POTASSIUM PERMANGANATE

C.I. NUMBER:77755
EPA PESTICIDE CHEMICAL CODE:068501
IMO CLASSIFICATION:5.1 - Potassium permanganate
STANDARD INDUSTRIAL TRADE CLASSIFICATION NUMBER:52389

MOLECULAR FORMULA

KMnO4
H-Mn-O4.K

ERG GUIDE NUMBER

140-OXIDIZERS(for UN/NA Number1490)

SYNONYM REFERENCE

(HSDB, 2004; Pohanish, 2002; RTECS, 2004)

USES/FORMS/SOURCES

USES

Potassium permanganate's industrial uses include bleaching resins, waxes, fats, oils, straw, cotton, silk and other fibers and chamois skins; dyeing wood; printing fabrics; purifying air and water; decontamination of skin; treatment of eczema; etching rubber and plastic; surface treatment of steel (especially in wire manufacture); and tanning leathers. It is also used as a fungicide; insecticide; miticide; algicide; bacteriocide; germicide; antiseptic; oxidizer; disinfectant; deodorant; sanitizer; chemical in photography; and reagent in analytical and synthetic organic chemistry (Goldfrank et al, 2002; HSDB, 2004; Pohanish, 2002; Budavari, 2001; Lewis, 2001; Lewis, 1998).
Therapeutically, potassium permanganate is used as a topical anti-infective. In veterinary medicine it is used as a topical antiseptic, astringent, and deodorant (Budavari, 2001).
Illicit uses have included the production of drugs of abuse, and induction of abortion by topical application to the vaginal wall (21 CFR 250.108, 2003; Lewis, 2000; Lewis, 2000; Lewis, 1998).
Historically, potassium permanganate has been used as a urethral irrigant, lavage fluid for alkaloid poisoning, and remedy for snakebites (Goldfrank et al, 2002).

FORMS

At room temperature, potassium permanganate exists as dark purple or bronze-colored, odorless, sweetish, astringent tasting orthorhombic crystals that are almost opaque by transmitted light and have a blue, metallic sheen by reflected light. It is readily soluble in water; aqueous solutions are pink to violet in color, depending on concentration, and slowly deposit manganese dioxide (HSDB, 2004; Budavari, 2001; Lewis, 2001; Lewis, 2000; Lewis, 1998; Freeman, 1998).
Available grades include technical, CP (chemically pure), reagent (99+% pure), and USP(CHRIS, 2004; Lewis, 2001a).
Formulations include ready-to-use solutions, pellets, tablets, crystals, and powder (HSDB, 2004).

SOURCES

Potassium permanganate is produced from manganese ore by electrolytic oxidation (Budavari, 2001; Lewis, 2001a).
It may be prepared by oxidizing manganese dioxide with potassium chlorate in potassium hydroxide solution, then completing the oxidation with chlorine or air and carbon dioxide (HSDB, 2004).
It is manufactured by a two-step process of thermal oxidation of manganese oxide (from ore) into potassium manganate, followed by electrolytic oxidation to potassium permanganate (HSDB, 2004).
The reaction between manganese ore and potassium hydroxide by thermal oxidation and electrolytic oxidation produces potassium permanganate (Ashford, 2001).
Treatment of a hot solution of manganate with carbon dioxide will, on cooling, result in the precipitation of potassium permanganate crystals (Lewis, 2001a).
It may be manufactured by roasting processes that use manganese(IV) oxide and potassium hydroxide in a molar ratio of 1:2 to 1:3, then heating to 300-400 degrees C, and exposure to secondary oxidation at 190-210 degrees C (HSDB, 2004).
A liquid-phase process can be used to manufacture potassium permanganate where manganese(IV) oxide and potassium hydroxide are in a molar ratio greater than or equal to 1:5. The molten mixture (at 200-350 degrees C) is oxygenated, and then the product may be obtained through separation (HSDB, 2004).

-CLINICAL EFFECTS

GENERAL CLINICAL EFFECTS

USES: Potassium permanganate is an antiseptic and astringent agent with powerful oxidizing effects. Industrial uses include bleaching resins, waxes, fats, oils, straw, cotton, silk and other fibers and chamois skins. It is also used as a disinfectant, deodorant, sanitizer, chemical in photography, and reagent in analytical and synthetic organic chemistry. Illicit uses have included the production of drugs of abuse and induction of abortion by topical application to the vaginal wall. Historically, potassium permanganate has been used as a urethral irrigant, and lavage fluid for alkaloid poisoning.

TOXICOLOGY: Potassium permanganate reacts with water to yield manganese dioxide, potassium hydroxide, and oxygen. Potassium hydroxide is a strong alkaline corrosive. In severe cases, systemic effects including disseminated intravascular coagulation (DIC), methemoglobinemia, hepatitis, pancreatitis, and acute renal failure may occur and are possibly caused by free radical generation. Chronic ingestion may cause neurotoxicity, including paresthesias, tremor, and Parkinsonism due to manganese toxicity. Neurotoxicity from manganese results from dopamine depletion and production of the neurotoxins, dopamine quinone and hydrogen peroxide.

EPIDEMIOLOGY: Patients may be exposed to potassium permanganate by occupational contact or illicit uses.

WITH POISONING/EXPOSURE

MILD TO MODERATE TOXICITY: Skin contact with concentrated solutions may cause severe irritation and burns. Contact with diluted solutions can cause purple brown staining of the skin and hardening of the outer layer of the skin. Potassium permanganate may be irritating to the respiratory tract, causing upper airway edema, chest tightness, and coughing. Caustic injury to the mouth and gastrointestinal tract may also occur after ingestion. Eye exposure can cause conjunctival discoloration and corneal and conjunctival burns.
SEVERE TOXICITY: Severe gastrointestinal burns have been reported after ingestion. Patients may also develop adult respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), methemoglobinemia, tachycardia, hypotension, metabolic acidosis, coagulopathy, hepatic necrosis, pancreatitis, and acute renal failure. Strictures and gastric outlet obstruction may develop as delayed complications following gastrointestinal burns. Chronic ingestion may cause neurotoxicity, paresthesias, tremor, and Parkinsonism due to manganese toxicity. Potassium permanganate use as an abortifacient may result in vaginal or cervical burns and erosions, with extensive bleeding, shock, severe scarring and miscarriage as possible complications.

POTENTIAL HEALTH HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

Inhalation, ingestion or contact (skin, eyes) with vapors or substance may cause severe injury, burns or death.
Fire may produce irritating, corrosive and/or toxic gases.
Runoff from fire control or dilution water may cause pollution.

ACUTE CLINICAL EFFECTS

SUMMARY

TOXICOLOGY: Potassium permanganate reacts with water to yield manganese dioxide, potassium hydroxide, and oxygen. Potassium hydroxide is a strong alkaline corrosive. In severe cases, systemic effects including disseminated intravascular coagulation (DIC), methemoglobinemia, hepatitis, pancreatitis, and acute renal failure may occur and are possibly caused by free radical generation. Chronic ingestion may cause neurotoxicity, including paresthesias, tremor, and Parkinsonism due to manganese toxicity. Neurotoxicity from manganese results from dopamine depletion and production of the neurotoxins, dopamine quinone and hydrogen peroxide.
EPIDEMIOLOGY: Patients may be exposed to potassium permanganate by occupational contact or illicit uses.
MILD TO MODERATE TOXICITY: Skin contact with concentrated solutions may cause severe irritation and burns. Contact with diluted solutions can cause purple brown staining of the skin and hardening of the outer layer of the skin. Potassium permanganate may be irritating to the respiratory tract, causing upper airway edema, chest tightness, and coughing. Caustic injury to the mouth and gastrointestinal tract may also occur after ingestion. Eye exposure can cause conjunctival discoloration and corneal and conjunctival burns.
SEVERE TOXICITY: Severe gastrointestinal burns have been reported after ingestion. Patients may also develop adult respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), methemoglobinemia, tachycardia, hypotension, metabolic acidosis, coagulopathy, hepatic necrosis, pancreatitis, and acute renal failure. Strictures and gastric outlet obstruction may develop as delayed complications following gastrointestinal burns. Chronic ingestion may cause neurotoxicity, paresthesias, tremor, and Parkinsonism due to manganese toxicity. Potassium permanganate use as an abortifacient may result in vaginal or cervical burns and erosions, with extensive bleeding, shock, severe scarring and miscarriage as possible complications.

ACID-BASE

METABOLIC ACIDOSIS: Profound metabolic acidosis may be noted in severe cases following ingestions (Lifshitz et al, 1999).

CARDIOVASCULAR

HYPERTENSION: Transient hypertension has been reported after ingestion and injection (Lustig et al, 1982; Middleton et al, 1990).
HYPOTENSION: Profound hypotension and circulatory collapse may develop in severe cases (Gawarammana et al, 2009; Lifshitz et al, 1999; Ong et al, 1997; Young et al, 1996; Middleton et al, 1990).
TACHYCARDIA: Tachycardia may develop in patients with serious exposure (Mahomedy et al, 1975; Middleton et al, 1990; Lustig et al, 1982).

DERMATOLOGIC

DISCOLORATION OF THE SKIN: Purple brown staining of the skin may develop after contact (Southwood et al, 1987).

ENDOCRINE

HYPERGLYCEMIA: Hyperglycemia has been reported in the setting of acute pancreatitis after potassium permanganate ingestion (Middleton et al, 1990).

GASTROINTESTINAL

ABDOMINAL PAIN: Abdominal pain may persist for weeks after ingestion (Guichardiere, 1965).
BURNS: Severe burns of the esophagus, stomach, and in severe cases small intestines may develop after ingestion (Lifshitz et al, 1999; Young et al, 1996; Holzgraefe et al, 1986; Middleton et al, 1990; Desmul et al, 1968; Mayer et al, 1972).
PANCREATITIS (CASE REPORT): A 75-year-old man developed severe abdominal pain, hyperglycemia and elevated serum amylase levels (3752 U/liter) after ingesting approximately 20 grams of potassium permanganate. Severe hemorrhagic pancreatitis was confirmed on autopsy (Middleton et al, 1990).
STRICTURES: Esophageal strictures and gastric outlet obstruction have been reported as delayed (by weeks) complications of potassium permanganate ingestion (Dagli et al, 1973; Kochhar et al, 1986; Wang, 1994).

GENITOURINARY

Acute renal failure has been reported several days after severe poisoning (Young et al, 1996; Ong et al, 1997; Gawarammana et al, 2009).

HEENT

DISCOLORATION: Purple-brown staining of the mouth and tongue is common after ingestion (Southwood et al, 1987; Middleton et al, 1990; Lifshitz et al, 1999).
BURNS: Burns and edema of the oral mucosa and tongue may develop after ingestion (Southwood et al, 1987; Young et al, 1996; Ong et al, 1997; Lifshitz et al, 1999).
BURNS: Ocular burns have been reported after exposure (Michaels & Zugsmith, 1973; Sigg et al, 1998).

HEMATOLOGIC

Disseminated intravascular coagulation (DIC) has been reported after large ingestions (Young et al, 1996; Ong et al, 1997).
Severe methemoglobinemia has been reported after exposure (Mahomedy et al, 1975).

HEPATIC

HEPATOTOXICITY: Hepatic injury has been described after ingestion and injection (Lustig et al, 1982; Middleton et al, 1990; Lifshitz et al, 1999). In severe cases fulminant hepatic failure and necrosis may develop (Ong et al, 1997; Young et al, 1996).

NEUROLOGIC

Paresthesia, tremor, Parkinsonism, and coma have been reported (Holzgraefe et al, 1986; Mahomedy et al, 1975).

RESPIRATORY

LARYNGEAL STRICTURES: Laryngeal strictures have been reported as delayed (by weeks or more) complications after ingestion of potassium permanganate (Wang, 1994).
BURNS AND EDEMA: Stridor and upper airway burns and edema may develop after ingestion (Justus & Gastmeier, 1967; Young et al, 1996; Ong et al, 1997; Southwood et al, 1987).
ACUTE LUNG INJURY (CASE REPORT): A 75-year-old man developed adult respiratory distress syndrome (ARDS) after ingesting approximately 20 grams of potassium permanganate (Middleton et al, 1990).
ACUTE RESPIRATORY DISTRESS SYNDROME (CASE REPORT): An 8-week-old infant developed acute respiratory distress syndrome, seen on chest x-ray, following the ingestion of an unknown amount of a 0.01% solution of potassium permanganate. The infant died 28 hours after admission (Lifshitz et al, 1999).

CHRONIC CLINICAL EFFECTS

Manganese in general is a CENTRAL NERVOUS SYSTEM POISON (ILO, 1983), and potassium permanganate has also been shown to have this property. Ingestion of an 8% potassium permanganate solution over a four week period (a total of 10 grams) was followed by psychological and CNS disturbances in one person. Elevated levels of manganese in the peripheral blood confirmed systemic distribution. After nine months, progressive PARKINSON'S DISEASE developed (Holzgraefe et al, 1986).

At the time of this review, no other studies were found on the potential effects of chronic potassium permanganate exposure in humans or experimental animals.

-FIRST AID

FIRST AID AND PREHOSPITAL TREATMENT

ORAL EXPOSURE

The role of gastric decontamination is unclear. Due to the irritant nature of this substance, do not induce vomiting. Neutralization and activated charcoal are all contraindicated.

DILUTION

If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. The exact 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).
USE OF DILUENTS IS CONTROVERSIAL: While experimental models have suggested that immediate dilution may lessen caustic injury (Homan et al, 1993; Homan et al, 1994; Homan et al, 1995), this has not been adequately studied in humans.
DILUENT TYPE: Use any readily available nontoxic, cool liquid. Both milk and water have been shown to be effective in experimental studies of caustic ingestion (Maull et al, 1985; Rumack & Burrington, 1977; Homan et al, 1995; Homan et al, 1994; Homan et al, 1993).
ADVERSE EFFECTS: Potential adverse effects include vomiting and airway compromise (Caravati, 2004).
CONTRAINDICATIONS: Do NOT attempt dilution in patients with respiratory distress, altered mental status, severe abdominal pain, nausea or vomiting, or patients who are unable to swallow or protect their airway. Diluents should not be force fed to any patient who refuses to swallow (Rao & Hoffman, 2002).

