Acute Methemoglobinemia—A Common Occupational Hazard in an Industrial City in Western India

Aruna DEWAN; Ashwin PATEL; Habibullah SAIYED

doi:10.1539/joh.43.168

Aruna DEWAN, Ashwin PATEL, Habibullah SAIYED

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Keywords: Methemoglobinemia, Acute poisoning, Small scale industry, Dye industry, Aromatic nitro amino compounds, Self employed workers

JOURNAL FREE ACCESS

2001 Volume 43 Issue 3 Pages 168-171

DOI https://doi.org/10.1539/joh.43.168

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Published: 2001 Received: August 09, 2000 Available on J-STAGE: March 27, 2006 Accepted: November 28, 2000 Advance online publication: - Revised: -
Correction information
Date of correction: March 27, 2006 Reason for correction: - Correction: ABSTRACT Details: Wrong : Acute Methemoglobinemia—A Common Occupational Hazard in an Industrial City in Western India: Aruna DEWAN, et al. Poison Information Centre, National Institute of Occupational Health (NIOH)—Cases of acute methemoglobinemia reported to the Poison Information Centre at NIOH over a period of six years from 1993 to 1999 were analyzed. Of 1067 acute poisonings, there were 30 cases of acute methemoglobinemia, the majority of which were due to occupational exposures. The causative agents were mostly aromatic nitro amino compounds used as intermediates in the manufacture of dyes. Diagnosis of acute methemoglobinemia was made on the basis of clinical presentation and occupational history. A particular occupation viz. washing chemical contaminated plastic bags was responsible for many cases of methemoglobinemia. This report highlights the risk of acute poisoning among workers in the small scale chemical industry and also among self employed workers handling toxic chemicals. (J Occup Health 2001; 43: 168-171)
Right : Acute Methemoglobinemia—A Common Occupational Hazard in an Industrial City in Western India: Aruna DEWAN, et al. Poison Information Centre, National Institute of Occupational Health (NIOH)—Cases of acute methemoglobinemia reported to the Poison Information Centre at NIOH over a period of six years from 1993 to 1999 were analyzed. Of 1067 acute poisonings, there were 30 cases of acute methemoglobinemia, the majority of which were due to occupational exposures. The causative agents were mostly aromatic nitro amino compounds used as intermediates in the manufacture of dyes. Diagnosis of acute methemoglobinemia was made on the basis of clinical presentation and occupational history. A particular occupation viz. washing chemical contaminated plastic bags was responsible for many cases of methemoglobinemia. This report highlights the risk of acute poisoning among workers in the small scale chemical industry and also among self employed workers handling toxic chemicals. (J Occup Health 2001; 43: 168-171)

