preface

 

This is the instructor’s guide for a module entitled Basics of Toxicology.

 

This module is part of Health Effects of Hazardous Materials , a 3 unit lecture core course in the EHMT Associate Degree and Certificate Program. The course is designed to provide students with instruction in principles of toxicology and industrial hygiene.

 

The course has been divided into three modules:

 

              Module I Basics of Toxicology (2 units)

 

              Module II Basics of Industrial Hygiene (1 unit)

 

This modularization has been designed in such a way that the course can be taught as two separate courses. Module I is 36 hours and therefore represents 2 units. Module II is 18 hours and therefore represents 1 unit.

 

Modularization will allow the maximum flexibility for individual colleges to meet both traditional educational goals and the immediate needs of local industry. This flexibility is evidenced by the following available options, since the modules can be used in whole or part for:

 

            •   Contract Education

            •    Community Service Classes

            •    Degree and Certificate Applicability

 

Note to Instructors:  It is suggested that the instructor using this guide become entirely familiar with the lesson plan and student materials prior to starting the course. Changes should be made as needed to reflect current regulations.

 

Basics of Toxicology

Intent and Purpose

 

This module presents the basics of toxicology and its applications to Risk Assessment studies. Topics include a discussion on exposure and entry routes, fates of toxic substances in the body (toxicokinetics), concepts in experimental toxicology, the dose response relationship, actions of toxic substances, target organ effects, the actions and types of carcinogens, and a survey of the health effects of common classes of toxic substances is also presented. The principles of Risk Assessment, as well as sources of information on toxic substances is also presented.

 

The competencies fulfilled by this course are:

 

I. Hazardous Materials Handling and Sampling

A. Handles hazardous materials/wastes

1. Identifies, selects, and recommends safety equipment

 

II. Procedures and Plans for Regulatory Compliance

A. Assists in development of organizational goals and prevention plans with relation to hazardous materials/wastes and safety

B. Tracks regulatory compliance

1. Procures current MSDS’s

2. Understands and utilizes information on MSDS’s

 

Specific objectives are listed for each of the 12 lessons described in this module.

 

Texts

 

Suggested Student Text:

Excerpts from the various sources described in the lessons.

Instructor Resources and References are described within this document as well.

Instructor Note

 

Note to Instructors:  It is suggested that the instructor using this module read through all lessons prior to starting the course. In this way, later concepts which are built on earlier activities can be better anticipated and planned for.

Lesson 1 — Introduction to Toxicology*

Lesson 2 — Exposure and Entry Routes*

Lesson 3 — Distribution, Metabolism, Elimination*

Lesson 4 — Experimental Toxicology & Dose-Response*

Lesson 5 — Action of Toxic Substances*

Lesson 6 — Target Organ Effects*

Lesson 7 —  Reproductive Toxins, Mutagens, Carcinogens*

Lesson 8 — Survey of Common Toxic Substances*

Lesson 9 — Survey of Common Toxic Substances*

Lesson 10 — Risk Assessment*

Lesson 11 — Clinical Symptoms & Treatment of Toxicity*

Lesson 12 — Sources of Information on Toxic Substances*

            * Supplemental Instructor & Student Materials Follow

 

Introduction to Toxicology and Sources of Information

Intent and Purpose

 

In this lesson, the student is introduced to the science of toxicology.  A distinction is made between a hazardous material and a toxic substance.  A distinction is also made between concentration and the total dose of a toxic substance. Total dose is the product of the concentration and the exposure.

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Distinguish between a hazardous material and a toxic substance.

 

2. Explain the differences between the exposure to toxic substances in actual work settings and how experimental animals are exposed in toxicological studies.

 

3. Define the following:

• Dose

• Chemical Concentration

• Exposure Time

 

4. Describe the units total dose is commonly expressed in for ingestion, dermal absorption, and inhalation.

 

Lesson Outline

 

1. The lesson is introduced with a definition of toxicology, including a distinction between a hazardous material and toxic a substance.

 

2. Common occasions of exposure to toxic substances is considered, including:

 

• Process Operations involving hazardous materials, like welding, machining, plating, spray coating, using cleaning solvents, etc.

 

• Maintenance activities at sites of hazardous materials.

 

• Process upsets and releases of toxic substances.

 

• Indoor and outdoor air pollutants.

 

• Drinking water contamination.

• Use of pesticides.

 

3. An introduction to some of the terminology and units used in toxicology is presented, including:

 

• dose

 

• chemical concentration

 

• exposure time

 

• mg/Kg & mg/Kg-Day

 

• mg/m2 & mg/m2-Day

 

• mL/L & mL/L-Day

 

• mg/m3 & mg/m3-Day

 

• ppm & ppm-Day

 

• fibers/cm3 & fibers/cm3-Day

 

Suggestions for Development and Presentation

 

A source of confusion is the inconsistent use of the terms “hazard”, “hazardous material”, and “toxic substance”. I would suggest the following:

 

hazard is anything having the capacity to cause physical damage (ex: cause a fire to a building) or harm the health of living organisms.

 

hazardous material refers to any chemical substance or agent (ex: a microorganism) that poses a physical and/or health hazard.

 

Those chemical substances or agents (hazardous materials) that have the potential to harm the health of living organisms are called toxic substances. Toxic substances are thus a subset of hazardous materials.

 

The difference between the total dose of a toxic substance and its concentration should be distinguished. The total dose is the product of the concentration and the exposure.

 

References and Resources

 

Also read: “Industrial Toxicology” (chap. 15) and “Appendix A; Sources of Help”, pp. 727-765 from: B. Plog; Fundamentals of Industrial Hygiene; National Safety Council; 3rd ed (1988); available from National Safety Council; Order Processing; 1815 Landmeier Road; Elk Grove Village, IL 60007-2420; (800) 621-7619 available from ACGIH; catalog no: 0670; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

Also see Chaps. 1 & 2 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold, Pub.; New York; 1985}

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

 

Exposure and Entry Routes

 

Intent and Purpose

 

In this lesson, the student will be introduced to some of the more common occasions of hazard exposure, as well as the most common routes of exposure and entry into the body.  A distinction is made between a hazardous material versus the absorption of a toxic substance into the body. This provides the basis for differentiating between the local effects produced by a hazardous material and any toxic effects that may develop systematically.