INHALATION EXPOSURE

INHALATION: Move patient to fresh air. Monitor for respiratory distress. If cough or difficulty breathing develops, evaluate for respiratory tract irritation, bronchitis, or pneumonitis. Administer oxygen and assist ventilation as required. Treat bronchospasm with an inhaled beta2-adrenergic agonist. Consider systemic corticosteroids in patients with significant bronchospasm.
ONSET: Onset of acute lung injury after toxic exposure may be delayed up to 24 to 72 hours after exposure in some cases.
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).

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)

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).
ANTIBIOTICS: Indicated only when there is evidence of infection (Artigas et al, 1998).
EXPERIMENTAL THERAPY: Partial liquid ventilation has shown promise in preliminary studies (Kollef & Schuster, 1995).
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).
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).

DERMAL EXPOSURE

DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

EYE EXPOSURE

DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.

-MEDICAL TREATMENT

LIFE SUPPORT

Support respiratory and cardiovascular function.

SUMMARY

FIRST AID - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

Move victim to fresh air.
Call 911 or emergency medical service.
Give artificial respiration if victim is not breathing.
Administer oxygen if breathing is difficult.
Remove and isolate contaminated clothing and shoes.
Contaminated clothing may be a fire risk when dry.
In case of contact with substance, immediately flush skin or eyes with running water for at least 20 minutes.
Keep victim warm and quiet.
Ensure that medical personnel are aware of the material(s) involved and take precautions to protect themselves.

FIRST AID

ORAL EXPOSURE

The role of gastric decontamination is unclear. Due to the irritant nature of this substance, do not induce vomiting. Neutralization and activated charcoal are both contraindicated.

DILUTION

If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. The exact 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).
USE OF DILUENTS IS CONTROVERSIAL: While experimental models have suggested that immediate dilution may lessen caustic injury (Homan et al, 1993; Homan et al, 1994; Homan et al, 1995), this has not been adequately studied in humans.
DILUENT TYPE: Use any readily available nontoxic, cool liquid. Both milk and water have been shown to be effective in experimental studies of caustic ingestion (Maull et al, 1985; Rumack & Burrington, 1977; Homan et al, 1995; Homan et al, 1994; Homan et al, 1993).
ADVERSE EFFECTS: Potential adverse effects include vomiting and airway compromise (Caravati, 2004).
CONTRAINDICATIONS: Do NOT attempt dilution in patients with respiratory distress, altered mental status, severe abdominal pain, nausea or vomiting, or patients who are unable to swallow or protect their airway. Diluents should not be force fed to any patient who refuses to swallow (Rao & Hoffman, 2002).

INHALATION EXPOSURE

INHALATION: Move patient to fresh air. Monitor for respiratory distress. If cough or difficulty breathing develops, evaluate for respiratory tract irritation, bronchitis, or pneumonitis. Administer oxygen and assist ventilation as required. Treat bronchospasm with an inhaled beta2-adrenergic agonist. Consider systemic corticosteroids in patients with significant bronchospasm.
ONSET: Onset of acute lung injury after toxic exposure may be delayed up to 24 to 72 hours after exposure in some cases.
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).

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)

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).
ANTIBIOTICS: Indicated only when there is evidence of infection (Artigas et al, 1998).
EXPERIMENTAL THERAPY: Partial liquid ventilation has shown promise in preliminary studies (Kollef & Schuster, 1995).
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).
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).

DERMAL EXPOSURE

DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

EYE EXPOSURE

DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.

-RANGE OF TOXICITY

MINIMUM LETHAL EXPOSURE

SUMMARY

The probable lethal dose for a 150 lb (70 kg) adult is 10 grams (approximately 1.5 teaspoons) (Pohanish, 2002; Ong et al, 1997; Middleton et al, 1990; Cowie & Escreet, 1981) .

Death may be delayed as much as 1 month after ingestion (HSDB, 2004).

CASE REPORTS

ADULT

A 75-year-old man died after ingesting 20 grams of potassium permanganate. Complications included ARDS, hepatocellular injury, acute tubular necrosis, gastrointestinal burns, and hemorrhagic pancreatitis (Middleton et al, 1990).
A 24-year-old, Chinese woman died after intentional ingestion of an unknown amount of potassium permanganate crystals. She was admitted to the hospital with initial symptoms of brownish-black staining of the hands, lips, oropharynx, and upper esophagus, and swelling of the tongue, lips, and laryngeal structures. Between hours 36 and 72 hours after admission, she developed cardiovascular instability, disseminated intravascular coagulation, hepatic and renal failure, and adult respiratory distress syndrome. Progressive cardiovascular failure developed, and the patient died on day 6. Serum manganese levels on days 5 and 6 were 756 and 1629 mcmol/L, respectively (Ong et al, 1997; Young et al, 1996).

PEDIATRIC

A 33-month-old child died after ingesting one teaspoonful of potassium permanganate crystals (Justus & Gastmeier, 1967).
An 8-week-old child died following ingestion of an unknown amount of a approximately 0.01% potassium permanganate solution. Upon admission to the hospital, the infant presented with a swollen tongue, drooling, inflamed oral mucosa with brownish-black staining, and severe edema of the mouth, pharynx, and epiglottis. He died 28 hours later despite intensive support, having developed hypotension, metabolic acidosis, acute respiratory distress syndrome (ARDS), E. coli bacteremia, severe bradycardia, and cardiac arrest (Lifshitz et al, 1999).

MAXIMUM TOLERATED EXPOSURE

CASE REPORTS

ADULT

An 18-year-old man who ingested ten 300-mg tablets of potassium permanganate developed gastric burns complicated by gastric outlet obstruction 9 weeks after ingestion (Dagli et al, 1973).
A 66-year-old man ingested approximately 10 grams of potassium permanganate (approximately 125 mL of an 8% solution) over the course of a 4 week period, due to a dispensing error. He suffered severe abdominal pain and cramping, a reduction in physical capacity and ability to concentrate, visual disturbances, paresthesias of the right hand and foot, as well as increased sweating. Manganese in the blood was measured at a maximal level of 15 g/100 mL, and in the hair, 1.6 g/g. Nine months following the poisoning, the patient exhibited parkinsonian symptoms, including a resting tremor of four beats/second, a slow grade rigor of the extremities, and a shortening of gait (Holzgraefe et al, 1986).

A 14 year follow-up with the patient (then 80 years old) showed that most of the initial symptoms were improved, however, the parkinsonian syndrome was unchanged (Bleich et al, 1999).

A 42-year-old man developed caustic gastric injury about 12 hours after ingesting 20 g of a household antiseptic, containing potassium permanganate dissolved in 300 mL of water. Following supportive care, including IV fluids, a proton pump inhibitor, and antibiotics, his condition gradually improved and he was discharged 4 days later (Younan et al, 2013).

PEDIATRIC

A 3-year-old boy developed upper airway edema after ingesting an estimated 5 to 10 grams of potassium permanganate crystals. The child was treated with intubation, antibiotics, and corticosteroids. Liver and renal function tests remained normal and the child recovered completely (Southwood et al, 1987).

CASE SERIES

ADULT

In Sri Lanka, intentional ingestion of a laundry detergent containing a sachet each of 12.5 g oxalic acid and 1.2 g potassium permanganate resulted in 115 cases of toxicity with 18 fatalities. Gastrointestinal symptoms developed within 24 hours of ingestion. Of the individuals that ingested oxalic acid only, a case fatality ratio of 25.4% was observed, while a case fatality ratio of 9.8% occurred in patients ingesting both oxalic acid and potassium permanganate. Of the 35 patients who ingested 2 or mor sachets of both potassium permanganate and oxalic acid, 16 died (46%). Of the 58 patients who ingested one sachet or less, 2 died (3%). Most deaths occurred within one hour of ingestion. No deaths were reported in the potassium permanganate only ingestion. Individuals ingesting a sublethal dose of oxalic acid and potassium permanganate (n=51), developed acute renal failure 2 to 3 days after exposure. Median serum creatinine was 1.7 (Interquartile range: 0.91-4.4). Most recovered with supportive care (Gawarammana et al, 2009).

Carcinogenicity Ratings for CAS7722-64-7 :

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed
EPA (U.S. Environmental Protection Agency, 2011): Not Listed
IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed
MAK (DFG, 2002): Not Listed
NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

TOXICITY AND RISK ASSESSMENT VALUES

EPA IRIS

EPA Risk Assessment Values for CAS7722-64-7 (U.S. Environmental Protection Agency, 2011):

Not Listed

TOXICITY VALUES

ANIMAL DATA
- LD- (SUBCUTANEOUS)MOUSE:
- LD50- (ORAL)GUINEA_PIG:
- LD50- (ORAL)GUINEA_PIG:
- LD50- (ORAL)MOUSE:
- LD50- (ORAL)MOUSE:
- LD50- (SUBCUTANEOUS)MOUSE:
- LD50- (ORAL)RAT:
- LD50- (ORAL)RAT:
- LDLo- (ORAL)DOG:
- LDLo- (INTRAVENOUS)RABBIT:
- LDLo- (ORAL)RABBIT:
- TDLo- (INTRATESTICULAR)GERBIL:
- TDLo- (ORAL)MOUSE:
- TDLo- (INTRATESTICULAR)RAT:
- TDLo- (ORAL)RAT:
HUMAN
- LDLo- (ORAL)HUMAN:
- LDLo- (ORAL)HUMAN:
- TDLo- (ORAL)HUMAN:

-STANDARDS AND LABELS

WORKPLACE STANDARDS

ACGIH TLV Values for CAS7722-64-7 (American Conference of Governmental Industrial Hygienists, 2010):

Not Listed

AIHA WEEL Values for CAS7722-64-7 (AIHA, 2006):

Not Listed

NIOSH REL and IDLH Values for CAS7722-64-7 (National Institute for Occupational Safety and Health, 2007):

Not Listed

OSHA PEL Values for CAS7722-64-7 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):

Not Listed

OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS7722-64-7 (U.S. Occupational Safety and Health Administration, 2010):

Not Listed

ENVIRONMENTAL STANDARDS

EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS7722-64-7 (U.S. Environmental Protection Agency, 2010):

Listed as: Potassium permanganate
Final Reportable Quantity, in pounds (kilograms):

100 (45.4)

Additional Information:

EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS7722-64-7 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA RCRA Hazardous Waste Number for CAS7722-64-7 (U.S. Environmental Protection Agency, 2010b):

Not Listed
Editor's Note: The D, F, and K series waste numbers and Appendix VIII to Part 261 -- Hazardous Constituents were not included. Please refer to 40 CFR Part 261.

EPA SARA Title III, Extremely Hazardous Substance List for CAS7722-64-7 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA SARA Title III, Community Right-to-Know for CAS7722-64-7 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):

Not Listed

DOT List of Marine Pollutants for CAS7722-64-7 (49 CFR 172.101 - App. B, 2005):

Not Listed

EPA TSCA Inventory for CAS7722-64-7 (EPA, 2005):

Listed as: Permanganic acid (HMnO4), potassium salt

SHIPPING REGULATIONS

SURFACE

DOT -- Table of Hazardous Materials and Special Provisions for UN/NA Number 1490 (49 CFR 172.101, 2005):

Hazardous materials descriptions and proper shipping name: Potassium permanganate

Symbol(s): Not Listed
Hazard class or Division: 5.1

5.1: Oxidizer. See 49 CFR section 173.127 for definitions.

Identification Number: UN1490
Packing Group: II

II: Packing Group II - indicates the degree of danger presented by the material is medium.

Label(s) required (if not excepted): 5.1

5.1: Oxidizer.

Special Provisions: IB8, IP4, T3, TP33

IB8: Authorized IBCs: Metal (11A, 11B, 11N, 21A, 21B, 21N, 31A, 31B and 31N); Rigid plastics (11H1, 11H2, 21H1, 21H2, 31H1 and 31H2); Composite (11HZ1, 11HZ2, 21HZ1, 21HZ2, 31HZ1 and 31HZ2); Fiberboard (11G); Wooden (11C, 11D and 11F); Flexible (13H1, 13H2, 13H3, 13H4, 13H5, 13L1, 13L2, 13L3, 13L4, 13M1 or 13M2).
IP4: Flexible, fiberboard or wooden IBCs must be sift-proof and water-resistant or be fitted with a sift-proof and water-resistant liner.
T3: Minimum test pressure (bar): 2.65; Minimum shell thickness (in mm-reference steel) (See sxn.178.274(d)): sxn.178.274(d)(2); Pressure-relief requirements (See sxn.178.275(g)): Normal; Bottom opening requirements (See sxn.178.275(d)): sxn.178.275(d)(2).
TP33: The portable tank instruction assigned for this substance applies for granular and powdered solids and for solids which are filled and discharged at temperatures above their melting point which are cooled and transported as a solid mass. Solid substances transported or offered for transport above their melting point are authorized for transportation in portable tanks conforming to the provisions of portable tank instruction T4 for solid substances of packing group III or T7 for solid substances of packing group II, unless a tank with more stringent requirements for minimum shell thickness, maximum allowable working pressure, pressure-relief devices or bottom outlets are assigned in which case the more stringent tank instruction and special provisions shall apply. Filling limits must be in accordance with portable tank special provision TP3. Solids meeting the defnintion of an elevated temperature material must be transported in accordance with the applicable requirements of this subchapter.

Packaging Authorizations (refer to 49 CFR 173.***):

Exceptions: 152
Non-bulk packaging: 212
Bulk packaging: 240

Quantity Limitations:

Passenger aircraft or railcar: 5 kg
Cargo aircraft only: 25 kg

Vessel Stowage Requirements:

Vessel stowage location: D

D: The material must be stowed "on deck only" on a cargo vessel and on a passenger vessel carrying a number of passengers limited to not more than the larger of 25 passengers or one passenger per each 3 m of overall vessel length, but the material is prohibited on passenger vessels in which the limiting number of passengers is exceeded.

Vessel stowage other: 56, 58

56: Stow "separated from" ammonium compounds.
58: Stow "separated from" cyanides.