Date of correction: March 27, 2006 Reason for correction: - Correction: CITATION Details: Wrong : 1) Hall AH, Kulig KW, Rumack BH. Drug and chemical induced methaemoglobinaemia: Clinical features and management. Med Toxicol 1986; 1: 253-260.
2) Donovan, JW. Nitrates, Nitrites and other sources of methemoglobinemia. In: Haddad LM and Winchester JF, eds. Clinical Management of Poisoning and Drug Overdose. W.B. Saunders Company, 1990: 1419-1431.
3) Done AK, The toxic emergency. Emergency Medicine 1976;8:283-286.
4) Gosselin RE, Smith RP, Hodge HC, eds. Clinical Toxicology of Commercial Products. Williams & Wilkins, Baltimore, 1984: III-31.
5) Cartwright GE. Methemoglobinemia and sulfhemoglobine In: Harrison TR (ed.), Principles of Internal Medicine 8th edition, New York: McGraw-Hill, 1977:1710-1713.
6) Lukens JN. The legacy of well-water methemoglobinemia. JAMA 1987; 257: 2793-2795.
7) Walley T, Flanagan M. Nitrite induced methemoglobinemia. Postgrad Med J 1987; 63: 643-644.
8) Dean BS, Lopez G, Krenzelok EP. Environmentally induced methemoglobineamia in an infant (abstract). Clin Toxicol 1992; 30: 127-133.
9) Fan AM, Willhite CC, Book SA. Evaluation of nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity. Regul Toxicol Pharmacol 1987; 7: 135-148.
10) Kao L, Leikin JB. Methemoglobinemia from artificial fingernail solution (letter). JAMA 1998; 278: 549-550.
11) Ramsay DHE, Harvey CC. Marking ink poisoning. An outbreak of methemoglobinemia cyanosis in newborn babies. Lancet 1959; 1: 910-912.
12) Sachdeva SM, Mani KV, Adaval SK, Jalpota YP, Rasela KC, Chadha DS. Acquired Toxic methaemoglobinaemia. J Assoc Physicians India 1992; 40: 239-240.
13) Freeman L, Wolford RW. Methemoglobinemia secondary to cleaning solution ingestion. J Emerg Med 1996;14:599-601.
14) Chugh KS, Singhal PC, Sharma BK. Methemoglobinemia in acute copper sulphate poisoning. Ann Intern Med 1975; 82: 226-227.
15) Johnson PN, Sullivan FM, Lewander WJ. Methemoglobinemia following occupational exposure to sodium betanaphthol disulfonate (R salt) (abstract). Vet Hum Toxicol 1987; 29: 460.
16) Wax PM, Hoffman RS. Methemoglobinemia: an occupational hazard of phenylpropanolamine production. Clin Toxicol 1994; 32: 299-303.
17) Bardoczky GI, Wathieu M, D'' Hollander A. Prilocaine-induced methemoglobinemia evidenced by pulse oximetry. Acta Anaesthesiol Scand 1990; 34: 162-164.
18) Erstad BL. Dapsone-induced methemoglobinemia and hemolytic anemia. Clin Pharm 1992; 11: 800-805.
19) O''Donohue WJ, Mass LN, Angelillo, VA. Acute methemoglobinemia induced by topical benzocaine and lidocaine. Arch Intern Med 1980; 140: 1508-1509.
20) Potter JL, Krill CE Jr., Neal D, Kofron WG. Methemoglobinemia due to ingestion of N, N-dimethyl p-toluidine, a component used in the fabrication of artificial fingernails. Ann Emerg Med 1988; 17: 1098-1100.
21) O''Toole JB, Robbins GB, Dixon DS. Ingestion of isobutyl nitrite, a recreational chemical of abuse, causing fatal methemoglobinemia. J Forensic Sci 1987; 32:1811-1812.
22) Hosek W, Scott M, Stork C, Long C. Methemo globinemia and syncope induced by butyl nitrite inhalation (abstract). J Toxicol Clin Toxicol 1998; 36: 470.
23) Henretig FM, Gribetz B, Kearney T, Lacouture P, Lovejoy FH. Interpretation of colour change in blood with varying degree of methemoglobinemia. J Toxicol Clin Toxicol 1988; 26: 293-301.
24) Curry S. Methemoglobinemia. Ann Emerg Med 1982; 11:214-221.
25) Howland M. Antidotes in depth Methylene Blue. In: Goldfrank L, Flomenbaum N et al. (eds.), Toxicologic Emergencies. Connecticut: Appleton & Lange, 1998: 1520-1521.
26) Chandra AM, Qualls CW Jr, Reddy G, Meinkoth JH. Haematological effects of 1,3,5-trinitrobenzene (TNB) in rats in vivo and in vitro J Toxicol Environ Health 1995;46:57-72.

