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PENTANE

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Classification   |    Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

    A) This compound exists in three isomeric forms: n-pentane (the most important), isopentane, and neopentane.

Specific Substances

    A) No Synonyms were found in group or single elements
    1.2.1) MOLECULAR FORMULA
    1) C5-H12

Available Forms Sources

    A) FORMS
    1) Pentane is a flammable, highly volatile, colorless liquid with a gasoline-like odor (Bingham et al, 2001; Budavari, 2000; HSDB , 2002; NIOSH , 2002).
    2) It is available in pure (99.2%), technical, research (99.98%), and commercial grades (CHRIS , 2002; HSDB , 2002).
    3) Pentane exists in three isomeric forms: n-pentane (the most important), isopentane, and neopentane (ACGIH, 1994).
    B) SOURCES
    1) n-Pentane is derived from the fractional distillation of crude oil and natural gas liquids, purified by rectification (Bingham et al, 2001; Lewis, 2001).
    2) It can be prepared by dehydration and subsequent hydrogenation of 2- and 3-pentanol or from bromopentane by Grignard reaction (Budavari, 2000).
    3) It can be produced through the catalytic crackdown of naphtha (Bingham et al, 2001).
    4) It is found naturally as a highly volatile constituent in the paraffin fraction of crude oil and natural gas (Howard, 1993).
    C) USES
    1) Pentane is used in: fuel; hydrolic fluids; paint and lacquer removers; tube oil additives; solvent extenders; chemical synthesis; artificial ice manufacture; low-temperature thermometers; solvent extraction processes; as a blowing agent in plastics (e.g., expandable polystyrene); and in pesticides (Hathaway et al, 1991; Lewis, 2001) NTP, 2001).
    2) It is also used in the production of olefin, hydrogen, and ammonia, and in the synthesis of amyl chlorides, and polychlorocyclopentanes (NTP, 2001).

Overview

Life Support

    A) This overview assumes that basic life support measures have been instituted.

Clinical Effects

    0.2.1) SUMMARY OF EXPOSURE
    A) INGESTION - Pulmonary toxicity due to pentane aspiration is the primary concern following ingestion. Chemical pneumonitis, acute lung injury, and hemorrhage may occur. In extreme cases, respiratory arrest secondary to hypoxia following pneumonitis may occur. Aspiration of pentane may also result in transient CNS depression or excitement.
    B) INHALATION - Anorexia, CNS depression with euphoria, dizziness, headache, depression, confusion, inability to concentrate, and loss of consciousness and coma in extreme cases may be seen. Polyneuropathies and seizures have been reported. Cardiovascular effects may include ventricular dysrhythmias and sudden death.
    C) DERMAL - Pentane is a skin irritant and may cause drying, erythema, hyperpigmentation, hyperemia, dermatitis, burning pain, and blisters.
    D) EYE - Pain, corneal irritation, and nystagmus may occur.
    0.2.3) VITAL SIGNS
    A) Impaired respiration may occur following inhalation exposure.
    B) Fever may occur secondary to aspiration pneumonitis.
    C) Hypotension may be seen.
    0.2.4) HEENT
    A) Pentane may cause pain, corneal irritation, and possibly nystagmus.
    B) Olfactory function does not appear to be affected by pentane.
    C) Taste dysfunction may occur.
    0.2.5) CARDIOVASCULAR
    A) Cardiac dysrhythmias, including ventricular fibrillation and sudden death, may result.
    0.2.6) RESPIRATORY
    A) Aspiration (coughing, choking, gagging), aspiration pneumonitis, asthma, hemoptysis, pulmonary edema, lipoid pneumonia, or respiratory arrest may occur.
    0.2.7) NEUROLOGIC
    A) Central nervous system depression, seizures, acute encephalopathy, and polyneuropathy have been seen with pentane toxicity.
    0.2.8) GASTROINTESTINAL
    A) Nausea, vomiting, gastritis, and diarrhea may occur.
    0.2.9) HEPATIC
    A) Liver injury may occur following ingestion or inhalation of pentane, but is uncommon. Elevated liver enzymes may occur.
    0.2.10) GENITOURINARY
    A) Renal effects appear to be infrequent, but may include acute renal failure, glomerulonephritis, interstitial nephritis, and Goodpasture's syndrome.
    0.2.11) ACID-BASE
    A) Metabolic acidosis may occur following aspiration pneumonitis.
    0.2.13) HEMATOLOGIC
    A) Hemolysis and hemolytic anemia may occur with pentane toxicity.
    0.2.14) DERMATOLOGIC
    A) Pentane is a skin irritant and may cause drying, erythema, hyperpigmentation, hyperemia, dermatitis, burning pain, and blisters.
    0.2.15) MUSCULOSKELETAL
    A) Rhabdomyolysis has been reported.
    0.2.16) ENDOCRINE
    A) Adrenocorticotropin hormone levels have been increased in animal studies.
    0.2.17) METABOLISM
    A) Hypocholesterolemia and hypoalbuminemia have been reported.
    0.2.20) REPRODUCTIVE
    A) Parental exposure to hydrocarbons might be a risk factor for Prader-Willi syndrome in the offspring.
    B) Spontaneous abortion may occur in women exposed to pentane during pregnancy.
    0.2.21) CARCINOGENICITY
    A) Renal neoplasia and dermal carcinogenesis may be seen following hydrocarbon exposure.
    0.2.22) OTHER
    A) Inhalational abuse of pentane has been reported. Subcutaneously injected pentane may cause cellulitis and sterile abscess formation.

Laboratory Monitoring

    A) A number of chemicals produce abnormalities of the hematopoietic system, liver, and kidneys. Monitoring complete blood count, urinalysis, and liver and kidney function tests is suggested for patients with significant exposure.
    B) Monitor arterial blood gases, chest x-ray, and pulmonary function tests in patients with significant pulmonary irritation or aspiration.

Treatment Overview

    0.4.2) ORAL/PARENTERAL EXPOSURE
    A) Activated charcoal may cause vomiting, which increases the risk of aspiration. Activated charcoal may be indicated in patients who have coingested an adsorbable substance that is very toxic; otherwise it should be avoided.
    1) 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.
    B) IN SYMPTOMATIC PATIENTS - (coughing, choking, etc) monitor blood gases to assure adequate ventilation. Admit the patient for observation.
    C) Observe patient for 6 hours. If vital signs become abnormal or symptoms develop admit patient to the hospital and obtain a chest x-ray. Asymptomatic patients can be discharged.
    D) ACIDOSIS - Treat metabolic acidosis (less than pH 7.1) with IV sodium bicarbonate.
    E) 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).
    1) Consider phenobarbital or propofol if seizures recur after diazepam 30 mg (adults) or 10 mg (children greater than 5 years).
    2) Monitor for hypotension, dysrhythmias, respiratory depression, and need for endotracheal intubation. Evaluate for hypoglycemia, electrolyte disturbances, and hypoxia.
    F) REFRACTORY SEIZURES: Consider continuous infusion of midazolam, propofol, and/or pentobarbital. Hyperthermia, lactic acidosis and muscle destruction may necessitate use of neuromuscular blocking agents with continuous EEG monitoring.
    G) 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.
    H) ANTIBIOTICS - are indicated only if bacterial superinfection of the lungs occurs.
    I) CORTICOSTEROIDS - have not been shown to be of benefit for pentane pneumonitis.
    0.4.3) INHALATION EXPOSURE
    A) 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.
    0.4.4) EYE EXPOSURE
    A) 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.
    0.4.5) DERMAL EXPOSURE
    A) OVERVIEW
    1) 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).
    2) Treat dermal irritation or burns with standard topical therapy. Patients developing dermal hypersensitivity reactions may require treatment with systemic or topical corticosteroids or antihistamines.

Range Of Toxicity

    A) Human subjects exposed to 5000 parts per million for 10 minutes did not experience mucous membrane irritation or other symptoms (Hathaway et al, 1991).
    B) The lowest concentration to produce toxic effects is 90,000 parts per million (Clayton & Clayton, 1981).
    C) Topical application of pentane to volunteers caused painful burning sensations accompanied by itching. After 5 hours, blisters formed on the exposed areas (Hathaway et al, 1991).

Clinical Effects

Acid-Base

    3.11.1) SUMMARY
    A) Metabolic acidosis may occur following aspiration pneumonitis.
    3.11.2) CLINICAL EFFECTS
    A) ACIDOSIS
    1) HUMANS
    a) It is reasonable to assume that metabolic acidosis may occur when pentane aspiration pneumonitis with hypoxia is present.

Hematologic

    3.13.1) SUMMARY
    A) Hemolysis and hemolytic anemia may occur with pentane toxicity.
    3.13.2) CLINICAL EFFECTS
    A) DISSEMINATED INTRAVASCULAR COAGULATION
    1) Three cases of aspiration pneumonia followed by disseminated intravascular coagulation have been reported with hydrocarbons (Banner & Walson, 1983; Janssen et al, 1988; Algren & Rodgers, 1992).
    B) HEMOLYTIC ANEMIA
    1) Hemolytic anemia developed in an adult who sustained a cardiopulmonary arrest associated with prolonged exposure to concentrated vapors from mineral spirits (Nierenberg et al, 1991). Screening for disseminated intravascular coagulation was negative.
    3.13.3) ANIMAL EFFECTS
    A) ANIMAL STUDIES
    1) LEUKOPENIA
    a) In rats injected subcutaneously with pentane, neutropenia and monocytosis was reported (Snyder, 1987; Wirtschafter & Bischel, 1960).
    2) WBC ANORMAL
    a) The reticuloendothelial cells of the thymus were increased and occasional macrophages and plasmacytes were seen in rats injected with pentane (Wirtschafter & Bischel, 1960).
    b) In the spleen, there was an increase in plasmacytes during the first 48 hours which was 10 to 12 times the normal value in pentane-injected rats (Wirtschafter & Bischel, 1960).
    c) In the lymph node, there was a marked increase of plasmacytes, and mature macrophages, with a simultaneous increase in lymph type reticuloendothelial cells in pentane-injected rats (Wirtschafter & Bischel, 1960).
    d) In the bone marrow, there was a 2-fold increase in cells of reticuloendothelial origin at 1 hour after pentane injection in rats (Wirtschafter & Bischel, 1960).

Dermatologic

    3.14.1) SUMMARY
    A) Pentane is a skin irritant and may cause drying, erythema, hyperpigmentation, hyperemia, dermatitis, burning pain, and blisters.
    3.14.2) CLINICAL EFFECTS
    A) DERMATITIS
    1) HUMANS
    a) Repeated or prolonged skin contact will dry and defat skin, resulting in irritation and dermatitis (HSDB , 1994).
    b) The liquid can cause blisters on contact (Howard, 1993; Hathaway et al, 1991). Persons with skin disorders may be more susceptible to the effects of pentane (Mackison et al, 1981).
    c) Dermal effects of pentane vapors applied to the skin of 5 volunteers were studied. Erythema, hyperemia, swelling, and pigmentation were observed after dermal exposure.
    1) The volunteers complained of a constant burning sensation accompanied by itching, and blisters were found after 5 hr of exposure. When the pentane was removed from the skin after 5 hr, pain subsided within 15 minutes (HSDB , 1994).

