Accidental spread of potentially toxic gases, fumes, and particulate chemicals has been reported recently in various cities throughout the country and appears to be on the increase throughout the world in the past few years. Moreover, cerebral trauma, septic shock (ARDS), and environmental pulmonary edema from drug intoxication have been commonly encountered. Newer modalities of treatment include earlier fiber optic bron choscopy, constant positive airway pressure mask, administration of surfactant, pentox ifylline, and use of newer experimental agents such as nitrous oxide, antitumor necrosis factor (ATNF), and extracorporeal carbon dioxide with low-frequency positive pressure (ECC02R-LFPPV). The future holds promise for probable reductions in both morbidity and mortality rates of this ubiquitous occupational and environmental health problem, which is of global importance.
Cordasco EM , Kosti H., Vance W., et al: Pulmonary edema of noncardiac origin . Arch Environ Health11:588-594, 1965.
19.
Zenz C., Velasco A.: Personal communication. Cleveland, Ohio. January 1994.
20.
China event. The Cleveland Plain Dealer. 1993 .
21.
Martin WJOxygen toxicity. In: Kelley WN: Textbook of Internal Medicine , Philadelphia: Lippincott , 1992, pp 1775, 1837.
22.
Langston JW, Finnegan KT: Approaches to patients with substance abuse. In: Kelley WN: Textbook of Internal Medicine. Philadelphia: Lippincott, 1992, pp 2299-2300.
23.
Burns D., Cordasco EM: Firesmoke inhalation. In: Cordasco EM, Demeter S, Zenz C: Textbook of Environmental Respiratory Diseases. New York: Van Nostrand Reinhold Co, 1994.
24.
Frey FJ, Speck RF: Glucocorticoids and infection. Schweiz Med Wochenschr122:137-146, 1992.
Demeter S., Cordasco EM: Personal communication, Akron and Columbus, Ohio, respectively, 1992.
31.
Rossaint R. , Falke KJ, Lopez F., et al: Inhaled nitric oxide for the adult respiratory distress syndrome. N Engl J Med328:399-405, 1993.
32.
Suchyta MR: Newer techniques for managing ARDS. Ann Intern Med IM 12:48-54, 1991.
33.
Gattinoi L. , Presenti A., Mascheroni D., et al: Low-frequency positive pressure ventilator with extracorporeal CO2 removal in acute respiratory failure. JAMA256:881-886, 1989.
34.
Fiascone JM : Update on surfactant replacement therapy. Neonatal Resp Dis2:1-10, 1992.
35.
Knight AL: Fluorides. In: Textbook of Occupational Medicine, ed. 3, ed. by Zenz C.Chicago : Mosby, 1992, pp 496-499.
Merriman M.: Not a drill. Occup Health Safety59:29-31, 1990.
41.
Miller NS, Gold MS, Millman RL: Cocaine (Review). American Family Physician39:115-120, 1989.
42.
Kosten TR, Klever HD: Clinician's Guide to Cocaine Addiction: Theory, Research and Treatment . New York: Guilford Press, 1992.
43.
Agiha.1991-1992. Threshold Limit Values for Chemical Substance Physical Agents and Biological Exposures. Handbook of the American Society of Government Industrial Hygienists . Cincinnati, Ohio, p 15.
44.
Zenz C., Mitchell F.: Personal communication. Milwaukee, Wisconsin, 1994.