For each of the principal routes of exposure (viz: the gastrointestinal system, the skin , the eyes, and the respiratory system), there is a brief review of its functional anatomy.  Following review of each route,  the most common clinical effects produced by exposure to hazardous materials is cited.  The principal goal of this lesson is for the student to learn the principal routes of exposure, their differences, and some of the typical health effects produced from exposure to hazardous materials by these routes.

 

 

Lesson Objectives

To successfully complete this lesson, the student will be able to :

 

1. Explain the difference between “exposure” to a hazard and the “absorption” of a toxic substance.

 

2. Explain the difference between a “local effect” and a “systemic effect”.

 

3. Identify the principal factors that affect the rate of systemic absorption.

 

4. Identify the most common hazard exposure routes.

 

5. Rank the exposure routes:

 

• based on their frequency

 

• based on their potential for systemic absorption

 

• based upon their potential toxicity

 

6. Identify the principal parts of the Digestive System and explain their function(s).

 

7. Identify the types of effects that can occur after ingesting a toxic substance.

 

8. Identify the principal functions of the skin.

 

9. Identify the principal types of local effects on the skin

 

10. List 4 factors that  determine the severity of a chemical burn.

 

11. Identify the principal parts of the eye and explain their function(s).

 

12. Identify the principal types of local effects on the eye.

 

13. Identify the principal parts of the Respiratory System and explain their function(s).

 

14. Identify the principal types of local effects of the Respiratory Tract.

 

15. Explain the difference between simple asphyxiation and chemical asphydation, and provide an example of each.

 

16. Define the following terms: Fibrosis; eduma; ulceration; defatting agent necrosis; narcosls

 

17. Identify the principal types of airborne hazardous substances

 

18. Explain why only particles between .5 the 5mm in length are of primary concern.

 

 

Lesson Outline

 

1. The principles of human exposure to toxic substances & their entry routes into the body are presented, including a consideration of:

• Local versus systemic effects

 

• Factors that affect the rate of systemic absorption

 

2. The ingestion of toxic substances is considered, including:

• Review of the principal functions of the digestive system

 

• Review of the functional parts of the digestive system

 

• Local effects on the alimentary cannel

 

• Systemic absorption of toxins substances

 

3. Skin contact of toxic substances is reviewed , including :

• Review of the principal functions of the skin

 

• Review of the basic anatomy of the skin

 

• Local effects on skin:

 

• cutaneous absorption

 

4. Exposure of the eyes to toxic substances is considered, including:

• Review of the functional parts of the eyes

 

• Local effects of the eyes

 

• Systemic absorption

 

5. The inhalation of toxic substances is considered , including:

• Review of the principal functions of the respiratory system

 

• Review of the functional parts of the respiratory system

 

• Types of airborne contaminants

 

• Local effects on the respiratory tract

 

• Systemic absorption

 

 

Suggestion for Development and Presentation

 

It is important to emphasize how the physical state of the hazardous material determines the most likely exposure route(s).  It is also important to clearly distinguish between exposure to a hazardous material, and its systemic absorption into the bloodstream.  It is possible that exposure to a very toxic substance might be poorly absorbed and produce only local effects.  It is also possible that another hazardous material might be less toxic,  but rapidly absorbed, producing both local and systemic effects.

 

Before considering the factors that can affect the rate of systemic absorption of a substance, I would suggest briefly reviewing the basic structure of (cell) membranes.  Specifically, mention should be made that membranes are fatty in nature (composed principally of phospholipids), This should aid in the student’s understanding of how the “lipid-solubility” of a substance affects its rate of absorption.

 

The instructor should encourage students to suggest which types of toxic substances would be most commonly absorbed by the different routes, as well as present examples.  It is important to emphasize however, that it is the concepts and principles that students should be learning rather tan long lists of esoteric chemicals

 

References and Resources

 

Sources of Potential Exposure

 

• Read: “Material and Their Characteristics”, Chap. 2 from :L.V Cralley & L.J. Cralley; In- Plant Practices for job Related Health Hazards Control; vol 2: Engineering Aspects-: John Wiley & Sons; 1989; (800) 225-5945

 

Exposure & Entry Routes

 

• See Lesson 2; Routes of Entry and Target Organs: pp 2-9 to 2-45 and 2-53 to 2-56 of HMTRI; Course HMT

   280; Hazardous Materials Health Effects: 1988

 

• Read pp 11-20, Section II; pp 78-100 , Section IV; and pp102-120 , Section V in; M, Key et al :

   Occupational Diseases; A Guide to Their Recognition; U.S. Dept. of Health Education, and Welfare; DHEW Pub. No. (NIOSH) 77-181, 1977

 

Read “Principals of Toxicology” in : EPA Training Manual 165.5 : hazardous Materials Incident Response Operations; available from ACGH; catalog no : 3110; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

• Also see Chaps. 3,8 &9 in : P. Williams & J Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold Pub.; New York 1985

 

• Also See Chaps. 2,3,5,7,8,14,& 15 in : B. Plog; Fundamentals of Industrial Hygiene; National Safety Council; 3rd ed (1988); available from National Safety Council; Order Processing : 1815 Landmeier Road;

   Elk Grove Village, IL 60007-2420; (800) 621- 7619 available from ACGIH; catalog no; 0670; 6500 Glenway Ave., Bldg. D-7 Cincinnati, OH 45211; (513) 661-7881

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/ study assignments are:

 

Lesson 2; Routes of Entry and Target Organs; pp. 2-9 to 2-45 and 2-53 to 2-56 of HMTRI: Course HMT 280 : Hazardous Materials Health Effects

 

Pages 11-20, Section II; pp. 78 to 100, Section IV; and pp. 102-120, Section V in :M Key et. al; Occupational Diseases ; A Guide to Their Recognition

 

Distribution, Metabolism & Elimination of Toxics

 

Intent and Purpose

 

In this lesson the basic principles of how a toxic substance moves through the body (“toxicokinetics”) are presented. This includes consideration of how the physical and chemical properties of a substance affect its uptake into the bloodstream, in which organs in the body it tends to accumulate, and how it is eliminated from the body. Consideration for how certain underlying illnesses can affect the severity of the toxic reaction is also given.

