Medical Aspects of Chemical Warfare (2008) - The Black Vault

PROCESSToxic Inhalational Injury and Toxic Industrial ChemicalsFig. 10–7. A lung section from the patient whose chest radiographsare shown in Figures 10-5 and 10-6. This sectionshows normal lung tissues without evidence of interstitialfibrosis or inflammation. Hematoxylin and eosin stain;original magnification × 400.Fig. 10-6. The same patient seen in Figure 10-5 now 7 hourspostexposure to phosgene with moderate resting dyspnea,a few crackles on auscultation, and a Po 2of 64 mm Hgbreathing room air. The radiograph shows mild interstitialedema.to 1 L/h), which leads to noncardiogenic pulmonaryedema (Figures 10-5 – 10-8). For this reason, peripherallyacting TIC poisoning is sometimes referred to as“dry land drowning.” The damage following acuteexposure to peripherally acting lung-damaging TICsis proportionate to the product of the concentrationand duration of exposure (Haber’s law); however,with chronic exposure Haber’s law does not apply. 1PerfluoroisobutyleneProduced as a common by-product in the fluoropolymerindustry, PFIB is used for long-term protectionagainst high temperatures and corrosive chemicalsin automobiles, jet aircraft, and other products. Teflon’slubricity, high dielectric constant, and chemicalinertness make it a desirable component for theinterior of many military vehicles, such as tanks andaircraft. PFIB smoke is given off when Teflon burns attemperatures above 400°C, such as in a vehicle fire.Closed-space fires in military vehicles have promptedresearch on the toxicity of exposure to the by-productsFig. 10–8. The chest radiograph of a female chemical worker2 hours postexposure to phosgene. Dyspnea progressedrapidly over the 2nd hour; Po 2was 40 mm Hg breathingroom air. This radiograph shows bilateral perihilar, fluffy,and diffuse interstitial infiltrates. The patient died 6 hourspostexposure.357