ACETYLSALICYLIC ACID
HAZARDTEXT ®
Information to help in the initial response for evaluating chemical incidents
-IDENTIFICATION
SYNONYMS
ACETYLSALICYLIC ACID AC 5230 ACENTERINE ACESAL ACETAL ACETICYL ACETILSALICILICO ACETILUM ACIDULATUM ACETISAL ACETOL ACETONYL ACETOPHEN ACETOSAL ACETOSALIC ACID ACETOSALIN o-ACETOXYBENZOIC ACID 2-ACETOXYBENZOIC ACID ACETYLIN 2-(ACETYLOXY)BENZOIC ACID ACETYL-SAL ACETYLSAL ACETYLSALICYLSAURE (German) ACIDE ACETYLSALICYLIQUE (French) ACIDO o-ACETIL-BENZOICO (Italian) ACIDO ACETILSALICILICO (Italian) ACIDUM ACETYLSALICYLICUM ACIMETTEN ACISAL ACYLPYRIN ANGETTES ASA A.S.A. A.S.A. EMPIRIN ASAGRAN ASATARD ASPALON ASPERGUM ASPIRDROPS ASPIRIN ASPIRINE ASPRO ASPRO CLEAR ASPIRINA O3 ASTERIC BENASPIR BENZOIC ACID, 2-(ACETYLOXY)-(9CI) BIALPIRINIA CAPRIN o-CARBOXYPHENYL ACETATE CARDIOASPIRIN CARDIPRIN CEMIRIT CLARADIN CLARAGINE COLFARIT CONTRHEUMA RETARD COSPRIN CRYSTAR DELGESIC DOLEAN pH 8 DURAMAX ECM ECOTRIN EMPIRIN ENCAPRIN ENDYDOL ENTERICIN ENTEROPHEN ENTEROSARINE ENTROPHEN EXTREN GLOBOID HELICON IDRAGIN ISTOPIRIN KAPSAZAL KILIOS KYSELINA 2-ACETOXYBENZOOVA (Czech) KYSELINA ACETYLSALICYLOVA (Czech) LEVIUS LONGASA MEASURIN MEDISYL MICRISTIN NEURONIKA NOVID PLATET POLOPIRYNA RHEUMIN TABLETTEN RHODINE RHONAL RONAL SALACETIN SALCETOGEN SALETIN SALICYLIC ACID, ACETATE SP 189 SOLPRIN SOLPYRON TRIPLE-SAL XAXA YASTA ZORPRIN
IDENTIFIERS
Editor's Note: This material is not listed in the Emergency Response Guidebook. Based on the material's physical and chemical properties, toxicity, or chemical group, a guide has been assigned. For additional technical information, contact one of the emergency response telephone numbers listed under Public Safety Measures.
SYNONYM REFERENCE
- (Budavari, 1989; Budavari, 2000; HSDB , 2001; Lewis, 2000; NIOSH , 1996; RTECS , 1996; RTECS , 2001)
USES/FORMS/SOURCES
Acetylsalicylic acid (aspirin) finds many uses in human and animal medicine, including being utilized as an analgesic, anticoagulant, anti-inflammatory agent, antipyretic, and antirheumatic. It is also used in veterinary medicine as an antipyretic and an analgesic (ACGIH, 1991; Budavari, 2000; HSDB , 2001; Lewis, 1998; Lewis, 1997a; NTP & 2001, 2001).
Acetylsalicylic acid can be in the form of needlelike crystals, a crystalline powder, and monoclinic tablets (Budavari, 2000; Lewis, 1997a; NTP & 2001, 2001). Acetylsalicylic acid is available in USP and technical grades (Lewis, 1997a).
-CLINICAL EFFECTS
GENERAL CLINICAL EFFECTS
- Acetylsalicylic acid is an acute irritant of the eyes, skin, and mucous membranes. Eye contact may cause chemical burns and scarring. Ingestion may produce an increased clotting time and a tendency to bleed.
- Patients with mild to moderate intoxication may develop fever, tachypnea, tinnitus, respiratory alkalosis, metabolic acidosis, lethargy, mild dehydration, nausea, and vomiting.
- Headache, dizziness, encephalopathy, seizures, coma, hypotension, pulmonary edema, acidemia, coagulopathy, cerebral edema, and dysrhythmias may develop in severe toxicity.
- Dermatological manifestations including urticaria, angioedema and skin eruptions may occur. Anaphylactic shock can also ensue.
- Liver and kidney injury may occur.
- POTENTIAL HEALTH HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
TOXIC; inhalation, ingestion or skin contact with material may cause severe injury or death. Contact with molten substance may cause severe burns to skin and eyes. Avoid any skin contact. Effects of contact or inhalation may be delayed. Fire may produce irritating, corrosive and/or toxic gases. Runoff from fire control or dilution water may be corrosive and/or toxic and cause pollution.
ACUTE CLINICAL EFFECTS
- Nearly all of the available literature on aspirin deals with its effects after ingestion. Aspirin also can be absorbed rectally in toxic amounts (Watson & Tagupa, 1994). Salicylates are also absorbed through intact skin. Little is known about their absorption and bioavailability after inhalation exposure. Aspirin is irritating to the skin and eyes (HSDB , 1996) ACGIH, 1991).
- The acute oral rat LD50 is 1.5 g/kg (RTECS , 1996) ACGIH, 1991). There have been many reported cases of serious or fatal intentional and accidental aspirin overdoses, however.
- A single oral dose of less than 150 mg/kg may result in nausea, gastritis and vomiting, but serious symptomology would not be expected (Temple, 1981). Significant toxicity may result from single oral doses greater than 300 to 500 mg/kg (Temple, 1981). Doses as small as 10 to 30 grams have caused fatalities in adults, however (HSDB , 1996).
- Aspirin may cause allergic reactions, ranging in severity from urticaria or angioedema to asthma and acute anaphylaxis (Blanca et al, 1989). Approximately 0.2 percent of the USA population has hypersensitivity reactions to aspirin (HSDB , 1996).
- Patients with mild to moderate intoxication may develop headache, fever, sweating, flushing, thirst, tachypnea, tinnitus, respiratory alkalosis, metabolic acidosis, mental confusion, lethargy, drowsiness, dim vision, mild dehydration, hyperventilation, nausea, vomiting, urticaria, skin eruptions, pruritis, and, occasionally, diarrhea (Done, 1960; McCleave & Havill, 1974; McGuigan, 1987; HSDB , 1996).
- Encephalopathy, coma, hypotension, pulmonary edema, seizures, acidemia, coagulopathy, thrombocytopenia, cerebral edema and dysrhythmias may develop in patients with severe aspirin toxicity. Death may be from respiratory failure, anaphylactic shock, pulmonary edema, cerebral edema, and/or cardiovascular collapse (HSDB , 1996).
- Tinnitus and hearing loss commonly occur in salicylate intoxication (Anderson et al, 1976). Tinnitus is frequently associated with blood salicylate concentrations exceeding 30 mg/dL (2.17 mmol/L) (Mongan et al, 1973). The presence or absence of tinnitus, however, is not a reliable indicator of aspirin overexposure (Halla et al, 1991). Hearing loss is usually in the range of 20 to 45 decibels, and is reversible upon discontinuation of salicylates (Myers & Bernstein, 1965; Bernstein & Weiss, 1967).
- CNS depression may develop, ranging from sleepiness and lethargy to confusion and coma (Fisher et al, 1985; Walters et al, 1983; Anderson et al, 1976; Schlegel et al, 1966; Brem et al, 1973; Dove & Jones, 1982; Quint & Allman, 1984; Skrum et al, 1989; Snodgrass et al, 1981; Pond et al, 1993; McGuigan, 1987; Thisted et al, 1987; Fiscina, 1986).
CNS depression generally follows a phase of agitation and confusion in severe overdoses (McGuigan, 1986). Seizures may develop in patients with severe toxicity (MacCready, 1943; Done, 1960; Anderson et al, 1976; Walters et al, 1983; Thisted et al, 1987; Cauthen & Hester, 1989; Chapman & Proudfoot, 1989; Abdel-Magid & Ahmed, 1993). Cerebral edema and increased intracranial pressure (papilledema, nuchal rigidity) may develop in severe cases of aspirin poisoning (Schlegel et al, 1966; McGuigan, 1987; Dove & Jones, 1982).
- Non-cardiogenic pulmonary edema has been reported in severe salicylate intoxication in children and adults (Snodgrass et al, 1981; Fisher et al, 1985; Andersen & Refstad, 1978; Hrnicek et al, 1974; Tashima & Rose, 1974; Chapman & Proudfoot, 1989; Skrum et al, 1989) Hormaechea et al;, 1979; (Thomas, 1979) Zimmerman et al, 1981; Niehoff & Baltatzis, 1985; (Leatherman & Schmitz, 1991) Cvauthen & Hester, 1989; (Pei & Thompson, 1987; Thisted et al, 1987) Sorensen, 1993; Tweeddale, 1974).
In a retrospective study of 111 patients with salicylate intoxication, 35 percent of patients over 30 years old developed noncardiogenic pulmonary edema (Walters et al, 1983). Adults who develop noncardiogenic pulmonary edema from salicylate intoxication are generally older, more likely to smoke cigarettes, more likely to have neurological effects, more often have chronic rather than acute salicylate intoxication, and are more likely to have metabolic acidosis than those who do not develop the adult respiratory distress syndrome (ARDS) (Walters et al, 1983; Anderson et al, 1976; Heffner & Sahn, 1981).
- Hepatotoxicity is rare following acute salicylate overdose, but has been reported (Starko & Mullick, 1983).
- Acute renal insufficiency is also a rare complication of acute salicylate toxicity.
It has been reported in two patients who developed rhabdomyolysis (Leventhal et al, 1989; (Montgomery et al, 1994), in a patient who developed gastric perforation (Christensen & Schmidt, 1987), and in a patient who developed full-thickness skin and muscle necrosis following dermal application of a menthol and methyl salicylate containing cream (Heng, 1987). Acute renal insufficiency has been reported in patients with severe salicylate intoxication complicated by hypotension, ARDS and multiorgan system failure (Pei & Thompson, 1987; Leatherman & Schmitz, 1991). Acute polyuric renal insufficiency has been reported to occur in the absence of rhabdomyolysis or hypotension following ingestion of 125 grams of buffered aspirin. There is also a retardation or renal elimination of drugs such as methotrexate (Rupp et al, 1983). Summary: Concomitant aspirin and methotrexate therapy has been reported to result in increased methotrexate toxicity (Mandel, 1976; Baker, 1970). Preexisting renal dysfunction (or salicylate-induced renal dysfunction) also increases the risk of adverse reactions.
- Proteinuria has been reported in patients with salicylate intoxication, and is associated with development of ARDS (Hormaechea et al, 1987; (Heffner & Sahn, 1981).
- Acid-base disturbances vary with age and can be a combination of metabolic and respiratory effects.
