What Are the Symptoms of Benzene Poisoning?

Benzene poisoning can be divided into acute benzene poisoning and chronic benzene poisoning. Acute benzene poisoning refers to a pathophysiological process mainly manifested by the central nervous system anesthesia after oral administration of benzene-containing organic solvents or inhalation of high concentrations of benzene vapor; chronic benzene poisoning refers to benzene and its metabolites, phenols, directly inhibiting cells Nuclear fission results in cell mutations that affect the hematopoietic function of the bone marrow. The clinical manifestation is a continuous decrease in white blood cell count, which eventually develops into aplastic anemia or leukemia.

Basic Information

Visiting department

Emergency Department

Common causes

Ingestion, acute inhalation of organic solvents containing benzene

Common symptoms

Central nervous system anesthesia, continuous decrease in white blood cell count, aplastic anemia, leukemia

Causes of benzene poisoning

Acute benzene poisoning is caused by accidental ingestion or acute inhalation of organic solvents containing benzene. These organic solvents include paints, thinners, industrial glues, etc. Chronic benzene poisoning is caused by long-term inhalation of low concentrations of benzene and metabolites, phenols.

Clinical manifestations of benzene poisoning

Acute poisoning

(1) Nervous system headache, dizziness, tinnitus, diplopia, staggering gait, drowsiness, drowsiness, severe cases with convulsions, coma, respiratory paralysis, delirium, hallucinations, and cerebral edema, a few patients have peripheral nerve damage; Further developed into consciousness and aggravation, entering a shallow coma, which should not be called, and continued to inhale high concentrations of benzene into a deep coma. In severe cases, breathing stops and cardiac arrest stops. The onset of the disease is determined by the concentration of benzene in the air, ranging from minutes to hours. Active rescue before cardiac arrest can recover in minutes to hours. If a deep coma occurs, those who inhale high concentrations can experience "lightning-like" deaths.

(2) Respiratory system Seeing inhalation poisoning, coughing, belching, chest tightness, severe cases with long duration, or weak breathing, may be complicated by hypoxic pulmonary edema, which may be accompanied by eye irritation.

(3) Circulatory system Flushing, palpitations, blood pressure drop, shock, myocarditis, various arrhythmias and even ventricular fibrillation can occur. The ECG shows first to second degree atrioventricular block.

(4) Digestive system Nausea, vomiting, abdominal pain, severe symptoms in oral patients. Occasionally hepatomegaly and elevated aminotransferase. Acute poisoning mainly causes toxic anesthesia, and its process is similar to general anesthesia during drunkenness or surgery.

2. Chronic poisoning

In addition to the nervous system, it also affects the hematopoietic system. Nervous system common manifestations are neurasthenia and autonomic dysfunction syndrome; individual patients may have acromimetic dysfunction, pain, hypotensiveness, numbness, and polyneuritis may also occur. The manifestation of hematopoietic system damage is the main feature of chronic benzene poisoning. Leukocyte counts and platelet counts are the most common. Toxic granules and vacuoles can appear in neutrophils, and the number of granulocytes is significantly reduced, causing repeated infection. Skin and mucous membrane bleeding tendency, women have more menstrual periods; severe cases of pancytopenia and aplastic anemia; individual cases of eosinophilia or mild hemolysis. Benzene can also cause myelodysplastic syndromes. Leukemia caused by benzene exposure has gradually increased. Leukemia caused by benzene mostly occurs after long-term high-level exposure, the shortest is 6 months and the longest is 23 years. Leukemia is mainly acute myeloid leukemia, followed by acute lymphocytic leukemia and erythroleukemia, and chronic myelogenous leukemia is rare.

Benzene poisoning test

Acute poisoning

(1) The total number of white blood cells in peripheral blood increases, and then returns to normal; occasionally it decreases.

(2) The benzene content, urinary phenol, and uronic glucuronic acid in blood can be increased.

(3) Urine inorganic sulfate accounts for less than 70% of total sulfate.