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Identify the principal factors that affect the distribution of a toxic substance in the body.

 

2. Explain what is meant by the “blood-brain-barrier”.

 

3. Differentiate between a toxic substance’s site of action and the inactive sites of accumulation.

 

4. Explain the function of making a toxic substance more water-soluble in a detoxification reaction.

 

5. Define the following terms: target organ; reservoir site; polyuria; uremia; anemia; clearance test; biliary

    secretion.

 

6. Differentiate between a Phase I (“destructive”) reaction and a Phase II (“conjugation”) detoxification reaction.

 

7. Explain what is meant by a “bioactivation” reaction.

 

8. List what factors could affect the rate of metabolism of a toxic substance.

 

9. Differentiate between acute liver damage and chronic liver damage.

 

10.Explain how the kidney acts to remove toxic substances from the bloodstream, and what factors affect its ability to do so.

 

Lesson Outline

 

1. The lesson is introduced with a series of questions: “What happens to a toxic substance after it enters the body? Where does it go? Can it be eliminated? And if so, then how?

 

2.The distribution of a toxic substance through the body is discussed, including a consideration of the following factors:

 

• route of exposure

 

• blood perfusion at the site of exposure

 

• lipid-solubility of the toxic substance

 

• binding to plasma proteins

 

• anatomic barriers

 

• sites of bioaccumulation, including both sites of action (“target organs”) and inactive sites (“reservoirs”)

 

3. The metabolism (biotransformation) of toxic substances is discussed, including:

 

• the liver’s role as the principal site of metabolism

 

• the types of detoxification reactions, including destructive reactions and conjugation reactions

 

• bioactivation reactions

 

• factors that affect the rate of metabolism, including age, liver disease, and chemical tolerance by enzyme induction.

4. The excretion of metabolites is discussed, including the role and function of:

 

• the kidneys

 

• the lungs

 

• biliary secretion

 

• sweat & saliva

 

• mother’s milk

 

5. The half-life of a toxic substance is defined, and consideration is given to the factors that would affect the half-life and the resulting consequences.

 

Suggestions for Development and Presentation

 

There are two principal concepts that should be emphasized in this lesson. First, is an appreciation for how the body handles toxic substances in general, from the point of uptake to the point of elimination. Second, is an appreciation for how the particular physical and chemical properties of the toxic substance determine the specifics of how it is handled by the body. The specifics for each toxic substance include the rates of uptake & elimination, what the target organ is, how is it metabolized, and how is it excreted. Examples of different toxic substances, and how they are handled differently by the body should be given to clarify this point for the student.

 

References and Resources

 

See Lesson 2: “Routes of Entry and Target Organs”; pp. 2-21 to 2-24; pp. 2-66 to 2-67; pp. 2-46 to 2-52; pp. 1-15 to 1-17 of HMTRI; Course HMT 280; Hazardous Materials Health Effects; 1988

 

See pp. 25 to 41; Section II in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition; U.S. Dept. of Health, Education, and Welfare; DHEW Pub. No. (NIOSH) 77-181; 1977

 

Also read Chaps. 3, 5, & 6 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold, Pub.; New York; 1985

 

Read “Principles of Toxicology” in: EPA Training Manual 165.5: Hazardous Materials Incident Response Operations; available from ACGIH; catalog no: 3110; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/study assignments are:

 

Students should read the appropriate pages in the HMTRI; Course HMT 280; Hazardous Materials Health Effects text before the lecture.

 

Students should read the appropriate pages in Occupational Diseases; A Guide to Their Recognition

 

Experimental Toxicology & the Dose-Response Relationship

 

Intent and Purpose

 

In this lesson, the student is introduced to the terminology and methodology used in experimental toxicology, especially using animals. The factors that affect the toxicity of a substance, as well as the factors that affect the variations in the response to a given substance are covered. The threshold theory of toxicity is presented, and those effects (such as cancer) that may not exhibit thresholds are briefly considered at this time, to be further developed later (under risk assessment). Finally a consideration of the three types of animal studies is covered, including some of the ways these studies differ from “real-world” human exposures.

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Describe the Dose-Response Relationship.

 

2. Explain the variations in response within the population.

 

3. Describe how the relative toxicity of substances is most commonly expressed.

 

4. List 5 factors that affect a substance’s toxicity.

 

5. Explain the Threshold Concept.

 

6. Define the following: toxicity, threshold dose, NOEL, LD50

 

7. Identify which toxic responses may not exhibit thresholds.

 

8. How is cancer experimentally identified in animal studies?

 

9. Explain the differences in the responses commonly observed following an acute exposure and chronic exposure to a toxic substance.

 

10. Explain why higher doses of a toxic substance must be used in animal experiments in order to statistically determine the responses that would occur in a larger population.

 

Lesson Outline

 

1. The three main types of animal studies are presented, including the examination of:

• Acute Exposures & the types of responses that occur

 

• Subchronic Exposures & the types of response that occur

 

• Chronic Exposures & the types of responses that occur

• Differences between animal studies and “real-world” exposures

 

2. The Dose-Response Relationship is presented, including:

• a description of a Dose-Frequency Response Curve (normal distribution)

 

• a description of a Dose-Cumulative Response Curve

 

3. The definition of toxicity (toxic potency) and the acute LD50 are presented, and the factors that affect a substance’s toxicity are considered, including:

• the chemical properties of the toxic substance

 

• the physical state of the toxic substance

 

• the route of entry into the body

 

• the duration of exposure to the toxic substance

 

• the frequency of exposure to the toxic substance

 

• the sensitivity of the individual to the toxic substance

 

4. The Threshold Theory of Toxicity is presented, including a description of the Threshold Dose (TDLO; LOAEL) and the No Observed Effect Level (NOEL).