In young infants, metabolic acidosis and acidemia is the most common presentation (Buchanan & Rabinowitz, 1974; Abdel-Magid & Ahmed, 1993). Pure respiratory alkalosis may occur after acute or chronic intoxication (Anderson et al, 1976). Respiratory alkalosis with a compensatory metabolic acidosis, usually with an increased anion gap, develops subsequently in most adults with moderate salicylate intoxication (Gabow et al, 1978; Krause et al, 1992; Anderson et al, 1976). Patients who develop only respiratory alkalosis usually have relatively mild toxicity and a good recovery (Done, 1960; Chapman & Proudfoot, 1989). In young infants, respiratory alkalosis either does not occur at all or is very short duration (Buchanan & Rabinowitz, 1974; Abdel-Magid & Ahmed, 1993). Profound metabolic acidosis with compensatory respiratory alkalosis and overall acidemia may develop in patients with severe salicylate intoxication. Potassium and bicarbonate depletion can be severe, and a shift in hydrogen ion to the extracellular space results in an acidic blood pH and acidic urine pH. Acidemia increases the non-ionized fraction of salicylate and increases salicylate distribution to tissues. Development of acidemia in salicylate poisoning is associated with a greater incidence of severe CNS effects, ARDS, and higher mortality rates (Done, 1960; Proudfoot & Brown, 1969; Anderson et al, 1976; Walters et al, 1983; Gaudreault et al, 1982; Watson & Tagupa, 1994).
- Hypokalemia is common (Robin et al, 1959; Thisted et al, 1987), and may worsen during attempts at treatment with alkaline diuresis (Anderson et al, 1976). As potassium becomes depleted intracellularly, hydrogen ions are excreted, resulting in an acidic urine pH (pH less than 6). Serum potassium levels may be within normal limits in the presence of significant intracellular potassium deficiency, as intracellular potassium moves extracellularly.
- Hypoglycemia may develop, particularly in children (Snodgrass et al, 1981; Quint & Allman, 1984; Everson & Krenzelok, 1986), but also in adults (Arena et al, 1978; Raschke et al, 1991; Thisted et al, 1987). Hyperglycemia has also been reported (Buchanan & Rabinowitz, 1974).
- Aspirin inhibits platelet aggregation and prolongs bleeding time at therapeutic doses (Weiss & Aledort, 1967). Small doses of aspirin increase bleeding time significantly (Weiss & Aledort, 1967). A single dose of 650 mg reportedly doubled the mean bleeding time for a period of 4 to 7 days in normal humans, due to inhibition of platelet cyclo-oxygenase (Gilman et al, 1990).
- Gastric ulcer or perforation can occur after acute aspirin ingestion (Robins et al, 1985; Christensen & Schmidt, 1987).
- The analgesic and antipyretic effects of aspirin are due to inhibition of prostaglandin synthesis, which in turn prevents sensitization of pain receptors (HSDB , 1996). Its anti-inflammatory effects are due to interference with interleukin action.
- The anticoagulant effects of aspirin result from its ability to block adhesion of platelets due to irreversible inhibition of platelet cyclooxygenase and resultant blockage of thromboxane A2 formation (HSDB , 1996; Packham & Mustard, 1977; Bye et al, 1979; Taylor et al, 1992; Szczeklik et al, 1992). This effect occurs at a dose of 5 to 100 mg, much less than that required to produce anti-inflammatory effects.
- Salicylates uncouple mitochondrial oxidative phosphorylation (Miyahara & Karler, 1965), resulting in increased oxygen consumption and CO2 production, mainly in skeletal muscle.
- Aspirin is rapidly hydroloyzed to salicylic acid by esterases in the liver, gastrointestinal mucosa, plasma, erythrocytes, and synovial fluid (Gilman et al, 1990).
- Salicylate elimination occurs by parallel processes of renal excretion of unchanged salicylic acid, formation of salicyluric acid by conjugation with glycine, and formation of salicyl phenolic and acyl glucuronides by conjugation with glucuronic acid (Smith, 1960). Salicylates are excreted in breast milk (Brigg et al, 1994).
CHRONIC CLINICAL EFFECTS
- Aspirin is used as an anti-inflammatory,, platelet aggregation inhibitor and analgesic medication. Because it inhibits platelet function, it is increasingly being used prophylactically to reduce the risk of myocardial infarction and transient ischemic attacks (HSDB , 1996).
- Nearly all of the literature on effects of chronic exposure to aspirin and salicylates involves ingestion, either with chronic therapeutic use or with chronic overdose. Significant toxicity can also occur with chronic dermal exposure to salicylate-containing creams and ointments (Aspinall & Goel, 1978; Davies et al, 1979; Anderson & Ead, 1979; Dwyer et al, 1994) Galea & Goal, 1990; (Raschke et al, 1991; Pec et al, 1992; Abdel-Magid & Ahmed, 1993).
- Typical chronic therapeutic doses for various conditions are:
- Chronic ingestion of greater than 100 mg/kg/24 hours over 2 or more days is thought to have the potential to produce toxicity (Temple, 1981). Doses of 150 mg/kg and 95 mg/kg for 2 weeks were associated with toxicity in children (Everson & Krenzelok, 1986; Quint & Allman, 1984).
- A dose of 96 grams over 9 days was fatal (Kearney, 1989). Another fatal case involved ingestion of 7.1 grams of enteric-coated aspiring daily for 10 days (Skrum et al, 1989).
- Nausea and vomiting can develop with chronic, as well as acute, overdose (Done, 1960; McCleave & Havill, 1974; McGuigan, 1987). CNS effects of chronic salicylate poisoning include irritability, confusion, disorientation, hyperactivity, slurred speech, agitation, combativeness, hallucinations, fever, tachycardia, ataxia, and restlessness (Done, 1960; Levy, 1967; Anderson et al, 1976; Brown & Wilson, 1971; Walters et al, 1983; Surapathana et al, 1970) Good & Welsh, 1975; (Liebman & Katz, 1981; Pei & Thompson, 1987; McGuigan, 1987; Everson & Krenzelok, 1986; Sainsbury, 1991; Krause et al, 1992).
- In the elderly, encephalopathy induced by chronic salicylate intoxication may be misdiagnosed as senile dementia (Steele & Morton, 1986; Bailey & Jones, 1989; Gittelman, 1993). In children, severe neurologic abnormalities (coma, seizures) are more common with chronic salicylate intoxication (Gaudreault et al, 1982).
- Chronic use of aspirin and other non-steroidal anti-inflammatory agents can result in lesions of the gastrointestinal tract, ranging from petechiae and superficial erosions to chronic peptic ulcers (Hirschowitz, 1996).
- Dehydration commonly develops secondary to fever, hyperpnea, vomiting and decreased fluid intake, particularly with chronic salicylate toxicity (McCleave & Havill, 1974; Mitchell, 1979; Snodgrass et al, 1981; Gaudreault et al, 1982; Sainsbury, 1991; Fiscina, 1986).
- Salicylates have caused allergic contact dermatitis, urticaria, eczema, edema of the eyelids, lips, face, and tongue, angioedema, pustular psoriasis, rhinitis, asthma, nasal polyps, potentially fatal laryngeal swelling, angina pectoris, syncope, shock and death (Camasara et al, 1989; Shelley, 1964; HSDB , 1996).
- Asthmatics sensitive to aspirin also experienced cross-reaction to high doses of acetaminophen (Settipane et al, 1995). Persons with aspirin-induced asthma were more likely to have antinuclear antibodies (Szczeklik et al, 1995).
- Chronic administration of salicylates can be hepatotoxic. There are numerous reports of hepatitis developing in patients administered chronic salicylate therapy for rheumatological disorders (O'Gorman & Koff, 1977; Cersosimo & Matthews, 1987; Kanada et al, 1978). One case of aspirin-related cirrhosis of the liver and granulomatous hepatitis has been seen (Dabrigeon et al, 1995).
- Hepatitis is more likely to develop in patients receiving high-dose salicylate therapy, but may develop in the absence of other evidence of salicylate toxicity (Rich & Johnson, 1973; Zucker et al, 1975; Hamdan et al, 1985). Aspirin-induced hepatitis may be a hypersensitivity reaction.
- Aspirin inhibits platelet aggregation and prolongs bleeding time at therapeutic doses (Weiss & Aledort, 1967). Prolongation of the PT and PTT occurs, particularly with chronic salicylate intoxication (Good & Welch, 1975; (Brown & Wilson, 1971; Hrnicek et al, 1974; Snodgrass et al, 1981; Mitchell, 1979; Quint & Allman, 1984; Anderson et al, 1976; Sainsbury, 1991) Gittleman, 1993; (Pond et al, 1993).
- In children, acidosis (pH less than 7.32) was noted more frequently in those who were chronically poisoned than in those with acute intoxication (Gaudreault et al, 1982).
- Leatherman & Schmitz (1991) identified a sometimes fatal condition called PSEUDOSEPSIS SYNDROME in five patients with chronic excessive salicylate toxicity.
All five patients had a history of chronic excessive ingestion of aspirin, some approaching 3,900 mg per day. Effects included fever, encephalopathy, acid-base disturbances, ARDS, prolonged prothrombin time, leukocytosis, left shift in the WBC differential count, hypotension, and disseminated intravascular coagulation (DIC) with severe thrombocytopenia. No bacteriologic or pathologic evidence of infection was found in these patients.
- Chronic administration of low doses of aspirin can be of benefit. Doses in the range of 30 to 300 mg per day have been shown to reduce the risk of cardiovascular disease. In one study, low-dose aspirin users had less severe myocardial infarctions than non-users (Col et al, 1995). Daily doses as low as 30 mg can protect against recurrent myocardial infarction; the lower dose may actually be superior to higher doses because it does not inhibit cardioprotective prostacyclin synthesis (Forster, 1995). Aspirin can be used prophlactically for venous thromboembolism.
- Aspirin-induced asthma can be prevented experimentally by inhalation of prostaglandin E(2) prior to the aspirin challenge (Szczeklik et al, 1996; Sestini et al, 1996). This is not currently recommended for routine clinical use.
-MEDICAL TREATMENT
LIFE SUPPORT
- Support respiratory and cardiovascular function.
SUMMARY
- FIRST AID - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
Move victim to fresh air. Call 911 or emergency medical service. Give artificial respiration if victim is not breathing. Do not use mouth-to-mouth method if victim ingested or inhaled the substance; give artificial respiration with the aid of a pocket mask equipped with a one-way valve or other proper respiratory medical device. Administer oxygen if breathing is difficult. Remove and isolate contaminated clothing and shoes. In case of contact with substance, immediately flush skin or eyes with running water for at least 20 minutes. For minor skin contact, avoid spreading material on unaffected skin. Keep victim warm and quiet. Effects of exposure (inhalation, ingestion or skin contact) to substance may be delayed. Ensure that medical personnel are aware of the material(s) involved and take precautions to protect themselves.
FIRST AID EYE EXPOSURE - Immediately wash the eyes with large amounts of water, occasionally lifting the lower and upper lids. Get medical attention immediately. Contact lenses should not be worn when working with this chemical. DERMAL EXPOSURE - Wash the contaminated skin with soap and water. INHALATION EXPOSURE - Move the exposed person to fresh air at once. If breathing has stopped, perform artificial respiration. Keep the affected person warm and at rest. Get medical attention as soon as possible. ORAL EXPOSURE - If this chemical has been swallowed, get medical attention immediately. TARGET ORGANS - Eyes, skin, respiratory system, blood, liver, and kidney (National Institute for Occupational Safety and Health, 2007).
GENERAL Move victims of inhalation exposure from the toxic environment and administer 100% humidified supplemental oxygen with assisted ventilation as required. Exposed skin and eyes should be copiously flushed with water. Because of the potential for rapid onset of CNS depression or seizures with possible aspiration of gastric contents, EMESIS SHOULD NOT BE INDUCED. Cautious gastric lavage followed by administration of activated charcoal may be of benefit if the patient is seen soon after the exposure.