ICAO International Shipping Name for UN1490 (ICAO, 2002):

Proper Shipping Name: Potassium permanganate
UN Number: 1490

LABELS

NFPA

NFPA Hazard Ratings for CAS7722-64-7 (NFPA, 2002):

Not Listed

-HANDLING AND STORAGE

HANDLING

Wear proper protective clothing, including chemical protective gloves, boots, and goggles. The material will attack rubber and most fibers (CHRIS, 2004; AAR, 2002; Pohanish, 2002).

Do not handle broken containers unless wearing adequate protective clothing (AAR, 2002).
Contact with skin will cause burns and stain the skin a dark brown color (CHRIS, 2004).

Isolate potassium permanganate from all other materials (Pohanish & Greene, 1997).

Do not allow potassium permanganate (dry or solution) to come into contact with organic or other readily oxidizable substances, as fire or explosion may result (Lewis, 2001; Lewis, 2000; Lewis, 1998).

The material should be kept out of contact with combustibles, including wood, as fire on contact may result (CHRIS, 2004).

Use explosion-proof electrical equipment and fittings in areas where potassium permanganate is manufactured, handled, used, or stored (Pohanish, 2002).

Sources of ignition are prohibited where the material is used, handled, or stored (Pohanish, 2002).

Do not eat, drink, or smoke when working with or around potassium permanganate (ILO ICSC, 2003).

Suppress the suspension of potassium permanganate dusts (OHM/TADS, 2004).

During chemical transfer operations, metal containers should be grounded and bonded. Use automatic transfer when possible (Pohanish, 2002).

STORAGE

CONTAINER

Aqueous solutions of potassium permanganate should be stored in steel vessels, rather than plastic or rubber containers (Freeman, 1998).
Potassium permanganate is stored in bottles and cans (OHM/TADS, 2004).
Containers should be tightly closed (Pohanish, 2002).
Protect containers from physical damage and moisture (OHM/TADS, 2004; Pohanish, 2002).

ROOM/CABINET RECOMMENDATIONS

Potassium permanganate should be stored in a cool, dry, well-ventilated, and dark location (Pohanish, 2002; Freeman, 1998).

INCOMPATIBILITIES

Potassium permanganate will attack rubber and most fibers, and may cause ignition of wood (CHRIS, 2004; Budavari, 2001).
Fire or explosion will result on contact with reducing materials, strong acids (hydrochloric, sulfuric, nitric), combustibles, organic matter, or oxidizable solids, liquids, or gases. Potassium permanganate must be stored so as to avoid contact with these types of materials (Pohanish, 2002).

-PERSONAL PROTECTION

SUMMARY

RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

Wear positive pressure self-contained breathing apparatus (SCBA).
Wear chemical protective clothing that is specifically recommended by the manufacturer. It may provide little or no thermal protection.
Structural firefighters' protective clothing will only provide limited protection.

Full PPE is recommended. Potassium permanganate is a toxic and caustic compound, causing severe irritation and burns of the skin and eyes on contact and respiratory irritation and possibly pulmonary edema. It causes poisoning if ingested. Death can result from exposure to high concentrations (Goldfrank et al, 2002; Pohanish, 2002; Budavari, 2001; Lewis, 2000).

Personal protective clothing (e.g., gloves, protective suits, boots, goggles, respirators) should be worn to prevent skin or eye contact with and inhalation of potassium permanganate (ILO ICSC, 2003; Pohanish, 2002).

EYE/FACE PROTECTION

Wear goggles or face shield (CHRIS, 2004; ILO ICSC, 2003; Pohanish, 2002).

When working with potassium permanganate solution, wear splash-proof chemical goggles and face shield, unless full facepiece respiratory protection is being used (Pohanish, 2002).
When working with the solid material in powder or dust form, wear dust-proof goggles, unless full facepiece respiratory protection is being used (Pohanish, 2002).

Do not wear contact lenses when working with or around potassium permanganate (Pohanish, 2002).

RESPIRATORY PROTECTION

Wear a NIOSH-approved respirator if the possibility of exposure to potassium permanganate dust or powder exists. A supplied air full-face respirator or self contained breathing apparatus (SCBA) may be necessary when working with solutions (Pohanish, 2002).

PROTECTIVE CLOTHING

CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 7722-64-7.

All data are compiled from published sources and are NOT recommended specifically by Truven Health Analytics. The appearance of specific manufacturers or products in this section does not represent an endorsement by Truven Health Analytics. No attempt has been made to verify the data presented. All product recommendations should be confirmed with the specific manufacturer for verification of product performance.
CLOTHING

Plastic Laminate

DuPont Personal Protection

Responder

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): >480
Permeation Rate (mcg/cm2/min): None detected
Notes: Not Listed
Citation: (DuPont, 2002)

Responder Plus

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): >480
Permeation Rate (mcg/cm2/min): None detected
Notes: Not Listed
Citation: (DuPont, 2002)

Tychem 10,000

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): Not Tested
Permeation Rate (mcg/cm2/min): Not Tested
Notes: liquid
Citation: (DuPont, 2002)

Tychem 7500

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): Not Tested
Permeation Rate (mcg/cm2/min): Not Tested
Notes: liquid
Citation: (DuPont, 2002)

Tychem 9400

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): Not Tested
Permeation Rate (mcg/cm2/min): Not Tested
Notes: liquid
Citation: (DuPont, 2002)

Tychem QC

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): >480
Permeation Rate (mcg/cm2/min): <0.1
Notes: liquid
Citation: (DuPont, 2002)
Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): >480
Permeation Rate (mcg/cm2/min): <0.1
Notes: Not Listed
Citation: (DuPont, 2002)

Tychem SL

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): Not Tested
Permeation Rate (mcg/cm2/min): Not Tested
Notes: liquid
Citation: (DuPont, 2002)

Tychem TK

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): Not Tested
Permeation Rate (mcg/cm2/min): Not Tested
Notes: liquid
Citation: (DuPont, 2002)

FOOTWEAR

Neoprene

North -- Safety 4H

Neoprene series - specific style not specified

Degradation Rating: Excellent
Breakthrough Time (minutes): Not Listed
Permeation Rate (mcg/cm2/min): Not Listed
Notes: Not Listed
Citation: (North, 2002)

Polyvinyl Chloride

North -- Safety 4H

PVC Series - specific style not specified

Degradation Rating: Fair
Breakthrough Time (minutes): Not Listed
Permeation Rate (mcg/cm2/min): Not Listed
Notes: Not Listed
Citation: (North, 2002)

Rubber

North -- Safety 4H

Rubber Series - specific style not specified

Degradation Rating: Fair
Breakthrough Time (minutes): Not Listed
Permeation Rate (mcg/cm2/min): Not Listed
Notes: Not Listed
Citation: (North, 2002)

GLOVES

Plastic Laminate

North -- Safety 4H

Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): Not Tested
Permeation Rate (mcg/cm2/min): Not reported
Notes: tested at 35 degrees C; 95 degrees F
Citation: (Safety 4, 2002)
Degradation Rating: No Degradation Rating provided
Breakthrough Time (minutes): >240
Permeation Rate (mcg/cm2/min): Not reported
Notes: tested at 21 degrees C; 70 degrees F
Citation: (Safety 4, 2002)

GENERAL INFORMATION

This section provides a compilation of chemical resistance information and test data for specific protective clothing products. Chemical resistance information includes both degradation resistance ratings and permeation resistance data. This information is designed to assist in the selection of appropriate protective clothing. Only data on specific products and manufacturers are included. Generic information or recommendations are not provided since significant differences can exist in the chemical resistance for apparent similar product types.
Specific product information is organized by general product type (gloves, garments, and footwear), material type, and manufacturer. The category 'garments' may include totally encapsulating suits, splash suits, as well as other items (e.g., coveralls, jackets, and aprons). Specific manufacturers should be contacted to determine the features of available styles/models.
In addition to chemical resistance information, there are many critical variables in the selection of protective clothing which cannot be represented in this summary of the literature. Some factors to be considered in choosing protective clothing include, but are not limited to: overall clothing integrity, physical hazard resistance, durability, human factors, ease of decontamination, and cost. Overall clothing integrity refers to a specific design's ability to offer consistent protection for all clothing-covered areas of the body. Physical hazards include resisting the effects of abrasion, cuts, tears, and punctures. Human factors entail effects on wearer mobility, visibility, and hearing for garments; dexterity, tactility, and grip for gloves; ankle support and weight for footwear; and, any effect of the clothing on the function of the wearer. There are several variations in the design for gloves, garments, and footwear that affect these factors. Protective clothing must properly be sized and correctly fit the wearer to ensure its proper use and function.
As required in the U.S.A., protective clothing should be selected based on a risk assessment of the workplace. This risk assessment must account for the identification of existing as well as potential hazards and involve the recommendation of protective clothing appropriate for the identified hazards. Therefore, the recommendations in this section should not be used as the sole basis for decisions on choice of protective clothing, but rather should be used as a tool by qualified occupational health and safety professionals or other technically qualified persons in conjunction with a review of all mitigating factors. Consult the OSHA PPE Standard (29 CFR 1910.132 - 1910.138) for regulations and additional guidance regarding the selection and use of protective clothing and equipment. For general information on protective clothing selection, refer to the "PERSONAL PROTECTIVE EQUIPMENT - OSHA PUB 3077" document.
PROTECTIVE CLOTHING SELECTION

Determine the type of protective clothing item needed based on a risk assessment (e.g., gloves, garments, footwear).
For high risk situations, choose clothing that covers all parts of the body that may be exposed. In many cases, multiple clothing items will be required. Low risk situations may permit partial body protective clothing. Select protective clothing products that have reported chemical resistance data. High risk situations involving full body clothing or extended chemical contact often require permeation resistance data to determine the barrier effectiveness of materials used in the construction of clothing. Relatively low risk situations, where only splash or incidental exposure occur, may allow use of protective clothing based on degradation or penetration resistance data. Specifics on the interpretation of chemical resistance data are presented below.
Other factors must be considered in addition to chemical resistance. The selected chemical protective clothing item should offer the optimal combination of protection against identified hazards while allowing maximum function and comfort.

INTERPRETATION OF DEGRADATION RATINGS

Degradation refers to physical changes in a material as the result of chemical exposure. Degradation may become evident in visible changes, such as discoloration, swelling, delamination, deterioration, or disintegration. Degradation effects may also be measured by weight change or other changes in a material's physical properties (e.g., strength, elasticity, hardness).
Degradation resistance ratings are provided by manufacturers to rate the amount of degradation that occurs for a particular protective clothing material when contacted by a chemical. All degradation ratings are qualitative and include ratings, such as "EXCELLENT," "GOOD," "FAIR," "POOR," and "NOT RECOMMENDED." There is no standard test method for the measurement of chemical degradation resistance; therefore, manufacturer ratings may be based on different testing approaches. This makes comparison of degradation ratings between manufacturers unreliable.
The use of degradation resistance ratings alone to recommend protective clothing, particularly for high hazard situations, should be avoided. Degradation resistance testing does not directly assess the barrier quality of protective clothing, since materials can show relatively little degradation but still allow either permeation or penetration by a chemical. Degradation resistance ratings can be used to exclude protective clothing materials from consideration. Protective clothing materials with a "NOT RECOMMENDED" degradation resistance rating should never be used.
For some products, the rating "NO PENETRATION" is provided. This refers to penetration resistance test results that are based on a different procedure (American Society for Testing and Materials (ASTM) Standard Test Method F 903). Penetration resistance testing involves placing a material sample in a test cell, exposing the exterior side of the material to a chemical, and then observing the interior side of the material for visible signs of liquid penetration. Part of the test is conducted at an elevated pressure. Test results are reported as pass (no penetration) or fail (penetration detected). Unlike degradation testing, penetration testing provides an assessment of protective clothing material barrier performance. Since penetration resistance testing examines only observable amounts of liquid penetration, permeation may still occur. The use of penetration resistance data must be restricted to liquid chemicals, and should be limited to scenarios where there is no reasonable vapor exposure hazard under the conditions of exposure.

INTERPRETATION OF PERMEATION DATA

Permeation is the process of chemical movement through a material on a molecular level. Permeation resistance refers to the ability of a material to retard or prevent chemical movement through it. Permeation may occur without any visible signs of degradation.
Permeation resistance is measured using a test cell which is divided into two halves by a protective clothing specimen. Chemical is placed on the challenge side, while the collection side is periodically monitored for permeating chemical. Permeation data were obtained in accordance with the American Society for Testing and Materials (ASTM) Standard Test Method F 739 (Resistance of Materials Used in Protective Clothing to Permeation by Liquids and Gases), unless stated otherwise. In the case of chemicals that are classified as warfare agents, the data were obtained in accordance with the Military Standard 282 (MIL-STD-282) (Military Standard, Filter Units, Protective Clothing, Gas-Mask Components, and Related Products: Performance Test Methods).
Permeation rate is the amount of chemical that passes through a material for a measured surface area per unit time. In this section, permeation rate is expressed in micrograms per square centimeter per minute (mcg/cm(2)/min). The reported permeation rate is either the steady-state rate or the maximum rate observed during testing. In some cases, very large permeation rates exceed measurement techniques and are reported as ">" (greater than) or "HIGH."
Breakthrough time is the elapsed time, in minutes, from the time the chemical comes in contact with the material exterior surface, to the time that chemical is detected on the interior surface. When no breakthrough is detected, the breakthrough time is report as ">" the testing period. If permeation breakthrough is rapid, results are reported as "<" (less than) the earlier sampling time or as "IMMEDIATELY" (which usually means breakthrough in less than 4 minutes).
The breakthrough time should exceed the expected use period of the selected protective clothing. Additionally, there are several other factors that must be taken into account to provide appropriate protection.
Permeation testing is usually conducted with full strength, undiluted chemical for the duration of the test period. Actual exposures may involve diluted chemical for short or intermittent exposure periods.
Permeation testing is usually conducted at room temperature. Permeation occurs faster at elevated temperatures (short breakthrough times and higher permeation rates) and slower at reduced temperatures (long breakthrough times and lower permeation rates).
Permeation resistance of mixtures cannot usually be determined on the basis of the individual chemicals making up the mixture. Synergistic effects may occur and result in more rapid permeation than accounted for by the individual mixture chemicals.
Permeation rates may be used to calculate potential wearer exposure; however, several assumptions must be made about the extent of exposure and condition of clothing wear. Furthermore, there are few chemicals with dermal exposure limits, making it difficult to determine an acceptable skin exposure level.

