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ACUTE EXPOSURE INFORMATION
- USES: Arsine (AsH3) is a colorless, flammable, water-soluble gas formed when arsenic comes in contact with an acidic aqueous solution. It has a garlic-like odor. It is used in smelting operations, organic synthesis, the microelectronics industry, and less frequently for galvanizing, soldering, etching, and lead plating. It has been rarely used in chemical warfare.
- TOXICOLOGY: Arsine is well absorbed by inhalation and distributed throughout the body. Large exposures result in hemolysis. The reported mechanism is fixation of arsine by sulfhydryl groups in hemoglobin and other essential proteins. The interaction forms a reactive intermediate that alters transmembrane ion flux and greatly increases intracellular calcium. Chronic exposure may result in arsenic being excreted in the urine; small amounts may be excreted as trimethylarsine, and arsine is excreted in the feces, hair, and nails in small amounts over long periods of time. It does not cause clinical manifestations of arsenic toxicity.
- EPIDEMIOLOGY: Arsine gas exposure is a rare occupational event and can be completely prevented with the use of appropriate protective gear. Deaths have been reported following occupational exposures but are very rare.
- WITH POISONING/EXPOSURE
- MILD TO MODERATE TOXICITY: May cause headaches, a garlic odor to the breath, nausea, vomiting, and abdominal or flank pain.
- SEVERE TOXICITY: Severe toxicity is caused by hemolysis and its complications. Hypotension, flank pain, urinary discoloration (eg, red, brown, or black), acute renal failure, hyperkalemia, muscle weakness and cramping, altered mental status, and ECG changes (eg, peaked T waves, QRS widening) secondary to hyperkalemia or ischemia secondary to reduced oxygen carrying capacity may develop. Evidence of hemolysis may develop within a few hours after severe exposure or may be delayed more than 6 hours after less severe exposure. Jaundice, hepatomegaly, and pleural effusions may develop over the next several days. Peripheral neuropathy may be a delayed effect and may not be completely reversible.
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