Musculoskeletal

    3.15.1) SUMMARY
    A) Rhabdomyolysis has been reported.
    3.15.2) CLINICAL EFFECTS
    A) RHABDOMYOLYSIS
    1) Rhabdomyolysis developed in an adult who sustained a cardiopulmonary arrest associated with prolonged exposure to concentrated vapors from mineral spirits (Nierenberg et al, 1991).

Endocrine

    3.16.1) SUMMARY
    A) Adrenocorticotropin hormone levels have been increased in animal studies.
    3.16.2) CLINICAL EFFECTS
    A) HORMONE LEVEL - FINDING
    1) ANIMAL STUDIES
    a) Adrenocorticotropin hormone (ACTH) levels increased in mice in a dose-dependent manner following inhalation exposure to pentane (Glowa, 1991).

Reproductive

    3.20.1) SUMMARY
    A) Parental exposure to hydrocarbons might be a risk factor for Prader-Willi syndrome in the offspring.
    B) Spontaneous abortion may occur in women exposed to pentane during pregnancy.
    3.20.2) TERATOGENICITY
    A) RISK FACTORS
    1) HUMANS
    a) PRADER-WILLI SYNDROME - Paternal exposure to hydrocarbons has been suggested as a causative factor in Prader-Willi syndrome (Strakowski & Butler, 1987).
    1) A study of 81 patients with Prader-Willi syndrome found that about half of the patient's fathers had been employed in hydrocarbon-exposing jobs at or around the time of conception (Cassidy et al, 1989).
    3.20.3) EFFECTS IN PREGNANCY
    A) ABORTION
    1) HUMANS
    a) A study of women biologically monitored for solvents supports the hypothesis of a positive association between spontaneous abortion and exposure to organic solvents (especially aliphatic hydrocarbons) during pregnancy (Lindbohm et al, 1990).

Carcinogenicity

    3.21.1) IARC CATEGORY
    A) IARC Carcinogenicity Ratings for CAS109-66-0 (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):
    1) Not Listed
    3.21.2) SUMMARY/HUMAN
    A) Renal neoplasia and dermal carcinogenesis may be seen following hydrocarbon exposure.
    3.21.3) HUMAN STUDIES
    A) RENAL CARCINOMA
    1) RENAL NEOPLASIA - Experimental animal studies and some studies on cancer incidence and mortality in human occupational groups suggest that hydrocarbon exposure is associated with renal neoplasia (Nelson et al, 1990).
    a) Moderate levels of hydrocarbon exposure produced the highest risk (odds ratio = 1.6) of renal cell carcinoma in a population-based case-control study (Kadamani et al, 1989).
    3.21.4) ANIMAL STUDIES
    A) SKIN CARCINOMA
    1) DERMAL CARCINOGEN - The majority of the used gasoline engine oils tested were carcinogenic in the dermal carcinogenesis bioassay (McKee & Plutnick, 1989). Fresh gasoline engine oil was not carcinogenic.

Summary Of Exposure

    A) INGESTION - Pulmonary toxicity due to pentane aspiration is the primary concern following ingestion. Chemical pneumonitis, acute lung injury, and hemorrhage may occur. In extreme cases, respiratory arrest secondary to hypoxia following pneumonitis may occur. Aspiration of pentane may also result in transient CNS depression or excitement.
    B) INHALATION - Anorexia, CNS depression with euphoria, dizziness, headache, depression, confusion, inability to concentrate, and loss of consciousness and coma in extreme cases may be seen. Polyneuropathies and seizures have been reported. Cardiovascular effects may include ventricular dysrhythmias and sudden death.
    C) DERMAL - Pentane is a skin irritant and may cause drying, erythema, hyperpigmentation, hyperemia, dermatitis, burning pain, and blisters.
    D) EYE - Pain, corneal irritation, and nystagmus may occur.

Vital Signs

    3.3.1) SUMMARY
    A) Impaired respiration may occur following inhalation exposure.
    B) Fever may occur secondary to aspiration pneumonitis.
    C) Hypotension may be seen.
    3.3.2) RESPIRATIONS
    A) Impaired respiration may occur following inhalation exposure.
    1) ANIMAL - Early impairment of respiration occurred in rats and mice exposed to pentane vapors (Fuhner, 1921).
    3.3.3) TEMPERATURE
    A) Fever may occur secondary to aspiration pneumonitis.
    1) HUMAN - Fever and leukocytosis may occur secondary to aspiration pneumonitis, but do not necessarily indicate a bacterial infection.
    3.3.4) BLOOD PRESSURE
    A) Hypotension may be seen.
    1) ANIMAL - Bonashevskaya & Partsev (1974) have concluded that statistically reliable hypotensive effects of hydrocarbons can be established following inhalation tests of pentane and hexane in rats.

Heent

    3.4.1) SUMMARY
    A) Pentane may cause pain, corneal irritation, and possibly nystagmus.
    B) Olfactory function does not appear to be affected by pentane.
    C) Taste dysfunction may occur.
    3.4.3) EYES
    A) Pentane may cause pain, corneal irritation, and possibly nystagmus.
    1) HUMAN - Nystagmus has been reported following inhalation exposure to pentane (Cali & Pennino, 1954).
    2) Pentane may cause pain on contact with the eye, but usually results in only slight, transient corneal irritation (Grant, 1986).
    3.4.5) NOSE
    A) Olfactory function does not appear to be affected by pentane.
    1) HUMAN - Occupational exposure to organic solvents in 54 painters did NOT alter olfactory function (smell) when compared to 42 unexposed referents (Sandmark et al, 1989).
    3.4.6) THROAT
    A) Taste dysfunction may occur.
    1) HUMAN - A persistent gasoline taste may be seen with systemic pentane toxicity (HSDB , 1994).

Cardiovascular

    3.5.1) SUMMARY
    A) Cardiac dysrhythmias, including ventricular fibrillation and sudden death, may result.
    3.5.2) CLINICAL EFFECTS
    A) VENTRICULAR ARRHYTHMIA
    1) HUMANS
    a) ORAL - Cardiac dysrhythmias, including ventricular fibrillation, may rarely occur following ingestion, but are most likely due to hypoxia or acidosis rather than to direct effects of pentane (Kulig & Rumack, 1981).
    b) INHALATION may cause various dysrhythmias. The fatal ventricular dysrhythmias, popularly labelled "sudden sniffing death" syndrome, may result from a lowering of the myocardial threshold to the arrhythmogenic effects of circulating catecholamines (Kulig & Rumack, 1981).
    1) CASE REPORT - Siphoning of gasoline was associated with sudden death, attributed to cardiac dysrhythmias, in a 9-year-old girl who raced up a hill (Bass, 1978).
    2) Gasoline was implicated as a cause of sudden death in inhalant abusers (Anderson et al, 1985; Anderson et al, 1986).
    3) Prolonged exposure to concentrated vapors from mineral spirits was associated with the development of ventricular fibrillation and cardiopulmonary arrest in a 42-year-old female (Nierenberg et al, 1991).
    2) ANIMAL STUDIES
    a) Pentane is only a weak agent which decreases the arrhythmogenic threshold of the dog myocardium to the effects of endogenously-released epinephrine (Clayton & Clayton, 1982).

Respiratory

    3.6.1) SUMMARY
    A) Aspiration (coughing, choking, gagging), aspiration pneumonitis, asthma, hemoptysis, pulmonary edema, lipoid pneumonia, or respiratory arrest may occur.
    3.6.2) CLINICAL EFFECTS
    A) SUFFOCATING
    1) HUMANS
    a) Pulmonary aspirations of pentane may result in chemical pneumonitis, pulmonary edema, and hemorrhage (HSDB , 1994). Initial signs and symptoms include coughing, choking, and gagging which most frequently occur during the act of swallowing (Beamon et al, 1976).
    b) ASPIRATION PNEUMONITIS - Signs and symptoms include fever, dyspnea, tachypnea, cyanosis, rales, ronchi, and decreased breath sounds. Fever and leukocytosis occur secondary to aspiration and do not necessarily indicate a bacterial infection.
    B) ACUTE LUNG INJURY
    1) HUMANS
    a) Following significant aspiration or inhalation, hemoptysis and pulmonary edema may occur (Shirkey, 1971; Janssen et al, 1988; Nierenberg et al, 1991).
    C) APNEA
    1) HUMANS
    a) Respiratory arrest may occur secondary to hypoxia following pentane pneumonitis.
    D) BRONCHOSPASM
    1) HUMANS
    a) In persons with impaired pulmonary function, especially those with obstructive airway diseases, breathing pentane might cause exacerbation of symptoms due to its irritant properties (Mackison et al, 1981).
    E) PNEUMONIA
    1) HUMANS
    a) An elderly woman developed lipoid pneumonia after using a lightweight aerosol cutting oil (WD-40(R)) for relief of arthritis for 2 years, with increased frequency of use during several months prior to admission (Glynn & Gale, 1990).
    F) HYPOXEMIA
    1) ANIMAL STUDIES
    a) Chronic exposure in rats and mice to higher concentrations of pentane resulted in anoxemia (HSDB , 1994) and respiratory depression (Lazarev, 1929).
    b) Massive doses, in the range of 40%, resulted in death of mice with collapsed lungs on autopsy (HSDB , 1994).
    c) Inhalation studies of pentane in mice have shown it to be a respiratory irritant (Swann et al, 1974).

Neurologic

    3.7.1) SUMMARY
    A) Central nervous system depression, seizures, acute encephalopathy, and polyneuropathy have been seen with pentane toxicity.
    3.7.2) CLINICAL EFFECTS
    A) CENTRAL NERVOUS SYSTEM DEFICIT
    1) HUMANS
    a) Exhilaration, dizziness, headache, depression, anorexia, confusion, inability to concentrate, and loss of consciousness and coma in extreme cases may accompany CNS depression (HSDB , 1994). CNS effects may also be secondary to hypoxia associated with pentane pneumonitis.
    B) NEUROPATHY
    1) HUMANS
    a) Polyneuropathy has occurred as a result of pentane toxicity. Symptoms have included fatigue, distal paresthesia, weakness and difficulty in walking (Yamada, 1972).
    b) Five cases of polyneuropathy occurred among employees of a belt manufacturing shop. The solvent believed responsible contained 80% pentane, 14% heptane, and 5% hexane. The symptoms in 3 of the cases consisted of anorexia, asthenia, paresthesis, fatigue, and bilateral symmetrical muscle failure found mostly in the legs. Electromyographic and nerve conduction studies revealed peripheral nerve changes (HSDB , 1994).
    c) Polyneuritis in 3 workers exposed to glues containing 80% pentane is reported. Initial symptoms were anorexia, asthenia, paresthesia, rapidly followed by fatigue and difficulty in performing certain movements. Examination showed widespread bilateral and symmetrical muscle failure, mostly proximal and predominantly in the legs (Gaultier et al, 1973).
    C) SEIZURE
    1) HUMANS
    a) Generalized seizures, nystagmus and tremor of the fingers have been reported in workers exposed to pentane and other hydrocarbons while cleaning oil tankers (Cali & Pennino, 1954).
    D) NEURITIS
    1) Occupational exposure to pentane has been reported to cause polyneuritis evidenced by hypotonia and loss of the osteotendinous reflexes. These findings were bilateral and symmetrical, and most prominent in the legs. No objective changes in sensitivity, plantar cutaneous reflexes, or cranial nerves were observed(Gaultier et al, 1973)
    E) TOXIC ENCEPHALOPATHY
    1) HUMANS
    a) Three welders in an enclosed storage container used to store waste oil developed confusion, dizziness, loss of balance, headache, nystagmus, weakness, and nausea. Vestibular dysfunction persisted for 3 to 18 months after the incident (Hodgson et al, 1989).
    F) CENTRAL NERVOUS SYSTEM FINDING
    1) ANIMAL STUDIES
    a) Exposure to air concentrations of 10.4, 50.9, and 94.7 mg/cu meter caused neurohistological, structural changes in the developing cerebral cortex of the rat (Clayton & Clayton, 1982).
    b) In animals, pentane causes narcosis at extremely high concentrations (Hathaway et al, 1991).