COMPANY INFORMATION

DuPont Personal Protection P. O. Box 80705 Wilmington, DE 19880-0705 USA Phone: (302) 774-1000 Toll-Free: (800) 931-3456 Website: http://personalprotection.dupont.com Email: personalprotection@usa.dupont.com
North -- Safety 4H 2000 Plainfield Pike Cranston, RI 02921 USA Phone: (800) 430-4110 Fax: (800) 572-6346 Toll-Free: (800) 430-4110 Website: http://www.safety4.com

REFERENCES

CHEMICAL PROTECTIVE CLOTHING CITATIONS

The following sources were consulted for chemical protective clothing data:

(Ansell-Edmont, 2001)
(Bata Shoe Company, 1995)
(Best Manufacturing, 2002)
(Best Manufacturing, 2004)
(Boss Manufacturing Company, 1998)
(ChemFab Corporation, 1993)
(Comasec Safety, Inc., 2003)
(Comasec Safety, Inc., 2003a)
(DuPont, 2002)
(DuPont, 2002)
(DuPont, 2003)
(Guardian Manufacturing Group, 2001)
(ILC Dover, Inc., 1998)
(Kappler Inc., 2001)
(Kimberly-Clark, 2002)
(LaCrosse-Rainfair, 1997)
(MAPA Professional, 2003)
(MAPA Professional, 2004)
(Mar-Mac Manufacturing, Inc, 1995)
(Marigold Industrial, 2003)
(Memphis Glove Company, 2001)
(Montgomery Safety Products, 1995)
(Nat-Wear, 2001)
(Neese Industries, Inc., 2003)
(North, 2002)
(North, 2002)
(Playtex, 1995)
(River City, 1995)
(Safety 4, 2002)
(Servus, 1995)
(Standard Safety Equipment, 1995)
(Tingley, 2002)
(Trelleborg-Viking, Inc., 2001)
(Trelleborg-Viking, Inc., 2002)
(Wells Lamont Industrial, 2002)
(Workrite, 1997)

ENGINEERING CONTROLS

Local exhaust ventilation is recommended to reduce worker exposure to potassium permanganate dust (ILO ICSC, 2003)

OTHER

INDUSTRIAL DECONTAMINATION

If potassium permanganate contacts the skin, immediately wash affected area(s) with soap and water. Remove any contaminated clothing, shoes, or equipment. Seek medical attention right away (ILO ICSC, 2003; Pohanish, 2002).
If potassium permanganate contacts the eye(s), remove contact lenses if present, then immediately flush the eye(s) with water for at least 15 minutes, occasionally lifting the upper and lower eyelids. Seek medical attention right away (ILO ICSC, 2003; Pohanish, 2002).
Provide emergency showers and eye wash stations in areas where potassium permanganate is used (Pohanish, 2002).

-PHYSICAL HAZARDS

FIRE HAZARD

SUMMARY

POTENTIAL FIRE OR EXPLOSION HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)
- These substances will accelerate burning when involved in a fire.
- Some may decompose explosively when heated or involved in a fire.
- May explode from heat or contamination.
- Some will react explosively with hydrocarbons (fuels).
- May ignite combustibles (wood, paper, oil, clothing, etc.).
- Containers may explode when heated.
- Runoff may create fire or explosion hazard.
Potassium permanganate is not combustible, but enhances combustion processes (ILO ICSC, 2003).
The reaction between potassium permanganate and a great number of different materials results in extreme fire hazard. Some of these hazardous reactions are detailed below (NFPA, 2002; Urben, 1999):
- The addition of a 20% potassium permanganate solution to nitric acid before mixing with an alcohol (methanol, ethanol, isopropanol, pentanol, or isopentanol) results in immediate ignition.
- Antimony and potassium permanganate will ignite on being ground together in a mortar.
- Pure dichloromethylsilane will ignite in the presence of potassium permanganate.
- Dimethyl sulfoxide and solid potassium permanganate ignite on contact.
- Attempted disinfection of a building using large quantities of formaldehyde (as formalin) and potassium permanganate resulted in a large fire.
- Contact of glycerol with solid potassium permanganate will result in a vigorous fire.
- Hydrogen peroxide that came in contact with packages of potassium permanganate led to a violent reaction and fire.
- Liquid hydrogen trisulfide will ignite on contact with solid potassium permanganate.
- Hydroxylamine will ignite on contact with solid potassium permanganate.
- Carbon and potassium permanganate mixtures will burn vigorously when heated.
- Mixtures of potassium permanganate and organic nitro compounds ignite easily when heated, or on contact with sulfuric acid. They are also shock-sensitive.
- Oxidation of 3,4,4'-trimethyldiphenyl sulfone using potassium permanganate can result in a vigorous exothermic reaction.
- Contact between solid potassium permanganate and wood, in the presence of moisture or mechanical friction, may lead to fire.
- Potassium permanganate ignited a polypropylene tube as it passed through.
Iron and potassium permanganate form shock-sensitive mixtures and may result in combustion when exposed to loud noise (percussion) (ITI, 1995).
Incandescence was reported for the following reactions (Urben, 1999):
- Mixtures of aluminum carbide and potassium permanganate will incandesce when warmed.
- Oxidation of ammonia with the potassium permanganate formed in the mixture of ammonia and sulfuric acid will result in incandescence due to the permanganic acid formed during the reaction.

FLAMMABILITY CLASSIFICATION

NFPA Flammability Rating for CAS7722-64-7 (NFPA, 2002):

Not Listed

INITIATING OR CONTRIBUTING PROPERTIES

While potassium permanganate itself is not combustible, it releases oxygen on decomposition, which will greatly intensify a surrounding fire and accelerate the combustion of combustible materials (AAR, 2002; Pohanish, 2002).

FIRE CONTROL/EXTINGUISHING AGENTS

SMALL FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

Use water. Do not use dry chemicals or foams. CO2 or Halon® may provide limited control.

LARGE FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

Flood fire area with water from a distance.
Move containers from fire area if you can do it without risk.
Do not move cargo or vehicle if cargo has been exposed to heat.
Fight fire from maximum distance or use unmanned hose holders or monitor nozzles.
Cool containers with flooding quantities of water until well after fire is out.
ALWAYS stay away from tanks engulfed in fire.
For massive fire, use unmanned hose holders or monitor nozzles; if this is impossible, withdraw from area and let fire burn.

NFPA Extinguishing Methods for CAS7722-64-7 (NFPA, 2002):

Not Listed

Use dry chemical or carbon dioxide extinguishers to fight fires involving potassium permanganate (Pohanish, 2002).

Fires involving potassium permanganate should be handled similar to sodium peroxide fires (Lewis, 2000).

COMBUSTION TOXICITY

Potassium permanganate decomposes on heating, releasing toxic gases and irritating fumes (ILO ICSC, 2003).
When heated to decomposition, toxic fumes of potassium oxide are released (Pohanish, 2002).

EXPLOSION HAZARD

The reaction between potassium permanganate and a great number of different materials results in extreme explosion hazard. Some of these hazardous reactions are detailed below (NFPA, 2002; Urben, 1999):

Contact of potassium permanganate with acetic acid or acetic anhydride may result in explosion.
Caking of solid potassium permanganate during oxidation of tert-alkylamines to nitroalkanes using 20% aqueous acetone led to a violent reaction with eruption of the flask.
A mixture of 0.5% potassium permanganate solution with ammonium nitrate exploded approximately 7 hours after the chemicals were combined. The explosion was attributed to the formation and exothermic decomposition of ammonium permanganate.
Arsenic and potassium permanganate will explode when ground together in a mortar.
Testing of coal samples to determine sulfur content incorporates use of an aqueous mixture of potassium permanganate and the peroxoacid. This strong oxidation process can result in violent explosion if a reflux condenser is not used.
The addition of potassium permanganate to dimethylformamide to get a 20% solution led to an explosion 5 minutes after the chemicals were mixed.
In the preparation of chlorine, the addition of concentrated hydrochloric acid to potassium permanganate resulted in a sharp explosion.
Contact between potassium permanganate and concentrated hydrogen peroxide can result in an explosion.
The addition of potassium permanganate to concentrated hydrofluoric acid in the preparation of potassium hexafluoromanganate(IV) resulted in a violent exothermic reaction.
Potassium permanganate mixed with phosphorus or sulfur will explode on heating or grinding.
The attempted preparation of permanganyl chloride involving the addition of concentrated sulfuric acid to a mixture of potassium chloride and potassium permanganate resulted in violent explosion.
Heating potassium permanganate and "Rocksil" slag wool resulted in minor explosion.
The addition of concentrated sulfuric acid to slightly damp potassium permanganate led to an explosion. Potassium permanganate solutions prepared in sulfuric acid are also explosive.
Mixtures of potassium permanganate and powered titanium exploded on heating.
Attempted purification of trifluoroacetic anhydride by distillation from potassium permanganate resulted in explosion. The violent reaction was attributed to the formation of dimanganese heptaoxide.
Explosive reactions will occur on contact with finely divided potassium permanganate and organic materials.

The reaction of tin and potassium permanganate when heated to 170 degrees C or higher results in explosion (ITI, 1995).

Glycerin and potassium permanganate can explode on contact due to released hydrogen (ITI, 1995).

There is a risk of fire and explosion on contact with combustibles and reducing agents (ILO ICSC, 2003).

DUST/VAPOR HAZARD

Potassium permanganate is a powerful oxidizing agent; its dust or finely ground powders can initiate fire or explosions when brought into contact with reducing agents, combustibles, strong acids, organic matter, or oxidizable materials (solid, liquid, gas) (Pohanish, 2002).

Incompatibility with nitric acid will produce toxic chlorine gas (Pohanish & Greene, 1997).

When it decomposes and is in contact with certain substances, it will release flammable oxygen gas (Pohanish, 2002).

Inhalation of potassium permanganate dust can cause respiratory tract irritation, and at higher concentrations, pulmonary edema (Pohanish, 2002).

On contact with acid or acid fumes, potassium permanganate can emit toxic fumes (Lewis, 2000).

REACTIVITY HAZARD

Potassium permanganate is a strong oxidizing agent that reacts violently with numerous compounds, resulting in explosion or fire hazard (Pohanish, 2002).

Potassium permanganate ignites on reaction with the following (NFPA, 2002; Pohanish, 2002; Urben, 1999):

Acetaldehyde (contact with powder)
Acetic acid (contact with powder)
Acetylacetone (contact with powder)
Alcohols + nitric acid
Antimony (on being ground)
Benzaldehyde (contact with powder)
3-Chloropropane-1,2-diol (contact with powder)
Dichloromethylsilane (pure material)
Dimethyl sulfoxide
Erythritol (contact with powder)
Esters of ethylene glycol (contact with powder)
Ethylene glycol (contact with powder)
Glycerol
Hydrogen peroxide
Hydrogen trisulfide
Hydroxylamine
Isobutyraldehyde (contact with powder)
Lactic acid (contact with powder)
Mannitol (contact with powder)
Organic matter
Oxalic acid (contact with powder)
Oxidizable solids, liquids, and gases
Propane-1,2-diol (contact with powder)
Reducing materials
Strong acids
Triethanolamine (contact with powder)
Wood (presence of moisture or friction)

Potassium permanganate explodes on reaction with the following (NFPA, 2002; Urben, 1999; Pohanish & Greene, 1997) :

Acetic acid
Acetic anhydride
Anhydrous ammonia
Ammonium nitrate
Arsenic
Dimethylformamide
Formaldehyde
Glycerol
Hydrochloric acid (concentrated)
Hydrogen peroxide
Hydroxylamine
Organic matter
Phosphorus (upon grinding)
Potassium chloride + sulfuric acid
Powdered sulfur (when heated)
Sulfuric acid + water
Titanium (powdered metal; when heated)

Potassium permanganate forms sensitive explosive mixtures with the following (Lewis, 2000):

Aluminum powder + ammonium nitrate + glyceryl nitrate + nitrocellulose
Ammonium perchlorate
Arsenic
Phosphorus
Sulfur
Sulfuric acid
Slag wool
Titanium

Violent reactions or ignition may occur from contact between potassium permanganate and the following (Lewis, 2000):

Acetone + tert-butylamine
Alcohols + nitric acid
Aluminum carbide
Ammonia + sulfuric acid
Antimony
Carbon
Coal + peroxomonosulfuric acid
Dichloromethylsilane
Dimethyl sulfoxide
Ethanol + sulfuric acid
Gylcerol
Hydrofluoric acid (concentrated)
Hydrogen peroxide
Hydrogen trisulfide
Hydroxylamine
Organic nitro compounds
Polypropylene
3,4,4'-Trimethyldiphenyl sulfone

Mixtures of aluminum carbide and potassium permanganate will incandesce when warmed (Urben, 1999).

Oxidation of ammonia with the potassium permanganate formed in the mixture of ammonia and sulfuric acid will result in incandescence due to the permanganic acid formed during the reaction (Urben, 1999).

Potassium permanganate reacts with nitric acid to produce toxic chlorine fumes (Pohanish & Greene, 1997).

Potassium permanganate reacts violently with most metal powders (HSDB, 2004).

Potassium permanganate is incompatible with (Budavari, 2001):

Alcohol
Arsenites
Bromides
Charcoal
Ferrous salts
Hydrochloric acid
Hypophosphites
Hyposulfites
Iodides
Mercurous salts
Organic substances
Oxalates
Peroxides
Sulfites

It is also incompatible with (Pohanish, 2002):

Antimony
Arsenic
Ethylene glycol
Finely divided combustible materials
Glycerin
Hydrogen peroxide
Hydrogen trisulfide
Hydroxylamine
Phosphorus
Polypropylene
Sulfuric acid

EVACUATION PROCEDURES

SUMMARY

Editor's Note: This material is not listed in the Table of Initial Isolation and Protective Action Distances.

LARGE SPILL - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

Consider initial downwind evacuation for at least 100 meters (330 feet).