INHALATION EXPOSURE INHALATION: Move patient to fresh air. Monitor for respiratory distress. If cough or difficulty breathing develops, evaluate for respiratory tract irritation, bronchitis, or pneumonitis. Administer oxygen and assist ventilation as required. Treat bronchospasm with an inhaled beta2-adrenergic agonist. Consider systemic corticosteroids in patients with significant bronchospasm. If bronchospasm and wheezing occur, consider treatment with inhaled sympathomimetic agents. ACUTE LUNG INJURY: Maintain ventilation and oxygenation and evaluate with frequent arterial blood gases and/or pulse oximetry monitoring. Early use of PEEP and mechanical ventilation may be needed.
DERMAL EXPOSURE DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999). Treat dermal irritation or burns with standard topical therapy. Patients developing dermal hypersensitivity reactions may require treatment with systemic or topical corticosteroids or antihistamines.
EYE EXPOSURE DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.
ORAL EXPOSURE Because of the potential for gastrointestinal tract irritation and CNS depression do not induce emesis. Significant esophageal or gastrointestinal tract irritation or burns may occur following ingestion. The possible benefit of early removal of some ingested material by cautious gastric lavage must be weighed against potential complications of bleeding or perforation. GASTRIC LAVAGE: Consider after ingestion of a potentially life-threatening amount of poison if it can be performed soon after ingestion (generally within 1 hour). Protect airway by placement in the head down left lateral decubitus position or by endotracheal intubation. Control any seizures first. ACTIVATED CHARCOAL: Administer charcoal as a slurry (240 mL water/30 g charcoal). Usual dose: 25 to 100 g in adults/adolescents, 25 to 50 g in children (1 to 12 years), and 1 g/kg in infants less than 1 year old. SEIZURES: Administer a benzodiazepine; DIAZEPAM (ADULT: 5 to 10 mg IV initially; repeat every 5 to 20 minutes as needed. CHILD: 0.1 to 0.5 mg/kg IV over 2 to 5 minutes; up to a maximum of 10 mg/dose. May repeat dose every 5 to 10 minutes as needed) or LORAZEPAM (ADULT: 2 to 4 mg IV initially; repeat every 5 to 10 minutes as needed, if seizures persist. CHILD: 0.05 to 0.1 mg/kg IV over 2 to 5 minutes, up to a maximum of 4 mg/dose; may repeat in 5 to 15 minutes as needed, if seizures continue). Consider phenobarbital or propofol if seizures recur after diazepam 30 mg (adults) or 10 mg (children greater than 5 years). Monitor for hypotension, dysrhythmias, respiratory depression, and need for endotracheal intubation. Evaluate for hypoglycemia, electrolyte disturbances, and hypoxia.
ACUTE LUNG INJURY: Maintain ventilation and oxygenation and evaluate with frequent arterial blood gases and/or pulse oximetry monitoring. Early use of PEEP and mechanical ventilation may be needed. Observe patients with ingestion carefully for the possible development of esophageal or gastrointestinal tract irritation or burns. If signs or symptoms of esophageal irritation or burns are present, consider endoscopy to determine the extent of injury.
-RANGE OF TOXICITY
MINIMUM LETHAL EXPOSURE
A 10 g dose may be fatal (Lewis, 2000; Lewis, 1997). A lethal dose, for a non-allergic adult, is likely in the range of 25-30 g (HSDB , 2001).
MAXIMUM TOLERATED EXPOSURE
In humans, the lowest dose which is reported to have any pharmacologic toxic effect is 150 mg. However, this does not take into account the fact that some portion of the population is allergic to acetylsalicylic acid; susceptible persons can have anaphylactic reactions after ingestion of very small doses. This is especially the case in children and asthmatics (ACGIH, 1991; (HSDB , 2001; Lewis, 1998; Lewis, 1997).
- Carcinogenicity Ratings for CAS50-78-2 :
ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed ; Listed as: Acetylsalicylic acid (Aspirin) EPA (U.S. Environmental Protection Agency, 2011): Not Listed IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed ; Listed as: Acetylsalicyclic acid MAK (DFG, 2002): Not Listed NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed
TOXICITY AND RISK ASSESSMENT VALUES
- EPA Risk Assessment Values for CAS50-78-2 (U.S. Environmental Protection Agency, 2011):
References: (ACGIH, 1991; Budavari, 2000 HSDB, 2001 Lewis, 2000 RTECS, 2001 LD50- (INTRAVENOUS)DOG: LD50- (ORAL)DOG: LD50- (ORAL)GUINEA_PIG: LD50- (ORAL)HAMSTER: LD50- (INTRAPERITONEAL)MOUSE: 167 mg/kg 280 mg/kg (Lewis, 2000)
LD50- (ORAL)MOUSE: LD50- (SUBCUTANEOUS)MOUSE: LD50- (INTRAPERITONEAL)RABBIT: LD50- (ORAL)RABBIT: LD50- (INTRAPERITONEAL)RAT: LD50- (ORAL)RAT: LD50- (RECTAL)RAT: LDLo- (ORAL)HUMAN: TCLo- (INHALATION)RAT: TDLo- (ORAL)CAT: TDLo- (ORAL)DOG: TDLo- (ORAL)HUMAN: 669 mg/kg for 11D -- liver affected 2880 mg/kg for 8W -- sense organs affected, nausea or vomiting, and constipation 480 mg/kg for 7D-intermittent -- tinnitus, depressed activity, and gastrointestinal changes 1050 mg/kg for 14D- intermittent -- vascular changes Child, 10 mg/kg for 1D- intermittent -- pulmonary edema; tubules changes; decreased urine volume Child, 39 mg/kg for 13D- intermittent -- liver effects Infant, 120 mg/kg -- respiratory stimulation, hematuria, and dehydration Female, 525 mg/kg for 5D- intermittent -- liver effects Female, 480 mg/kg for 5D- intermittent -- tubules changes and other biochemical changes Female, 17,280 mg/kg at 1-39W of pregnancy -- circulatory and respiratory system abnormalities; apgar score effected Female, 800 mg/kg -- tubules changes and musculoskeletal changes Female, 7500 mg/kg at 34-37W of pregnancy -- maternal effects; stillborn Female, 546 mg/kg at 37-39W of pregnancy -- postnatal effects on newborn; CNS, craniofacial, and other changes Female, 700 mg/kg at 35-36W of pregnancy -- CNS and circulatory system abnormalities; biochemical and metabolic effects on newborn Female, 17,550 mg/kg at 12-39W of pregnancy -- parturition Female, 100 mg/kg at 37W of pregnancy -- neonatal effects Female, 189 mg/kg at 12-39W of pregnancy -- parturition; fetotoxicity; blood and lymphatic system abnormalities Male, 857 mg/kg -- coma, respiratory stimulation Male, 1625 mg/kg -- coma, increased body temperature Male, 13,036 mg/kg for 5Y- intermittent -- gastrointestinal, joint, and skin changes
TDLo- (RECTAL)HUMAN: TDLo- (ORAL)MOUSE: Female, 800 mg/kg at 17D of pregnancy -- fetal death; embryo effects; other developmental abnormalities Female, 1200 mg/kg at 8-9D of pregnancy -- post-implantation mortality; craniofacial abnormalities Female, 19,200 mg/kg at 6-21D of pregnancy -- stillbirth; other neonatal effects Female, 2500 mg/kg at 6-15D of pregnancy -- fetotxicity (except death); musculoskeletal abnormalities
TDLo- (ORAL)RABBIT: Female, 800 mg/kg at 8-15D of pregnancy -- developmental abnormalities Female, 600 mg/kg at 2D prior to mating -- effects on fertility Female, 1750 mg/kg at 6-12D of pregnancy -- fetotoxicity (except death) Female, 1800 mg/kg at 8-16D of pregnancy -- developmental abnormalities; fetal death
TDLo- (INTRAPERITONEAL)RAT: TDLo- (INTRAUTERINE)RAT: TDLo- (ORAL)RAT: 8127 mg/kg for 43W-continuous -- changes in urine composition 9500 mg/kg for 3W-intermittent -- death 200 mg/kg for 4D-intermittent -- gastrointestinal changes Female, 500 mg/kg at 9D of pregnancy -- fetal death; CNS, eye, ear, and musculoskeletal development abnormalities Female, 10 mg/kg at 22D of pregnancy -- parturition; stillbirth; live birth index effects Female, 1 g/kg at 12D of pregnancy -- post-implantation mortality; fetal death Female, 200 mg/kg at 9D of pregnancy -- fetotoxicity (except death) Female, 125 mg/kg at 12D of pregnancy -- musculoskeletal abnormalities Female, 1 g/kg at 3D of pregnancy -- post-implantation mortality Male, 2100 mg/kg at 14D prior to mating -- effects on testes, epididymis, sperm duct
TDLo- (SUBCUTANEOUS)RAT: Female, 380 mg/kg at 9D of pregnancy -- fertility effects; fetotoxicity (except death); developmental abnormalities Female, 300 mg/kg at 1D prior to mating -- effects on fertility Female, 500 mg/kg at 11D of pregnancy -- musculosketal abnormalities; post- implantation mortality; fetal death; extra embryonic structures; fetotoxicity (except death); craniofacial abnormalities Male, 1800 mg/kg at 12D prior to mating -- spermatogenesis; testes, epididymus, and sperm duct effects
-STANDARDS AND LABELS
WORKPLACE STANDARDS
- ACGIH TLV Values for CAS50-78-2 (American Conference of Governmental Industrial Hygienists, 2010):
Editor's Note: The listed values are recommendations or guidelines developed by ACGIH(R) to assist in the control of health hazards. They should only be used, interpreted and applied by individuals trained in industrial hygiene. Before applying these values, it is imperative to read the introduction to each section in the current TLVs(R) and BEI(R) Book and become familiar with the constraints and limitations to their use. Always consult the Documentation of the TLVs(R) and BEIs(R) before applying these recommendations and guidelines.
- AIHA WEEL Values for CAS50-78-2 (AIHA, 2006):
- NIOSH REL and IDLH Values for CAS50-78-2 (National Institute for Occupational Safety and Health, 2007):
- OSHA PEL Values for CAS50-78-2 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):
- OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS50-78-2 (U.S. Occupational Safety and Health Administration, 2010):
ENVIRONMENTAL STANDARDS
- EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS50-78-2 (U.S. Environmental Protection Agency, 2010):
- EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS50-78-2 (U.S. Environmental Protection Agency, 2010):
- EPA RCRA Hazardous Waste Number for CAS50-78-2 (U.S. Environmental Protection Agency, 2010b):
- EPA SARA Title III, Extremely Hazardous Substance List for CAS50-78-2 (U.S. Environmental Protection Agency, 2010):
- EPA SARA Title III, Community Right-to-Know for CAS50-78-2 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):
- DOT List of Marine Pollutants for CAS50-78-2 (49 CFR 172.101 - App. B, 2005):
- EPA TSCA Inventory for CAS50-78-2 (EPA, 2005):
SHIPPING REGULATIONS
- DOT -- Table of Hazardous Materials and Special Provisions (49 CFR 172.101, 2005):
- ICAO International Shipping Name (ICAO, 2002):
LABELS
- NFPA Hazard Ratings for CAS50-78-2 (NFPA, 2002):
-HANDLING AND STORAGE
SUMMARY
STORAGE
Containers should have child resistant caps, and they should hold not more than 36 tablets, each containing 81 mg of the drug (HSDB , 2001).
