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These substance-specific estimates, which are intended to serve as screening levels, are used by ATSDR health assessors and other responders to identify contaminants and potential health effects that may be of concern at hazardous waste sites.

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The toxicological profiles include an examination, summary, and interpretation of available toxicological information and epidemiologic evaluations of a hazardous substance. During the development of toxicological profiles, MRLs are derived when ATSDR determines that reliable and sufficient data exist to identify the target organ s of effect or the most sensitive health effect s for a specific duration for a given route of exposure to the substance.

disulfoton

MRLs are based on noncancer health effects only and are not based on a consideration of cancer effects. Radiation MRLs are expressed as external exposures in units of millisieverts. They are set below levels that, based on current information, might cause adverse health effects in the people most sensitive to such substance-induced effects. MRLs are generally based on the most sensitive substance-induced end point considered to be of relevance to humans.


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ATSDR does not use serious health effects such as irreparable damage to the liver or kidneys, or birth defects as a basis for establishing MRLs. Exposure to a level above the MRL does not mean that adverse health effects will occur. MRLs are intended to serve as a screening tool to help public health professionals decide where to look more closely. They may also be viewed as a mechanism to identify those hazardous waste sites that are not expected to cause adverse health effects.

Most MRLs contain some degree of uncertainty because of the lack of precise toxicological information on the people who might be most sensitive e.

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Suction secretions. Endotracheal intubation may be necessary because of respiratory muscle weakness or bronchorrhea. Avoid succinylcholine for rapid sequence intubation as prolonged paralysis may result. Oximes pralidoxime in the US, or obidoxime in some other countries are used to reverse neuromuscular blockade.

Insecticides: organochlorines, organophosphates and carbamates

Use of oximes is usually indicated for patients with moderate to severe toxicity. Each self-contained unit dispenses 2. These autoinjectors contain benzyl alcohol as a preservative. Since the AtroPen R comes in different strengths, certain dose units have been approved for use in children. If pralidoxime is required, pralidoxime prefilled autoinjector delivers mg IM adult dosing.

The safety and efficacy of pralidoxime auto-injector for use in nerve agent poisoning have not been established in pediatric patients. If inadequate response in 3 to 5 minutes, double the dose. Continue doubling the dose and administer it IV every 3 to 5 minutes as needed to dry pulmonary secretions.

The Risk Assessment Information System

Monitor frequently for evidence of cholinergic effects or atropine toxicity e. Large doses hundreds of milligrams are sometimes required. Atropinization may be required for hours to days depending on severity. Administer for 24 hours after cholinergic manifestations have resolved. May require prolonged administration. Repeat initial bolus dose in 1 hour and then every 3 to 8 hours if muscle weakness or fasciculations persist continuous infusion preferred. Intravenous dosing is preferred; however, intramuscular administration may be considered.

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A continuous infusion of pralidoxime is generally preferred to intermittent bolus dosing to maintain a target concentration with less variation. Onset of toxicity is variable; most patients will develop symptoms within 6 hours. Patients that remain asymptomatic 12 hours after an ingestion or a dermal exposure are unlikely to develop severe toxicity. However, highly lipophilic agents eg; fenthion can produce initially subtle effects followed by progressive weakness including respiratory failure.

Cholinesterase activity should be determined to confirm the degree of exposure. Determine cholinesterase activity to assess if a significant exposure occurred. Patients who develop signs or symptoms of cholinergic toxicity e. Patients with severe toxicity require rapid administration of large doses, titrate to the endpoint or drying pulmonary secretions. Highly lipophilic organophosphates e. Early oxime administration may prevent aging and shorten clinical manifestations of toxicity.

B Inhaled ipratropium or glycopyrrolate may be useful in addition to intravenous atropine for bronchorrhea and bronchospasm. Inhaled beta agonists may be useful for bronchospasm unresponsive to anticholinergics. Systemic toxicity is unlikely to develop from ocular exposure alone. Remove contaminated clothing, wash skin thoroughly with soap and water. Use universal precautions and nitrile gloves to protect staff from contamination.

A A toxic dose has not been established.

Catalog Record: Toxicological profile for disulfoton | HathiTrust Digital Library

Organophosphates are absorbed across the lung, mucous membranes including gut , and skin. Poisoning depends upon inherent toxicity, dosage, rate of absorption, rate of metabolic breakdown, and prior exposure to other cholinesterase inhibitors. B No inhibition of red cell or plasma cholinesterases was seen in human volunteers administered 0. Accumulation of OPPs in sediments was relatively high and in accordance with the organic matter, except site 5, which have saline alkaline soil.


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