 

5. The toxicity of essential nutrients is considered.

 

6. The toxic responses that may not exhibit thresholds are considered, including the experimental identification of cancer:

• the presence of types of tumors not seen in controls

 

• the increase in the incidence of tumor types occurring in controls

 

• the development of tumors earlier than in controls

 

• an increase in tumors in various organs

 

• the Ames Test

 

7. Types of toxicological studies are considered:

• Typical protocols used in animal toxicity studies

 

• Clinical studies

 

• Epidemiologic studies

 

• Plant and wildlife studies

 

8. The problems with extrapolating toxicological data from animals to humans is considered.

 

 

Suggestions for Development and Presentation

 

It should be emphasized that any given toxic substance produces a series of dose-response curves: at the lowest end, the response might be irritation (showing a bell-shaped curve distribution based on differential sensitivity to the substance), followed by a second dose-response curve reflecting headache & nausea. This might be followed by a third bell-shaped distribution showing narcosis (drowsiness) in response to a yet higher dose. Each bell-shaped response typically overlaps with the next one, reflecting the differences between the most sensitive and the least sensitive (affected) individuals.

 

Both a Dose-Frequency Response Curve (normal distribution) and a Dose-Cumulative Response Curve, reflecting the cumulative percent increase of the affected population as the dose is increased. Indeed, it is the latter curve that is most commonly drawn when describing dose-response relationships. The LC50 is used to express the lethal airborne level, and an aquatic LC50 is used to express the lethal level for fish or other aquatic organisms, such as in aquatic toxicity test described under CCR §66696.

 

It should be emphasized that the LD50 is used to express the relative lethal toxicity, but tells you nothing about the non-lethal toxic effects.

 

It might be useful to mention that exposure guidelines (such as the Threshold Limit Values (TLV’s)) used by governmental agencies are in essence like the NOEL’s observed in experimental animals.

 

There are significant differences between animal studies and “real-world” exposures, as well as some important assumptions that are made in the designing of the experiments and the extrapolating of the data. For example, although most exposures to toxics substances in industrial settings are by inhalation or skin contact, in most experimental studies the toxic substance is administered orally. Secondly, when only small numbers of animals are used in an experimental study, higher doses of the toxic substance must be used to statistically “force” comparable results to what would occur in a much larger population (consider: if a dose actually caused a response in l/200, but only 100 test animals were used, it is possible the experimenter would not observe any toxic responses in the study!)

 

Thirdly, the human population is more heterogeneous than the experimental animal populations, & thus contain individuals who are probably more sensitive.

 

Differences, such as these, are the heart of the “Risk Assessment” controversies.

 

References and Resources

 

See Lesson 1: “Risk Assessment”; pp. 1-15 to 1-30 of: HMTRI; Course HMT 280; Hazardous Materials Health Effects; 1988

 

Also read: “Industrial Toxicology” (chap. 15) from: B. Plog; Fundamentals of Industrial Hygiene; National Safety Council; 3rd ed (1988); available from National Safety Council; Order Processing; 1815 Landmeier Road; Elk Grove Village, IL 60007-2420; (800) 621-7619 available from ACGIH; catalog no: 0670; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

See: Toxicology: The Science of Poisons (Pub. #21221); ANR Publications; University of California; 6701 San Pablo Ave.; Oakland, CA.94608-1239; (415) 642-2431

 

Read “Principles of Toxicology” in: EPA Training Manual 165.5: Hazardous Materials Incident Response Operations; available from ACGIH; catalog no: 3110; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

See “Toxicity Hazards of Chemical Substances”, chap. 6 from the FEMA/US DOT/US EPA Handbook of Chemical Hazard Analysis Procedures; 1989; (301) 447-1068

 

Also see Chaps. 3, 5, & 6 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold, Pub.; New York; 1985}

This lesson is suggested to take 3 hours of classroom instruction.

 

 

Schedule and Assignment

 

Student reading/study assignments are:

 

Pages 1-15 to 1-30 of Lesson 1: “Risk Assessment” in the HMT 280; Hazardous Materials Health Effects

 

“Toxicology: The Science of Poisons” (Pub. #21221); ANR Publications; University of California

 

“Principles of Toxicology” in: EPA Training Manual 165.5: HazardousMaterials Incident Response  Operations

 

 

 

Action of Toxic Substances

 

Intent and Purpose

 

In this lesson the student is introduced to the way toxic substances directly act on the body. Further, since most exposures are to numerous toxic substances, consideration is given to types of interactions between toxic substances (with respect to effects on the body).

 

Lesson Objective

 

To successfully complete this lesson, the student will be able to:

 

1. Explain the two types of direct actions a toxic substance can have on the body.

 

2. Define the following types of interactions between toxic substances:

 

• additive

 

• synergistic

 

• potentiation

 

• antagonistic

 

• sensitizing

 

Lesson Outline

 

1. The lesson is introduced with a consideration of how Toxic Substances act on the body, including examples of:

 

• Direct physical actions

 

• Chemical interactions at specific receptor sites

 

• Stimulating Agents (Agonists)

 

•Blocking Agents (Antagonists)

 

• Enzyme Inhibitors

 

2. The types of interactions that may occur between toxic substances is reviewed, including: addititve, synergistic, potentiation, antagonistic, and sensitizing.

 

 

Suggestions for Development and Presentation

 

Specific examples should be presented of the actions and interactions that of toxic substances. However, the purpose of this lesson is not to have the student learn these actions for a multitude of specific toxic substances, but to understand the types of actions that can occur.

 

The reason for describing interactions between toxic substances is because most exposures are not to a single toxic substance, but to numerous substances. This is because individuals are exposed all the time to various substances in the air, water and food. Furthermore, most toxic substances encountered do not consist of a single entity, but a mixture of substances. For example, a typical solvent may contain one or more chlorinated hydrocarbons plus an alcohol. Part of the uncertainty in effect to a given toxic substance, is associated with possible interactions that may occur with exposure to additional substances.