FIRE - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

If tank, rail car or tank truck is involved in a fire, ISOLATE for 800 meters (1/2 mile) in all directions; also, consider initial evacuation for 800 meters (1/2 mile) in all directions.

PUBLIC SAFETY MEASURES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)

CALL Emergency Response Telephone Number on Shipping Paper first. If Shipping Paper not available or no answer, refer to appropriate telephone number:

MEXICO:

SETIQ:

01-800-00-214-00 in the Mexican Republic;
For calls originating in Mexico City and the Metropolitan Area: 5559-1588;
For calls originating elsewhere, call: 011-52-555-559-1588.

CENACOM:

01-800-00-413-00 in the Mexican Republic;
For calls originating in Mexico City and the Metropolitan Area: 5550-1496, 5550-1552, 5550-1485, or 5550-4885;
For calls originating elsewhere, call: 011-52-555-550-1496, or 011-52-555-550-1552; 011-52-555-550-1485, or 011-52-555-550-4885.

ARGENTINA:

CIQUIME:

0-800-222-2933 in the Republic of Argentina;
For calls originating elsewhere, call: +54-11-4613-1100.

BRAZIL:

PRÓ-QUÍMICA:

0-800-118270 (Toll-free in Brazil);
For calls originating elsewhere, call: +55-11-232-1144 (Collect calls are accepted).

COLUMBIA:

CISPROQUIM:

01-800-091-6012 in Colombia;
For calls originating in Bogotá, Colombia, call: 288-6012;
For calls originating elsewhere, call: 011-57-1-288-6012.

CANADA:

CANUTEC:

613-996-6666 (Collect calls are accepted);
*666 cellular (in Canada only).

UNITED STATES:

CHEMTREC®:

1-800-424-9300 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
703-527-3887 for calls originating elsewhere (Collect calls are accepted).

CHEM-TEL, INC.:

1-800-255-3924 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
813-248-0585 for calls originating elsewhere (Collect calls are accepted).

INFOTRAC:

1-800-535-5053 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
352-323-3500 for calls originating elsewhere (Collect calls are accepted).

3E COMPANY:

1-800-451-8346 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
760-602-8703 for calls originating elsewhere (Collect calls are accepted).

NATIONAL RESPONSE CENTER (NRC):

1-800-424-8802 - (24 hours) (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
202-267-2675 for calls in the District of Columbia.

MILITARY SHIPMENTS:

703-697-0218 - Explosives/ammunition incidents (Collect calls are accepted);
1-800-851-8061 - All other dangerous goods incidents.

NATIONWIDE POISON CONTROL CENTER (United States only):

1-800-222-1222 (Toll-free in the U.S.).

For additional details see the section entitled "WHO TO CALL FOR ASSISTANCE" under the ERG Instructions.
As an immediate precautionary measure, isolate spill or leak area in all directions for at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids.
Keep unauthorized personnel away.
Stay upwind.
Keep out of low areas.
Ventilate closed spaces before entering.

Relocate any persons in the vicinity of the spill to areas of fresh air, and seek medical care for victims of exposure (AAR, 2002).

AIHA ERPG Values for CAS7722-64-7 (AIHA, 2006):

Not Listed

DOE TEEL Values for CAS7722-64-7 (U.S. Department of Energy, Office of Emergency Management, 2010):

Listed as Potassium permanganate
TEEL-0 (units = mg/m3): 0.575
TEEL-1 (units = mg/m3): 8.63
TEEL-2 (units = mg/m3): 14.4
TEEL-3 (units = mg/m3): 500
Definitions:

TEEL-0: The threshold concentration below which most people will experience no adverse health effects.
TEEL-1: The airborne concentration (expressed as ppm [parts per million] or mg/m(3) [milligrams per cubic meter]) of a substance above which it is predicted that the general population, including susceptible individuals, could experience notable discomfort, irritation, or certain asymptomatic, nonsensory effects. However, these effects are not disabling and are transient and reversible upon cessation of exposure.
TEEL-2: The airborne concentration (expressed as ppm or mg/m(3)) of a substance above which it is predicted that the general population, including susceptible individuals, could experience irreversible or other serious, long-lasting, adverse health effects or an impaired ability to escape.
TEEL-3: The airborne concentration (expressed as ppm or mg/m(3)) of a substance above which it is predicted that the general population, including susceptible individuals, could experience life-threatening adverse health effects or death.

AEGL Values for CAS7722-64-7 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):

Not Listed

NIOSH IDLH Values for CAS7722-64-7 (National Institute for Occupational Safety and Health, 2007):

Not Listed

CONTAINMENT/WASTE TREATMENT OPTIONS

SUMMARY

SPILL OR LEAK PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)
- Keep combustibles (wood, paper, oil, etc.) away from spilled material.
- Do not touch damaged containers or spilled material unless wearing appropriate protective clothing.
- Stop leak if you can do it without risk.
- Do not get water inside containers.
RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)
- Wear positive pressure self-contained breathing apparatus (SCBA).
- Wear chemical protective clothing that is specifically recommended by the manufacturer. It may provide little or no thermal protection.
- Structural firefighters' protective clothing will only provide limited protection.
Evacuate persons not wearing personal protective equipment until the spill clean up is complete (Pohanish, 2002).
Remove or extinguish all sources of ignition from the area of the spill (Pohanish, 2002).
For spills or leaks of potassium permanganate solution, ventilate the area of release (Pohanish, 2002).
Do not absorb spills of potassium permanganate with sawdust or other combustible absorbents (ILO ICSC, 2003).
Absorb potassium permanganate solution in vermiculite, dry sand, earth, peat, or other absorbant material. Collect and deposit in sealed containers for disposal (Pohanish, 2002).
Solid potassium permanganate spills should be collected in the safest manner possible. Prevent dispersion of dusts. After spill is cleaned up, ventilate the area (Pohanish, 2002).
Sweep the solid material into containers to be sealed and removed to a safe location (ILO ICSC, 2003).
Prevent potassium permanganate from entering confined spaces, such as a sewer, due to the explosion hazard (Pohanish, 2002).
Prevent this chemical from entering the environment and water. Notify downstream users if it or contaminated runoff enters the waterways (ILO ICSC, 2003; Pohanish, 2002).
In situ clean-up can be accomplished through use of an anion exchanger. Use ferrous salts, alcohols, and charcoal to decompose the potassium permanganate, only if these substances themselves do not pose a threat to the environment. Seek professional environmental engineering assistance (OHM/TADS, 2004).

SMALL LEAK/SPILL

SMALL LIQUID SPILL PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)
- Use a non-combustible material like vermiculite or sand to soak up the product and place into a container for later disposal.
SMALL DRY SPILL PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)
- With clean shovel place material into clean, dry container and cover loosely; move containers from spill area.

LARGE LEAK/SPILL

LARGE SPILL PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 140 (ERG, 2004)
- Dike far ahead of liquid spill for later disposal.
- Following product recovery, flush area with water.
Only trained personnel should perform spill clean up (Pohanish, 2002):
- Cover the potassium permanganate with weak a reducing agent (e.g., sodium thiosulfate, bisulfates or ferrous salts).
- Transfer the material into a large container of water.
- Neutralize with soda ash.
For a spill on land, contain the spilled material in a holding area, and if necessary, cover with a plastic tarp to prevent it from dissolving in rain or firefighting water. Neutralize the potassium permanganate with sodium bisulfate (AAR, 2002).
For a spill in water, add dilute caustic acid (NaOH) or sodium bisulfite (NaHSO3); use mechanical dredges or lifts to remove the material (AAR, 2002).

WASTE TREATMENT OPTIONS

CHEMICAL TREATMENT

Add potassium permanganate to a large volume of reducing agent, then neutralize with soda ash or dilute hydrochloric acid (OHM/TADS, 2004).
Waste management activities associated with material disposition are unique to individual situations. Proper waste characterization and decisions regarding waste management should be coordinated with the appropriate local, state, or federal authorities to ensure compliance with all applicable rules and regulations.

-ENVIRONMENTAL HAZARD MANAGEMENT

POLLUTION HAZARD

Release of potassium permanganate to the environment can occur through its use in aquatic systems (Cruz & Tamse, 1989).

Occupational exposure has been reported (HSDB, 2004).

Direct release to the environment occur through its use as an effective algaecide in reservoirs (OHM/TADS, 2004).

ENVIRONMENTAL FATE AND KINETICS

Potassium permanganate is stable in air (HSDB, 2004).

WATER

SURFACE WATER
- Potassium permanganate will sink and dissolve in water, and it rapidly oxidizes any organic material present. It is reduced to manganese dioxide, a brown precipitate (OHM/TADS, 2004).

ABIOTIC DEGRADATION

In an aquatic environement, potassium permanganate will sink and dissolve in the water column (OHM/TADS, 2004).

ENVIRONMENTAL TOXICITY

TOXICITY VALUES

LC - MINUTE CRUSTACEANS: 5 mg/L (OHM/TADS, 2004)
LC5 - MILKFISH, fingerling (Chanos chanos): 1.2317 ± 0.0315 for 96H (Cruz & Tamse, 1989)
LC5 - MILKFISH, fingerling (Chanos chanos): 1.5070 mg/L ± 0.0325 for 24H (Cruz & Tamse, 1989)
LC50 - CHANNEL CATFISH (Ictalurus punctatus): 0.75 mg/L for 96H (HSDB, 2004)
LC50 - CHANNEL CATFISH (Ictalurus punctatus): 4.5 mg/L for 96H (single dose; chemical oxygen demand of 21 mg/L) (HSDB, 2004)
LC50 - CHANNEL CATFISH (Ictalurus punctatus): 9.0 mg/L for 96H (four doses, applied equally at 30 minute intervals; relatively lower chemical oxygen demand) (HSDB, 2004)
LC50 - CHANNEL CATFISH (Ictalurus punctatus): 17.6 mg/L for 96H (single dose; chemical oxygen demand of 118 mg/L) (HSDB, 2004)
LC50 - CHANNEL CATFISH (Ictalurus punctatus): 25.6 mg/L for 96H (four doses, applied equally at 30 minute intervals; relatively higher chemical oxygen demand) (HSDB, 2004)
LC50 - GOLDFISH (Carassius auratus): 3.6 mg/L for 96H (HSDB, 2004)
LC50 - MILKFISH, fingerling (Chanos chanos): 1.4757 ± 0.0227 for 96H (Cruz & Tamse, 1989)
LC50 - MILKFISH, fingerling (Chanos chanos): 1.4860 ± 0.0200 for 24H (Cruz & Tamse, 1989)
LC50 - STRIPED BASS, fingerling: 4 mg/L for 48-96H (OHM/TADS, 2004)
LC50 - STRIPED BASS, fingerling: 5 mg/L for 24H -- static conditions (OHM/TADS, 2004)
LC50 - STRIPED BASS, larvae: 1 mg/L for 48 - 96H -- static conditions (OHM/TADS, 2004)
LC50 - STRIPED BASS, larvae: 1.5 mg/L for 24H -- static conditions (OHM/TADS, 2004)
LC50 - FISH (Trachinotus carolinus), juvenile: 1.6 - 2.9 mg/L for 96H -- static conditions (OHM/TADS, 2004)
LC95 - MILKFISH, fingerling (Chanos chanos): 1.6980 ± 0.0530 for 96H (Cruz & Tamse, 1989)
LC95 - MILKFISH, fingerling (Chanos chanos): 1.7257 ± 0.0227 for 24H (Cruz & Tamse, 1989)
LD50 - BLUEGILL SUNFISH (Lepomis macrochirus): 2.7 - 3.6 mg/L for 96H (HSDB, 2004)
TC - BLUEGILL: 3 mg/L (OHM/TADS, 2004)
TC - EEL, young: 11.8 mg/L for 8H (OHM/TADS, 2004)
TC - FATHEAD MINNOW: 5 mg/L (OHM/TADS, 2004)
TC - FISH (unspecified): 22 - 62 mg/L for 0.5H (OHM/TADS, 2004)
TC - GOLDFISH: 10 mg/L for 12 - 18H (OHM/TADS, 2004)
TC - LARGEMOUTH BASS: 4 mg/L (OHM/TADS, 2004)
TC - TROUT: 6.25 mg/L for 24H (OHM/TADS, 2004)
TLm - BLUEGILL: 4.2 mg/L for 24H, 48H, and 96H (OHM/TADS, 2004)
TLm - BLUEGILL: 5.2 mg/L for 24H (OHM/TADS, 2004)
TLm - BLUEGILL: 5.4 mg/L for 48H (CHRIS, 2004; OHM/TADS, 2004)
TLm - CATFISH, fingerling: 3.2 mg/L for 24H (OHM/TADS, 2004)
TLm - CREEK CHUB: 3.7 mg/L for 96H (OHM/TADS, 2004)
TLm - MOSQUITOFISH: 12 mg/L for 24H and 96H (OHM/TADS, 2004)

Milkfish fingerlings (Chanos chanos) from a commercial fish farm were exposed to potassium permanganate at concentrations ranging from 1.0 mg/L to 1.8 mg/L. An avoidance response was observed in all fish immediately following addition of the potassium permanganate to the test waters. Following the addition of sublethal concentrations (1.0 - 1.25 mg/L), the fish had increased activity levels for approximately 15 minutes, after which time they slowed; the fish were able to tolerate this concentration for the entire 96 hours of the test. At lethal concentrations (1.8 mg/L), the fish swam rapidly for 30 minutes, and evidence of oxidation, including blackening of the snouts, fin tips, and dorsal body region, was apparent; at this level, all fish died within 6 to 24 hours (Cruz & Tamse, 1989).

It was observed that the toxicity of potassium permanganate to fish may be related to the amount of oxidizable organic material in the water; the toxicity decreases as the amount of oxidizable material increases (Cruz & Tamse, 1989).

Potassium permanganate is extremely toxic to fish and other aquatic organisms, even in low concentrations (CHRIS, 2004; OHM/TADS, 2004; ILO ICSC, 2003).

