Exposures to hydrocarbons and volatiles most commonly occur in one of two settings: ingestion or inhalation. Hydrocarbon ingestions account for approximately 3 to 10 percent of all unintentional childhood poisonings in the United States. Ingestions of gasoline, kerosene, lighter fluid, mineral seal oil, and turpentine are most frequent. In less-developed countries kerosene ingestion accounts for 33 to 59 percent of unintentional childhood poisonings. 2 It is estimated that 3.5 to 10 percent of young people have experimented with volatile substance inhalation to produce inebriation. 3
Most hydrocarbon exposures have a benign clinical course. The 1997 American Association of Poison Control Centers Toxic Exposure Surveillance System revealed that 66,645 potential hydrocarbon exposures were reported to poison control centers (3 percent of all reported exposures). Of these, 3.6 percent involved aromatic hydrocarbons and 12.2 percent involved halogenated hydrocarbons and/or propellants. Three thousand and fifty-eight (4.6 percent) developed moderate to severe toxicity, and 12 died.4 Nine of the 12 deaths followed inhalational exposure; 8 involved intentional inhalational abuse and 7 occurred in teenagers. Two of the other fatalities were in toddlers who ingested and aspirated gasoline and paint thinner. An epidemiologic study of volatile substance abuse in the United Kingdom revealed that 605 people under age 18 years died from volatile substance abuse during the period 1981 to 1990. 5 The most commonly implicated volatiles were butane (39 percent), aerosols (26 percent), cleaners (16 percent), and glue (10 percent).
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