2. Chronic poisoning

(1) Blood routine The number of white blood cells and platelets is reduced, and the whole blood cells are reduced in severe cases. Corresponding leukocyte abnormalities of a certain line occur in patients with leukemia.

(2) Bone marrow examination to understand the situation of hematopoietic damage. In patients with chronic poisoning, it is very helpful for the timely diagnosis and differential diagnosis of a certain line of blood cell abnormalities, pancytopenia, aplastic anemia, myelodysplastic syndrome, and leukemia.

(3) Determination of neutrophil alkaline phosphatase activity and neutrophil toxicity particles

Diagnosis of benzene poisoning

Acute poisoning

Based on a short history of inhaling large amounts of high-concentration benzene vapor or taking benzene by mistake, symptoms of central nervous system depression (drunk state) can be diagnosed. Perform a poison test if necessary. Pay attention to identify the poisoning phase with other organic solvents (halogenated hydrocarbons, ethers, ketones, etc.).

2. Chronic poisoning

(1) Mild poisoning Have a history of exposure to high-concentration benzene or long-term life history in the environment contaminated with benzene. Neurasthenia syndromes of different severity. Blood white blood cell count continued to be lower than 4.0 × 10 ⁹ / L, neutrophils decreased, lymphocytes increased, and platelets continued to decrease below 80.0 × 10 ⁹ / L.

(2) Severe poisoning In addition to the above clinical manifestations, whole blood cells are reduced. Toxic aplastic anemia occurs late, or focal hyperplasia of bone marrow remains and ineffective production of red blood cells. Chronic severe benzene poisoning can cause leukemia. Slight symptoms of mucosal irritation (dizziness, headache, nausea, staggering gait, etc.); severe symptoms include toxic encephalopathy, coma, convulsions, decreased blood pressure, pulmonary edema, and respiratory and circulatory failure.

Benzene poisoning treatment

Acute poisoning

The most important rescue measure for acute inhalation poisoning is to remove the patient from the poisoning site as soon as possible, move to fresh air, remove contaminated clothes, wash the skin with warm soapy water, and keep warm. The conscious patient asks him to exhale deeply so that benzene is expelled quickly and in large quantities, and the symptoms can gradually disappear; if the patient is comatose, he should keep his airway open and assist him to increase his breathing strength. Patients can usually be rescued as long as they have a heartbeat. Such as cardiac arrest, respiratory arrest, the first should be CPR. If hypoxemia is present, emergency tracheal intubation is required, and the ventilator assists in breathing. During cardiopulmonary resuscitation, cardiac arrest is prohibited and epinephrine injection is prohibited because it can induce ventricular fibrillation. If you have convulsions or muscle cramps, you can use sedatives. Irritability can be injected intramuscularly with promethazine. Convulsions can be injected intramuscularly with phenobarbital or an enema with 10% chloral hydrate and warm water. Protect the airway from accidental inhalation of vomit. For coma patients, monitor partial oxygen pressure, serum electrolytes, and peripheral blood to prevent complications. Coma should actively prevent cerebral edema. 50% glucose or 20% mannitol can be injected intravenously, 2 to 3 times a day. Shock patients can properly use vasoactive drugs to maintain blood pressure on the basis of supplementing blood volume. Eye burns should be rinsed thoroughly with warm water and eyed with norfloxacin eye drops and cortisone eye drops. For patients with leukopenia, shark liver alcohol, vitamin B ₄ and inosine are available. Oral person should induce vomiting and gastric lavage as soon as possible. Benzene poisoning currently has no specific antidote, hemodialysis is not effective, those who enter the body in large quantities can try hemoperfusion.

2. Chronic poisoning

For comprehensive symptomatic treatment, corresponding treatment is given to cell damage in all lines of the hematopoietic system.

Prevention of benzene poisoning

1. Benzene and other organic solvents should be properly kept and clearly marked to prevent misuse (due to the colorless transparent liquid of thin materials).

2. Workers pay attention to environmental ventilation and respiratory protection when working on paint deployment, painting, and applying glue.

3. Do not stay in the newly decorated room for a long time.