 

 

References and Resources

 

See pp. 22-26; Section II: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition; U.S. Dept. of Health, Education, and Welfare; Pub. No. (NIOSH) 77-181; 1977

 

Also read: “Industrial Toxicology”, pp. 359-365 (chap. 15) from: B. Plog; Fundamentals of Industrial Hygiene; National Safety Council; 3rd ed (1988); available from National Safety Council; Order Processing; 1815 Landmeier Road; Elk Grove Village, IL 60007-2420; (800) 621-7619 or available from ACGIH; catalog no: 0670; 6500 Glenway Ave.; Bldg. D-7;Cincinnati, OH 45211; (513) 661-7881

 

See Lesson 2: Routes of Entry and Target Organs; pp. 2-21 to 2-24; pp. 2-66 to 2-67; pp. 2-46 to 2-52 of HMTRI; Course HMT 280;Hazardous Materials Health Effects; 1988

 

See: Toxicology: The Science of Poisons (Pub. #21221); ANR Publications; University of California; 6701 San Pablo Ave.; Oakland, CA.94608-1239; (415) 642-2431

 

Read “Principles of Toxicology” in: EPA Training Manual 165.5: Hazardous Materials Incident Response Operations; available from ACGIH; catalog no: 3110; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

Also see Chaps. 3 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold, Pub.; New York; 1985

 

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/study assignments are:

 

Pages 22 to 26; Section II in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition.

 

“Industrial Toxicology”, pp. 359-365 (chap. 15) from: B. Plog; Fundamentals of Industrial Hygiene.

 

 

Target Organ Effects

 

Intent and Purpose

 

In this lesson, the student will be introduced to the principal sites (target organs) that toxic substances effect after systemic absorption.

 

For each target organ, its general organization and functions are briefly reviewed. This should give students the background of normal function so that they will better understand the specific consequences of toxic substances on the target organs.

 

The specific toxic substances identified that can cause a toxic disease are cited only as examples, and are not intended to necessarily be memorized.

 

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Describe the function of the heart, including:

 

• the role of the electrical impulse in synchronizing the heart beat

 

• the effect of cardiotoxins on the electrical pattern of the heart

 

2. Describe the nervous system, including:

 

• the general organization

 

• the Blood-Brain Barrier

 

• the 3 functional categories of neurons

 

• the symptoms associated with narcosis

 

• the 3 types of neural damage caused by neurotoxins, and the clinical manifestations

 

3. Describe the liver, including:

 

• the principal functions of the liver

 

• the clinical symptoms of toxic hepatitis

 

• the most common types hepatotoxins

 

• medical diagnosis of toxic hepatitis

 

4. Describe the kidney, including:

 

• the principal functions of the kidneys

 

• the clinical symptoms of renal failure

 

• the most common types of nephrotoxins

 

5. Describe the blood, including:

 

• the general composition of whole blood

 

• the principal types of “formed elements” and their functions

 

• the role of blood platelets

 

• the types of hemotoxins and their effects

 

6. Describe the immune system, including:

 

• the general functions of the immune system

 

• the functional components of the immune system and their roles in the immune response

 

• the effects of immunotoxins on the immune response

 

 

Lesson Outline

 

The lesson is introduced with a definition of “target organ” as the principal site(s) where a toxic substances produces its effect after systemic absorption.

 

1. The heart is presented, including:

 

• Review of its functional anatomy

• Effects of cardiotoxins

• Clinical symptoms of cardiac arrythmias

 

2.The nervous system is presented, including:

 

• Review of the general organization of the nervous system

• Review of the functional structure and types of neurons

• Effects of neurotoxins

• Clinical symptoms of neurotoxicity

 

3. The liver is presented, including:

 

• Review of the principal functions of the liver

• Effects of hepatotoxins

• Clinical symptoms of liver damage

• Examples of hepatotoxic substances

 

4. The kidney is presented, including:

 

• Review of the principal functions of the kidneys

• Effects of Nephrotoxins

• Clinial symptoms of kidney damage

• Examples of nephrotoxic substances

 

5. The blood is presented, including:

 

• Review of the components of whole blood

• Review of the functions of red blood cells

• Review of the functions of white blood cells

• Review of the functions of blood platelets

• Effects of hemotoxins

• Clinical symptoms of hemotoxicity

• Examples of hemotoxic substances

 

6. The immune system is presented, including:

 

• Review of the general functions of the immune system

• Functional components of the immune system

• Effects of immunotoxins

• Clinical symptoms of immunotoxicity

 

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/study assignments are:

 

Lesson 2: Routes of Entry and Target Organs; pp. 2-21 to 2-92 of HMTRI; Course HMT 280; Hazardous

Materials Health Effects.

 

“Principles of Toxicology” in: EPA Training Manual 165.5: Hazardous Materials Incident Response Operations.

 

Reproductive Toxins, Mutagens, and Carcinogens

 

Intent and Purpose

 

In this lesson, the student will be introduced to the principal sites (target organs) that toxic substances effect after systemic absorption.

 

For each target organ, its general organization and functions are briefly reviewed. This should give students the background of normal function so that they will better understand the specific consequences of toxic substances on the target organs.

 

The specific toxic substances identified that can cause a toxic disease are cited only as examples, and are not intended to necessarily be memorized.