Gastrointestinal

    3.8.1) SUMMARY
    A) Nausea, vomiting, gastritis, and diarrhea may occur.
    3.8.2) CLINICAL EFFECTS
    A) GASTRITIS
    1) HUMANS
    a) Gastritis has been reported following inhalation of pentane (Cali & Pennino, 1954). Diarrhea may occur with gastritis. Gastroenteritis is frequent, but usually self-limited (Kulig & Rumack, 1981).
    b) Burning sensation in the mouth, nausea, and vomiting may occur. Spontaneous vomiting was reported in 43% of patients in one study (Anas et al, 1981).

Hepatic

    3.9.1) SUMMARY
    A) Liver injury may occur following ingestion or inhalation of pentane, but is uncommon. Elevated liver enzymes may occur.
    3.9.2) CLINICAL EFFECTS
    A) LIVER DAMAGE
    1) HUMANS
    a) Liver injury may occur following acute oral ingestion, but is uncommon (Shirkey, 1971; Janssen et al, 1988). Hepatic damage may also rarely follow hydrocarbon vapor inhalation (Gosselin et al, 1976).
    B) ABNORMAL LIVER FUNCTION
    1) ANIMAL STUDIES
    a) Subcutaneous injections of pentane produce temporary impairment of liver function in rats (Snyder, 1987).
    b) Pretreatment of guinea pigs with n-pentane has been shown to enhance glucuronidation and to stimulate oxidative drug metabolizing enzymes (Snyder, 1987).

Genitourinary

    3.10.1) SUMMARY
    A) Renal effects appear to be infrequent, but may include acute renal failure, glomerulonephritis, interstitial nephritis, and Goodpasture's syndrome.
    3.10.2) CLINICAL EFFECTS
    A) CRUSH SYNDROME
    1) HUMANS
    a) Acute tubular necrosis (Crisp et al, 1979; Barrientos et al, 1977), proteinuria, and hematuria may occur, but are apparently rare (Goldfrank et al, 1979; Janssen et al, 1988; Roy et al, 1991).
    B) GLOMERULONEPHRITIS
    1) HUMANS
    a) Glomerulonephritis and resultant nephrotic syndrome has been reported following long-term inhalation or dermal exposure to various hydrocarbons (Zimmerman et al, 1975; Cagnoli et al, 1980; Beirne & Brennan, 1972; Ehrenreich, 1977) Raunskov, 1979; (Roy et al, 1991).
    b) GOODPASTURE'S SYNDROME - Hydrocarbon-associated anti-glomerular basement membrane disease has been reported (Roy et al, 1991) to occur following a duration of exposure from one day to 10 years (Bombassei & Kaplan, 1992).
    C) NEPHRITIS
    1) HUMANS
    a) An adult male was reported to develop progressive tubulointerstitial nephritis, documented by biopsy, following inhalation and dermal occupational exposure to mineral spirits and helicopter fuel. Only mild glomerular sclerotic changes were present (Narvarte et al, 1989).
    D) ABNORMAL RENAL FUNCTION
    1) ANIMAL STUDIES
    a) Degenerative kidney lesions were associated with the inhalation exposure of rats to trimethyl-pentane (Mehlman, 1988).

Genotoxicity

    A) Mutagenicity has been demonstrated in a salmonella mutagenicity study.
    B) Non-Hodgkin's lymphoma patients may be more likely to develop clonal chromosome aberrations in lymphoma cells.

Laboratory Monitoring

Monitoring Parameters Levels

    4.1.1) SUMMARY
    A) A number of chemicals produce abnormalities of the hematopoietic system, liver, and kidneys. Monitoring complete blood count, urinalysis, and liver and kidney function tests is suggested for patients with significant exposure.
    B) Monitor arterial blood gases, chest x-ray, and pulmonary function tests in patients with significant pulmonary irritation or aspiration.
    4.1.2) SERUM/BLOOD
    A) BLOOD/SERUM CHEMISTRY
    1) Levels of pentane may be measured in blood using a gas chromatographic method (Devaux, 1983). The clinical utility of such measurements, however, is undetermined.
    B) ACID/BASE
    1) Obtain arterial blood gases in symptomatic patients.
    C) HEMATOLOGIC
    1) Monitor CBC in patients with aspiration pneumonitis.
    4.1.3) URINE
    A) URINARY LEVELS
    1) Levels of urinary pentanol may correlate with exposure in individuals (HSDB , 1994).
    B) URINALYSIS
    1) Monitor urine for evidence of hemoglobin in patients with aspiration pneumonitis.
    2) URINARY CELLULAR SEDIMENT - The presence of urinary cellular sediment was associated with increasing frequency of use of organic solvents in study of 284 newspaper press workers (Hashimoto et al, 1991).
    a) Occasional use of analgesics was associated with a decreased incidence of urinary cellular sediment in newspaper pressworkers exposed to solvents (Hashimoto et al, 1991).
    C) OTHER
    1) FRACTIONAL ALBUMIN CLEARANCE was a better marker of hydrocarbon exposure in workers when compared to glycosaminoglycans (Hotz et al, 1991).
    4.1.4) OTHER
    A) OTHER
    1) PULMONARY FUNCTION TESTS
    a) If respiratory tract irritation is present, it may be useful to monitor pulmonary function tests.
    2) CEREBROSPINAL FLUID
    a) Moen et al (1990) found the concentrations of albumin, IgG, and total protein were significantly higher in cerebrospinal fluid from 19 patients (including 11 painters) with chronic toxic encephalopathy due to organic solvents than found in 16 patients with myalgia and/or backache.
    b) Concentration of taurine in cerebrospinal fluid was found (multiple regression analyses) to decrease with increasing solvent exposure (Moen et al, 1990).

Radiographic Studies

    A) CHEST RADIOGRAPH
    1) If respiratory tract irritation is present, monitor chest x-ray.
    B) MRI
    1) One study found cerebral magnetic resonance imaging (MRI) superior to computerized tomography (CT) in the diagnosis of solvent-induced encephalopathy (Leira et al, 1992).

Methods

    A) CHROMATOGRAPHY
    1) AIR LEVELS - Pentane in air samples may be determined by gas chromatography with flame ionization detection using NIOSH Method 1500 (NIOSH, 1994).
    2) LIQUID AND GAS CHROMATOGRAPHY - Supercritical fluid chromatography (SFC) and high performance liquid chromatography (HPLC) may be used to analyze pentane (Leyendecker et al, 1985).
    B) SPECTROSCOPY/SPECTROMETRY
    1) NMR SPECTROSCOPY - Yamaguchi et al (1992) report a method for analyzing gastric contents for kerosene using nuclear magnetic resonance (NMR) spectroscopy.

Treatment

Life Support

    A) Support respiratory and cardiovascular function.

Patient Disposition

    6.3.1) DISPOSITION/ORAL EXPOSURE
    6.3.1.1) ADMISSION CRITERIA/ORAL
    A) IN SYMPTOMATIC PATIENTS: (coughing, choking, tachypnea, etc) monitor blood gases to assure adequate ventilation. Admit the patient for observation.
    6.3.1.2) HOME CRITERIA/ORAL
    A) Accidental ingestions of small quantities of pentane can safely be handled at home by home monitoring provided the patient is asymptomatic, there is access to a follow-up mechanism, and no suspicious indications of child abuse or attempted suicide exist.
    6.3.1.5) OBSERVATION CRITERIA/ORAL
    A) Admit and obtain chest x-ray in all symptomatic patients.
    B) If symptoms develop obtain chest x-ray. Observe patient for 6 hours. Discharge if asymptomatic.
    6.3.3) DISPOSITION/INHALATION EXPOSURE
    6.3.3.1) ADMISSION CRITERIA/INHALATION
    A) IN SYMPTOMATIC PATIENTS: (coughing, choking, tachypnea, etc) monitor blood gases to assure adequate ventilation. Admit the patient for observation.
    B) Admit and obtain chest x-ray in all symptomatic patients.
    6.3.3.5) OBSERVATION CRITERIA/INHALATION
    A) OBSERVATION: Carefully observe patients with inhalation exposure for the development of any systemic signs or symptoms and administer symptomatic treatment as necessary. If symptoms develop obtain chest x-ray. Observe patient for 6 hours. Discharge if asymptomatic.

Monitoring

    A) A number of chemicals produce abnormalities of the hematopoietic system, liver, and kidneys. Monitoring complete blood count, urinalysis, and liver and kidney function tests is suggested for patients with significant exposure.
    B) Monitor arterial blood gases, chest x-ray, and pulmonary function tests in patients with significant pulmonary irritation or aspiration.

