[PCOL and TOXICOLOGY] PPT Air Pollutants (Part 2 of intro)

Carbon monoxide

• Colorless, tasteless, odorless and nonirritating gas

• Byproduct of incomplete combustion

• Average concentration in the atmosphere is about 0.1ppm in heavy traffic it may exceed 100ppm

Carbon Monoxide

• Combines tightly but irreversibly with oxygen-binding sites of hemoglobin and has an affinity for hemoglobin 220x that of oxygen

• Reduces the transfer of oxygen to tissues especially the organs with the highest oxygen demand (brain, heart and kidney)

• Product form: Carboxyhemoglobin

Carboxyhemoglobin

Product of CO and Hemoglobin

brain, heart and kidney

The CO Reduces the transfer of oxygen to tissues especially the organs with the highest oxygen demand such as what

Sources of CO at home

hypoxia

Principal signs of CO intoxication are those of _____:

• Psychomotor impairment

• Headache and tightness in the temporal area

• Confusion and loss of visual acuity

• Tachycardia, tachypnea, syncope and coma

• Deep coma, convulsions, shock and respiratory failure

High Labor (Trabaho)

High Altitudes (Taas)

High Temperatures (Temp)

3 factors that can aggravate the effect of CO

Key: 3 Ts

Acute toxicity

What type of exposure is usual for CO intoxication

cardiac effects

neurologic disturbances

emotional disorders

Chronic exposures to low CO levels may lead to adverse effects on what body systems

Elevated CO exposure

The ff are effects of what intoxication

critical periods of fetal development may cause fetal death or serious and irreversible but survivable birth defects

removal of exposure

Respiration (high oxygen)

Mechanical ventilation

Hypothermic Therapy

4 ways to treat CO intoxication

Short period of time

when experiencing CO intoxication, should high concentration treatment be in short or long period of time?

Mechanical ventilation

CO intoxication treatment if respiratory failure is present

Hypothermic Therapy

CO intoxication treatment to reduce metabolic demand of the brain

Sulfur Dioxide

Emitted by volcanoes

Colorless, irritant gas generated primarily by the combustion of sulfur- containing fossil fuels

Sulfur Dioxide

• high solubility of _____ in moist membranes forms sulfurous acid.

• severe irritant on the eyes, mucous membranes, respiratory tract and skin

• 90% of inhaled form is absorbed in the Upper Respiratory tract causing Acute Irritant Asthma

sulfurous acid

high solubility of SO2 in moist membranes forms ________

Acute Irritant Asthma

90% of inhaled form of SO2 is absorbed in the Upper Respiratory tract causing ____________

Sulfur Dioxide

• eye, nose and throat irritation, reflex bronchoconstriction and increased bronchial secretions

> Eyes nose (mucosal), bronchial (lungs)

• Asthmatic subjects exposed to ____ may result in acute asthmatic episode

• When combined exposure to high respirable particulate loads and ____ the mixed irritant load may increase the toxic respiratory response

respirable particulate loads

When SO2 is combined exposure to high ___________ , the mixed irritant load may increase the toxic respiratory response

depends on respiratory tracts and asthma

Treatment of SO2 intoxication/irritation

Nitrogen Oxides (NO2)

• Brownish irritant gas associated with fires

• Farmers exposed to fresh silage

• Miners exposed to diesel equipment

• Automobile truck traffic emissions

Nitrogen Oxides (NO2)

• Relatively insoluble deep lung irritant, producing lung edema and adult pulmonary respiratory distress syndrome

Nitrogen Oxides (NO2)

• Inhalation damages the lung infrastructure that produces the surfactant necessary to allow smooth and low-effort lung alveolar expansion

• Type I pneumocytes of the alveoli appears to be the cells chiefly affected by acute low to moderate inhalation exposure

Type I pneumocytes

________ pneumocytes of the alveoli appears to be the cells chiefly affected by acute low to moderate inhalation exposure of Nitrogen Oxides (NO2)

Nitrogen Oxides (NO2)

Acute: Irritation of eyes and nose, cough, mucoid or frothy sputum production, dyspnea and chest pain; Pulmonary edema, fibrotic destruction of terminal bronchioles

1-2hours

Pulmonary edema appears how many hours after exposure to Nitrogen Oxide

Emphysematous changes

Chronic exposure effect of Nitrogen Oxides

No specific Treatment

What is the specific treatment for acute exposure to NO2

Deep lung irritation management (for Non-cardiogenic Pulmonary edema)

Bronchodilators

Sedatives

Antibiotics

Therapeutic Measures for NO2

Ozone (O3) and other Oxides

• Bluish irritant gas naturally found in the earth’s atmosphere

• Ground level ____ pollution is derived from photolysis of oxides, nitrogen, volatile organic compounds, and heat and sunlight

• Compounds are produced primarily from fossil fuels such as gasoline, oil or coal or when some chemicals evaporate

• Emitted from power plants, motor vehicles and other sources of high heat compounds

• High-voltage electrical equipment and air and water purification systems

• Agricultural sources of ______ are also important as well, as there are numerous adverse effects to plants

Ozone (O3) and other Oxides

• Irritant of mucous membranes

• Produces upper respiratory tract irritation to deep lung irritation with pulmonary edema

• Formation of reactive free radicals

Shallow

rapid breathing

decrease in pulmonary compliance

Clinical effect of Ozone and other oxides

changes to visual acuity

Irritation and dryness to throat

substernal pain

dyspnea

ARDS

Clinical effects of Acute exposure to ozones and other oxides

Chronic Bronchitis

Bronchiolitis

Empyshema

effects of chronic exposure to Ozones and other oxides (BOBOE)

No specific Treatment

Treatment for Acute exposure to O3

Reduce time

Management varies

deep lung irritation management - noncardiogenic pulmonary edema to ARDS

Treatment for O3 exposure

Particulate matter

Complicated topic due to different sizes of particulate matter and health effect depending on the size

PM 10

this micron of particulate matter elicit health effects

PM 2.5

this micron of particulate matter or smaller elicits most profound effects, this can be emitted from construction sites, industries (smokestacks), vehicles, and fires

2.5-10

Coarse particles of particulate matter in the range of _____ microns tend to deposit in the upper thoracic airways

< 2.5 microns

Fine particulate matters in microns can deposit in gas exchange areas

< 0.1 microns

Ultrafine particles suspected to cause serious health effects

No specific treatment

time reduction of exposure

N95 or KN95 masks (w/ Hepa filter)

Treatment or mitigation of Particulate matter exposures