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1.Describe the Reproductive System, including:

 

• the principal functions of the Male Reproductive System and the potential effects of toxic substances

 

• the principal functions of the Female Reproductive System and the potential effects of toxic substances

 

2. Describe the effects of Fetal Toxins, including:

 

• the differences between embryotoxicity, congenital malformations, growth retardation, and mental

   retardation

 

• the effects of prenatal carcinogens

 

3. Describe the effects of Mutagens, including:

 

• the difference in consequences between somatic cell mutations and reproductive cell mutations

 

• the difference between genetic point mutations and chromosomal alterations

 

4. Describe the effects of Carcinogens, including:

 

• the normal rate of cancer in the population

 

• the characteristics of cancer

 

• the difference between benign and malignant tumors

 

• the difference between initiator and promoter types of carcinogens

 

• the carcinogens associated with Lung Cancer

 

• the carcinogens associated with Urinary Bladder Cancer

 

• the carcinogens associated with Liver Cancer

 

• the carcinogens associated with Leukemia

 

• the carcinogens associated with Skin Cancer

 

• the treatment of cancer

 

 

Lesson Outline

 

1. The lesson is introduced with the Reproductive System, including:

 

• Review of the Male Reproductive System

• Effects of Male Reproductive Toxins

• The Effects of Female Reproductive Toxins

• Effects of Female Reproductive Toxins

 

2. The Effects of Fetal Toxins is presented, including:

 

• Embryotoxicity

• Congenital malformations

• Growth retardation

• Mental retardation

• Prenatal carcinogens

 

3. The Effects of Mutagens are presented, including:

 

• Change in the DNA

• Somatic versus reproductive cell mutations

• Types of DNA changes

• Chemical mutagens

• Types of ionizing radiation

 

4. The Effects of Carcinogens are presented, including:

 

• The description of cancer

• Types of carcinogens

• Sites of cancer

• Examples of cancer

• Clinical symptoms of cancer

• Treatment of cancer

 

 

 

 


Suggestions for Development and Presentation

 

The instructor presenting this material should be knowledgeable in the anatomy & physiology of the human reproductive system , cell biology and cancer. Any nursing "anatomy & physiology” textbook would serve as a useful reference source. A somewhat simpler, but very useful textbook is Human Biology by Sylvia Mader (Wm. C. Brown, Publisher). Another excellent reference for the instructor would be C. Kupchella;Dimensions of Cancer (Wadsworth Pub.) for a straightforward presentation of all facets of cancer.

 

The specific toxic substances identified that can cause a toxic disease are cited only as examples, and are not intended to necessarily be memorized.

 

 

References and Resources

 

Read: Lesson 2: Routes of Entry and Target Organs; pp. 2-21 to 2-92 of HMTRI; Course HMT 280; Hazardous Materials Health Effects

 

Also read: “Principles of Toxicology” in: EPA Training Manual 165.5: Hazardous Materials Incident Response Operations; available from ACGIH; catalog no: 3110; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

Also read: “Industrial Toxicology” (chap. 15) from: B. Plog; Fundamentals of Industrial Hygiene; National Safety Council; 3rd ed (1988); available from National Safety Council; Order Processing; 1815 Landmeier Road; Elk Grove Village, IL 60007-2420; (800) 621-7619 available from ACGIH; catalog no: 0670; 6500 Glenway Ave.; Bldg. D-7; Cincinnati, OH 45211; (513) 661-7881

 

See pp. 443 to 449; Section VIII in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition; U.S. Dept. of Health, Education, and Welfare; DHEW Pub. No. (NIOSH) 77-181; 1977

 

Also see Chaps. 4-10 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold, Pub.; New York; 1985

 

See Chaps. 8; “Carcinogenesis”; in: C. Kupchella; Dimensions of Cancer; Wadsworth Pub. Co; Belmont, CA.; 1987

 

 

Schedule and Assignment

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/study assignments are:

 

Lesson 2: Routes of Entry and Target Organs; pp. 2-21 to 2-92 of HMTRI; Course HMT 280; Hazardous Materials Health Effects

 

“Principles of Toxicology” in: EPA Training Manual 165.5: Hazardous Materials Incident Response Operations

 

Pages 443 to 449; Section VIII in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition


Survey of Common Toxic Substances

 

Intent and Purpose

 

This lesson provides students with the principal toxicity associated with those chemical groups most commonly released in the U.S. and inCalifornia. These include the corrosives (like sulfuric acid and ammonium hydroxide), metals (such as aluminum oxide), organic solvents (such as trichloroethane and toluene), other organic compounds (such as methanol, glycol ether, and acetone) and pesticides (such as the organophosphate insecticides).

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Identify the most commonly released chemicals associated with human injury or death.

 

2. Describe the principal toxicity of chlorine.

 

3. Describe the principal toxicity of ammonia.

 

4. Describe the principal toxicity of corrosives.

 

5. Describe the principal toxicity of the following metals:

 

• arsenic

 

• mercury

 

• cadmium

 

• beryllium

 

• chromium VI

 

• lead

 

• aluminum

 

6. Describe the principal toxicity of methane.

 

7. Describe the principal toxicity of gasoline.

 

8. Describe the principal toxicity of methylene chloride.

 

9. Describe the principal toxicity of trichloroethane.

 

10.Describe the principal toxicity of the freons.

 

11.Describe the principal toxicity of methanol.

 

12.Describe the principal toxicity of glycol ether.

 

13.Describe the principal toxicity of epoxy compounds.

 

14.Describe the principal toxicity of acetone.

 

15.Describe the principal toxicity of benzene, toluene & xylene.

 

16.Describe the principal toxicity of the polycyclic aromatic compounds.

 

17.Describe the principal toxicity of the organochlorine insecticides.

 

18.Describe the principal toxicity of organophosphate insecticides.

 

19.Describe the principal toxicity of carbamate insecticides.