Oral Exposure

    6.5.2) PREVENTION OF ABSORPTION
    A) SUMMARY
    1) DILUTION with milk or water is recommended.
    2) In general, gastric emptying is NOT INDICATED unless there is a history of a very large ingestion. Systemic toxicity is not expected, and gastric emptying increases the risk of aspiration pneumonitis.
    3) Activated charcoal may cause vomiting, which increases the risk of aspiration. Activated charcoal may be indicated in patients who have coingested an adsorbable substance that is very toxic; otherwise it should be avoided.
    B) DILUTION
    1) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    C) ACTIVATED CHARCOAL
    1) Activated charcoal adsorbs kerosene, turpentine, and benzene in vitro and in animal models (Chin et al, 1969; Laass, 1974; Laass, 1980; Raush, 1935; Decker et al, 1981).
    a) PRECAUTION - Activated charcoal may cause vomiting, which may be hazardous to patients who have ingested hydrocarbons.
    b) COINGESTANTS - Activated charcoal may be indicated in patients who have coingested adsorbable substances which are very toxic; otherwise it should be avoided.
    2) CHARCOAL ADMINISTRATION
    a) Consider administration of activated charcoal after a potentially toxic ingestion (Chyka et al, 2005). Administer charcoal as an aqueous slurry; most effective when administered within one hour of ingestion.
    3) CHARCOAL DOSE
    a) Use a minimum of 240 milliliters of water per 30 grams charcoal (FDA, 1985). Optimum dose not established; usual dose is 25 to 100 grams in adults and adolescents; 25 to 50 grams in children aged 1 to 12 years (or 0.5 to 1 gram/kilogram body weight) ; and 0.5 to 1 gram/kilogram in infants up to 1 year old (Chyka et al, 2005).
    1) Routine use of a cathartic with activated charcoal is NOT recommended as there is no evidence that cathartics reduce drug absorption and cathartics are known to cause adverse effects such as nausea, vomiting, abdominal cramps, electrolyte imbalances and occasionally hypotension (None Listed, 2004).
    b) ADVERSE EFFECTS/CONTRAINDICATIONS
    1) Complications: emesis, aspiration (Chyka et al, 2005). Aspiration may be complicated by acute respiratory failure, ARDS, bronchiolitis obliterans or chronic lung disease (Golej et al, 2001; Graff et al, 2002; Pollack et al, 1981; Harris & Filandrinos, 1993; Elliot et al, 1989; Rau et al, 1988; Golej et al, 2001; Graff et al, 2002). Refer to the ACTIVATED CHARCOAL/TREATMENT management for further information.
    2) Contraindications: unprotected airway (increases risk/severity of aspiration) , nonfunctioning gastrointestinal tract, uncontrolled vomiting, and ingestion of most hydrocarbons (Chyka et al, 2005).
    6.5.3) TREATMENT
    A) SUPPORT
    1) IN SYMPTOMATIC PATIENTS - (coughing, choking, tachypnea, etc) monitor blood gases to assure adequate ventilation. Admit the patient for observation and obtain a chest x-ray.
    2) ACIDOSIS - Treat metabolic acidosis (less than pH 7.1) with IV sodium bicarbonate.
    3) SEIZURES - Treat symptomatically with diazepam, phenytoin, or phenobarbital.
    4) ACUTE LUNG INJURY - Treat symptomatically.
    5) CORTICOSTEROIDS - may not be of benefit in treating pentane pneumonitis.
    6) ANTIBIOTICS - are indicated only if bacterial superinfection of the lungs occurs.
    B) MONITORING OF PATIENT
    1) COUGHING - If the patient is symptomatic upon arrival at the medical facility, aspiration has probably already occurred. Monitor arterial blood gases in cases of severe aspiration pneumonitis to ensure adequate ventilation.
    2) CHEST X-RAY - Admit and obtain chest x-ray in all symptomatic patients.
    a) If symptoms develop obtain chest x-ray. Observe patient for 6 hours. Discharge if asymptomatic.
    C) ACIDOSIS
    1) METABOLIC ACIDOSIS: Treat severe metabolic acidosis (pH less than 7.1) with sodium bicarbonate, 1 to 2 mEq/kg is a reasonable starting dose(Kraut & Madias, 2010). Monitor serum electrolytes and arterial or venous blood gases to guide further therapy.
    2) Repeat doses of no more than one-half the original amount may be given no more often than every 10 minutes if required (American Heart Association, 1987).
    D) SEIZURE
    1) SUMMARY
    a) Attempt initial control with a benzodiazepine (eg, diazepam, lorazepam). If seizures persist or recur, administer phenobarbital or propofol.
    b) Monitor for respiratory depression, hypotension, and dysrhythmias. Endotracheal intubation should be performed in patients with persistent seizures.
    c) Evaluate for hypoxia, electrolyte disturbances, and hypoglycemia (or, if immediate bedside glucose testing is not available, treat with intravenous dextrose).
    2) DIAZEPAM
    a) ADULT DOSE: Initially 5 to 10 mg IV, OR 0.15 mg/kg IV up to 10 mg per dose up to a rate of 5 mg/minute; may be repeated every 5 to 20 minutes as needed (Brophy et al, 2012; Prod Info diazepam IM, IV injection, 2008; Manno, 2003).
    b) PEDIATRIC DOSE: 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 (Loddenkemper & Goodkin, 2011; Hegenbarth & American Academy of Pediatrics Committee on Drugs, 2008).
    c) Monitor for hypotension, respiratory depression, and the need for endotracheal intubation. Consider a second agent if seizures persist or recur after repeated doses of diazepam .
    3) NO INTRAVENOUS ACCESS
    a) DIAZEPAM may be given rectally or intramuscularly (Manno, 2003). RECTAL DOSE: CHILD: Greater than 12 years: 0.2 mg/kg; 6 to 11 years: 0.3 mg/kg; 2 to 5 years: 0.5 mg/kg (Brophy et al, 2012).
    b) MIDAZOLAM has been used intramuscularly and intranasally, particularly in children when intravenous access has not been established. ADULT DOSE: 0.2 mg/kg IM, up to a maximum dose of 10 mg (Brophy et al, 2012). PEDIATRIC DOSE: INTRAMUSCULAR: 0.2 mg/kg IM, up to a maximum dose of 7 mg (Chamberlain et al, 1997) OR 10 mg IM (weight greater than 40 kg); 5 mg IM (weight 13 to 40 kg); INTRANASAL: 0.2 to 0.5 mg/kg up to a maximum of 10 mg/dose (Loddenkemper & Goodkin, 2011; Brophy et al, 2012). BUCCAL midazolam, 10 mg, has been used in adolescents and older children (5-years-old or more) to control seizures when intravenous access was not established (Scott et al, 1999).
    4) LORAZEPAM
    a) MAXIMUM RATE: The rate of intravenous administration of lorazepam should not exceed 2 mg/min (Brophy et al, 2012; Prod Info lorazepam IM, IV injection, 2008).
    b) ADULT DOSE: 2 to 4 mg IV initially; repeat every 5 to 10 minutes as needed, if seizures persist (Manno, 2003; Brophy et al, 2012).
    c) PEDIATRIC DOSE: 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 (Brophy et al, 2012; Loddenkemper & Goodkin, 2011; Hegenbarth & American Academy of Pediatrics Committee on Drugs, 2008; Sreenath et al, 2009; Chin et al, 2008).
    5) PHENOBARBITAL
    a) ADULT LOADING DOSE: 20 mg/kg IV at an infusion rate of 50 to 100 mg/minute IV. An additional 5 to 10 mg/kg dose may be given 10 minutes after loading infusion if seizures persist or recur (Brophy et al, 2012).
    b) Patients receiving high doses will require endotracheal intubation and may require vasopressor support (Brophy et al, 2012).
    c) PEDIATRIC LOADING DOSE: 20 mg/kg may be given as single or divided application (2 mg/kg/minute in children weighing less than 40 kg up to 100 mg/min in children weighing greater than 40 kg). A plasma concentration of about 20 mg/L will be achieved by this dose (Loddenkemper & Goodkin, 2011).
    d) REPEAT PEDIATRIC DOSE: Repeat doses of 5 to 20 mg/kg may be given every 15 to 20 minutes if seizures persist, with cardiorespiratory monitoring (Loddenkemper & Goodkin, 2011).
    e) MONITOR: For hypotension, respiratory depression, and the need for endotracheal intubation (Loddenkemper & Goodkin, 2011; Manno, 2003).
    f) SERUM CONCENTRATION MONITORING: Monitor serum concentrations over the next 12 to 24 hours. Therapeutic serum concentrations of phenobarbital range from 10 to 40 mcg/mL, although the optimal plasma concentration for some individuals may vary outside this range (Hvidberg & Dam, 1976; Choonara & Rane, 1990; AMA Department of Drugs, 1992).
    6) OTHER AGENTS
    a) If seizures persist after phenobarbital, propofol or pentobarbital infusion, or neuromuscular paralysis with general anesthesia (isoflurane) and continuous EEG monitoring should be considered (Manno, 2003). Other anticonvulsants can be considered (eg, valproate sodium, levetiracetam, lacosamide, topiramate) if seizures persist or recur; however, there is very little data regarding their use in toxin induced seizures, controlled trials are not available to define the optimal dosage ranges for these agents in status epilepticus (Brophy et al, 2012):
    1) VALPROATE SODIUM: ADULT DOSE: An initial dose of 20 to 40 mg/kg IV, at a rate of 3 to 6 mg/kg/minute; may give an additional dose of 20 mg/kg 10 minutes after loading infusion. PEDIATRIC DOSE: 1.5 to 3 mg/kg/minute (Brophy et al, 2012).
    2) LEVETIRACETAM: ADULT DOSE: 1000 to 3000 mg IV, at a rate of 2 to 5 mg/kg/min IV. PEDIATRIC DOSE: 20 to 60 mg/kg IV (Brophy et al, 2012; Loddenkemper & Goodkin, 2011).
    3) LACOSAMIDE: ADULT DOSE: 200 to 400 mg IV; 200 mg IV over 15 minutes (Brophy et al, 2012). PEDIATRIC DOSE: In one study, median starting doses of 1.3 mg/kg/day and maintenance doses of 4.7 mg/kg/day were used in children 8 years and older (Loddenkemper & Goodkin, 2011).
    4) TOPIRAMATE: ADULT DOSE: 200 to 400 mg nasogastric/orally OR 300 to 1600 mg/day orally divided in 2 to 4 times daily (Brophy et al, 2012).
    E) ACUTE LUNG INJURY
    1) ONSET: Onset of acute lung injury after toxic exposure may be delayed up to 24 to 72 hours after exposure in some cases.
    2) NON-PHARMACOLOGIC TREATMENT: The treatment of acute lung injury is primarily supportive (Cataletto, 2012). Maintain adequate ventilation and oxygenation with frequent monitoring of arterial blood gases and/or pulse oximetry. If a high FIO2 is required to maintain adequate oxygenation, mechanical ventilation and positive-end-expiratory pressure (PEEP) may be required; ventilation with small tidal volumes (6 mL/kg) is preferred if ARDS develops (Haas, 2011; Stolbach & Hoffman, 2011).
    a) To minimize barotrauma and other complications, use the lowest amount of PEEP possible while maintaining adequate oxygenation. Use of smaller tidal volumes (6 mL/kg) and lower plateau pressures (30 cm water or less) has been associated with decreased mortality and more rapid weaning from mechanical ventilation in patients with ARDS (Brower et al, 2000). More treatment information may be obtained from ARDS Clinical Network website, NIH NHLBI ARDS Clinical Network Mechanical Ventilation Protocol Summary, http://www.ardsnet.org/node/77791 (NHLBI ARDS Network, 2008)
    3) FLUIDS: Crystalloid solutions must be administered judiciously. Pulmonary artery monitoring may help. In general the pulmonary artery wedge pressure should be kept relatively low while still maintaining adequate cardiac output, blood pressure and urine output (Stolbach & Hoffman, 2011).
    4) ANTIBIOTICS: Indicated only when there is evidence of infection (Artigas et al, 1998).
    5) EXPERIMENTAL THERAPY: Partial liquid ventilation has shown promise in preliminary studies (Kollef & Schuster, 1995).
    6) CALFACTANT: In a multicenter, randomized, blinded trial, endotracheal instillation of 2 doses of 80 mL/m(2) calfactant (35 mg/mL of phospholipid suspension in saline) in infants, children, and adolescents with acute lung injury resulted in acute improvement in oxygenation and lower mortality; however, no significant decrease in the course of respiratory failure measured by duration of ventilator therapy, intensive care unit, or hospital stay was noted. Adverse effects (transient hypoxia and hypotension) were more frequent in calfactant patients, but these effects were mild and did not require withdrawal from the study (Wilson et al, 2005).
    7) However, in a multicenter, randomized, controlled, and masked trial, endotracheal instillation of up to 3 doses of calfactant (30 mg) in adults only with acute lung injury/ARDS due to direct lung injury was not associated with improved oxygenation and longer term benefits compared to the placebo group. It was also associated with significant increases in hypoxia and hypotension (Willson et al, 2015).
    F) CONTRAINDICATED TREATMENT
    1) Catecholamines should be used with caution due to possible decrease in the myocardial threshold for the arrythmogenic effects of endogenous catecholamines. Ventricular dysrhythmias may occur in this setting.
    G) CORTICOSTEROID
    1) Have not been shown to be of benefit in treating pentane pneumonitis.
    H) INJECTION
    1) Close medical follow-up for potential pneumonitis or local reaction is imperative. Aggressive management of local abscess with incision, drainage and appropriate antibiotic usage is indicated.