- ROOM/CABINET RECOMMENDATIONS
Aspirin suppositories need to stored at temperatures between 2-15 degrees C (HSDB , 2001). Store acetylsalilcylic acid in dry areas in ambient temperatures (NTP & 2001, 2001).
Keep acetylsalicylic acid away from water or moist air; it is hydrolyzed into salicylic acid and acetic acids. It is stable in dry air (HSDB , 2001). This compound is incompatible with oxidizers, strong acids and strong bases. It may react with water or nucleophiles, such as amines and hydroxy groups (NTP & 2001, 2001).
-PERSONAL PROTECTION
SUMMARY
- RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
Wear positive pressure self-contained breathing apparatus (SCBA). Wear chemical protective clothing that is specifically recommended by the manufacturer. It may provide little or no thermal protection. Structural firefighters' protective clothing provides limited protection in fire situations ONLY; it is not effective in spill situations where direct contact with the substance is possible.
- Appropriate protective clothing should be worn to prevent skin contact. If skin contact occurs, washing should be done immediately. There is no recommendation for workers to remove contaminated or wet clothing. Workers should change into uncontaminated clothing before leaving the job site (NIOSH, 2001).
EYE/FACE PROTECTION
- Use appropriate eye protection to prevent contact with this substance. In areas where there is any possibility that persons may be exposed to acetylsalicylic acid, eyewash fountains should be provided (NIOSH, 2001).
RESPIRATORY PROTECTION
- Refer to "Recommendations for respirator selection" in the NIOSH Pocket Guide to Chemical Hazards on TOMES Plus(R) for respirator information.
PROTECTIVE CLOTHING
- CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 50-78-2.
ENGINEERING CONTROLS
- Facilities for quickly drenching the body or body parts with water should be provided within the immediate work area. Water flow must be sufficient to quickly remove acetylsalicylic acid from any body areas likely to be exposed. Depending on the specific circumstances, a hose connected to a sink may be permissible or a full deluge shower may be required (NIOSH, 2001).
-PHYSICAL HAZARDS
FIRE HAZARD
Editor's Note: This material is not listed in the Emergency Response Guidebook. Based on the material's physical and chemical properties, toxicity, or chemical group, a guide has been assigned. For additional technical information, contact one of the emergency response telephone numbers listed under Public Safety Measures. POTENTIAL FIRE OR EXPLOSION HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004) Non-combustible, substance itself does not burn but may decompose upon heating to produce corrosive and/or toxic fumes. Some are oxidizers and may ignite combustibles (wood, paper, oil, clothing, etc.). Contact with metals may evolve flammable hydrogen gas. Containers may explode when heated.
It is combustible when exposed to open flame or heat (Lewis, 2000). Acetylsalicylic acid dust presents an explosion hazard if dispersed in air (Lewis, 1997; NIOSH, 2001).
- FLAMMABILITY CLASSIFICATION
- NFPA Flammability Rating for CAS50-78-2 (NFPA, 2002):
- FIRE CONTROL/EXTINGUISHING AGENTS
- SMALL FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
- LARGE FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
Dry chemical, CO2, alcohol-resistant foam or water spray. Move containers from fire area if you can do it without risk. Dike fire control water for later disposal; do not scatter the material.
- TANK OR CAR/TRAILER LOAD FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
Fight fire from maximum distance or use unmanned hose holders or monitor nozzles. Do not get water inside containers. Cool containers with flooding quantities of water until well after fire is out. Withdraw immediately in case of rising sound from venting safety devices or discoloration of tank. ALWAYS stay away from tanks engulfed in fire.
- NFPA Extinguishing Methods for CAS50-78-2 (NFPA, 2002):
- Halon, carbon dioxide, water, and dry chemical extinguishers can be used to control acetylsalicylic acid fires (NTP & 2001, 2001).
EXPLOSION HAZARD
- Acetylsalicylic acid dust presents an explosion hazard if dispersed in air (Lewis, 1997; NIOSH, 2001).
DUST/VAPOR HAZARD
- This compound emits acrid fumes and smoke when heated to decomposition (Lewis, 2000).
- Acetylsalicylic acid dust dispersed in the air can be a serious explosion risk (Lewis, 1997).
REACTIVITY HAZARD
- Acetylsalicylic acid is incompatible with the following compounds(Budavari, 2000; Lewis, 1997; NIOSH, 2001; NTP & 2001, 2001):
- On contact with moisture this compound develops an acetic acid-like (vinegar-like) odor. It slowly hydrolyzes in the presence of moisture to SALICYLIC ACID and ACETIC ACID. It is stable in dry air (Budavari, 2000; Lewis, 1997; NIOSH, 2001).
- It emits acrid fumes and smoke when heated to decomposition (Lewis, 2000).
EVACUATION PROCEDURES
- Editor's Note: This material is not listed in the Table of Initial Isolation and Protective Action Distances.
- SPILL - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
Increase, in the downwind direction, as necessary, the isolation distance of at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids in all directions.
- FIRE - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
If tank, rail car or tank truck is involved in a fire, ISOLATE for 800 meters (1/2 mile) in all directions; also, consider initial evacuation for 800 meters (1/2 mile) in all directions.
- PUBLIC SAFETY MEASURES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004)
CALL Emergency Response Telephone Number on Shipping Paper first. If Shipping Paper not available or no answer, refer to appropriate telephone number: MEXICO: SETIQ: 01-800-00-214-00 in the Mexican Republic; For calls originating in Mexico City and the Metropolitan Area: 5559-1588; For calls originating elsewhere, call: 011-52-555-559-1588.
CENACOM: 01-800-00-413-00 in the Mexican Republic; For calls originating in Mexico City and the Metropolitan Area: 5550-1496, 5550-1552, 5550-1485, or 5550-4885; For calls originating elsewhere, call: 011-52-555-550-1496, or 011-52-555-550-1552; 011-52-555-550-1485, or 011-52-555-550-4885.
ARGENTINA: CIQUIME: 0-800-222-2933 in the Republic of Argentina; For calls originating elsewhere, call: +54-11-4613-1100.
BRAZIL: PRÓ-QUÍMICA: 0-800-118270 (Toll-free in Brazil); For calls originating elsewhere, call: +55-11-232-1144 (Collect calls are accepted).
COLUMBIA: CISPROQUIM: 01-800-091-6012 in Colombia; For calls originating in Bogotá, Colombia, call: 288-6012; For calls originating elsewhere, call: 011-57-1-288-6012.
CANADA: UNITED STATES:
For additional details see the section entitled "WHO TO CALL FOR ASSISTANCE" under the ERG Instructions. As an immediate precautionary measure, isolate spill or leak area in all directions for at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids. Keep unauthorized personnel away. Stay upwind. Keep out of low areas. Ventilate enclosed areas.
- AIHA ERPG Values for CAS50-78-2 (AIHA, 2006):
- DOE TEEL Values for CAS50-78-2 (U.S. Department of Energy, Office of Emergency Management, 2010):
- AEGL Values for CAS50-78-2 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):
- NIOSH IDLH Values for CAS50-78-2 (National Institute for Occupational Safety and Health, 2007):
CONTAINMENT/WASTE TREATMENT OPTIONS
SPILL OR LEAK PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004) ELIMINATE all ignition sources (no smoking, flares, sparks or flames in immediate area). Do not touch damaged containers or spilled material unless wearing appropriate protective clothing. Stop leak if you can do it without risk. Prevent entry into waterways, sewers, basements or confined areas. Absorb or cover with dry earth, sand or other non-combustible material and transfer to containers. DO NOT GET WATER INSIDE CONTAINERS.
RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 154 (ERG, 2004) Wear positive pressure self-contained breathing apparatus (SCBA). Wear chemical protective clothing that is specifically recommended by the manufacturer. It may provide little or no thermal protection. Structural firefighters' protective clothing provides limited protection in fire situations ONLY; it is not effective in spill situations where direct contact with the substance is possible.
Dampen a solid spill with 60-70% ethanol to avoid airborne dust. Scoop the material into an appropriate container for disposal and use paper towels dampen with 60-70% ethanol to pick up any left over material. Seal the contaminated paper towels in an air-tight plastic bag along with any contaminated clothes for disposal (NTP & 2001, 2001) Sittig, 1991). Use 60-70% ethanol to wash down the spill area. Follow up with a washing of soap and water (NTP & 2001, 2001).
Dampen a solid spill with 60-70% ethanol to avoid airborne dust. Scoop the material into an appropriate container for disposal and use paper towels dampened with 60-70% ethanol to pick up any left over material. Seal the contaminated paper towels in an air-tight plastic bag along with any contaminated clothes for disposal (NTP & 2001, 2001) Sittig, 1991). Use 60-70% ethanol to wash down the spill area. Follow up with a washing of soap and water (NTP & 2001, 2001).
-ENVIRONMENTAL HAZARD MANAGEMENT
POLLUTION HAZARD
- Acetylsalicylic acid may be released to the environment via effluents at locations where it is produced and used (HSDB, 2004).
ENVIRONMENTAL FATE AND KINETICS
In ambient air, this compound is expected to exist in particulate and vapor form. The vapor is likely to react with photochemically produced hydroxyl radicals; estimated half-life of 19.8 days. Due to its water solubility, wet deposition / precipitation may remove some acetylsalicylic acid from the air (HSDB, 2004). In air at 25 degrees C, the rate constant for the reaction of photochemically produced hydroxyl radicals with acetylsalicyclic acid is estimated to be 8.10 x 10(-13) cm(3)/molecules/cm(3) (HSDB, 2004).
SURFACE WATER Hydrolysis is thought to be a very significant process: Half-lives in water at 17 degrees C have ranged from 1.2 hours to 12.5 days for pHs 3.5-11.3. Based on data for SALICYLIC ACID, acetylsalicylic acid may undergo photochemical degradation (HSDB, 2004). Henry's Law Constant of 1.30 x 10(-9) atm-cu m/mole at 25 degrees C suggests that volatilization from natural bodies of water is not an important fate process (HSDB, 2004). The potential for acetylsalicylic acid to partition from the water column to organic matter in sediments and suspended solids is low (HSDB, 2004). Limited aqueous screening tests indicate the potential for biodegradation following acclimation under anaerobic conditions (HSDB, 2004). Photooxidation may occur in natural sunlit surface waters (HSDB, 2004). Acetylsalicyclic acid is almost completely hydrolyzed within a week in a saturated aqueous solution at 25 degrees C and pH 5-7 (HSDB, 2004). The half-lives of acetylsalicyclic acid in water at 17 degrees C and pHs 3.5, 5.0, 7.4, 9.5, and 11.3 were 12.5 days, 5.4 days, 6.3 days, 2.2 days, and 1.2 hours, respectively (HSDB, 2004). Following the OECD procedure, the hydrolysis rate constants in water at 17 degrees C and pHs at 3.5, 5.0, 7.4, 9.5, and 11.3 were 6.5 x 10(-7)/sec, 1.5 x 10(-6)/sec, 1.3 x 10(-6)/sec, 3.7 x 10(-6)/sec, and 1.6 x 10(-4)/sec, respectively (HSDB, 2004).