 

 

Lesson Outline

 

1. The lesson is introduced by presenting a list of the most commonly released chemicals in the U.S and in California.

 

2. The principal toxicity of the following chemicals or chemical groups is presented:

 

• Chlorine

 

• Ammonia & ammonium compounds

 

• Corrosives

 

• Metals & metal compounds

 

3. The principal toxicity of the following solvents & other organic compounds is presented:

 

• The Aliphatic Hydrocarbons

 

• The Chlorinated Aliphatic Hydrocarbons

 

• The Aliphatic Alcohols

 

• The Glycols & Derivatives

 

• The Ethers & Epoxy Compounds

 

• The Aldehydes & Ketones

 

• The Aromatic Hydrocarbons

 

• Phenol & phenolic compounds

 

• Polycyclic aromatic compounds

 

4. The principal toxicity of Carbon Disulfide is presented.

 

5. The principal toxicity of Pesticides (biocides) is presented, including:

 

• algicides

 

• fungicides

 

• herbicides

 

• nematocides

 

• molluscides

 

• rodenticides

 

• organochlorine insecticides

 

• organophosphate insecticides

 

• carbamate insecticides

 

• rotenoid insecticides

 

• pyrethroid insecticides

 

• inorganic insecticides

 

 

Suggestions for Development and Presentation

 

The main purpose of this survey of toxic substances is to present a summary of the principal toxicity of those chemical most commonly associated with spills and releases in the U.S. in general, and California specifically. I would emphasize the major characteristics and not focus on all the minutiae.

 

 

References and Resources

 

See Lesson 3: Control Measures; pp. 3-70 to 3-94 of HMTRI; Course HMT 280; Hazardous Materials Health Effects; 1988

 

See Section VII in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition; U.S. Dept. of Health, Education, and Welfare; DHEW Pub. No. (NIOSH) 77-181; 1977

 

Also see Chaps. 18, 19, 20, 21, 25, & 26 in: C. Klaassen, et. al; Casarett & Doull’s Toxicology: The Basic Science of Poisons; (3rd ed.); MacMillan Publishing Co.; New York; 1986

Also see Chapter 7 in: E. Hodgson & P. Levi; A Textbook of Modern Toxicology; Elsevier Science Publishing Co, Inc; New York; 1987

 

Also see Chaps. 5-9 in: R. Scott; Chemical Hazards in the Workplace; CRC-Lewis Publishers; 1989

 

Also see Chaps. 10, 11, & 12 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van NostrandReinhold, Pub.; New York; 1985

 

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/study assignments are:

 

Lesson 3: Control Measures; pp. 3-70 to 3-94 of HMTRI; Course HMT 280; Hazardous Materials Health Effects

 

Section VII in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition

 

 

Survey of Common Toxic Substances

 

Intent and Purpose

 

This lesson provides students with the principal toxicity associated with asbestos, radon, the criteria air pollutants, and the most common indoor air pollutants are identified and assessed. In addition, the principal sources of infectious wastes are considered.

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Describe the principal toxicity of asbestos.

 

2. Describe the principal toxicity of radon.

 

3. Describe the principal toxicity of the criteria air pollutants.

 

4. Describe the principal types of indoor air pollutants.

 

5. Describe the principal sources of infectious wastes.

 

 

Lesson Outline

 

The principal toxicity of the following materials is presented:

 

1. Asbestos (dust & fibers)

 

2. Radiation & Radioactive Materials, including:

 

• radon

 

• Radiation Protection Standards

 

3. Air Pollutants, including:

 

• ambient pollutants

 

• indoor pollutants

 

4. Infectious Wastes, including:

 

• laboratory waste (incl: cultures)

 

• pathologic specimens (incl: tissues; blood; excreta; secretions)

 

• disposable fomites, disposable instruments, equipment; dialysis wastes; needles, etc.

 

• animal carcasses

 

 

Suggestions for Development and Presentation

 

The main purpose of this survey of toxic substances is to present a summary of the principal toxicity associated with asbestos, radon, the criteria air pollutants, the most common indoor air pollutants and the principal types of infectious wastes. I would emphasize the major characteristics and not focus on all the minutiae.

 

 

References and Resources

 

Also see Chaps. 18, 19, 20, 21, 25, & 26 in: C. Klaassen, et. al; Casarett & Doull’s Toxicology: The Basic Science of Poisons; (3rd ed.); MacMillan Publishing Co.; New York; 1986

 

See Sections III, VIII & X in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition; U.S. Dept. of Health, Education, and Welfare; DHEW Pub. No. (NIOSH) 77-181; 1977

 

Also see Chapter 7 in: E. Hodgson & P. Levi; A Textbook of Modern Toxicology; Elsevier Science Publishing Co, Inc; New York; 1987

 

Also see Chaps. 5-9 in: R. Scott; Chemical Hazards in the Workplace; CRC-Lewis Publishers; 1989

 

Also see Chaps. 10, 11, & 12 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van NostrandReinhold, Pub.; New York; 1985

 

 

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction.

 

Student reading/study assignments are:

 

Section III, VIII, & X in: M. Key, et. al; Occupational Diseases; A Guide to Their Recognition

 

 

Risk Assessment

 

Intent and Purpose

 

In this lesson the complex processes of risk assessment and risk management are introduced. As each of the four components of risk assessment are presented, various complicating factors and uncertainties are considered. The derivation of the Reference Dose (RfD) for non-carcinogenic (threshold) effects and the Cancer Potency Factor (q1*) for carcinogenic (non-threshold) effects is also presented. Also considered are the factors that affect the public’s perception of a risk as being acceptable or not acceptable. Finally, the theoretical basis for “action levels” is considered.

 

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Describe 5 applications of the Risk Assessment methodology.

 

2. Define the following:

 

• risk

 

• de minimis risk

 

• safe

 

• Maximum Exposed Individual (MEI)

 

3. Identify and describe the four components of the risk assessment process.

 

4. Identify the five principal exposure pathways.

 

5. Compute the following:

 

• The average daily intake of a substance for an adult given the concentration of a substance in drinking water

 

• Normalize this average daily intake for body weight

 

6. Explain under what conditions it is appropriate to sum the doses each different exposure route and when it is not appropriate.