-PHYSICAL/CHEMICAL PROPERTIES

MOLECULAR WEIGHT

158.03

DESCRIPTION/PHYSICAL STATE

At room temperature, potassium permanganate exists as dark purple or bronze-colored, odorless, sweetish, astringent tasting crystals, that are described as having a blue, metallic sheen. It is readily soluble in water; aqueous solutions are pink to violet in color and slowly deposit manganese dioxide (Budavari, 2001; Lewis, 2001; Lewis, 2000; Lewis, 1998; Freeman, 1998).

SPECIFIC GRAVITY

OTHER TEMPERATURE AND/OR PRESSURE

2.70 (at 15 degrees C) (CHRIS, 2004)

TEMPERATURE AND/OR PRESSURE NOT LISTED

2.7 (Budavari, 2001)
2.703 (Lewis, 2000)
2.7032 (Lewis, 2001)

DENSITY

TEMPERATURE AND/OR PRESSURE NOT LISTED

2.70 kg/L (Ashford, 2001)

FREEZING/MELTING POINT

FREEZING POINT

>513 K; >240 degrees C; >464 degrees F (CHRIS, 2004)

SOLUBILITY

IN WATER

Potassium permanganate is soluble in water (Ashford, 2001; Lewis, 2001; Lewis, 2000).
63.8 g/L (at 20 degrees C) (Bingham et al, 2001)
64 g/L (at 20 degrees C) (HSDB, 2004)
65 g/L (at 20 degrees C) (Freeman, 1998)
Soluble in 14.2 parts cold water or 3.5 parts boiling water (Budavari, 2001)

IN ORGANIC SOLVENTS

Potassium permanganate is soluble in acetone and methanol (Lewis, 2001).
Moderately soluble in methanol, alcohol, acetone, and pyridine (Lewis, 2000)
Soluble in acetic acid, trifluoroacetic acid, acetic anhydride, pyridine, benzonitrile, and sulfolane (HSDB, 2004)

OTHER

Potassium permanganate is decomposed by alcohol (Lewis, 2001).

OTHER/PHYSICAL

ODOR THRESHOLD

Odorless (Lewis, 2001)

DECOMPOSITION TEMPERATURE

<240 degrees C (Pohanish, 2002; Ashford, 2001; Bingham et al, 2001; Lewis, 2001; Lewis, 2000)
~240 degrees C (Budavari, 2001)

INDEX OF REFRACTION

1.59 (HSDB, 2004)

-REFERENCES

GENERAL BIBLIOGRAPHY

21 CFR 250.108: Food and Drug Administration - Potassium permanganate preparations as prescription drugs.. National Archives and Records Associations (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Oct 31, 2003.

40 CFR 372.28: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Lower thresholds for chemicals of special concern. National Archives and Records Administration (NARA) and the Government Printing Office (GPO). Washington, DC. Final rules current as of Apr 3, 2006.

40 CFR 372.65: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Chemicals and Chemical Categories to which this part applies. National Archives and Records Association (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Apr 3, 2006.

49 CFR 172.101 - App. B: Department of Transportation - Table of Hazardous Materials, Appendix B: List of Marine Pollutants. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 29, 2005.

49 CFR 172.101: Department of Transportation - Table of Hazardous Materials. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 11, 2005.

62 FR 58840: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 1997.

65 FR 14186: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 39264: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 77866: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

66 FR 21940: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2001.

67 FR 7164: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2002.

68 FR 42710: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2003.

69 FR 54144: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2004.

AAR: Emergency Handling of Hazardous Materials in Surface Transportation, American Association of Railroads, Bureau of Explosives, Transportation Technology Center, Pueblo, CO, 2002.

AIHA: 2006 Emergency Response Planning Guidelines and Workplace Environmental Exposure Level Guides Handbook, American Industrial Hygiene Association, Fairfax, VA, 2006.

Aceto T Jr, Terplan K, & Fiore RR: Chemical burns of the esophagus in children and glucocorticoid therapy. J Med 1970; 1:101-109.

Adam JS & Brick HG: Pediatric caustic ingestion. Ann Otol Laryngol 1982; 91:656-658.

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.

Anderson KD, Touse TM, & Randolph JG: A controlled trial of corticosteroids in children with corrosive injury of the esophagus. N Engl J Med 1990; 323:637-640.

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.

Arlauskas A: Environ Res 1985; 36:379-388.

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.

Ashford R: Ashford's Dictionary of Industrial Chemicals, 2nd ed, Wavelength Publications Ltd, London, England, 2001.

Azuara-Blanco A, Pillai CT, & Dua HS: Amniotic membrane transplantation for ocular surface reconstruction. Br J Ophthalmol 1999; 83:399-402.

Bata Shoe Company: Industrial Footwear Catalog, Bata Shoe Company, Belcamp, MD, 1995.

Best Manufacturing: ChemRest Chemical Resistance Guide. Best Manufacturing. Menlo, GA. 2002. Available from URL: http://www.chemrest.com. As accessed 10/8/2002.

Best Manufacturing: Degradation and Permeation Data. Best Manufacturing. Menlo, GA. 2004. Available from URL: http://www.chemrest.com/DomesticPrep2/. As accessed 04/09/2004.

Bingham E, Cohrssen B, & Powell CH: Patty's Toxicology, Vol 3. 5th ed, John Wiley & Sons, New York, NY, 2001.

Bleich S, Degner D, Sprung R, et al: Chronic Manganism: Fourteen Years of Follow-up (letter). J Neuropsychiatry Clin Neurosci 1999; 11:117.

Boss Manufacturing Company: Work Gloves, Boss Manufacturing Company, Kewanee, IL, 1998.

Boukthir S, Fetni I, Mrad SM, et al: [High doses of steroids in the management of caustic esophageal burns in children]. Arch Pediatr 2004; 11(1):13-17.

Brodovsky SC, McCarty AC, & Snibson G: Management of alkali burns an 11-year retrospective review. Ophthalmology 2000; 107:1829-1835.

Brodovsky SC, McCarty CA, & Snibson G: Management of alkali burns an 11-year retrospective review. Ophthalmology 2000a; 107:1829-1835.

Brodovsky SC, McCarty CA, & Snibson G: Management of alkali burns an 11-year review. Ophthalmology 2000b; 107:1829-1835.

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.

Budavari S: The Merck Index, 13th ed (CD-ROM version). Merck & Co, Inc. Whitehouse Station, NJ. 2001.

Burgess JL, Kirk M, Borron SW, et al: Emergency department hazardous materials protocol for contaminated patients. Ann Emerg Med 1999; 34(2):205-212.

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.

Caravati EM: Alkali. In: Dart RC, ed. Medical Toxicology, Lippincott Williams & Wilkins, Philadelphia, PA, 2004.

Cartotto RC, Peters WJ, & Neligan PC: Chemical Burns. Canad J Surg 1996; 39:205-211.

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.

Cattan P, Munoz-Bongrand N, & Berney T: Extensive abdominal surgery after caustic ingestion. Ann Surg 2000; 231:519-523.

ChemFab Corporation: Chemical Permeation Guide Challenge Protective Clothing Fabrics, ChemFab Corporation, Merrimack, NH, 1993.

Chiene KY, Wang PY, & Lu KS: Esophagoplasty of corrosive stricture of the esophagus. Ann Surg 1974; 179:510-515.

Cleveland WW, Chandler JR, & Lawson RB: Treatment of caustic burns of the esophagus. JAMA 1963; 186:182-183.

Cohn P, Navitski M, & Monaco A: Permanganate as a cause of apparent chloramine breakthrough in dialysis water. Semin Dial 2005; 18:351-352.

Coln D & Chang JHT: Experience with esophageal stenting for caustic burns in children. J Pediatr Surg 1986; 21:588-592.

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.

Comasec Safety, Inc.: Product Literature, Comasec Safety, Inc., Enfield, CT, 2003a.

Conso F, Celerier M, & Maury D: Ingestion de comprimes de permanganate de potassium. La Nouvelle Presse Medicale 1974; 3:2184-2185.

Cook DG, Fahn S, & Bratt KA: Chronic manganese intoxication. Arch Neurol 1974; 30:59-64.

Cowie RL & Escreet BC: Potassium permanganate toxicity (letter). SA Med J 1981; 304.

Crain EF, Gershel JC, & Mezey AP: Caustic ingestions. Symptoms as predictors of esophageal injury. Am J Dis Child 1984a; 138(9):863-865.

Crain EF, Gershel JC, & Mezey AP: Caustic ingestions; symptoms as predictors of esophageal injury. Am J Dis Child 1984; 138:863-865.

Cruz ER & Tamse CT: Acute toxicity of potassium permanganate to milkfish fingerlings, Chanos chanos. Bull. Environ. Contam. Toxicol. 1989; 43:785-788.

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.

Dagli AJ, Golden D, & Finkel M: Pyloric stenosis following ingestion of potassium permanganate. Dig Dis 1973; 18:1091-1094.

Desmul A, Desneux JJ, & Kinnaert P: Gastrite corrosive par ingestion de caustique. Acta Chirurgica Belgica 1968; 3:281-291.

Dixit VP: Indian J Exp Biol 1976; 14:617-619.

Dogan Y, Erkan T, Cokugras FC, et al: Caustic gastroesophageal lesions in childhood: an analysis of 473 cases. Clin Pediatr (Phila) 2006; 45(5):435-438.

Donaldson J & Barbeau A: Manganese neurotoxicity: possible clues to the etiology of human brain disorders, in: Gabay S, Harris J, Beng TH (Eds). Heavy Ions in Neurology and Psychiatry, Alan R Liss, New York, NY, 1985.

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.

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.

DuPont: Permeation Test Results. DuPont. Wilmington, DE. 2002a. Available from URL: http://www.tyvekprotectiveapprl.com/databases/default.htm. As accessed 7/31/2002.

Dunipace AJ, Beaven R, Noblitt T, et al: Mutagenic potential of toluidine blue evaluated in the Ames test. Mutat Res 1992; 279(4):255-259.

EPA: Search results for Toxic Substances Control Act (TSCA) Inventory Chemicals. US Environmental Protection Agency, Substance Registry System, U.S. EPA's Office of Pollution Prevention and Toxics. Washington, DC. 2005. Available from URL: http://www.epa.gov/srs/.

ERG: Emergency Response Guidebook. A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/Hazardous Materials Incident, U.S. Department of Transportation, Research and Special Programs Administration, Washington, DC, 2004.

Endicott JN: Corrosive esophagitis: current management of the acute esophageal lye burn. South Med J 1971; 64:270-272.

Ernst AA, Thomson T, & Haynes ML: Warmed versus room temperature saline solution for ocular irrigation: a randomized clinical trial. Ann Emerg Med 1998; 32:676-679.

Estrera A, Taylor W, & Mills LJ: Corrosive burns of the esophagus and stomach: a recommendation of an aggressive surgical approach. Ann Thorac Surg 1986; 41:276-283.

Ferguson MK, Migliore M, & Staszak VM: Early evaluation and therapy for caustic esophageal injury. Am J Surg 1989; 157:116-120.

Fish R & Davidson RS: Management of ocular thermal and chemical injuries, including amniotic membrane therapy. Curr Opin Ophthalmol 2010; 21(4):317-321.

Florence TM & Stauber JL: Neurotoxicity of manganese. Lancet 1988; 1:363.

Freeman HM: Standard Handbook of Hazardous Waste Treatment and Disposal, 2nd ed, McGraw-Hill Book Company, New York, NY, 1998.

Gandhi RP, Cooper A, & Barlow BA: Successful management of esophageal stricture without resection or replacement. J Pediatr 1989; 24:745-750.

Gaudreault P, Parent M, & McGuigan MA: Predictability of esophageal injury from signs and symptoms: a study of caustic ingestion in 378 children. Pediatrics 1983; 71:761-770.

Gaudreault P, Parent M, McGuigan MA, et al: Predictability of esophageal injury from signs and symptoms: a study of caustic ingestion in 378 children. Pediatrics 1983a; 71(5):767-770.

Gawarammana IB, Ariyananda PL, Palangasinghe C, et al: Emerging epidemic of fatal human self-poisoning with a washing powder in Southern Sri Lanka: a prospective observational study. Clin Toxicol (Phila) 2009; 47(5):407-411.

Goldfrank LR, Flomenbaum NE, & Lewin NA: Goldfrank's Toxicologic Emergencies, 7th ed, McGraw-Hill, Medical Publishing Division, New York, NY, 2002.

Gorman RL, Khin-Maung-Gyi MT, & Klein-Schwartz W: Initial symptoms as predictors of esophageal injury in alkaline corrosive ingestions. Am J Emerg Med 1992; 10:89-94.

Grant WM & Schuman JS: Toxicology of the Eye, 4th ed, Charles C Thomas, Springfield, IL, 1993.

Grant WM & Schuman JS: Toxicology of the Eye, 4th ed, Charles C Thomas, Springfield, IL, 1993a.

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.

Guichardiere MA: Accidents digestifs au cours d'une intoxication a visee therapeutique. Tyon Med 1965; 213(14):1077-1078.

Gundogdu HZ, Tanyel FC, & Buyukpamukcu N: Conservative treatment of caustic esophageal strictures in children. J Pediatr Surg 1992; 27:767-770.

Gupta SK, Croffie JM, & Fitzgerald JF: Is esophagogastroduodenoscopy necessary in all caustic ingestions?. J Ped Gastroenterol Nutr 2001; 32:50-53.

HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 1998; provided by Truven Health Analytics Inc., Greenwood Village, CO.

HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2004; provided by Truven Health Analytics Inc., Greenwood Village, CO.

Haas CF: Mechanical ventilation with lung protective strategies: what works?. Crit Care Clin 2011; 27(3):469-486.

Haller JA & Bachman K: The comparative effect of current therapy on experimental caustic burns of the esophagus. Pediatrics 1964; 236-245.

Haller JA, Andrews HG, & White JJ: Pathophysiology and management of acute corrosive burns of the esophagus. J Pediatr Surg 1971; 6:578-584.

Hawkins DB, Demeter MJ, & Barnett TE: Caustic ingestion: controversies in management. A review of 214 cases. Laryngoscope 1980; 90:98-109.

Herman MI, Chyka PA, & Butlse AY: Methylene blue by intraosseous infusion for methemoglobinemia. Ann Emerg Med 1999; 33:111-113.