TERRESTRIAL Soil pH may influence the form of acetylsalicyclic acid. Above pH 5.5, it will exist as the acetylsalicylate ion and is not expected to significantly volatilize, adsorb, or bioconcentrate (HSDB, 2004). Acetylsalicylic acid is expected to be highly mobile in soil. Biodegradation is possible under anaerobic conditions, based on aqueous screening tests (HSDB, 2004). Photochemical data in water suggests it may photochemically degrade in sunlit surface soil (HSDB, 2004).
ABIOTIC DEGRADATION
- Environmental pH influences the form and environmental fate of acetylsalicylic acid. Hydrolysis is expected to be an important fate process. Particulate or vapor forms can exist in the atmosphere. Vapors react with photochemically produced hydroxyl radicals. Atmospheric removal also occurs from rain washout (wet deposition). It is highly mobile in soil. Volatilization and adsorption are not significant for acetylsalicyclic acid. It will undergo photooxidation in surface water and soil exposed to sunlight. Photodegradation is likely based on data for salicyclic acid. Anaerobic conditions may allow biodegradation (HSDB, 2004).
- At pH greater than 5.5, almost all acetylsalicylic acid will exist as the acetylsalicylate ion. In this form, the compound is not expected to significantly volatilize, adsorb, or bioconcentrate (HSDB, 2004).
BIODEGRADATION
- Based on limited aqueous screening tests, this compound is thought to biodegrade upon acclimation under anaerobic conditions (HSDB, 2004).
BIOACCUMULATION
-PHYSICAL/CHEMICAL PROPERTIES
MOLECULAR WEIGHT
DESCRIPTION/PHYSICAL STATE
- Acetylsalicylic acid exists a colorless to white needles or crystalline powder. This compound is odorless and has a slightly bitter taste (ACGIH, 1991; (Budavari, 2000; Lewis, 1997; NTP & 2001, 2001) Sittig, 1991).
- Under normal conditions, when acetylsalicylic acid is mixed with acetone it remains stable for 24 hours. The pH for maximum stability is 2-3; urea increases stability above pH of 2.75. Solubility increases by the addition of polysorbates and urea (NTP & 2001, 2001).
- It is stable in dry air, and moisture causes acetylsalicylic acid to hydrolyze and give off an acetic acid odor. In boiling water, acetylsalicylic acid decomposes (Budavari, 2000) Sittig, 1991).
- Acetylsalicyclic acid is stable at pH 2-3, less stable at pH 4-8, and the least stable at pH greater than 8 or less than 2 (HSDB , 2001).
PH
- "With a pKa of 3.49, acetylsalicylic acid and its conjugate base, the acetylsalicylate ion, will occur in varying proportions which are pH dependent. Above pH 5.5, virtually all acetylsalicylic acid will exist as the acetylsalicylate ion" (HSDB , 2001).
VAPOR PRESSURE
- 2.52x10(-5) mmHg (at 25 degrees C) (calculated) (HSDB , 2001)
- approximately 0 mmHg (NIOSH, 2001)
SPECIFIC GRAVITY
- TEMPERATURE AND/OR PRESSURE NOT LISTED
1.35 (NIOSH, 2001) 1.40 (NTP & 2001, 2001)
DENSITY
- TEMPERATURE AND/OR PRESSURE NOT LISTED
1.40 g/mL (Budavari, 2000) 1.35 g/mL (NTP & 2001, 2001)
FREEZING/MELTING POINT
Molten acetylsalicylic acid solidifies at 118 degrees C (Budavari, 2000; Lewis, 2000) 118 degrees C (NTP & 2001, 2001)
135 degrees C (rapid heating) (Budavari, 2000; Lewis, 2000; NTP & 2001, 2001; Sittig, 1991) 132-136 degrees C (ACGIH, 1991; Lewis, 1997) 275 degrees F (NIOSH, 2001)
BOILING POINT
- 140 degrees C (decomposes) (ACGIH, 1991; (Lewis, 1997; NTP & 2001, 2001)
- 284 degrees F (decomposes) (NIOSH, 2001)
FLASH POINT
- 250 degrees C; 482 degrees F (NTP & 2001, 2001)
EXPLOSIVE LIMITS
SOLUBILITY
1 g in 100 mL (at 37 degrees C) (Budavari, 2000; NIOSH , 1996) 1 g in 300 mL (at 25 degrees C) (Budavari, 2000) 4600 mg/L (at 25 degrees C) (HSDB , 2001) 0.3% (at 77 degrees F) (Lewis, 1994; NIOSH, 2001) 1% (at 77 degrees C) (Lewis, 2000) <1 mg/mL (at 23 degrees C) (NTP & 2001, 2001)
Acetone: >=100 mg/mL (at 23 degrees C) (NTP & 2001, 2001) Alcohol: 1 g/5 mL (Budavari, 2000; NTP & 2001, 2001) Alkali hydroxide solutions: dissolves with decomposition (NTP & 2001, 2001) Benzene: 0.0033 g/mL (NTP & 2001, 2001) Carbonate solutions: dissolves with decompostion (NTP & 2001, 2001) Carbon Tetrachloride: 0.0004 g/mL (NTP & 2001, 2001) Chloroform: 1 g/17 mL (Budavari, 2000; NTP & 2001, 2001) Citrates: soluble (NTP & 2001, 2001) Ethanol: Absolute: soluble (NTP & 2001, 2001) 95%: >=100 mg/mL (at 23 degrees C) (NTP & 2001, 2001)
Ether: 5% soluble (at 20 degrees C) (Lewis, 2000) 1 g/10-15 mL (Budavari, 2000) 0.1-0.2 g/mL (NTP & 2001, 2001) Less soluble in anhydrous ether (Budavari, 2000) Petroleum ether: Insoluble (NTP & 2001, 2001)
DMSO: >=100 mg/mL (at 23 degrees C) (NTP & 2001, 2001) Solutions of acetates: soluble (NTP & 2001, 2001)
OCTANOL/WATER PARTITION COEFFICIENT
- log Kow = 1.19 (HSDB , 2001)
HENRY'S CONSTANT
- 1.30x10(-9) atm-m(3)/mol (at 25 degrees C) (calculated) (HSDB , 2001)
SPECTRAL CONSTANTS
25 (Sadtler Research Laboratories Spectral Collection) (HSDB , 2001) 229 nm (E1%, cm=484) (in 0.1 N H2SO4) (Budavari, 2000; NTP & 2001, 2001) 277 nm (E1%, cm=68) (in chloroform) (Budavari, 2000; NTP & 2001, 2001) 229 nm (E1%, cm=434) (in 0.1 N HCl) (NTP & 2001, 2001) 278 nm (E1%, cm=65) (in 0.1 N HCl) (NTP & 2001, 2001) 226 nm (E1%, cm=411) (in 95% alcohol) (NTP & 2001, 2001) 278 nm (E1%, cm=58) (in 95% alcohol) (NTP & 2001, 2001)
OTHER/PHYSICAL
- NUCLEAR MAGNETIC RESONANCE
-REFERENCES
GENERAL BIBLIOGRAPHY- 40 CFR 372.28: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Lower thresholds for chemicals of special concern. National Archives and Records Administration (NARA) and the Government Printing Office (GPO). Washington, DC. Final rules current as of Apr 3, 2006.
- 40 CFR 372.65: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Chemicals and Chemical Categories to which this part applies. National Archives and Records Association (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Apr 3, 2006.
- 49 CFR 172.101 - App. B: Department of Transportation - Table of Hazardous Materials, Appendix B: List of Marine Pollutants. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 29, 2005.
- 49 CFR 172.101: Department of Transportation - Table of Hazardous Materials. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 11, 2005.
- 62 FR 58840: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 1997.
- 65 FR 14186: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.
- 65 FR 39264: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.
- 65 FR 77866: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.
- 66 FR 21940: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2001.
- 67 FR 7164: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2002.
- 68 FR 42710: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2003.
- 69 FR 54144: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2004.
- ACGIH: Documentation of the Threshold Limit Value and Biological Exposure Indices, 6th ed, Am Conference of Govt Ind Hyg, Inc, Cincinnati, OH, 1991.
- AIHA: 2006 Emergency Response Planning Guidelines and Workplace Environmental Exposure Level Guides Handbook, American Industrial Hygiene Association, Fairfax, VA, 2006.
- Abdel-Magid EH & Ahmed FR: Salicylate intoxication in an infant with ichthyosis transmitted through skin ointment - a case report. Pediatrics 1993; 94:939-940.
- Adelman HM, Wallach PM, & Flannery MT: Inability to interpret toxic salicylate levels in patients taking aspirin and diflunisal. J Rheumatol 1991; 18:522-523.
- Ahlfors CE, Shwer Ml, & Ford KB: Bilirubin-albumin binding in neonatal salicylate intoxication. Dev Pharmacol Ther 1982; 4:47-60.
- American Conference of Governmental Industrial Hygienists : ACGIH 2010 Threshold Limit Values (TLVs(R)) for Chemical Substances and Physical Agents and Biological Exposure Indices (BEIs(R)), American Conference of Governmental Industrial Hygienists, Cincinnati, OH, 2010.
- Andersen R & Refstad S: Adult respiratory distress syndrome precipitated by massive salicylate poisoning. Intens Care Med 1978; 4:211-213.
- Anderson JAR & Ead RD: Percutaneous salicylate poisoning. Clin Exp Dermatol 1979; 4:349-351.
- Anderson PO: Drugs and breast feeding - a review. Drug Intell Clin Pharm 1977; 11:208.
- Anderson RJ, Potts DE, & Gabow PA: Unrecognized adult salicylate intoxication. Ann Intern Med 1976; 85:745-748.
- Arena PA, Dugowson C, & Saudek CD: Salicylate-induced hypoglycemia and ketoacidosis in a nondiabetic adult. Arch Intern Med 1978; 138:1153-1154.
- Aspinall JB & Goel KM: Salicylate poisoning in dermatological therapy (Letter). Br Med J 1978; 1373.
- Atallah AN, Collins R, & Farrell B: ECPPA - randomised trial of low dose aspirin for the prevention of maternal and fetal complications in high risk pregnant women. Br J Obstet Gynaecol 1996; 103:39-47.
- Bailey RB & Jones SR: Chronic salicylate intoxication: a common cause of morbidity in the elderly. J Am Geriatr Soc 1989; 37:556-561.
- Baker H: Intermittent high dose oral methotrexate therapy in psoriasis. Br J Dermatol 1970; 82:65.
- Barrett MJ: Association of Reye's syndrome with use of Pepto-Bismol(R) (bismuth subsalicylate). Pediatr Infect Dis 1986; 5:610-611.
- Benawra R, Mangurten HH, & Duffell DR: Cyclopia and other anomalies following maternal ingestion of salicylates. J Pediatr 1980; 96:1069-1071.
- Benedek IH, Joshi AS, & Pieniaszek HJ: Variability in the pharmacokinetics and pharmacodynamics of low dose aspirin in healthy male volunteers. J Clin Pharmacol 1995; 35:1181-1186.
- Bernstein JM & Weiss AD: Further observations on salicylate ototoxicity. J Laryngol Otol 1967; 81:915-925.
- Blanca M, Perez E, & Garcia JJ: Angioedema and IgE antibodies to aspirin: a case report. Ann Allergy 1989; 62:295-298.