Inhalation Exposure

    6.7.1) DECONTAMINATION
    A) Move patient from the toxic environment to fresh air. Monitor for respiratory distress. If cough or difficulty in breathing develops, evaluate for hypoxia, respiratory tract irritation, bronchitis, or pneumonitis.
    B) OBSERVATION: Carefully observe patients with inhalation exposure for the development of any systemic signs or symptoms and administer symptomatic treatment as necessary.
    C) INITIAL TREATMENT: Administer 100% humidified supplemental oxygen, perform endotracheal intubation and provide assisted ventilation as required. Administer inhaled beta-2 adrenergic agonists, if bronchospasm develops. Consider systemic corticosteroids in patients with significant bronchospasm (National Heart,Lung,and Blood Institute, 2007). Exposed skin and eyes should be flushed with copious amounts of water.
    6.7.2) TREATMENT
    A) SUPPORT
    1) INITIAL TREATMENT: Administer 100% humidified supplemental oxygen with assisted ventilation as required. Exposed skin and eyes also exposed should be copiously flushed with water.
    B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Eye Exposure

    6.8.1) DECONTAMINATION
    A) EYE IRRIGATION, ROUTINE: 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, an ophthalmologic examination should be performed (Peate, 2007; Naradzay & Barish, 2006).

Dermal Exposure

    6.9.1) DECONTAMINATION
    A) DERMAL DECONTAMINATION
    1) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water for 10 to 15 minutes. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).
    6.9.2) TREATMENT
    A) IRRITATION SYMPTOM
    1) Treat dermal irritation or burns with standard topical therapy. Patients developing dermal hypersensitivity reactions may require treatment with systemic or topical corticosteroids or antihistamines.
    B) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Abstracts

Case Reports

    A) ROUTE OF EXPOSURE
    1) ORAL
    a) A 23-year-old male developed respiratory failure, seizures, severe esophagitis and gastritis, disseminated intravascular coagulation, hepatocellular injury, and oliguric renal insufficiency after ingesting 600 mL of refined gasoline (aliphatic hydrocarbon mixture with a small amount of aromatics) (Janssen et al, 1988).
    b) Two pediatric patients who ingested aliphatic hydrocarbons exhibited evidence of intravascular hemolysis (Algren & Rogers, 1992).
    c) A 3-year-old male who had ingested gasoline was initially stabilized with intubation, ventilation, and fluid resuscitation, with subsequent dopamine infusion. When his serum hemoglobin decreased from 14.5 g/dL to 4.6 g/dL within the first 8 hours, a transfusion of packed red blood cells was instituted with hemoglobin recovery and stability thereafter.
    d) A 1-year-old male ingested and aspirated kerosene. He developed severe pneumonitis and adult respiratory distress syndrome, requiring 6 weeks of mechanical ventilation and 3 months of hospitalization.

Range Of Toxicity

Summary

    A) Human subjects exposed to 5000 parts per million for 10 minutes did not experience mucous membrane irritation or other symptoms (Hathaway et al, 1991).
    B) The lowest concentration to produce toxic effects is 90,000 parts per million (Clayton & Clayton, 1981).
    C) Topical application of pentane to volunteers caused painful burning sensations accompanied by itching. After 5 hours, blisters formed on the exposed areas (Hathaway et al, 1991).

Minimum Lethal Exposure

    A) HUMAN
    1) The minimum lethal human dose to this agent has not been delineated.
    B) ANIMAL DATA
    1) The lethal inhalation concentration for mice is 129,000 ppm (OHM/TADS , 2002).

Maximum Tolerated Exposure

    A) HUMAN
    1) Based on results from multiple studies investigating pentane's acute, subchronic, developmental, and mutagenic effects, the conclusion was reached that n-pentane presents a very limited toxic hazard to humans (McKee et al, 1998).
    2) Pentane is moderately toxic by inhalation and intravenous routes, and narcotic in high concentrations. It may cause blisters on dermal contact. Its vapors can be irritating to the mucous membranes (Hathaway et al, 1996; Lewis, 2000) NTP, 2001). Aspiration of the liquid may result in chemical pneumonia or pulmonary edema (Budavari, 2000) NTP, 2001).
    a) However, persons with skin disorders or impaired pulmonary function may be more susceptible to the effects of exposure to pentane (HSDB , 2002).
    3) Pentane is not acutely toxic via ingestion (McKee et al, 1998).
    4) Human subjects exposed to pentane for 10 minutes at a concentration of 5000 ppm did not experience mucous membrane irritation or other symptoms (Hathaway et al, 1996).
    5) Topical application of pentane (concentration not specified) to five volunteers caused painful burning sensations accompanied by itching. Blisters formed on the exposed areas after five hours. Pain continued for 15 minutes after the pentane was removed (Bingham et al, 2001; Hathaway et al, 1991).
    6) Chronic exposure to pentane has resulted in anoxia (Bingham et al, 2001).
    7) Pentane has been judged to be clinically non-irritating to the skin (McKee et al, 1998).
    B) ANIMAL DATA
    1) In mice, no effects were observed after 5-minute exposures at 16,000 ppm or below (Hathaway et al, 1996).
    2) Rats exposed to 3000 ppm for 12 hours/day, 7 days/week, for 16 weeks exhibited no abnormal motor activity or peripheral neuropathy (Bingham et al, 2001).
    3) Rats exposed to 3000 ppm for for 9 hours/day, 5 days/week for 33 weeks showed no evidence of neurotoxicity, although an increase in body weight was observed (Bingham et al, 2001).
    4) Mice survived a 2-hour exposure to an excess of 100,000 ppm pentane (McKee et al, 2001).
    5) Based upon a 90-day inhalation test, the no-observable-adverse-effect-level (NOAEL) for rats was estimated at 20,000 mg/m(3). This was the highest concentration tested in this study (McKee et al, 1998).
    6) Subcutaneous injection of pentane produced neutropenia and temporarily decreased liver function in rats (HSDB , 2002).
    7) Rabbits experienced some limited and transient dermal irritation when pentane was applied to their skin. Erythema and/or edema was observed in most of the animals; these effects had subsided by the seventh day following pentane administration (McKee et al, 1998).
    8) Pentane was found to be non-sensitizing to the skin of guinea pigs (McKee et al, 1998).

Workplace Standards

    A) ACGIH TLV Values for CAS109-66-0 (American Conference of Governmental Industrial Hygienists, 2010):
    1) 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.
    a) Adopted Value
    1) Pentane, all isomers
    a) TLV:
    1) TLV-TWA: 600 ppm
    2) TLV-STEL:
    3) TLV-Ceiling:
    b) Notations and Endnotes:
    1) Carcinogenicity Category: Not Listed
    2) Codes: Not Listed
    3) Definitions: Not Listed
    c) TLV Basis - Critical Effect(s): Peripheral neuropathy
    d) Molecular Weight: 72.15
    1) For gases and vapors, to convert the TLV from ppm to mg/m(3):
    a) [(TLV in ppm)(gram molecular weight of substance)]/24.45
    2) For gases and vapors, to convert the TLV from mg/m(3) to ppm:
    a) [(TLV in mg/m(3))(24.45)]/gram molecular weight of substance
    e) Additional information:

    B) NIOSH REL and IDLH Values for CAS109-66-0 (National Institute for Occupational Safety and Health, 2007):
    1) Listed as: n-Pentane
    2) REL:
    a) TWA: 120 ppm (350 mg/m(3))
    b) STEL:
    c) Ceiling: 610 ppm (1800 mg/m(3)) [15-minute]
    d) Carcinogen Listing: (Not Listed) Not Listed
    e) Skin Designation: Not Listed
    f) Note(s):
    3) IDLH:
    a) IDLH: 1500 ppm
    b) Note(s): [10%LEL]
    1) [10%LEL]: The 10%LEL designation is provided where the IDLH was based on 10% of the lower explosive limit. This is used for safety purposes in some cases even though toxicity is not indicative of irreversible health effects or impairment of escape exists only at higher concentrations.

    C) Carcinogenicity Ratings for CAS109-66-0 :
    1) ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed ; Listed as: Pentane, all isomers
    2) EPA (U.S. Environmental Protection Agency, 2011): Not Listed
    3) 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
    4) NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed ; Listed as: n-Pentane
    5) MAK (DFG, 2002): Not Listed
    6) NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

    D) OSHA PEL Values for CAS109-66-0 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):
    1) Listed as: Pentane
    2) Table Z-1 for Pentane:
    a) 8-hour TWA:
    1) ppm: 1000
    a) Parts of vapor or gas per million parts of contaminated air by volume at 25 degrees C and 760 torr.
    2) mg/m3: 2950
    a) Milligrams of substances per cubic meter of air. When entry is in this column only, the value is exact; when listed with a ppm entry, it is approximate.
    3) Ceiling Value:
    4) Skin Designation: No
    5) Notation(s): Not Listed

Toxicity Information

    7.7.1) TOXICITY VALUES
    A) References: Bingham et al, 2001 Budavari, 2000 HSDB, 2002 Lewis, 2000 OHM/TADS, 2002 RTECS, 2002
    1) LD50- (ORAL)RAT:
    a) 400 mg/kg
    2) TCLo- (INHALATION)HUMAN:
    a) 130,000 ppm (OHM/TADS, 2002)

Pharmacology Toxicology

Pharmacologic Mechanism

    A) Pentane is an inhalational aesthetic. It has been shown in rat experiments that isonarcotic concentrations of pentane varied in the brain depending on the regimen of monoanesthesia.
    1) It has been demonstrated that the high content of anesthetic in the priming mixture results in a decline of the isoeffective brain concentration. Preliminary anesthesia leads to an increase in this indicator (Fateev et al, 1984).

Toxicologic Mechanism

    A) When applied to segments of rat nerve, n-pentane had a slow inhibitory action on the myelin sheath of the peripheral nerve tissue. A nerve impulse blockage has been demonstrated in the squid axon and also in the frog sciatic nerve that could be verified for pentane (Clayton & Clayton, 1981).
    B) Central nervous system degeneration affects exclusively the peripheral nervous system through demyelinization and axonal degeneration (Anon, 1974).
    C) MECHANISMS OF SUDDEN DEATH - Sudden death associated with volatile substance abuse may result from anoxia, vagal inhibition, respiratory depression, or cardiac arrhythmia (Shepherd, 1989).