 

7. Define the following:

 

• SNARL

 

• Reference Dose (RfD)

 

• Cancer Potency Factor (q1*)

 

• Action level

 

8. Compute the following:

 

• The Individual Lifetime Cancer Risk (ILCR) given a substance’s average lifetime exposure and its

   cancer potency factor

 

• The Aggregate Lifetime Cancer Risk (ALCR) given the size of a population and given a substance’s

   average lifetime exposure and its cancer potency factor

 

• The annual incidence of cancer in a population as a result of the exposure, given the size of a population

   and given the lifetime exposure and its cancer potency factor

 

• The risk of harm from a non-carcinogenic (threshold) effect given the RfD and the estimated daily

   human dose

 

• The carcinogenic (non-threshold) risk given the estimated daily dose and the cancer potency factor

 

9. Distinguish between risk assessment and risk management.

 

10.Identify and explain five factors that affect the public’s perception of a risk.

 

11.Compute the Acceptable Daily Intake (ADI) given a substance’s NOAEL and a safety factor of 100.

 

 

Lesson Outline

 

1. The lesson is introduced by considering the concept of Risk Assessment, including:

 

• The uses of Risk Assessment

 

• The definition of risk

 

• Expressing the risk qualitatively & quantitatively

 

• The definition of safety

 

• Acceptable (“de minimis”) risk

 

2. The Hazard Identification component is presented, including:

 

• The purpose of Hazard Identification

 

• The elements of Hazard Identification

 

3. The Human Exposure Evaluation component is presented, including:

 

• The purpose of Human Exposure Evaluation

 

• The elements of Human Exposure Evaluation

 

• Distinguishing between exposure and dose absorbed

 

• Maximum Exposed Individual (MEI)

 

4. The Dose-Response Evaluation component is presented, including:

 

• The purpose of the Dose-Response Evaluation

 

• The elements of the Dose-Response Evaluation

 

• The Suggested No Adverse Response Level (SNARL)

 

• Computing the Reference Dose (RfD)

 

• Computing the Cancer Potency Factor (q1*)

 

• Computing the Individual Lifetime Cancer Risk (ILCR)

 

• Computing the Aggregate Lifetime Cancer Risk (ALCR)

 

5. The Risk (Characterization) Estimation component is presented, including:

 

• The purpose of the Risk (Characterization) Estimation

 

• The elements of the Risk (Characterization) Estimation

 

• Computing the Margin of Safety (MOS)

 

• Computing the Carcinogenic Risk

 

5. The concept of Risk Management is presented, including:

 

• The purpose of the Risk Management

 

• The factors affecting risk perception

 

• Acceptable Daily Intakes (ADI)

 

• Use of safety (uncertainty) factors

 

• The use of “action levels”

 

Suggestions for Development and Presentation

 

The mathematical nature of this material demands that the instructor be well prepared before presenting it. I would also strongly recommend that the students should be given some problems to solve after the lesson for practice. The ability to do the computations not only indicates a mastery over the arithmetic operations, but more importantly, it reflects conceptual understanding of the principles and derived values.

 

 

References and Resources

 

See Lesson 1: Risk Assessment; pp. 1-9 to 1-44 of HMTRI; Course HMT 280; Hazardous Materials Health Effects; 1988

 

Read EPA; Principles of Risk Assessment; A Nontechnical Review

 

Also see Chap. 17 in: P. Williams & J. Burson; Industrial Toxicology; Safety and Health Applications in the Workplace; Van Nostrand Reinhold, Pub.; New York; 1985

 

See AAAS: Science; April 17, 1987; 236: 267-300

 

See American Chemical Society; Chemical Risk Communication; 1988; available from: ACS; Department of Government Relations & Science Policy; 1155 Sixteenth Street, NW; Washington, DC 20036; (202) 872-4395

 

Schedule and Assignments

 

This lesson is suggested to take 3 hours of classroom instruction  Student reading/study assignments are:

 

Lesson 1: Risk Assessment; pp. 1-9 to 1-44 of HMTRI; Course HMT 280; Hazardous Materials Health Effects

 

Students should have the EPA; Principles of Risk Assessment; A Nontechnical Review to read

Clinical Symptoms and Treatment of Toxicity

 

Intent and Purpose

 

In this lesson the basic principles of medical diagnosis and initial response to toxicity is presented.

 

Lesson Objectives

 

To successfully complete this lesson, the student will be able to:

 

1. Describe the signs and symptoms of chemical exposure.

 

2. Describe the order for treating symptoms.

 

3. Describe the treatment for chemical inhalation.

 

4. Describe the treatment for chemical ingestion.

 

5. Describe the treatment for chemical contact on the skin.

 

6. Describe the treatment for chemical contact in the eyes.

 

 

Lesson Outline

 

1. The lesson is introduced by considering the signs and symptoms of chemical exposure, including:

 

            • irritation of eyes, nose, skin or throat

            • light-headedness or dizziness

            • headache

            • coughing or sneezing

            • tightness in chest or breathing difficulties

            • weakness or decrease in coordination

            • sweating

            • changes in skin color

            • tearing

            • nausea

            • cramps & diarrhea

            • irritability or behavioral changes

 

2. The order for treating symptoms is presented:

 

• Cessation of Breathing

• Eye Injury

• Skin Contact

• Shock

 

 

3. The treatment for chemical inhalation is presented, including:

 

• Remove him from the contaminated area

 

• Lay him down with his Legs Raised

 

• Loosen his collar & belt

 

• Cover him with a blanket

 

• Calm & Reassure him

 

4. The treatment for chemical ingestion is presented, including:

 

• Remove him from the contaminated area

 

• Make him rinse his mouth with cold water

 

• Loosen his collar & belt

 

• Lay him down with his Legs Raised

 

• Cover him with a blanket

 

• Minimize his moving & speaking

 

5. The treatment for chemical contact on the skin is presented, including:

 

• Take him immediately to the nearest shower

 

• Remove clothing from the affected areas

 

• Wipe off any excess chemical very gently

 

• Wash affected area under the shower with soap

 

• Rinse affected area with lukewarm water

 

• Dry the skin gently with soft towel

 

6. The treatment for chemical contact in the eyes is presented, including:

 

• Take him immediately to the nearest shower

 

• Wipe off any excess chemical very gently

 

• With eyelids held open, wash eyes under slowly running water for at least 15 minutes

 
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