- Bove KE, Bhathena D, & Wyatt RJ: Diffuse metanephric adenoma after in utero aspirin intoxication. Arch Pathol Lab Med 1979; 103:187-190.
- Brem J, Pereli EM, & Gopalan SK: Salicylism, hyperventilation, and the central nervous system. J Pediatr 1973; 83:264-266.
- Briggs GG, Freeman RK, & Yaffe SJ: Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 4th ed, Williams & Wilkins, Baltimore, MD, 1994, pp 65a-73a.
- Briggs GG, Freeman RK, & Yaffe SJ: Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 5th ed, Williams & Wilkins, Baltimore, MD, 1998, pp 73-81.
- Brown GL & Wilson WP: Salicylate intoxication and the CNS: with special reference to EEG findings. Dis Nerv Sys 1971; 135-140.
- Buchanan N & Rabinowitz L: Infantile salicylism. A reappraisal. J Pediatr 1974; 84:391-395.
- Buck ML, Grebe TA, & Bond GR: Toxic reaction to salicylate in a newborn infant: similarities to neonatal sepsis. J Pediatr 1993; 122:955-958.
- Budavari S: The Merck Index, 11th ed, Merck & Co, Inc, Rahway, NJ, 1989.
- Budavari S: The Merck Index, 12th ed. on CD-ROM. Version 12:3a. Chapman & Hall/CRCnetBASE. Whitehouse Station, NJ. 2000.
- Burgess JL, Kirk M, Borron SW, et al: Emergency department hazardous materials protocol for contaminated patients. Ann Emerg Med 1999; 34(2):205-212.
- Bye A, Lewis Y, & O'Grady J: Effect of a single oral dose of aspirin on the platelet aggregation response to arachidonic acid. Br J Clin Pharmacol 1979; 7:283-286.
- Camasara JG, Lluch M, & Serra-Baldrich E: Allergic contact dermatitis from 3-(aminomethyl)-pyridyl salicylate. Contact Dermatitis 1989; 20:347-351.
- Cauthen WL & Hester WH: Accidental ingestion of oil of wintergreen. J Fam Pract 1989; 29:680-681.
- Cersosimo RJ & Matthews SJ: Hepatotoxicity associated with choline magnesium trisalicylate: case report and review of salicylate-induced hepatotoxicity. Drug Intell Clin Pharm 1987; 21:621-625.
- Chapman BJ & Proudfoot AT: Adult salicylate poisoning: deaths and outcome in patients with high plasma salicylate concentrations. Quart J Med 1989; 72:699-707.
- Christensen LA & Schmidt EB: Perforated peptic ulcer - a complication in acute salicylate intoxication. Acta Med Scand 1987; 222:191-192.
- Col NF, Yarzebski J, & Gore JM: Does aspirin consumption affect the presentation or severity of acute myocardial infarction. Arch Intern Med 1995; 155:1386-1389.
- Collins E: Maternal and fetal effects of acetaminophen and salicylates in pregnancy. Obstet Gynecol 1981; 58 (Suppl):57S-62S.
- Corby DG: Aspirin in pregnancy: maternal and fetal effects. Pediatrics 1978; 62(Suppl):930-937.
- DFG: List of MAK and BAT Values 2002, Report No. 38, Deutsche Forschungsgemeinschaft, Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area, Wiley-VCH, Weinheim, Federal Republic of Germany, 2002.
- Dabrigeon G, Blanc P, & Durand L: Cirrhosis and granulomatous hepatitis induced by long term administration of acetylsalicylic acid (French). Gastroenterol Clin Biol 1995; 19:944-947.
- Dadgar D, Climax J, & Lambe R: High-performance liquid chromatographic determination of certain salicylates and their major metabolites in plasma following topical administration of a liniment to healthy subjects. J Chromatogr 1985; 342:315-321.
- Damiani P, Ribone ME, & Ibanez G: Determination of three aspirin metabolites in human urine by derivative synchronous spectrofluorimetry. Analyst 1995; 120:443-445.
- Davies MG, Briffa DV, & Greaves MW: Systemic toxicity from topically applied salicylic acid. Br Med J 1979; 1:661.
- Davies NJ, Gazvani MR, & Farquharson RG: Low-dose aspirin in the prevention of hypertensive disorders of pregnancy in relatively low-risk nulliparous women. Hypertens Preg 1995; 14:49-55.
- Davis DP, Daston GP, & Odio MR: Maternal reproductive effects of oral salicylic acid in Sprague-Dawley rats. Toxicol Lett 1996; 84(3):135-141.
- Deykin D, Janson P, & McMahon L: Ethanol potentiation of aspirin induced prolongation of the bleeding time. N Engl J Med 1982; 306:852-854.
- Done AK: Salicylate intoxication: Significance of measurements of salicylates in blood in cases of acute ingestion. Pediatrics 1960; 26:800-807.
- Dove DJ & Jones T: Delayed coma associated with salicylate intoxication. J Pediatr 1982; 100:493-496.
- Dwyer CM, McCloskey RH, & Kerr REI: Poisoning from topical salicylic acid (Letter). Postgrad Med J 1994; 70:146.
- EPA: Search results for Toxic Substances Control Act (TSCA) Inventory Chemicals. US Environmental Protection Agency, Substance Registry System, U.S. EPA's Office of Pollution Prevention and Toxics. Washington, DC. 2005. Available from URL: http://www.epa.gov/srs/.
- ERG: Emergency Response Guidebook. A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/Hazardous Materials Incident, U.S. Department of Transportation, Research and Special Programs Administration, Washington, DC, 2004.
- Everson GW & Krenzelok EP: Chronic salicylism in a patient with juvenile rheumatoid arthritis. Clin Pharm 1986; 5:334-341.
- Farrell B, Heineman J, & Handoll H: Low dose aspirin in pregnancy and early childhood development - follow up of the collaborative low dose aspirin study in pregnancy. Br J Obstet Gynaecol 1995; 102:861-868.
- Findlay JWA, DeAngelis RL, & Kearney MF: Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther 1981; 29:625-633.
- Fiscina S: Death associated with aspirin overdose. Milit Med 1986; 151:499.
- Fisher CJ Jr, Albertson TE, & Foulke GE: Salicylate-induced pulmonary edema: clinical characteristics in children. Am J Emerg Med 1985; 3:33-37.
- Forster W: Prevention of reinfarction through 100 mg or 30 mg acetylsalicylic acid per day (German). Zeitschr Kardiol 1995; 84:335-343.
- Funkhouser EM & Sharp GB: Aspirin and reduced risk of esophageal carcinoma. Cancer 1995; 76:1116-1119.
- Gabow PA, Anderson RJ, & Potts DE: Acid-base disturbances in the salicylate-intoxicated adult. Arch Intern Med 1978; 138:1481-1484.
- Garrettson LK, Procknal JA, & Levy G: Fetal acquisition and neonatal elimination of a large amount of salicylate. Study of a neonate whose mother regularly took therapeutic doses of aspirin during pregnancy. Clin Pharmacol Ther 1975; 17:98-103.
- Gaudreault P, Temple AR, & Lovejoy FH: The relative severity of acute versus chronic salicylate poisoning in children: a clinical comparison. Pediatrics 1982; 70:566-569.
- Gilman AG, Rall TW, & Nies AS: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed, Pergamon Press, New York, NY, 1990.
- Giovannucci E, Egan KM, & Hunter DJ: Aspirin and the risk of colorectal cancer in women. New Engl J Med 1995; 333:609-614.
- Gittelman DK: Chronic salicylate intoxication. South Med J 1993; 86:683-685.
- Goldenberg RL, Hauth JC, & DuBard MB: Fetal growth in women using low-dose aspirin for the prevention of pre-eclampsia: effect of maternal size. J Matern Fetal Med 1995; 4:218-224.
- HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 10/31/2001; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 1996; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2004; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- Halla JT, Atchison SL, & Hardin JG: Symptomatic salicylate ototoxicity: a useful indicator of serum salicylate concentration?. Ann Rheum Dis 1991; 50:682-684.
- Hamdan JA, Manasra K, & Ahmed M: Salicylate-induced hepatitis in rheumatic fever. Am J Dis Child 1985; 139:453-455.
- Hamed MR, Al-Assy YS, & Ezzeldin E: Influence of protein malnutrition on teratogenicity of acetylsalicylic acid in rats. Human Exp Toxicol 1994; 13:83-88.
- Hansen JR, McCray PB, & Bale JF Jr: Reye syndrome associated with aspirin therapy for systemic lupus erythematosus. Pediatrics 1985; 76:202-205.
- Hauth JC, Goldenberg RL, & Parker CR: Low-dose aspirin - lack of association with an increase in abruptio placentae or perinatal mortality. Obstet Gynecol 1995; 85:1055-1058.
- Heffner JE & Sahn SA: Salicylate-induced pulmonary edema. Ann Intern Med 1981; 95:405-409.
- Heng MCY: Local necrosis and interstitial nephritis due to topical methyl salicylate and menthol. Cutis 1987; 39:442-444.
- Hertz-Picciotto I, Hopenhayn-Rich C, & Golub M: The risks and benefits of taking aspirin during pregnancy. Epidemiol Rev 1990; 12:108-148.
- Hirschowitz BI: Nonsteroidal anti-inflammatory drugs and the gut. South Med J 1996; 89:259-263.
- Hrnicek G, Skelton J, & Miller WC: Pulmonary edema and salicylate intoxication. JAMA 1974; 230:866-867.
- Hurwitz ES, Barrett MJ, & Bergman D: Public health service study on Reye's syndrome and medications: report of the pilot phase. N Engl J Med 1985; 313:849-856.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: 1,3-Butadiene, Ethylene Oxide and Vinyl Halides (Vinyl Fluoride, Vinyl Chloride and Vinyl Bromide), 97, International Agency for Research on Cancer, Lyon, France, 2008.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol, 88, International Agency for Research on Cancer, Lyon, France, 2006.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Household Use of Solid Fuels and High-temperature Frying, 95, International Agency for Research on Cancer, Lyon, France, 2010a.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines, 89, International Agency for Research on Cancer, Lyon, France, 2007.
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Some Non-heterocyclic Polycyclic Aromatic Hydrocarbons and Some Related Exposures, 92, International Agency for Research on Cancer, Lyon, France, 2010.
- IARC: List of all agents, mixtures and exposures evaluated to date - IARC Monographs: Overall Evaluations of Carcinogenicity to Humans, Volumes 1-88, 1972-PRESENT. World Health Organization, International Agency for Research on Cancer. Lyon, FranceAvailable from URL: http://monographs.iarc.fr/monoeval/crthall.html. As accessed Oct 07, 2004.
- ICAO: Technical Instructions for the Safe Transport of Dangerous Goods by Air, 2003-2004. International Civil Aviation Organization, Montreal, Quebec, Canada, 2002.
- International Agency for Research on Cancer (IARC): IARC monographs on the evaluation of carcinogenic risks to humans: list of classifications, volumes 1-116. International Agency for Research on Cancer (IARC). Lyon, France. 2016. Available from URL: http://monographs.iarc.fr/ENG/Classification/latest_classif.php. As accessed 2016-08-24.
- International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. World Health Organization. Geneva, Switzerland. 2015. Available from URL: http://monographs.iarc.fr/ENG/Classification/. As accessed 2015-08-06.
- Kanada SA, Kolling WM, & Hindin BI: Aspirin hepatotoxicity. Am J Hosp Pharm 1978; 35:330-336.