Right : 1) Hall AH, Kulig KW, Rumack BH. Drug and chemical induced methaemoglobinaemia: Clinical features and management. Med Toxicol 1986; 1: 253-260.
2) Donovan, JW. Nitrates, Nitrites and other sources of methemoglobinemia. In: Haddad LM and Winchester JF, eds. Clinical Management of Poisoning and Drug Overdose. W.B. Saunders Company, 1990: 1419-1431.
3) Done AK, The toxic emergency. Emergency Medicine 1976;8:283-286.
4) Gosselin RE, Smith RP, Hodge HC, eds. Clinical Toxicology of Commercial Products. Williams & Wilkins, Baltimore, 1984: III-31.
5) Cartwright GE. Methemoglobinemia and sulfhemoglobine In: Harrison TR (ed.), Principles of Internal Medicine 8th edition, New York: McGraw-Hill, 1977:1710-1713.
6) Lukens JN. The legacy of well-water methemoglobinemia. JAMA 1987; 257: 2793-2795.
7) Walley T, Flanagan M. Nitrite induced methemoglobinemia. Postgrad Med J 1987; 63: 643-644.
8) Dean BS, Lopez G, Krenzelok EP. Environmentally induced methemoglobineamia in an infant (abstract). Clin Toxicol 1992; 30: 127-133.
9) Fan AM, Willhite CC, Book SA. Evaluation of nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity. Regul Toxicol Pharmacol 1987; 7: 135-148.
10) Kao L, Leikin JB. Methemoglobinemia from artificial fingernail solution (letter). JAMA 1998; 278: 549-550.
11) Ramsay DHE, Harvey CC. Marking ink poisoning. An outbreak of methemoglobinemia cyanosis in newborn babies. Lancet 1959; 1: 910-912.
12) Sachdeva SM, Mani KV, Adaval SK, Jalpota YP, Rasela KC, Chadha DS. Acquired Toxic methaemoglobinaemia. J Assoc Physicians India 1992; 40: 239-240.
13) Freeman L, Wolford RW. Methemoglobinemia secondary to cleaning solution ingestion. J Emerg Med 1996;14:599-601.
14) Chugh KS, Singhal PC, Sharma BK. Methemoglobinemia in acute copper sulphate poisoning. Ann Intern Med 1975; 82: 226-227.
15) Johnson PN, Sullivan FM, Lewander WJ. Methemoglobinemia following occupational exposure to sodium betanaphthol disulfonate (R salt) (abstract). Vet Hum Toxicol 1987; 29: 460.
16) Wax PM, Hoffman RS. Methemoglobinemia: an occupational hazard of phenylpropanolamine production. Clin Toxicol 1994; 32: 299-303.
17) Bardoczky GI, Wathieu M, D' Hollander A. Prilocaine-induced methemoglobinemia evidenced by pulse oximetry. Acta Anaesthesiol Scand 1990; 34: 162-164.
18) Erstad BL. Dapsone-induced methemoglobinemia and hemolytic anemia. Clin Pharm 1992; 11: 800-805.
19) O'Donohue WJ, Mass LN, Angelillo, VA. Acute methemoglobinemia induced by topical benzocaine and lidocaine. Arch Intern Med 1980; 140: 1508-1509.
20) Potter JL, Krill CE Jr., Neal D, Kofron WG. Methemoglobinemia due to ingestion of N, N-dimethyl p-toluidine, a component used in the fabrication of artificial fingernails. Ann Emerg Med 1988; 17: 1098-1100.
21) O'Toole JB, Robbins GB, Dixon DS. Ingestion of isobutyl nitrite, a recreational chemical of abuse, causing fatal methemoglobinemia. J Forensic Sci 1987; 32:1811-1812.
22) Hosek W, Scott M, Stork C, Long C. Methemo globinemia and syncope induced by butyl nitrite inhalation (abstract). J Toxicol Clin Toxicol 1998; 36: 470.
23) Henretig FM, Gribetz B, Kearney T, Lacouture P, Lovejoy FH. Interpretation of colour change in blood with varying degree of methemoglobinemia. J Toxicol Clin Toxicol 1988; 26: 293-301.
24) Curry S. Methemoglobinemia. Ann Emerg Med 1982; 11:214-221.
25) Howland M. Antidotes in depth Methylene Blue. In: Goldfrank L, Flomenbaum N et al. (eds.), Toxicologic Emergencies. Connecticut: Appleton & Lange, 1998: 1520-1521.
26) Chandra AM, Qualls CW Jr, Reddy G, Meinkoth JH. Haematological effects of 1,3,5-trinitrobenzene (TNB) in rats in vivo and in vitro J Toxicol Environ Health 1995;46:57-72.

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Abstract

Acute Methemoglobinemia—A Common Occupational Hazard in an Industrial City in Western India: Aruna DEWAN, et al. Poison Information Centre, National Institute of Occupational Health (NIOH)—Cases of acute methemoglobinemia reported to the Poison Information Centre at NIOH over a period of six years from 1993 to 1999 were analyzed. Of 1067 acute poisonings, there were 30 cases of acute methemoglobinemia, the majority of which were due to occupational exposures. The causative agents were mostly aromatic nitro amino compounds used as intermediates in the manufacture of dyes. Diagnosis of acute methemoglobinemia was made on the basis of clinical presentation and occupational history. A particular occupation viz. washing chemical contaminated plastic bags was responsible for many cases of methemoglobinemia. This report highlights the risk of acute poisoning among workers in the small scale chemical industry and also among self employed workers handling toxic chemicals. (J Occup Health 2001; 43: 168-171)

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