Physicochemical

Physical Characteristics

    A) Pentane is a flammable, highly volitile, colorless liquid with a gasoline-like odor (Bingham et al, 2001; Budavari, 2000; HSDB , 2002; NIOSH , 2002).

Ph

    1) No information found at the time of this review.

Molecular Weight

    A) 72.15

References

General Bibliography

    1) 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.
    2) 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.
    3) 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.
    4) 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.
    5) 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.
    6) 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.
    7) 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.
    8) 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.
    9) 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.
    10) 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.
    11) 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.
    12) 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.
    13) AAR: Emergency Handling of Hazardous Materials in Surface Transportation, Bureau of Explosives, Association of American Railroads, Washington, DC, 2000.
    14) ACGIH: Documentation of the Threshold Limit Values and Biological Exposure Indices, 6th ed, Am Conference of Govt Ind Hyg, Inc, Cincinnati, OH, 1991.
    15) ACGIH: Documentation of the Threshold Limit Values and Biological Exposure Indices, 6th ed, Am Conference of Govt Ind Hyg, Inc, Cincinnati, OH, 1992, pp 1185-1187.
    16) ACGIH: Documentation of the Threshold Limit Values and Biological Exposure Indices. 6th ed, Am Conference of Govt Ind Hyg, Inc, Cincinnati, OH, 1991a.
    17) AIHA: 2006 Emergency Response Planning Guidelines and Workplace Environmental Exposure Level Guides Handbook, American Industrial Hygiene Association, Fairfax, VA, 2006.
    18) AMA Department of DrugsAMA Department of Drugs: AMA Evaluations Subscription, American Medical Association, Chicago, IL, 1992.
    19) Algren JT & Rodgers GC Jr: Intravascular hemolysis associated with hydrocarbon poisoning. Pediatr Emerg Care 1992; 8:34-35.
    20) Allerheiligen SR, Ludden TM, & Burk RF: The pharmacokinetics of pentane, a by-product of lipid peroxidation. Drug Metab Disp 1987; 15:794-800.
    21) 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.
    22) Anas N, Namasonthi V, & Ginsburg CM: Criteria for hospitalizing children who have ingested products containing hydrocarbons. JAMA 1981; 246:840-843.
    23) Anderson HR, Bloor K, & Macnair RS: Recent trends in mortality associated with abuse of volatile substances in the UK. Br Med J 1986; 293:1472-1473.
    24) Anderson HR, Macnair RS, & Ramsey JD: Deaths from abuse of volatile substances: a national epidemiological study. Br Med J 1985; 290:304-307.
    25) Anon: Hexane (n-hexane). Work Groups for Determination of MAK Values and Determination of Limit Values for Dusts: Work Substances Harmful to Health -- Toxicologic and Occupational-Medical Justifications of MAK Values (Maximum Work Place Concentrations), Verlag Chemie, Wurzburg, Germany, 1974.
    26) Ansell-Edmont: SpecWare Chemical Application and Recommendation Guide. Ansell-Edmont. Coshocton, OH. 2001. Available from URL: http://www.ansellpro.com/specware. As accessed 10/31/2001.
    27) Artigas A, Bernard GR, Carlet J, et al: The American-European consensus conference on ARDS, part 2: ventilatory, pharmacologic, supportive therapy, study design strategies, and issues related to recovery and remodeling.. Am J Respir Crit Care Med 1998; 157:1332-1347.
    28) Ashford R: Ashford's Dictionary of Industrial Chemicals, Wavelength Publications Ltd, London, England, 1994.
    29) Banner W Jr & Walson PD: Systemic toxicity following gasoline aspiration. Am J Emerg Med 1983; 3:292-294.
    30) Barrientos A, Ortuno MT, & Morales JM: Acute renal failure after use of diesel fuel as shampoo. Arch Intern Med 1977; 37:1217.
    31) Bass M: Death from sniffing gasoline (Letter). N Engl J Med 1978; 299:203.
    32) Bata Shoe Company: Industrial Footwear Catalog, Bata Shoe Company, Belcamp, MD, 1995.
    33) Beamon RF, Siegel CJ, & Landers G: Hydrocarbon ingestion in children: a six-year retrospective study. JACEP 1976; 5:771-775.
    34) Beirne GJ & Brennan JT: Glomerulonephritis associated with hydrocarbon solvents. Arch Environ Health 1972; 25:365-369.
    35) Best Manufacturing: ChemRest Chemical Resistance Guide. Best Manufacturing. Menlo, GA. 2002. Available from URL: http://www.chemrest.com. As accessed 10/8/2002.
    36) Best Manufacturing: Degradation and Permeation Data. Best Manufacturing. Menlo, GA. 2004. Available from URL: http://www.chemrest.com/DomesticPrep2/. As accessed 04/09/2004.
    37) Bingham E, Cohrssen B, & Powell CH: Patty's Toxicology, Vol 4. 5th ed, John Wiley & Sons, New York, NY, 2001.
    38) Bingham E, Cohrssen B, & Powell CH: Patty's Toxicology, Vol 4. 5th ed, John Wiley & Sons, New York, NY, 2001a.
    39) Bombassei GJ & Kaplan AA: The association between hydrocarbon exposure and anti-glomerular basement membrane antibody-mediated disease (Goodpasture's syndrome). Am J Ind Med 1992; 21:141-153.
    40) Boss Manufacturing Company: Work Gloves, Boss Manufacturing Company, Kewanee, IL, 1998.
    41) Brophy GM, Bell R, Claassen J, et al: Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012; 17(1):3-23.
    42) Brower RG, Matthay AM, & Morris A: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Eng J Med 2000; 342:1301-1308.
    43) Budavari S: The Merck Index, 11th ed, Merck & Co, Inc, Rahway, NJ, 1989, pp 1128.
    44) Budavari S: The Merck Index, 12th ed, Merck & Co, Inc, Whitehouse Station, NJ, 1996, pp 1224.
    45) Budavari S: The Merck Index, 12th ed. on CD-ROM. Version 12:3a. Chapman & Hall/CRCnetBASE. Whitehouse Station, NJ. 2000.
    46) Burgess JL, Kirk M, Borron SW, et al: Emergency department hazardous materials protocol for contaminated patients. Ann Emerg Med 1999; 34(2):205-212.
    47) CHRIS : CHRIS Hazardous Chemical Data. US Department of Transportation, US Coast Guard. Washington, DC (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    48) CHRIS: CHRIS Hazardous Chemical Data. US Department of Transportation, US Coast Guard. Washington, DC (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    49) CHRIS: CHRIS Hazardous Chemical Data. US Department of Transportation, US Coast Guard. Washington, DC (Internet Version). Edition expires 2004; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    50) CRS: Results for Pentane.. U.S. Environmental Protection Agency's Chemical Registry System. Washington, DC, USA. 2002. Available from URL: http://oaspub.epa.gov/crs/. As accessed Accessed July 22, 2002.
    51) Cagnoli L, Casanova S, & Pasquali S: Relation between hydrocarbon exposure and nephrotic syndrome. Br Med J 1980; 280:1068-1069.
    52) Cali V & Pennino G: Contribution to the study of acute intoxication from crude oil vapors. Folia Medica 1954; 37:827-836.
    53) Caravati EM: Alkali. In: Dart RC, ed. Medical Toxicology, Lippincott Williams & Wilkins, Philadelphia, PA, 2004.
    54) Cassidy SB, Gainey AJ, & Butler MG: Occupational hydrocarbon exposure among fathers of Prader-Willi syndrome patients with and without deletions of 15q. Am J Human Genet 1989; 44:806-810.
    55) Cataletto M: Respiratory Distress Syndrome, Acute(ARDS). In: Domino FJ, ed. The 5-Minute Clinical Consult 2012, 20th ed. Lippincott Williams & Wilkins, Philadelphia, PA, 2012.
    56) Chamberlain JM, Altieri MA, & Futterman C: A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children. Ped Emerg Care 1997; 13:92-94.
    57) ChemFab Corporation: Chemical Permeation Guide Challenge Protective Clothing Fabrics, ChemFab Corporation, Merrimack, NH, 1993.
    58) Chemsoft(R) : Electronic EPA, NIOSH, & OSHA Methods(TM). Windowchem(TM) Software. Fairfield, CA. 2000.
    59) Chin RF , Neville BG , Peckham C , et al: Treatment of community-onset, childhood convulsive status epilepticus: a prospective, population-based study. Lancet Neurol 2008; 7(8):696-703.
    60) Choonara IA & Rane A: Therapeutic drug monitoring of anticonvulsants state of the art. Clin Pharmacokinet 1990; 18:318-328.
    61) Chyka PA, Seger D, Krenzelok EP, et al: Position paper: Single-dose activated charcoal. Clin Toxicol (Phila) 2005; 43(2):61-87.
    62) Clayton GD & Clayton FE: Patty's Industrial Hygiene and Toxicology, Vol 2B, Toxicology, 3rd ed, John Wiley & Sons, New York, NY, 1981, pp 3184-3185.
    63) Clayton GD & Clayton FE: Patty's Industrial Hygiene and Toxicology, Vol 2B, Toxicology, 4th ed, John Wiley & Sons, New York, NY, 1994, pp 1231-1232.
    64) Comasec Safety, Inc.: Chemical Resistance to Permeation Chart. Comasec Safety, Inc.. Enfield, CT. 2003. Available from URL: http://www.comasec.com/webcomasec/english/catalogue/mtabgb.html. As accessed 4/28/2003.
    65) Comasec Safety, Inc.: Product Literature, Comasec Safety, Inc., Enfield, CT, 2003a.
    66) Crisp AJ, Bhalla AK, & Hoffbrand BI: Acute tubular necrosis after exposure to diesel oil. Br Med J 1979; 7:177.
    67) 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.
    68) Devaux M: J Med Leg Droit Med 1983; 26:269-278.
    69) Drury JA, Nycyk JA, & Cooke RWI: Pentane measurement in ventilated infants using a commercially available system. Free Radic Biol Med 1997; 22:895-900.
    70) DuPont: DuPont Suit Smart: Interactive Tool for the Selection of Protective Apparel. DuPont. Wilmington, DE. 2002. Available from URL: http://personalprotection.dupont.com/protectiveapparel/suitsmart/smartsuit2/na_english.asp. As accessed 10/31/2002.
    71) DuPont: Permeation Guide for DuPont Tychem Protective Fabrics. DuPont. Wilmington, DE. 2003. Available from URL: http://personalprotection.dupont.com/en/pdf/tyvektychem/pgcomplete20030128.pdf. As accessed 4/26/2004.
    72) DuPont: Permeation Test Results. DuPont. Wilmington, DE. 2002a. Available from URL: http://www.tyvekprotectiveapprl.com/databases/default.htm. As accessed 7/31/2002.
    73) 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/.
    74) 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.
    75) Ehrenreich T: Renal disease from exposure to solvents. Ann Clin Lab Sci 1977; 7:6-16.
    76) Elliot CG, Colby TV, & Kelly TM: Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal. Chest 1989; 96:672-674.
    77) Euler DE, Dave SJ, & Guo HS: Effect of cigarette smoking on pentane excretion in alveolar breath. Clin Chem 1996; 42:303-308.
    78) FDA: Poison treatment drug product for over-the-counter human use; tentative final monograph. FDA: Fed Register 1985; 50:2244-2262.
    79) Fateev VA, Titov NS, & Saliaev VN: General inhalant anesthetics: the dependence of the narcotic effect on the concentration in the brain. Farmakologiia i Toksikologiia 1984; 47:8-15.
    80) Fuhner H: The narcotic effect of gasoline and its components (pentane, hexane, heptane, octane). Biochemische Zeitschrift 1921; 115:235-261.
    81) Gaultier M, Rancurel G, & Piva C: Polyneuritis and aliphatic hydrocarbons. Eur J Toxicol 1973; 6:294-296.
    82) Glowa JR: Behavioral toxicology of volatile organic solvents. V. comparisons of the behavioral and neuroendocrine effects among n-alkanes. J Am Coll Toxicol 1991; 10:639-646.
    83) Glynn KP & Gale NA: Exogenous lipoid pneumonia due to inhalation of spray lubricant (WD-40 lung). Chest 1990; 97:1265-1266.
    84) Goldfrank L, Kirstein R, & Bresnitz E: Gasoline and other hydrocarbons. Hosp Phys 1979; 32-39.
    85) Golej J, Boigner H, Burda G, et al: Severe respiratory failure following charcoal application in a toddler. Resuscitation 2001; 49:315-318.
    86) Gosselin R, Hodge H, & Smith R: Clinical Toxicology of Commercial Products, 4th ed, Williams & Wilkins, Baltimore, MD, 1976, pp 189.