- Kearney TE: Salicylate poisoning: recognition and management. Emerg Med Services 1989; 18:39-43.
- Kees F, Jehnich D, & Grobecker H: Simultaneous determination of acetylsalicylic acid and salicylic acid in human plasma by high-performance liquid chromatography. J Chromatog B: Biomed Appl 1996; 677:172-177.
- Khera KS: Adverse effects in humans and animals of prenatal exposure to selected therapeutic drugs and estimation of embryo-fetal sensitivity of animals for human risk assessment. Issues Rev Teratol 1984; 2:399-507.
- Klebanoff MA & Berendes HW: Aspirin exposure during the first 20 weeks of gestation and IQ at four years of age. Teratology 1988; 37:249-255.
- Klein KL, Scott WJ, & Wilson JG: Aspirin-induced teratogenesis: A unique pattern of cell death and subsequent polydactyly in the rat. J Exp Zool 1981; 216:107-112.
- Kotwani A, Mehta VL, & Iyengar B: Aspirin by virtue of its acidic property may act as teratogen in early chick embryo. Indian J Physiol Pharmacol 1995; 39(2):131-134.
- Krause DS, Wolf BA, & Shaw LM: Acute aspirin overdose: mechanisms of toxicity. Ther Drug Monit 1992; 14:441-451.
- Leatherman JW & Schmitz PG: Fever, hyperdynamic shock, and multiple-system organ failure: a pseudo-sepsis syndrome associated with chronic salicylate intoxication. Chest 1991; 100:1391-1396.
- Leslie GI, Gallery EDM, & Arnold JD: Neonatal outcome in a randomized, controlled trial of low-dose aspirin in high-risk pregnancies. J Paediatr Child Health 1995; 31:549-552.
- Levy RI: Overwhelming salicylate intoxication in an adult. Arch Intern Med 1967; 119:399-402.
- Lewis RA: Lewis' Dictionary of Toxicology, Lewis Publishers, Boca Raton, FL, 1998.
- Lewis RJ: Hawley's Condensed Chemical Dictionary, 13th ed, John Wiley & Sons, Inc, New York, NY, 1997.
- Lewis RJ: Hawley's Condensed Chemical Dictionary, 13th ed, John Wiley & Sons, Inc, New York, NY, 1997a.
- Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 10th ed, Van Nostrand Reinhold Company, New York, NY, 2000.
- Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 9th ed, Van Nostrand Reinhold Company, New York, NY, 1994.
- Liebman RM & Katz HM: Pulmonary edema in a 52-year-old woman ingesting large amounts of aspirin. JAMA 1981; 246:2227-2228.
- Liu JH & Smith PC: Direct analysis of salicylic acid, salicyl acyl glucuronide, salicyluric acid and gentisic acid in human plasma and urine by high-performance liquid chromatography. J Chromatogr B: Biomed Appl 1996; 675:61-70.
- Lou YJ, Ding GS, & Tu ZH: Toxicity to transferred rat embryos after aspirin treatment during preimplantation stage in vivo. Chung Kuo Yao Li Hsueh Pao 1996; 17:52-54.
- Lynd PA, Andreasen AC, & Wyatt RJ: Intrauterine salicylate intoxication in a newborn: A case report. Clin Pediatr 1976; 15:912.
- MacCready RA: Methyl salicylate poisoning: a report of five cases. N Engl J Med 1943; 228:155-156.
- Mandel NA: The synergistic effect of salicylates on methotrexate toxicity. Plast Reconstr Surg 1976; 57:733.
- McCleave DJ & Havill J: A review of acute salicylate poisoning. Anaesth Intens Care 1974; 4:340-344.
- McGuigan MA: A two-year review of salicylate deaths in Ontario. Arch Intern Med 1987; 147:510-512.
- McGuigan MA: Death due to salicylate poisoning in Ontario. Canad Med Assoc J 1986; 135:891-894.
- McNeil JR: The possible effect of salicylates on the developing fetus. Brief summaries of eight suggestive cases. Clin Pediatr (Phila) 1973; 12:347-350.
- Mitchell I: Therapeutic salicylate poisoning in children (Letter). Br Med J 1979; 1081.
- Miyahara JT & Karler R: Effect of salicylate on oxidative phosphorylation and respiration of mitochondrial fragments. Biochem J 1965; 97:194-198.
- Miyamoto T: Osaka Shiritsu Daigaku Igaku Zasshi 1972; 21:123-139.
- Mongan E, Kelly P, & Nies K: Tinnitus as an indication of therapeutic serum salicylate levels. JAMA 1973; 226:142-145.
- Montgomery H, Porter JC, & Bradley RD: Salicylate intoxication causing a severe systemic inflammatory response and rhabdomyolysis. Am J Emerg Med 1994; 12:531-532.
- Mullick FG, Delage C, & Irey NS: Sickle cell crisis associated with drugs. Arch Environ Health 1973; 26:221-222.
- Myers EN & Bernstein JM: Salicylate ototoxicity: a clinical and experimental study. Arch Otolaryngol 1965; 82:483-493.
- NFPA: Fire Protection Guide to Hazardous Materials, 13th ed., National Fire Protection Association, Quincy, MA, 2002.
- NIOSH : Pocket Guide to Chemical Hazards. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 1996; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- NIOSH: Pocket Guide to Chemical Hazards. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 2001; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 1, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2001.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 2, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2002.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 3, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2003.
- NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 4, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2004.
- NTP & 2001: Acetylsalicylic Acid. National Toxicology Program Chemical Repository, National Toxicology Progam, US Department of Human Health Services, National Institutes of Health, Research Triangle Park, NC, 2001.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,3-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,4-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Butylene Oxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648083cdbb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Dibromoethane (Proposed). United States Environmental Protection Agency. Washington, DC. 2007g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802796db&disposition=attachment&contentType=pdf. As accessed 2010-08-18.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,3,5-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 2-Ethylhexyl Chloroformate (Proposed). United States Environmental Protection Agency. Washington, DC. 2007b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037904e&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Acrylonitrile (Proposed). United States Environmental Protection Agency. Washington, DC. 2007c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648028e6a3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Adamsite (Proposed). United States Environmental Protection Agency. Washington, DC. 2007h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Agent BZ (3-quinuclidinyl benzilate) (Proposed). United States Environmental Protection Agency. Washington, DC. 2007f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ad507&disposition=attachment&contentType=pdf. As accessed 2010-08-18.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Allyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039d9ee&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Arsenic Trioxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480220305&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Automotive Gasoline Unleaded (Proposed). United States Environmental Protection Agency. Washington, DC. 2009a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cc17&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Biphenyl (Proposed). United States Environmental Protection Agency. Washington, DC. 2005j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1b7&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bis-Chloromethyl Ether (BCME) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648022db11&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Boron Tribromide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae1d3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromine Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2007d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039732a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromoacetone (Proposed). United States Environmental Protection Agency. Washington, DC. 2008e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187bf&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Calcium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae328&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Sulfide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037ff26&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Chlorobenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803a52bb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Cyanogen (Proposed). United States Environmental Protection Agency. Washington, DC. 2008f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187fe&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Dimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbf3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Diphenylchloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091884e&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Phosphorodichloridate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480920347&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809203e7&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Germane (Proposed). United States Environmental Protection Agency. Washington, DC. 2008j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963906&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Hexafluoropropylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1f5&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ketene (Proposed). United States Environmental Protection Agency. Washington, DC. 2007. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ee7c&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Malathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2009k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809639df&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Mercury Vapor (Proposed). United States Environmental Protection Agency. Washington, DC. 2009b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a087&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Isothiocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a03&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a57&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl tertiary-butyl ether (Proposed). United States Environmental Protection Agency. Washington, DC. 2007a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802a4985&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methylchlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5f4&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c646&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN1 CAS Reg. No. 538-07-8) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN2 CAS Reg. No. 51-75-2) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN3 CAS Reg. No. 555-77-1) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Tetroxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091855b&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Trifluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e0c&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008o. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e32&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perchloryl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e268&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perfluoroisobutylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2009d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26a&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008p. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dd58&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2006d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020cc0c&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phorate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008q. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dcc8&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene (Draft-Revised). United States Environmental Protection Agency. Washington, DC. 2009e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a08a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene Oxime (Proposed). United States Environmental Protection Agency. Washington, DC. 2009f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26d&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Propargyl Alcohol (Proposed). United States Environmental Protection Agency. Washington, DC. 2006e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec91&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Selenium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec55&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Silane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d523&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Strontium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sulfuryl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec7a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tear Gas (Proposed). United States Environmental Protection Agency. Washington, DC. 2008s. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e551&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tellurium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e2a1&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tert-Octyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2008r. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5c7&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tetramethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-17.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7d608&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethylacetyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008t. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5cc&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Zinc Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for n-Butyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064808f9591&disposition=attachment&contentType=pdf. As accessed 2010-08-12.
- National Institute for Occupational Safety and Health: NIOSH Pocket Guide to Chemical Hazards, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Cincinnati, OH, 2007.
- National Research Council : Acute exposure guideline levels for selected airborne chemicals, 5, National Academies Press, Washington, DC, 2007.
- National Research Council: Acute exposure guideline levels for selected airborne chemicals, 6, National Academies Press, Washington, DC, 2008.
- National Research Council: Acute exposure guideline levels for selected airborne chemicals, 7, National Academies Press, Washington, DC, 2009.
- National Research Council: Acute exposure guideline levels for selected airborne chemicals, 8, National Academies Press, Washington, DC, 2010.
- Neault JF, Naoui M, & Manfait M: Aspirin-DNA interaction studied by FTIR and laser Raman difference spectroscopy. FEBS Letters 1996; 382:26-30.
- Nelson NM & Forfar JO: Associations between drugs administered during pregnancy and congenital abnormalities of the fetus. Br Med J 1971; 1:523-527.
- O'Gorman T & Koff RF: Salicylate hepatitis. Gastroenterol 1977; 72:726-728.
- Packham MA & Mustard JF: Clinical pharmacology of platelets. Blood 1977; 50:555.
- Padmanabhan R & Pallot DJ: Aspirin-alcohol interaction in the production of cleft palate and limb malformations in the TO mouse. Teratology 1995; 51:404-417.
- Pec J, Strmenova M, & Palencarova E: Salicylate intoxication after use of topical salicylic acid ointment by a patient with psoriasis. Cutis 1992; 50:307-309.
- Pei YPC & Thompson DA: Severe salicylate intoxication mimicking septic shock (Letter). Am J Med 1987; 82:381-382.
- Pinsky PF, Hurwitz ES, & Schonberger LB: Reye's syndrome and aspirin: evidence for a dose-response effect. JAMA 1988; 260:657-661.
- Pond SM, Armstrong JG, & Henderson A: Late diagnosis of chronic salicylate intoxication (Lletter). Lancet 1993; 342:687.
- Posner JB & Plum F: Spinal fluid pH and neurological symptoms in systemic acidosis. N Engl J Med 1967; 227:605-613.
- Proudfoot AT & Brown SS: Acidemia and salicylate poisoning in adults. Br Med J 1969; 2:547-550.
- Quint PA & Allman FD: Differentiation of chronic salicylism from Reye syndrome. Pediatrics 1984; 74:1117-1119.
