II. Background

  1. Vinyl Chloride is a Hydrocarbon used in the production of PVC pipes, coatings and plastics
  2. Colorless, sweat smelling compound
  3. Flammable, and may be explosive in some forms

III. Toxicity

  1. Human exposures are via inhalation, and occur at production sites and in transport as a liquid gas
  2. Maximal OSHA permissible exposure is 1 ppm
  3. Symptomatic levels at >8000 ppm for 5 minutes (CNS depression, Dizziness)
  4. Lethal exposure >120,000 ppm
  5. Metabolism: CYP2E1
  6. Renal excretion

IV. Findings: Acute

  1. Airway and Respiratory
    1. Mucous membrane irritation
    2. Dyspnea
    3. Pneumonitis
  2. Cardiovascular
    1. Dysrhythmias (Catecholamine sensitization)
      1. See Hydrocarbon Ingestion for mechanism
  3. Neurologic
    1. Headache
    2. Dizziness
    3. Seizures
    4. Altered Level of Consciousness with CNS Depression

V. Complications: Chronic

  1. Malignancy
    1. Hepatic Angiosarcoma
    2. Hepatocellular Carcinoma
    3. Brain Cancer
    4. Lung Cancer
    5. Lymphoma
    6. Leukemia
  2. Extremity
    1. Phalanges with lytic lesions (acro-osteolysis)
    2. Skin thickening (Scleroderma-like skin changes)
    3. Raynaud's Phenomenon
    4. Chronic joint and Muscle pain
  3. Neurologic
    1. Axonal Neuropathy

VI. Management

  1. Remove patient from exposure source
  2. Decontamination
  3. Inhalational symptoms
    1. Humidified Oxygen
    2. Inhaled Bronchodilators
  4. Seizures
    1. Benzodiazepines

VII. References

  1. Fralish (2022) Vinyl Chloride Toxicity, StatPearls, Treasure Island, Florida
    1. https://www.ncbi.nlm.nih.gov/books/NBK544334/
  2. Tomaszewski (2023) Crit Dec Emerg Med 37(3): 32

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