Determinants of Toxicity

The toxic potential of hydrocarbons depends on physical characteristics (volatility, viscosity, and surface tension), chemical characteristics (aliphatic, aromatic, or halogenated), presence of toxic additives such as pesticides or heavy metals, route of exposure, concentration, and dose. Viscosity, defined as the resistance to flow, and surface tension, denoting "creeping" ability, both play a major role in determining the aspiration potential. Viscosity is measured in Saybolt Seconds Universal (SSU). Patients ingesting substances with viscosities less than 60 SSU (e.g., gasoline, kerosene, mineral seal oil, turpentine, and aromatic and halogenated hydrocarbons) are at greater risk for aspiration than those ingesting substances with viscosities greater than 100 SSU (e.g., diesel oil, grease, mineral oil, paraffin wax, and petroleum jelly). Low surface tension also increases the risk of aspiration. Volatility denotes the ability of a substance to vaporize. Inhalation of highly volatile agents, such as aromatic hydrocarbons, halogenated hydrocarbons, or gasoline, results in systemic absorption and the potential for significant toxicity.

Dermal exposure to hydrocarbons causes local toxicity, and occasionally leads to systemic absorption. Dermal toxicity secondary to intravenous administration of hydrocarbons has also been reported. When used intravenously, hydrocarbons may cause pulmonary toxicity by their first-pass exposure through the lungs.

Toxicity from hydrocarbon exposure can be divided into different clinical syndromes based on the organ system(s) predominately affected. Characteristic presentations usually affect one or more of the following systems: pulmonary, neurologic (central and/or peripheral), GI, cardiac, hepatic, renal, hematologic, or dermal.

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