Hix WR & Wilson WR: Toluidine blue staining of the esophagus: a useful adjunct in the panendoscopic evaluation of patients with squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 1987; 113(8):864-865.

Hjelt K, Lund JT, Scherling B, et al: Methaemoglobinaemia among neonates in a neonatal intensive care unit. Acta Paediatr 1995; 84(4):365-370.

Hogan RB & Polter DE: Nonsurgical management of lye-induced antral strictures with hydrostatic balloon dilation. Gastrointest Endosc 1986; 32:228-230.

Holzgraefe M, Poser W, & Kijewski H: Chronic enteral poisoning caused by potassium permanganate: a case report. Clin Toxicol 1986; 24:235-244.

Homan CS, Maitra SR, & Lane BP: Effective treatment of acute alkali injury of the esopahgus with early saline dilution therapy. Ann Emerg Med 1993; 22:178-182.

Homan CS, Maitra SR, & Lane BP: Histopathologic evaluation of the therapeutic efficacy of water and mild dilution for esophageal acid injury. Acad Emerg Med 1995; 2:587-591.

Homan CS, Maitra SR, & Lane BP: Therapeutic effects of water and milk for acute alkali injury of the esophagus. Ann Emerg Med 1994; 24:14-19.

Howell JM, Dalsey WC, & Hartsell FW: Steroids for the treatment of corrosive esophageal injury: a statistical analysis of past studies. Am J Emerg Med 1992; 10:421-425.

Howell JM: Alkaline ingestions. Ann Emerg Med 1987; 15:820-825.

Howland MA: Antidotes in Depth. In: Goldfrank LR, Flomenbaum N, Hoffman RS, et al, eds. Goldfrank's Toxicologic Emergencies. 8th ed., 8th ed. McGraw-Hill, New York, NY, 2006, pp 826-828.

Huy PTB & Celerier M: Management of severe caustic stenosis of the hypopharynx and esophagus by ileocolic transposition via suprahyoid or transepiglottic approach. Ann Surg 1988; 207:439-445.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: 1,3-Butadiene, Ethylene Oxide and Vinyl Halides (Vinyl Fluoride, Vinyl Chloride and Vinyl Bromide), 97, International Agency for Research on Cancer, Lyon, France, 2008.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol, 88, International Agency for Research on Cancer, Lyon, France, 2006.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Household Use of Solid Fuels and High-temperature Frying, 95, International Agency for Research on Cancer, Lyon, France, 2010a.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines, 89, International Agency for Research on Cancer, Lyon, France, 2007.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Some Non-heterocyclic Polycyclic Aromatic Hydrocarbons and Some Related Exposures, 92, International Agency for Research on Cancer, Lyon, France, 2010.

IARC: List of all agents, mixtures and exposures evaluated to date - IARC Monographs: Overall Evaluations of Carcinogenicity to Humans, Volumes 1-88, 1972-PRESENT. World Health Organization, International Agency for Research on Cancer. Lyon, FranceAvailable from URL: http://monographs.iarc.fr/monoeval/crthall.html. As accessed Oct 07, 2004.

ICAO: Technical Instructions for the Safe Transport of Dangerous Goods by Air, 2003-2004. International Civil Aviation Organization, Montreal, Quebec, Canada, 2002.

ILC Dover, Inc.: Ready 1 The Chemturion Limited Use Chemical Protective Suit, ILC Dover, Inc., Frederica, DE, 1998.

ILO ICSC: International Chemical Safety Card 0672: Potassium Permanganate. International Labour Organization; prepared in cooperation with the International Programme on Chemical Safety and the European Commission. Geneva, Switzerland. 2003. Available from URL: http://www.ilo.org/public/english/protection/safework/cis/products/icsc/dtasht/_icsc06/icsc0672.htm. As accessed 27th January, 2004.

ILO: Encyclopaedia of Occupational Health and Safety, 3rd ed, Vols 1 & 2, International Labour Organization, Geneva, Switzerland, 1983.

ITI: Toxic and Hazardous Industrial Chemicals Safety Manual, The International Technical Information Institute, Tokyo, Japan, 1995.

International Agency for Research on Cancer (IARC): IARC monographs on the evaluation of carcinogenic risks to humans: list of classifications, volumes 1-116. International Agency for Research on Cancer (IARC). Lyon, France. 2016. Available from URL: http://monographs.iarc.fr/ENG/Classification/latest_classif.php. As accessed 2016-08-24.

International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. World Health Organization. Geneva, Switzerland. 2015. Available from URL: http://monographs.iarc.fr/ENG/Classification/. As accessed 2015-08-06.

Jiang YM, Mo XA, Du FQ, et al: Effective treatment of manganese-induced occupational Parkinsonism with p-aminosalicylic acid: a case of 17-year follow-up study. J Occup Environ Med 2006; 48(6):644-649.

Johnson TB & Cassidy DD: Unintentional ingestion of potassium permanganate. Pediatr Emerg Care 2004; 20:185-187.

Justus J & Gastmeier G: Todliche kaliumpermanganatvergiftung infolge verwechslung mit tierkohle. Dentoche Gesundheitwesen 1967; 22:897-899.

Kamijo Y, Kondo I, Kokuto M, et al: Miniprobe ultrasonography for determining prognosis in corrosive esophagitis. Am J Gastroenterol 2004; 99(5):851-854.

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.

Kiese M , Lorcher W , Weger N , et al: Comparative studies on the effects of toluidine blue and methylene blue on the reduction of ferrihaemoglobin in man and dog. Eur J Clin Pharmacol 1972; 4(2):115-118.

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.

Kleinman ME, Chameides L, Schexnayder SM, et al: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 14: pediatric advanced life support. Circulation 2010; 122(18 Suppl.3):S876-S908.

Knox WG, Scott JR, & Zintel HA: Bouginage and steroids used singly or in combination in experimental corrosive esophagitis. Ann Surg 1967; 166:930-941.

Kochhar R, Das K, & Mehta SK: Potassium permanganate induced oesophageal stricture. Human Toxicol 1986; 5:393-394.

Kollef MH & Schuster DP: The acute respiratory distress syndrome. N Engl J Med 1995; 332:27-37.

Kuckelkorn R, Kottek A, & Schrage N: Poor prognosis of severe chemical and thermal eye burns: the need for adequate emergency care and primary prevention. Int Arch Occup Environ Health 1995; 281-284.

LaCrosse-Rainfair: Safety Products, LaCrosse-Rainfair, Racine, WI, 1997.

Lamireau T, Rebouissoux L, & Denis D: Accidental caustic ingestion in children: is endoscopy always mandatory?. J Ped Gastroenterol Nutr 2001; 33:81-84.

Lewis RA: Lewis' Dictionary of Toxicology, Lewis Publishers, Boca Raton, FL, 1998.

Lewis RJ: Hawley's Condensed Chemical Dictionary, 13th ed, John Wiley & Sons, Inc, New York, NY, 2001.

Lewis RJ: Hawley's Condensed Chemical Dictionary, 14th ed, John Wiley & Sons, Inc, New York, NY, 2001a.

Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 10th ed, John Wiley & Sons, New York, NY, 2000.

Lifshitz M, Shahak E, & Sofer S: Fatal potassium permanganate intoxication in an infant (letter). Clin Toxicol 1999; 37:801-802.

Lindenmann J, Matzi V, Kaufmann P, et al: Hyperbaric oxygenation in the treatment of life-threatening isobutyl nitrite-induced methemoglobinemia--a case report. Inhal Toxicol 2006; 18(13):1047-1049.

Little AG, Naunheim KS, & Ferguson MK: Surgical management of esophageal strictures. Ann Thorac Surg 1988; 45:144-147.

LoVecchio F, Hamilton R, & Sturman K: A meta-analysis of the use of steroids in the prevention of stricture formation from second degree caustic burns of the esophagus (abstract). J Toxicol-Clin Toxicol 1996; 35:579-580.

Lustig S, Pitlik SD, & Rosenfeld JB: Liver damage in acute self-induced hypermanganemia. Arch Intern Med 1982; 142:405-406.

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.

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.

Mahomedy MC, Mahomedy YH, & Canham PAS: Methaemoglobinaemia following treatment dispensed by witch doctors. Aanesthesia 1975; 30:190-193.

Mar-Mac Manufacturing, Inc: Product Literature, Protective Apparel, Mar-Mac Manufacturing, Inc., McBee, SC, 1995.

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.

Marquez A & Todd M: Acute hemolytic anemia and agranulocytosis following intravenous administration of toluidine blue. Am Pract 1959; 10:1548-1550.

Marshall F II: Caustic burns of the esophagus: ten year results of aggressive care. South Med J 1979; 72:1236-1237.

Marzin DR & Phi HV: Mutat Res 1985; 155:49-51.

Matsui S: Weed Res 1980; 14:1613-1620.

Maull KI, Osman AP, & Maull CD: Liquid caustic ingestions: an in vitro study of the effects of buffer, neutralization, and dilution. Ann Emerg Med 1985; 4:1160-1162.

Mayer J, Choquart P, & Frileux CC: Lesions gastriques par ingestion de comprimes de permanganate de potassium. Chirurgie 1972; 98:487-491.

McDonough JF: Vaginal bleeding from potassium permanganate as an abortifacient. N Engl J Med 1945; 232:189-190.

Meller D, Pires RT, & Mack RJS: Amniotic membrane transplantation for acute chemical or thermal burns. Ophthalmology 2000; 107:980-990.

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.

Meredith JW, Kon ND, & Thompson JN: Management of injuries from liquid lye ingestion. J Trauma 1988; 28:1173-1180.

Michaels DD & Zugsmith GS: Potassium permanganate burn of the eye. Eye Ear Nose Throat Monthly 1973; 52:42-43.

Middleton SJ, Jacyna M, & McClaren D: Haemorrhagic pancreatitis - a cause of death in severe potassium permanganate poisoning. Postgrad Med J 1990; 66:657-658.

Millar AJW, Numanoglu A, & Mann M: Detection of caustid oesophageal injury tiwh technetium 99m-labelled sucralfate. J Ped SUrg 2001; 36:262-265.

Moazam F, Talbert JL, & Miller D: Caustic ingestion and its sequelae in children. South Med J 1987; 80:187-188.

Montgomery Safety Products: Montgomery Safety Products Chemical Resistant Glove Guide, Montgomery Safety Products, Canton, OH, 1995.

Morgan S & Murray A: Limbal autotransplantation in the acute and chronic phases of severe chemical injuries. Eye 1996; 10:349-354.

NFPA: Fire Protection Guide to Hazardous Materials, 13th ed., National Fire Protection Association, Quincy, MA, 2002.

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.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 1, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2001.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 2, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2002.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 3, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2003.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 4, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2004.

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.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,3-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,4-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Butylene Oxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648083cdbb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Dibromoethane (Proposed). United States Environmental Protection Agency. Washington, DC. 2007g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802796db&disposition=attachment&contentType=pdf. As accessed 2010-08-18.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,3,5-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 2-Ethylhexyl Chloroformate (Proposed). United States Environmental Protection Agency. Washington, DC. 2007b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037904e&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Acrylonitrile (Proposed). United States Environmental Protection Agency. Washington, DC. 2007c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648028e6a3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Adamsite (Proposed). United States Environmental Protection Agency. Washington, DC. 2007h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Agent BZ (3-quinuclidinyl benzilate) (Proposed). United States Environmental Protection Agency. Washington, DC. 2007f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ad507&disposition=attachment&contentType=pdf. As accessed 2010-08-18.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Allyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039d9ee&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Arsenic Trioxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480220305&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Automotive Gasoline Unleaded (Proposed). United States Environmental Protection Agency. Washington, DC. 2009a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cc17&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Biphenyl (Proposed). United States Environmental Protection Agency. Washington, DC. 2005j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1b7&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bis-Chloromethyl Ether (BCME) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648022db11&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Boron Tribromide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae1d3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromine Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2007d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039732a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromoacetone (Proposed). United States Environmental Protection Agency. Washington, DC. 2008e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187bf&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Calcium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae328&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Sulfide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037ff26&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Chlorobenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803a52bb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Cyanogen (Proposed). United States Environmental Protection Agency. Washington, DC. 2008f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187fe&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Dimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbf3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Diphenylchloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091884e&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Phosphorodichloridate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480920347&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809203e7&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Germane (Proposed). United States Environmental Protection Agency. Washington, DC. 2008j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963906&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Hexafluoropropylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1f5&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ketene (Proposed). United States Environmental Protection Agency. Washington, DC. 2007. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ee7c&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Malathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2009k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809639df&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Mercury Vapor (Proposed). United States Environmental Protection Agency. Washington, DC. 2009b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a087&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Isothiocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a03&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a57&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl tertiary-butyl ether (Proposed). United States Environmental Protection Agency. Washington, DC. 2007a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802a4985&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methylchlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5f4&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c646&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN1 CAS Reg. No. 538-07-8) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN2 CAS Reg. No. 51-75-2) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN3 CAS Reg. No. 555-77-1) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Tetroxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091855b&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Trifluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e0c&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008o. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e32&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perchloryl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e268&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perfluoroisobutylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2009d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26a&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008p. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dd58&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2006d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020cc0c&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phorate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008q. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dcc8&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene (Draft-Revised). United States Environmental Protection Agency. Washington, DC. 2009e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a08a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene Oxime (Proposed). United States Environmental Protection Agency. Washington, DC. 2009f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26d&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Propargyl Alcohol (Proposed). United States Environmental Protection Agency. Washington, DC. 2006e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec91&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Selenium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec55&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Silane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d523&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Strontium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sulfuryl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec7a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tear Gas (Proposed). United States Environmental Protection Agency. Washington, DC. 2008s. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e551&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tellurium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e2a1&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tert-Octyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2008r. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5c7&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tetramethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-17.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7d608&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethylacetyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008t. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5cc&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Zinc Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for n-Butyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064808f9591&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Institute for Occupational Safety and Health: NIOSH Pocket Guide to Chemical Hazards, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Cincinnati, OH, 2007.

National Research Council : Acute exposure guideline levels for selected airborne chemicals, 5, National Academies Press, Washington, DC, 2007.

National Research Council: Acute exposure guideline levels for selected airborne chemicals, 6, National Academies Press, Washington, DC, 2008.