    87) Graff GR, Stark J, & Berkenbosch JW: Chronic lung disease after activated charcoal aspiration. Pediatrics 2002; 109:959-961.
    88) Grant WM: Toxicology of the Eye, 3rd ed, Charles C Thomas, Springfield, IL, 1986.
    89) Guardian Manufacturing Group: Guardian Gloves Test Results. Guardian Manufacturing Group. Willard, OH. 2001. Available from URL: http://www.guardian-mfg.com/guardianmfg.html. As accessed 12/11/2001.
    90) HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 1994; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    91) HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    92) 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.
    93) HSDB: Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    94) Haas CF: Mechanical ventilation with lung protective strategies: what works?. Crit Care Clin 2011; 27(3):469-486.
    95) Harris CR & Filandrinos D: Accidental administration of activated charcoal into the lung: aspiration by proxy. Ann Emerg Med 1993; 22:1470-1473.
    96) Hashimoto DB, Kelsey KT, & Seitz T: The presence of urinary cellular sediment and albuminuria in newspaper press workers exposed to solvents. J Occup Med 1991; 33:516-526.
    97) Hathaway GJ, Proctor NH, & Hughes JP: Chemical Hazards of the Workplace, 3rd ed, Van Nostrand Reinhold Company, New York, NY, 1991, pp 462-463.
    98) Hathaway GJ, Proctor NH, & Hughes JP: Chemical Hazards of the Workplace, 4th ed, Van Nostrand Reinhold Company, New York, NY, 1996.
    99) Hegenbarth MA & American Academy of Pediatrics Committee on Drugs: Preparing for pediatric emergencies: drugs to consider. Pediatrics 2008; 121(2):433-443.
    100) Hodgson MJ, Furman J, & Ryan C: Encephalopathy and vestibulopathy following short-term hydrocarbon exposure. J Occup Med 1989; 31:51-54.
    101) Hotz P, Pilliod J, & Berode M: Glycosaminoglycans, albuminuria and hydrocarbon exposure. Nephron 1991; 58:184-191.
    102) Howard PH: Handbook of Environmental Fate and Exposure Data for Organic Chemicals, Volume IV: Solvents 2, Lewis Publishers, Chelsea, MI, 1993.
    103) Howard: Handbook of Environmental Fate & Exposure Data for Organic Chemicals, 4, Lewis Publishers, Chelsea, MI, 1993a.
    104) Hvidberg EF & Dam M: Clinical pharmacokinetics of anticonvulsants. Clin Pharmacokinet 1976; 1:161.
    105) 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.
    106) 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.
    107) 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.
    108) 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.
    109) 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.
    110) 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.
    111) ICAO: Technical Instructions for the Safe Transport of Dangerous Goods by Air, 2003-2004. International Civil Aviation Organization, Montreal, Quebec, Canada, 2002.
    112) ICSC: International Chemical Safety Cards: n-Pentane. International Programme of Chemical Safety (IPCS) and the Commission of the European Union (EC). International Programme of Chemical Safety (IPCS) and the Commission of the European Union (EC), Canadian Center for Occupation Health and Safety. Geneva, Switzerland, and Ontario, Canada. 2001. Available from URL: http://www.inchem.org. As accessed Accessed 2002 Jul 22.
    113) ILC Dover, Inc.: Ready 1 The Chemturion Limited Use Chemical Protective Suit, ILC Dover, Inc., Frederica, DE, 1998.
    114) ILO : Encyclopedia of Occupational Health and Safety, 4th ed. Vol 1-4. (CD ROM Version). International Labour Organization. Geneva, Switzerland. 1998.
    115) ILO: Encyclopaedia of Occupational Health & Safety, 4th ed. Vol 1-4.JM Stellman (Ed), International Labour Organization, Geneva, Switzerland, 1998.
    116) ITI: Toxic and Hazardous Industrial Chemicals Safety Manual, The International Technical Information Institute, Tokyo, Japan, 1995.
    117) 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.
    118) 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.
    119) Janssen S, van der Geest S, & Meijer S: Impairment of organ function after oral ingestion of refined petrol. Intensive Care Med 1988; 14:238-240.
    120) Kadamani S, Asal NR, & Nelson RY: Occupational hydrocarbon exposure and risk of renal cell carcinoma. Am J Ind Med 1989; 15:131-141.
    121) Kappler, Inc.: Suit Smart. Kappler, Inc.. Guntersville, AL. 2001. Available from URL: http://www.kappler.com/suitsmart/smartsuit2/na_english.asp?select=1. As accessed 7/10/2001.
    122) Kimberly-Clark, Inc.: Chemical Test Results. Kimberly-Clark, Inc.. Atlanta, GA. 2002. Available from URL: http://www.kc-safety.com/tech_cres.html. As accessed 10/4/2002.
    123) Kollef MH & Schuster DP: The acute respiratory distress syndrome. N Engl J Med 1995; 332:27-37.
    124) Kraut JA & Madias NE: Metabolic acidosis: pathophysiology, diagnosis and management. Nat Rev Nephrol 2010; 6(5):274-285.
    125) Kulig K & Rumack B: Hydrocarbon ingestion. Curr Top Emerg Med 1981; 3:1-5.
    126) LaCrosse-Rainfair: Safety Products, LaCrosse-Rainfair, Racine, WI, 1997.
    127) Lazarev NW: Toxicity of various hydrocarbon vapors. Arch Exp Pathol Pharmakol 1929; 143:223-233.
    128) Leira HL, Myhr G, & Nilsen G: Cerebral magnetic resonance imaging and cerebral computerized tomography for patients with solvent-induced encephalopathy. Scand J Work Environ Health 1992; 18:68-70.
    129) Lewis RJ: Hawley's Condensed Chemical Dictionary, 13th ed, John Wiley & Sons, Inc, New York, NY, 1997.
    130) Lewis RJ: Hawley's Condensed Chemical Dictionary, 13th ed, John Wiley & Sons, Inc, New York, NY, 2001a.
    131) Lewis RJ: Hawley's Condensed Chemical Dictionary, 14th ed, John Wiley & Sons, Inc, New York, NY, 2001.
    132) Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 10th ed, John Wiley & Sons, New York, NY, 2000a.
    133) Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 10th ed, Van Nostrand Reinhold Company, New York, NY, 2000.
    134) Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 8th ed, Van Nostrand Reinhold Company, New York, NY, 1992, pp 2687.
    135) Leyendecker D, Schmitz FP, & Leyendecker D: Chromatography with sub- and supercritical eluents: influence of temperature, pressure and flow-rate on the behaviour of lower alkanes. J Chromatogr 1985; 321:273-286.
    136) Lindbohm ML, Taskinen H, & Sallmen M: Spontaneous abortions among women exposed to organic solvents. Am J Ind Med 1990; 17:449-463.
    137) Linden CH: Volatile substances of abuse. Emerg Med Clin North Am 1990; 8:559-578.
    138) Loddenkemper T & Goodkin HP: Treatment of Pediatric Status Epilepticus. Curr Treat Options Neurol 2011; Epub:Epub.
    139) MAPA Professional: Chemical Resistance Guide. MAPA North America. Columbia, TN. 2003. Available from URL: http://www.mapaglove.com/pro/ChemicalSearch.asp. As accessed 4/21/2003.
    140) MAPA Professional: Chemical Resistance Guide. MAPA North America. Columbia, TN. 2004. Available from URL: http://www.mapaglove.com/ProductSearch.cfm?id=1. As accessed 6/10/2004.
    141) Mackison FW, Stricoff RS, & Partridge LJ Jr: NIOSH/OSHA - Occupational Health Guidelines for Chemical Hazards. DHHS(NIOSH) Publication No 81-123 (3 VOLS), US Government Printing Office, Washington, DC, 1981.
    142) Manno EM: New management strategies in the treatment of status epilepticus. Mayo Clin Proc 2003; 78(4):508-518.
    143) Mar-Mac Manufacturing, Inc: Product Literature, Protective Apparel, Mar-Mac Manufacturing, Inc., McBee, SC, 1995.
    144) Marigold Industrial: US Chemical Resistance Chart, on-line version. Marigold Industrial. Norcross, GA. 2003. Available from URL: www.marigoldindustrial.com/charts/uschart/uschart.html. As accessed 4/14/2003.
    145) McKee R, Frank E, & Heath J: Toxicology of n-Pentane (CAS no. 109-66-0). J. Appl. Toxicol 1998; 18:431-442.
    146) McKee RH & Plutnick RT: Carcinogenic potential of gasoline and diesel engine oils. Fundam Appl Toxicol 1989; 13:545-553.
    147) Mehlman MA: Recent laboratory studies in chemical carcinogenesis: gasoline. Ann Acad Sci 1988; 534:408-411.
    148) Memphis Glove Company: Permeation Guide. Memphis Glove Company. Memphis, TN. 2001. Available from URL: http://www.memphisglove.com/permeation.html. As accessed 7/2/2001.
    149) Moen BE, Kyvik KR, & Engelsen BA: Cerebrospinal fluid proteins and free amino acids in patients with solvent induced chronic toxic encephalopathy and healthy controls. Br J Ind Med 1990; 47:277-280.
    150) Montgomery Safety Products: Montgomery Safety Products Chemical Resistant Glove Guide, Montgomery Safety Products, Canton, OH, 1995.
    151) NFPA: Fire Protection Guide to Hazardous Materials, 13th ed, National Fire Protection Association, Quincy, MA, 2002a.
    152) NFPA: Fire Protection Guide to Hazardous Materials, 13th ed., National Fire Protection Association, Quincy, MA, 2002.
    153) NHLBI ARDS Network: Mechanical ventilation protocol summary. Massachusetts General Hospital. Boston, MA. 2008. Available from URL: http://www.ardsnet.org/system/files/6mlcardsmall_2008update_final_JULY2008.pdf. As accessed 2013-08-07.
    154) NIOSH : Pocket Guide to Chemical Hazards (Internet Version). National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    155) NIOSH: Criteria for a Recommended Standard...Occupational Exposure to Alkanes (C5-C8). NIOSH, Hew Pub No. 77-151, National Institutue for Occupational Safety and Health, Cincinnati, OH, 1977, pp 137.
    156) NIOSH: Pocket Guide to Chemical Hazards. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    157) 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.
    158) 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.
    159) 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.
    160) 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.
    161) NTP : National Toxicology Program. 2001 August. Health and Safety Guideline for Pentane. National Toxicology Program, US Department of Human Health Services, National Institutes of Health. Research Triangle Park, NC. 2001. Available from URL: http://ntp-server.niehs.nih.gov/htdocs/CHEM_H&S/NTP_Chem1/ Radian109-66-0.html.
    162) Naradzay J & Barish RA: Approach to ophthalmologic emergencies. Med Clin North Am 2006; 90(2):305-328.
    163) Narvarte J, Saba SR, & Ramirez G: Occupational exposure to organic solvents causing chronic tubulointerstitial nephritis. Arch Intern Med 1989; 149:154-158.
    164) Nat-Wear: Protective Clothing, Hazards Chart. Nat-Wear. Miora, NY. 2001. Available from URL: http://www.natwear.com/hazchart1.htm. As accessed 7/12/2001.
    165) 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.
    166) 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.
    167) 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.
    168) 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.
    169) 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.
    170) 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.
    171) 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.
    172) 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.
    173) 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.
    174) 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.
    175) 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.
    176) 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.
    177) 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.
    178) 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.
    179) 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.
    180) 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.
    181) 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.
    182) 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.
    183) 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.
    184) 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.
    185) 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.
    186) 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.
    187) 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.
    188) 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.
    189) 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.
    190) 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.
    191) 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.
    192) 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.
    193) 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.
    194) 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.
    195) 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.
    196) 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.
    197) 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.
    198) 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.
    199) 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.
    200) 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.
    201) 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.
    202) 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.
    203) 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.
    204) 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.
    205) 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.
    206) 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.
    207) 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.
    208) 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.
    209) 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.
    210) 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.
    211) 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.
    212) 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.
    213) 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.
    214) 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.
    215) 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.
    216) 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.
    217) 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.
    218) 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.
    219) 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.
    220) 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.
    221) 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.
    222) 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.
    223) 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.
    224) 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.
    225) 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.
    226) 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.
    227) 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.
    228) 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.
    229) 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.
    230) 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.
    231) 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.
    232) 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.
    233) 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.
    234) 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.
    235) 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.
    236) 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.
    237) 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.
    238) 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.
    239) National Heart,Lung,and Blood Institute: Expert panel report 3: guidelines for the diagnosis and management of asthma. National Heart,Lung,and Blood Institute. Bethesda, MD. 2007. Available from URL: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.
    240) 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.
    241) National Research Council : Acute exposure guideline levels for selected airborne chemicals, 5, National Academies Press, Washington, DC, 2007.
    242) National Research Council: Acute exposure guideline levels for selected airborne chemicals, 6, National Academies Press, Washington, DC, 2008.
    243) National Research Council: Acute exposure guideline levels for selected airborne chemicals, 7, National Academies Press, Washington, DC, 2009.
    244) National Research Council: Acute exposure guideline levels for selected airborne chemicals, 8, National Academies Press, Washington, DC, 2010.
    245) Neese Industries, Inc.: Fabric Properties Rating Chart. Neese Industries, Inc.. Gonzales, LA. 2003. Available from URL: http://www.neeseind.com/new/TechGroup.asp?Group=Fabric+Properties&Family=Technical. As accessed 4/15/2003.
    246) Nelson NA, Robins TG, & Port FK: Solvent nephrotoxicity in humans and experimental animals. Am J Nephrol 1990; 10:10-20.
    247) Nierenberg DW, Horowitz MB, & Harris KM: Mineral spirits inhalation associated with hemolysis, pulmonary edema, and ventricular fibrillation. Arch Intern Med 1991; 151:1437-1440.
    248) None Listed: Position paper: cathartics. J Toxicol Clin Toxicol 2004; 42(3):243-253.
    249) North: Chemical Resistance Comparison Chart - Protective Footwear . North Safety. Cranston, RI. 2002. Available from URL: http://www.linkpath.com/index2gisufrm.php?t=N-USA1. As accessed April 30, 2004.
    250) North: eZ Guide Interactive Software. North Safety. Cranston, RI. 2002a. Available from URL: http://www.northsafety.com/feature1.htm. As accessed 8/31/2002.
    251) OHM/TADS : Oil and Hazardous Materials/Technical Assistance Data System. US Environmental Protection Agency. Washington, DC (Internet Version). Edition expires 8/31/2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    252) OHM/TADS: Oil and Hazardous Materials Technical Assistance Data System. US Environmental Protection Agency. Washington, D.C. (Internet Version). Edition expires 2004; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    253) OHM/TADS: Oil and Hazardous Materials/Technical Assistance Data System. US Environmental Protection Agency. Washington, DC (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.
    254) Peate WF: Work-related eye injuries and illnesses. Am Fam Physician 2007; 75(7):1017-1022.
    255) Playtex: Fits Tough Jobs Like a Glove, Playtex, Westport, CT, 1995.
    256) Pohanish RP & Greene SA: Rapid Guide to Chemical Incompatibilities, Van Nostrand Reinhold Company, New York, NY, 1997.
    257) Pollack MM, Dunbar BS, & Holbrook PR: Aspiration of activated charcoal and gastric contents. Ann Emerg Med 1981; 10:528-529.
    258) Pollard TG: Relative addiction potential of major centrally-active drugs and drug classes -- inhalants and anesthetics. Adv Alcohol Subst Abuse 1990; 9:149-165.
    259) Product Information: diazepam IM, IV injection, diazepam IM, IV injection. Hospira, Inc (per Manufacturer), Lake Forest, IL, 2008.
    260) Product Information: lorazepam IM, IV injection, lorazepam IM, IV injection. Akorn, Inc, Lake Forest, IL, 2008.
    261) Rau NR, Nagaraj MV, Prakash PS, et al: Fatal pulmonary aspiration of oral activated charcoal. Br Med J 1988; 297:918-919.
    262) River City: Protective Wear Product Literature, River City, Memphis, TN, 1995.
    263) Roy AT, Brautbar N, & Lee DBN: Hydrocarbons and renal failure. Nephron 1991; 58:358-392.
    264) Safety 4: North Safety Products: Chemical Protection Guide. North Safety. Cranston, RI. 2002. Available from URL: http://www.safety4.com/guide/set_guide.htm. As accessed 8/14/2002.
    265) Sandmark B, Broms I, & Lofgren L: Olfactory function in painters exposed to organic solvents. Scand J work Environ Health 1989; 15:60-63.
    266) Scott R, Besag FMC, & Neville BGR: Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomized trial. Lancet 1999; 353:623-626.
    267) Servus: Norcross Safety Products, Servus Rubber, Servus, Rock Island, IL, 1995.
    268) Shepherd RT: Mechanism of sudden death associated with volatile substance abuse. Human Toxicol 1989; 8:287-292.
    269) Shirkey HC: Treatment of petroleum distillate ingestion. Mod Treatment 1971; 8:580-592.
    270) Sittig M: Handbook of Toxic and Hazardous Chemicals and Carcinogens, 3rd ed, Noyes Publications, Park Ridge, NJ, 1991.
    271) Snyder R: Ethyl Browning's Toxicity and Metabolism of Industrial Solvents, 2nd ed, Vol 1: Hydrocarbons, Elsevier, New York, NY, 1987.
    272) Sreenath TG, Gupta P, Sharma KK, et al: Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: A randomized controlled trial. Eur J Paediatr Neurol 2009; Epub:Epub.
    273) Standard Safety Equipment: Product Literature, Standard Safety Equipment, McHenry, IL, 1995.
    274) Stolbach A & Hoffman RS: Respiratory Principles. In: Nelson LS, Hoffman RS, Lewin NA, et al, eds. Goldfrank's Toxicologic Emergencies, 9th ed. McGraw Hill Medical, New York, NY, 2011.
    275) Strakowski SM & Butler MG: Paternal hydrocarbon exposure in Prader-Willi syndrome (Letter). Lancet 1987; 2:1458.
    276) Swann HE, Kwon BK, & Hogan GK: Acute inhalation toxicology of volatile hydrocarbons. Am Ind Hyg Assoc J 1974; 35:511-518.
    277) Tingley: Chemical Degradation for Footwear and Clothing. Tingley. South Plainfield, NJ. 2002. Available from URL: http://www.tingleyrubber.com/tingley/Guide_ChemDeg.pdf. As accessed 10/16/2002.
    278) Trelleborg-Viking, Inc.: Chemical and Biological Tests (database). Trelleborg-Viking, Inc.. Portsmouth, NH. 2002. Available from URL: http://www.trelleborg.com/protective/. As accessed 10/18/2002.
    279) Trelleborg-Viking, Inc.: Trellchem Chemical Protective Suits, Interactive manual & Chemical Database. Trelleborg-Viking, Inc.. Portsmouth, NH. 2001.
    280) 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.
    281) 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.
    282) 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-.
    283) 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.
    284) 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.
    285) 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.
    286) 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.
    287) 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-.
    288) U.S. Occupational Safety, and Health Administration (OSHA): Process safety management of highly hazardous chemicals. 29 CFR 2010 2010; 29(1910.119):348-.
    289) 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.
    290) Verschueren K: Handbook of Environmental Data on Organic Chemicals. 4th ed. CD-ROM version. Wiley-Interscience. Hoboken, NJ. 2001.
    291) Wedin GP & Jones RR: Parenteral administration of hydrocarbons. Clin Toxicol 1984; 22:485-492.
    292) Wells Lamont Industrial: Chemical Resistant Glove Application Chart. Wells Lamont Industrial. Morton Grove, IL. 2002. Available from URL: http://www.wellslamontindustry.com. As accessed 10/31/2002.
    293) Willson DF, Truwit JD, Conaway MR, et al: The adult calfactant in acute respiratory distress syndrome (CARDS) trial. Chest 2015; 148(2):356-364.
    294) Wilson DF, Thomas NJ, Markovitz BP, et al: Effect of exogenous surfactant (calfactant) in pediatric acute lung injury. A randomized controlled trial. JAMA 2005; 293:470-476.
    295) Wirtschafter ZT & Bischel MG: Reticuloendothelial response to pentane. Am Med Assoc Arch Ind Health 1960; 21:152-159.
    296) Workrite: Chemical Splash Protection Garments, Technical Data and Application Guide, W.L. Gore Material Chemical Resistance Guide, Workrite, Oxnard, CA, 1997.
    297) Yamada S: Polyneuritis in workers exposed to n-hexane, its cause and symptoms. Japan J Ind Health 1972; 9:651-659.
    298) Zimmerman SW, Groehler K, & Beirne GJ: Hydrocarbon exposure and chronic glomerulonephritis. Lancet 1975; 2:199-201.