- RTECS : Registry of Toxic Effects of Chemical Substances. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 10/31/2001; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- RTECS : Registry of Toxic Effects of Chemical Substances. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 1996; provided by Truven Health Analytics Inc., Greenwood Village, CO.
- Raschke R, Arnold-Capell PA, & Richeson R: Refractory hypoglycemia secondary to topical salicylate intoxication. Arch Intern Med 1991; 151:591-593.
- Rejent TA & Baik S: Fatal in utero salicylism. J Forens Sci 1985; 30:942-944.
- Rich RR & Johnson JS: Salicylate hepatotoxicity in patients with juvenile rheumatoid arthritis. Arthritis Rheum 1973; 16:1-9.
- Richards ID: Congenital malformations and environmental influences in pregnancy. Br J Prev Soc Med 1969; 23:218-225.
- Robin ED, Davis RP, & Rees SB: Salicylate intoxication with special reference to the development of hypokalemia. Am J Med 1959; 26869-882.
- Robins JB, Turnbull JA, & Robertson C: Gastric perforation after acute aspirin overdose. Human Toxicol 1985; 4:527-528.
- Rosenfeld RG & Liebhaber MI: Acute encephalopathy in siblings. Am J Dis Child 1976; 130:295-297.
- Rothman KJ, Fyler DC, & Goldblatt A: Exogenous hormones and other drug exposures of children with congenital heart disease. Am J Epidemiol 1979; 109:433-439.
- Rudolph AM: Effects of aspirin and acetaminophen in pregnancy and in the newborn. Arch Intern Med 1981; 141:358-363.
- Rumack CM, Guggenheim MA, & Rumack BH: Neonatal intracranial hemorrhage and maternal use of aspirin. Obstet Gynecol 1981; 58(Suppl):52-56.
- Rupp DJ, Seaton RD, & Wiegmann TB: Acute polyuric renal failure after aspirin intoxication. Arch Intern Med 1983; 143:1237-1238.
- Sainsbury SJ: Fatal salicylate toxicity from bismuth salicylate. West J Med 1991; 155:637-639.
- Sakata T, Hasegawa R, & Johansson SL: Inhibition by aspirin of N-(4-(5-nitro-2-furyl)-2-thiazolyl]formamide initiation and sodium saccharin promotion of urinary bladder carcinogenesis in male F344 rats. Cancer Res 1986; 46:3903-3906.
- Saxen I: Associations between oral clefts and drugs during pregnancy. Internat J Epidemiol 1975; 4:37-44.
- Schlegel RJ, Altstatt LB, & Canales L: Peritoneal dialysis for severe salicylism: an evaluation of indications and results. J Pediatr 1966; 69:553-562.
- Segar WE: The critically ill child: salicylate intoxication. Pediatrics 1969; 44:440-444.
- Sestini P, Armetti L, & Gambaro G: Inhaled PGE(2) prevents aspirin-induced bronchoconstriction and urinary LTE(4) excretion in aspirin-sensitive asthma. Am J Resp Crit Care Med 1996; 153:572-575.
- Settipane RA, Schrank PJ, & Simon RA: Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects. J Allergy Clin Immunol 1995; 96:480-485.
- Shahidi NT & Westring DW: Acetylsalicylic acid - induced hemolysis and its mechanism. J Clin Invest 1970; 49:1334-1340.
- Shelley WB: Birch pollen and aspirin psoriasis. JAMA 1964; 189:985-988.
- Sibai BM, Mirro R, & Chesney CM: Low-dose aspirin in pregnancy. Obstet Gynecol 1989; 74:551-557.
- Sienko DG, Anda RF, & McGee HB: Reye's syndrome and salicylates (Letter). JAMA 1987; 258:3117-3119.
- Sittig M: Handbook of Toxic and Hazardous Chemicals and Carcinogens, 3rd ed, Noyes Publications, Park Ridge, NJ, 1991.
- Skrum MJ, Gay RM, & Hudson P: Fatal iatrogenic salicylate intoxication in a long-term user of enteric-coated aspirin. Arch Pathol Lab Med 1989; 113:89-90.
- Slone D, Heinonen OP, & Kaufman DW: Aspirin and congenital malformations. Lancet 1976; 1:1373-1375.
- Smith PK: The pharmacology of salicylates and related compounds. Ann Acad Sci 1960; 86:38-63.
- Snodgrass W, Rumack BH, & Peterson RG: Salicylate toxicity following therapeutic doses in young children. Clin Toxicol 1981; 18:247-259.
- Starko KM & Mullick FG: Hepatic and cerebral pathology findings in children with fatal salicylate intoxication: further evidence for a causal relation between salicylate and Reye's syndrome. Lancet 1983; 1:326-329.
- Steele TE & Morton WA: Salicylate-induced delirium. Psychosomatics 1986; 27:455-456.
- Streissguth AP, Treder RP, & Barr HM: Aspirin and acetaminophen use by pregnant women and subsequent child IQ and attention decrements. Teratology 1987; 35:211-219.
- Stuart MJ, Gross SJ, & Elrad H: Effects of acetyl salicylic-acid ingestion on maternal and neonatal hemostasis. N Engl J Med 1982; 307:909-912.
- Surapathana LA-OR, Futrakul P, & Campbell RA: Salicylism revisited: unusual problems in diagnosis and management. Clin Pediatr 1970; 9:658-661.
- Szczeklik A, Kizanowski M, & Gora P: Antiplatelet drugs and generation of thrombin in clotting blood. Blood 1992; 80:2006-2011.
- Szczeklik A, Mastalerz L, & Nizankowska E: Protective and bronchodilator effects of prostaglandin E and salbutamol in aspirin-induced asthma. Am J Resp Crit Care Med 1996; 153:567-571.
- Szczeklik A, Nizankowska E, & Serafin A: Autoimmune phenomena in bronchial asthma with special reference to aspirin intolerance. Am J Resp Crit Care Med 1995; 152:1753-1756.
- Tashima CK & Rose M: Pulmonary edema and salicylates (Letter). Ann Intern Med 1974; 81:274-275.
- Taylor ML, Misso NLA, & Stewart GA: The effects of varying doses of aspirin on human platelet activation induced by PAR, collagen and arachidonic acid. Br J Clin Pharmacol 1992; 33:25-31.
- Temple AR: Acute and chronic effects of aspirin toxicity and their treatment. Arch Intern Med 1981; 141:364-369.
- Thisted B, Krantz T, & Strom J: Acute salicylate self-poisoning in 177 consecutive patients treated in ICU. Acta Anaesthesiol Scand 1987; 31(4):312-316.
- Thomas C: Adult respiratory-distress syndrome in salicylate intoxication (Letter). Lancet 1979; 2:1294-1295.
- Turner G & Collins E: Fetal effects of regular salicylate ingestion in pregnancy. Lancet 1975; 2:338-339.
- U.S. Department of Energy, Office of Emergency Management: Protective Action Criteria (PAC) with AEGLs, ERPGs, & TEELs: Rev. 26 for chemicals of concern. U.S. Department of Energy, Office of Emergency Management. Washington, DC. 2010. Available from URL: http://www.hss.doe.gov/HealthSafety/WSHP/Chem_Safety/teel.html. As accessed 2011-06-27.
- U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project : 11th Report on Carcinogens. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. Washington, DC. 2005. Available from URL: http://ntp.niehs.nih.gov/INDEXA5E1.HTM?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932. As accessed 2011-06-27.
- U.S. Environmental Protection Agency: Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof. Environmental Protection Agency's (EPA) Resource Conservation and Recovery Act (RCRA); List of hazardous substances and reportable quantities 2010b; 40CFR(261.33, e-f):77-.
- U.S. Environmental Protection Agency: Integrated Risk Information System (IRIS). U.S. Environmental Protection Agency. Washington, DC. 2011. Available from URL: http://cfpub.epa.gov/ncea/iris/index.cfm?fuseaction=iris.showSubstanceList&list_type=date. As accessed 2011-06-21.
- U.S. Environmental Protection Agency: List of Radionuclides. U.S. Environmental Protection Agency. Washington, DC. 2010a. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.
- U.S. Environmental Protection Agency: List of hazardous substances and reportable quantities. U.S. Environmental Protection Agency. Washington, DC. 2010. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.
- U.S. Environmental Protection Agency: The list of extremely hazardous substances and their threshold planning quantities (CAS Number Order). U.S. Environmental Protection Agency. Washington, DC. 2010c. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-part355.pdf. As accessed 2011-06-17.
- U.S. Occupational Safety and Health Administration: Part 1910 - Occupational safety and health standards (continued) Occupational Safety, and Health Administration's (OSHA) list of highly hazardous chemicals, toxics and reactives. Subpart Z - toxic and hazardous substances. CFR 2010 2010; Vol6(SEC1910):7-.
- U.S. Occupational Safety, and Health Administration (OSHA): Process safety management of highly hazardous chemicals. 29 CFR 2010 2010; 29(1910.119):348-.
- United States Environmental Protection Agency Office of Pollution Prevention and Toxics: Acute Exposure Guideline Levels (AEGLs) for Vinyl Acetate (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6af&disposition=attachment&contentType=pdf. As accessed 2010-08-16.
- Vermeersch G, Marko J, & Cartigny B: Salicylate poisoning detected by (1)H NMR spectroscopy (Letter). Clin Chem 1988; 34:1003-1004.
- Wada I, Hsu CC, & Williams G: The benefits of low-dose aspirin therapy in women with impaired uterine perfusion during assisted conception. Human Reproduct 1994; 9:1954-1957.
- Waldman RJ, Hall WN, & McGee H: Aspirin as a risk factor in Reye's syndrome. JAMA 1982; 247:3089-3094.
- Walters JS, Woodring JH, & Stelling CB: Salicylate-induced pulmonary edema. Radiology 1983; 146:289-293.
- Waltman R, Tricomi V, & Shabanah EH: The effect of anti-inflammatory drugs on parturition parameters in the rat. Prostaglandins 1973; 4:93-106.
- Wang ZH & Li WJ: A prospective randomized placebo-controlled trial of low-dose aspirin for prevention of intra-uterine growth retardation. Chinese Med J 1996; 109:238-242.
- Watson JE & Tagupa ET: Suicide attempt by means of aspirin enema. Ann Pharmacother 1994; 28:467-469.
- Weiss HJ & Aledort LM: Impaired platelet/connective-tissue reaction in man after aspirin ingestion. Lancet 1967; 2:495-497.
- Wenstrom KD, Hauth JC, & Goldenberg RL: The effect of low-dose aspirin on pregnancies complicated by elevated human chorionic gonadotropin levels. Am J Obstet Gynecol 1995; 173:1292-1296.
- Werler MM, Mitchell AA, & Shapiro S: The relation of aspirin use during the first trimester of pregnancy to congenital cardiac defects. N Engl J Med 1989; 321:1639-1642.
- Wilson JG, Ritter EJ, & Scott WJ: Comparative distribution and embryotoxicity of acetylsalicylic acid in pregnant rats and rhesus monkeys. Toxicol Appl Pharmacol 1977; 41:67-78.
- Wortzman DJ & Grunfeld A: Delayed absorption following enteric-coated aspirin overdose. Ann Emerg Med 1987; 16:434-436.
- Zierler S & Rothman KJ: Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy. N Engl J Med 1985; 313:347-352.
- Zucker P, Daum F, & Cohen MI: Aspirin Hepatitis. Am J Dis Child 1975; 129:1433-1434.
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