National Research Council: Acute exposure guideline levels for selected airborne chemicals, 7, National Academies Press, Washington, DC, 2009.

National Research Council: Acute exposure guideline levels for selected airborne chemicals, 8, National Academies Press, Washington, DC, 2010.

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.

Nemec K: Antidotes in acute poisoning. Eur J Hosp Pharm Sci Pract 2011; 17(4):53-55.

Nishioka H: Mutat Res 1975; 31:185-189.

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.

North: eZ Guide Interactive Software. North Safety. Cranston, RI. 2002a. Available from URL: http://www.northsafety.com/feature1.htm. As accessed 8/31/2002.

Nuutinen M, Uhari M, & Karvali T: Consequences of caustic ingestions in children. Acta Paediatr 1994; 83:1200-1205.

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.

Oakes DD, Sherck JP, & Mark JBD: Lye ingestion. J Thorac Cardiovasc Surg 1982; 83:194-204.

Ong KL, Tan TH, & Cheung WL: Potassium permanganate poisoning--a rare cause of fatal self poisoning. J Accid Emerg Med 1997; 14:43-45.

Peberdy MA , Callaway CW , Neumar RW , et al: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science. Part 9: post–cardiac arrest care. Circulation 2010; 122(18 Suppl 3):S768-S786.

Pelclova D & Navratil T: Do corticosteroids prevent oesophageal stricture after corrosive ingestion?. Toxicol Rev 2005; 24(2):125-129.

Perry HD, Hodes LW, & Seedor JA: Effect of doxycycline hyclate on corneal epithelial wound healing in the rabbit alkali-burn model. Preliminary observations. Cornea 1993; 12:379-82.

Playtex: Fits Tough Jobs Like a Glove, Playtex, Westport, CT, 1995.

Pohanish RP & Greene SA: Rapid Guide to Chemical Incompatibilities, Van Nostrand Reinhold Company, New York, NY, 1997.

Pohanish RP: Sittig's Handbook of Toxic and Hazardous Chemicals and Carcinogens, 4th ed, Noyes Publications / William Andrew Publishing, Norwich, NY, 2002.

Previtera C, Giusti F, & Gugliemi M: Predictive value of visible lesions (cheeks, lips, oropharynx) in suspected caustic ingestion: may endoscopy reasonably be omitted in completely negative pediatric patients?. Pediatr Emerg Care 1990; 6:176-178.

Product Information: PROVAYBLUE(TM) intravenous injection, methylene blue intravenous injection. American Regent (per FDA), Shirley, NY, 2016.

Product Information: dopamine hcl, 5% dextrose IV injection, dopamine hcl, 5% dextrose IV injection. Hospira,Inc, Lake Forest, IL, 2004.

Product Information: methylene blue 1% IV injection, methylene blue 1% IV injection. American Regent, Inc (per manufacturer), Shirley, NY, 2011.

Product Information: methylene blue 1% intravenous injection, methylene blue 1% intravenous injection. Akorn, Inc. (per manufacturer), Lake Forest, IL, 2011.

Product Information: norepinephrine bitartrate injection, norepinephrine bitartrate injection. Sicor Pharmaceuticals,Inc, Irvine, CA, 2005.

RTECS: Registry of Toxic Effects of Chemical Substances.. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 2004; provided by Truven Health Analytics Inc., Greenwood Village, CO.

Rao RB & Hoffman RS: Caustics and Batteries, in Goldfrank LR, Flomenbaum NE, Lewin NA et al (eds): Goldfrank's Toxicologic Emergencies, 7th ed, McGraw-Hill, New York, NY, 2002.

Reyes HM, Lin CY, & Schluhk FF: Experimental treatment of corrosive esophageal burns. J Pediatr Surg 1974; 9:317-327.

River City: Protective Wear Product Literature, River City, Memphis, TN, 1995.

Rodier J: Manganese poisoning in Moroccan miners. Br J Ind Med 1955; 12:21-35.

Ronk JF, Ruiz-Esmenjaud S, & Osorio M: Limbal conjunctival autograft in subacute alkaline corneal burn. Cornea 1994; 13:465-468.

Rosenberg N, Kunderman PJ, & Vroman L: Prevention of experimental esophageal stricture by cortisone II. Arch Surg 1953; 66:593-598.

Rumack BH & Burrington JD: Caustic ingestions: a rational look at diluents. J Toxicol Clin Toxicol 1977; 11:27-34.

Saari KM, Leinonen J, & Aine E: Management of chemical eye injuries with prolonged irrigation. Acta Ophthalmol Suppl 1984; 52-59.

Saedi S, Nyhus LM, & Gabrys BF: Pharmacological prevention of esophageal stricture: an experimental study in the cat. Am Surg 1973a; 39:465-469.

Saedi S, Nyhust LM, & Gabrys BF: Pharmacological prevention of esophageal stricture: an experimental study in the cat. Am Surg 1973; 39:465-469.

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.

Schild JA: Caustic ingestion in adult patients. Laryngoscope 1985; 95:1199-1201.

Seedor JA, Perry HD, & McNamara TF: Systemic tetracycline treatment of alkali-induced corneal ulceration in rabbits. Arch Ophthalmol 1987; 105:268-271.

Servus: Norcross Safety Products, Servus Rubber, Servus, Rock Island, IL, 1995.

Seth PK & Chandra SV: Neurotoxic effects of manganese, in: Bondy SC & Prasad KN (Eds). Metal Neurotoxicity, CRC Press, Boca Raton, FL, 1988.

Shepherd G & Keyes DC: Methylene blue. In: Dart,RC, ed. Medical Toxicology, 3rd ed. 3rd ed, Philadelphia, PA, 2004, pp -.

Shuqin K, Haishang D, & Peiyi X: A report of two cases of chronic serious manganese poisoning treated with sodium para-aminosalicylic acid. Br J Ind Med 1992; 49:66-69.

Sigg T, Leikin JB, & Sigg K: Treatment of ocular potassium permanganate exposure with 5% ascorbic acid solution. Ann Emerg Med 1998; 32:754-755.

Singh P, Tyagi M, Kumar Y, et al: Ocular chemical injuries and their management. Oman J Ophthalmol 2013; 6(2):83-86.

Smilkstein MJ & Fraunfelder F: Ophthalmic Principles, In: Goldfrank LR, Flomenbaum NE, Lewin NA, et al, eds. Goldfrank's Toxicologic Emergencies. 7th ed., McGraw-Hill, New York, NY, 2002.

Southwood T, Lamb CM, & Freeman J: Ingestion of potassium permanganate crystals by a three-year-old boy. Med J Aust 1987; 146:639-640.

Spector J & Fernandez WG: Chemical, thermal, and biological ocular exposures. Emerg Med Clin North Am 2008; 26(1):125-136.

Sridhar MS, Bansal AK, & Sangwan VS: Amniotic membrans transplantation in acute chemical and thermal injury. Am J Ophthalmol 2000; 130:134-137.

Standard Safety Equipment: Product Literature, Standard Safety Equipment, McHenry, IL, 1995.

Stanford SC , Stanford BJ , & Gillman PK : Risk of severe serotonin toxicity following co-administration of methylene blue and serotonin reuptake inhibitors: an update on a case report of post-operative delirium. J Psychopharmacol 2010; 24(10):1433-1438.

Stokinger HE: The Metals: Manganese, in Clayton GD & Clayton FE (eds): Patty's Industrial Hygiene and Toxicology, 3rd ed, John Wiley & Sons, New York, NY, 1981.

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.

Su CY & Lin CP: Combined use of an amniotic membrane and tissue adhesive in treating corneal perforation: a case report. Ophtalmic Sufr Lasers 2000; 31:151-154.

Sugawa C & Lucas CE: Caustic injury of the upper gastrointestinal tract in adults: a clinical and endoscopic study. Surgery 1989; 106:802-807.

Symbas PN, Vlasis SE, & Hatcher CR Jr: Esophagitis secondary to ingestion of caustic material. Ann Thorac Surg 1983; 36:73-77.

Teunis BS, Leftwich EI, & Pierce LE: Acute methemoglobinemia and hemolytic anemia due to toluidine blue. Arch Surg 1970; 101:527-531.

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.

Tipton PJ: Nightmare from the sixties. Ann Intern Med 2000; 132:1002-1003.

Treem WR, Long WR, & Friedman D: Successful management of an acquired gastric outlet obstruction with endoscopy guided balloon dilatation. J Pediatr Gastroenterol Nutr 1987; 6:992-996.

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.

Trelleborg-Viking, Inc.: Trellchem Chemical Protective Suits, Interactive manual & Chemical Database. Trelleborg-Viking, Inc.. Portsmouth, NH. 2001.

Tuft SJ & Shortt AJ: Surgical rehabilitation following severe ocular burns. Eye (Lond) 2009; 23(10):1966-1971.

U.S. Department of Energy, Office of Emergency Management: Protective Action Criteria (PAC) with AEGLs, ERPGs, & TEELs: Rev. 26 for chemicals of concern. U.S. Department of Energy, Office of Emergency Management. Washington, DC. 2010. Available from URL: http://www.hss.doe.gov/HealthSafety/WSHP/Chem_Safety/teel.html. As accessed 2011-06-27.

U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project : 11th Report on Carcinogens. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. Washington, DC. 2005. Available from URL: http://ntp.niehs.nih.gov/INDEXA5E1.HTM?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932. As accessed 2011-06-27.

U.S. Environmental Protection Agency: Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof. Environmental Protection Agency's (EPA) Resource Conservation and Recovery Act (RCRA); List of hazardous substances and reportable quantities 2010b; 40CFR(261.33, e-f):77-.

U.S. Environmental Protection Agency: Integrated Risk Information System (IRIS). U.S. Environmental Protection Agency. Washington, DC. 2011. Available from URL: http://cfpub.epa.gov/ncea/iris/index.cfm?fuseaction=iris.showSubstanceList&list_type=date. As accessed 2011-06-21.

U.S. Environmental Protection Agency: List of Radionuclides. U.S. Environmental Protection Agency. Washington, DC. 2010a. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.

U.S. Environmental Protection Agency: List of hazardous substances and reportable quantities. U.S. Environmental Protection Agency. Washington, DC. 2010. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.

U.S. Environmental Protection Agency: The list of extremely hazardous substances and their threshold planning quantities (CAS Number Order). U.S. Environmental Protection Agency. Washington, DC. 2010c. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-part355.pdf. As accessed 2011-06-17.

U.S. Food and Drug Administration: FDA Drug Safety Communication: Serious CNS reactions possible when methylene blue is given to patients taking certain psychiatric medications. U.S. Food and Drug Administration. Silver Spring, MD. 2011. Available from URL: http://www.fda.gov/Drugs/DrugSafety/ucm263190.htm. As accessed 2011-07-26.

U.S. Occupational Safety and Health Administration: Part 1910 - Occupational safety and health standards (continued) Occupational Safety, and Health Administration's (OSHA) list of highly hazardous chemicals, toxics and reactives. Subpart Z - toxic and hazardous substances. CFR 2010 2010; Vol6(SEC1910):7-.

U.S. Occupational Safety, and Health Administration (OSHA): Process safety management of highly hazardous chemicals. 29 CFR 2010 2010; 29(1910.119):348-.

Umeda M & Nishimura M: Mutat Res 1979; 67:221-230.

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.

Urben PG: Bretherick's Handbook of Reactive Chemical Hazards, Volumes 1 & 2, 6th ed, Butterworth-Heinemann Ltd, Oxford, England, 1999.

Verelli D: Quad Clin Ostet Ginecol 1965; 20:617-643.

Vergauwen p, Moulin D, & Buts JP: Caustic burns of the upper digestive and respiratory tracts. Eur J Pediatr 1991; 150:700-703.

Wang Z: Dilation of simultaneous laryngeal and oesophageal stricture with two T-tubes. J Laryngol Otol 1994; 108:42-43.

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.

Wijburg FA, Beukers MM, & Heymans HS: Nasogastric intubation as sole treatment of caustic esophageal lesions. Ann Otol Rhinol Laryngol 1985; 94:337-341.

Wijburg FA, Heymans HS, & Urbanus NA: Caustic esophageal lesions in childhood: prevention of stricture formation. J Pediatr Surg 1989; 24(2):171-173.

Willimott SG: Potassium permanganate poisoning. Br Med J 1936; 58-59.

Willson DF, Truwit JD, Conaway MR, et al: The adult calfactant in acute respiratory distress syndrome (CARDS) trial. Chest 2015; 148(2):356-364.

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.

Winek CL, Collom WD, & Martineau P: Toluidine blue intoxication. Clin Toxicol 1969; 2:1-3.

Wolpowitz A: Alkali and acid ingestion (letter). SA Med J 1974; 2615-2616.

Wolters EC, Huang CC, & Clark C: Positron emission tomography in manganese intoxication. Ann Neurol 1989; 26:647-651.

Workrite: Chemical Splash Protection Garments, Technical Data and Application Guide, W.L. Gore Material Chemical Resistance Guide, Workrite, Oxnard, CA, 1997.

Wu MH & Lai WW: Surgical management of extensive corrosive injuries of the alimentary tract. Surg Gynecol Obstetr 1993; 177:12-16.

Yarington CT & Heatly CA: Steroids, antibiotics, and early esophagoscopy in caustic esophageal trauma. N Y State J Med 1963; 63:2960-2963.

Younan L, Eloubeidi M, & Barada K: A rare cause of caustic gastric injury in a young man. Gastroenterology 2013; 145(1):60, 259-260.

Young RJ, Critchley JA, Young KK, et al: Fatal acute hepatorenal failure following potassium permanganate ingestion. Human Exp Toxicol 1996; 15:259-261.

Zargar SA, Kochhar R, & Mehta S: The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc 1991; 37:165-169.

Zargar SA, Kochhar R, & Nagi B: Ingestion of corrosive acids: spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology 1989; 97:702-707.

do Nascimento TS, Pereira RO, de Mello HL, et al: Methemoglobinemia: from diagnosis to treatment. Rev Bras Anestesiol 2008; 58(6):651-664.

FeedBack

POTASSIUM PERMANGANATE

Classification | Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents