10/03/2024

Chemical Hazards & Their Adverse

Health Effects
`

Seminar on the Safe Use of Chemicals at Work

Objectives
• Describe the key concepts of toxicology

• Discuss & explain the toxic effects of common chemical hazards

• Understand the role of individual susceptibility in the development

of toxic health effects

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Toxicology

• The study of the adverse effects of chemical agents on living

organisms

• The science of poisons

Basic terminologies
• Toxicity
• Intrinsic capacity of a chemical agent to adversely affect an organism

• Toxic substance
• Agent that causes toxicity

• Hazardous substance
• Under a specific situation, the potential for a substance to cause toxicity may
be realized

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Are all
hazardous
substances Are all toxic
toxic? substances
hazardous?

Antoine-Laurent de Lavoisier
1743 – 1794

TOXICITY = HAZARD
x
WORKER’S EXPOSURE
Toxic agent becomes hazardous when there is potential for worker exposure

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What is risk?

• Probability or likelihood that adverse effects will occur when a living

organism is exposed to a toxic agent

Are all
toxic
substances Yes.
hazardous?

Antoine-Laurent de Lavoisier & Jacques Louise David

c. 1788

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Are all
hazardous
substances No.
toxic?

Antoine-Laurent de Lavoisier & Jacques Louise David

c. 1788

What determines risk?

• Response of the host (based on host’s physiology)

• Physical properties of the toxic agent

• Dose or concentration of toxin which includes the amount of the

substance, duration of exposure, & frequency of exposure

• Synergistic effects – combination of different elements or materials

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Will exposure to chemical hazards in the

workplace always result in illness or
other adverse health effects?

Genetic
Multiplicity of
factors
exposure
Lifestyle
Duration of
WORK- exposure
RELATED
Age Workplace Physical
Worker’s DISEASE from
susceptibility CHEMICAL factors properties
Race HAZARDS
EXPOSURE Magnitude of
exposure
Sex
Medical Timing of
history exposure

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Will exposure to chemical hazards in the

workplace always result in illness or
other adverse health effects?

NO

Routes of Entry into the Body

Inhalation Ingestion Skin Contact

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Routes of Excretion
Renal
Skin

Gastrointestinal

Respiratory

Chemical Hazards
All substances
are poisons.
Only the dose
separates a
posion from a
remedy.

Areolus Phillipus Theophrastus

Bombastus von Hohenheim
a.k.a. LD 50 – dose lethal to 50% of test
Paracelsus (1493 – 1541) animals

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Dose
• The amount of a substance absorbed inside the body

• Number of doses

• Frequency

• Total time period of the exposure

Toxicology Concepts
Dose – amount of substance biologically available

Exposure dose – amount encountered in the environment

Absorbed dose – actual amount of the exposed dose that enters the body

Total dose – the sum of all doses

Agents which cause damage at the site of exposure need not be absorbed to produce their effects,
e.g., irritants to the eye, skin, & respiratory tract.

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Dose-Response Relationship
• Establishes causality that the chemical has in fact induced the
observed effects

• Establishes the lowest dose where an induced effect occurs – the

threshold effect

• Determines the rate at w/c injury builds up – the slope for the dose
response

Threshold

• Point at w/c toxicity first appears

• Occurs at the point where the body’s ability to detoxify/repair toxic injury has
been exceeded

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Dose Estimate of Toxic Effects

• LD 50 – dose lethal to 50% of test animals.

Interactions
• The presence of one chemical may drastically affect the response to another
chemical
Addivity A combination of 2 or more chemicals is
1+1=1 the sum of the expected individual
e.g., n-hexane & methyl-ethyl ketone responses.
= Nerve toxicity
Antagonism Exposure to 1 chemical results in a
1+1=0 reduction in the effect of the other
e.g., benzene & toluene chemical.
Synergism Exposure to 1 chemical causes a dramatic
1+1=2 increase in the effect of another
e.g., ethanol & carbon tetrachloride chemical.
= Liver toxicity

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Synergistic Interaction of Asbestos & Smoking

• If a person is a smoker as well as having been exposed to asbestos,
then in absolute terms the risk of developing lung cancer is greater
than the simple addition of the risks from tobacco or smoking alone

RISK OF LUNG CANCER

Non-smoker Smoker
No asbestos
1 11
exposure
With asbestos
5 53
exposure
Doll & Hill,1964; Peto & Doll, 1985; McDonald, et. al., 1980

Classification of Toxic Effects

Chemical Hazards & their Adverse Health Effects

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Local v Systemic Toxicity

Local Systemic
Occurs at the site of chemical contact Distant site from point of contact, may
involve many organ systems
Contact with acid creating a chemical Consumption of lead causing damage to
burn the kidneys
Ozone exposure causing lung irritation Exposure to carbon tetrachloride causing
liver damage
Aldehyde splash in the eyes Exposure to arsine gas causing hemolysis
on RBCs

Systemic Toxic Effects

• Acute toxicity
• Occurs almost immediately (hours/days) after an exposure
• Respiratory irritation
• Sub-chronic toxicity
• Results from repeated exposure for several weeks or months
• Exposure to lead for several weeks can result in anemia
• Chronic toxicity
• Represents cumulative damage to specific organ systems; many months or
years to have recognizable clinical disease
• CKD in workmen with several years exposure to lead

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Systemic Toxic Effects

• Carcinogenicity
• Process of abnormal cell growth & differentiation
• Lung CA for workers exposed to asbestos for several years

• Developmental toxicity (teratogenecity)

• Adverse toxic effects to the developing embryo or fetus
• Alcohol drinking during pregnancy can result to malformed child

• Genetic toxicity (mutagenecity)

• Damage to DNA & altered genetic expression
• Abnormal offspring

Health Effects
• Teratogenic
• Neurotoxicity
• Ocular toxicity
• Cardiovascular toxicity
• Hematologic toxicity
• Respiratory toxicity
• Hepatotoxicity
• Nephrotoxicity
• Reproductive toxicity
• Dermal toxicity
• Carcinogenic
• Immunotoxicity

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Occupational Hematologic Diseases

Causative Agents Industry/Process Disease
Lead Battery manufacturing Anemia
Lead smelting
Benzene Solvent Aplastic anemia
Soap manufacturing
Arsine gas Chemical industries Hemolysis

Occupational Heart Diseases

Causative Agents Industry/Process Disease
Lead Battery manufacturing Hypertension
Cadmium Recycling
Carbon disulfide Degreasing Atherosclerosis
Dry cleaning
Fluorocarbons Refrigeration Arrhythmias
Trichloroethylene Solvent workers
Nitrates Explosives Angina
Myocardial infarction

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Dermal Toxicity

• Dermal irritation due to skin exposure to gasoline

• Dermal corrosion due to skin exposure to sodium hydroxide (lye)

• Dermal hypersensitivity due to skin exposure to poison ivy

• Skin cancer due to ingestion of arsenic or skin exposure to UV light

Dermal Toxicity
Cement burns Arsenic exposure

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Ophthalmological Toxicity

• Acids & strong alkalis may cause severe corneal

corrosion

• Methanol (wood alcohol) may damage the optic nerve

Ophthalmological Toxicity
• Acid burn to the eye

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Hepatotoxicity
Steatosis Lipid accumulation in hepatocytes
Chemical hepatitis Inflammation of the liver from chemical exposure
Hepatic necrosis Death of the hepatocytes
Intrahepatic cholestasis Back up of bile salts into the liver cells
Hepatic cancer Cancer of the liver
Cirrhosis Chronic fibrosis of the liver cells often due to alcohol
Hypersensitivity Immune reaction resulting in hepatic necrosis

Occupational Liver Diseases

Causative Agent Industry/Process Disease
Carbon tetrachloride Cleaning fluids Acute liver toxicity
Dry cleaners
Arsenic Smelting Cirrhosis
Chlorinated hydrocarbons Insecticides
Chemical industry
Epoxy resins Rubber & synthetic fabric Acute hepatitis
manufacturing
Vinyl chloride Plastics & vinyl chloride Liver cancer
Aflatoxins monomer manufacturing

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Immunotoxicity

• Hypersensitivity
• Allergy & autoimmunity

• Immunodeficiency, & uncontrolled proliferation

• Leukemia (benzene)

Stevens-Johnson Syndrome

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Nephrotoxicity

• Decreased ability to excrete body wastes

• Inability to maintain body fluid & electrolyte balance

• Decreased synthesis of essential hormones (e.g., erythropoietin)

Occupational Kidney Diseases

Causative Agents Industry/Process Disease
Mercury Battery manufacturing Chronic renal failure
Lead Chemical industry Renal stones (cadmium)
Cadmium Nephrotic syndrome
(mercury)
Chloroform Solvents Acute renal failure
Carbon tetrachloride Chemical industry
Ethylene glycol Solvents Chronic renal failure
Carbon disulfide Cosmetics

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Pulmonary Toxicity
• Pulmonary irritation
• Asthma
• Bronchitis
• Reactive airway disease
• Emphysema
• Allergic alveolitis
• Fibrotic lung disease
• Pneumoconiosis
• Lung cancer

Chest X-ray
Normal Pneumoconiosis

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Chest X-ray
Normal Lung Cancer

Neurotoxicity
• Neuronopathies (neuronal injury)
• Organic mercury
• Axonopathies (axonal injury)
• Inorganic lead
• n-hexane
• Demyelination (loss of axon insulation)
• Trichloroethylene
• Interference w/ neurotransmission
• Organophosphates

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Acetylcholine Release in Nerve Endings

Mechanism of Action of Acetylcholine

• Constriction of pupils

• Increased sweating & salivation

• Palpitation

• Breathing difficulty

• Abdominal pains, diarrhea

• Muscle tremors, cramps

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Symptoms of Organophosphate Poisoning

• Increased levels of acetylcholine in the brain
• Anxiety
• Irritability
• Impaired memory
• Restlessness
• Severe poisoning
• Incontinence of urine & feces
• Bradycardia
• Hypotension
• Confusion
• Ataxia
• Respiratory paralysis
• Convulsions
• Coma

Reproductive Toxicity
• Decreased libido & impotence
• Infertility
• Interrupted pregnancy (abortion, fetal death, or premature delivery)
• Infant death or childhood morbidity
• Chromosome abnormalities & birth defects
• Childhood cancer

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Proven Reproductive Hazards (based on human studies)

Causative Agent Health Effect
Anesthetic gases Miscarriage
Neonatal death
Diethylstilbestrol (DES) Cancer
Organic mercury Neonatal hepatitis
Liver cancer
Lead Cerebral palsy
Brain malformation
Polychlorinated biphenyls (PCBs) Miscarriage
Premature birth
Low birth weight neonates
Radiation Miscarriage
Brain defects
Skeletal defects

Suspected Reproductive Hazards (based on human studies)

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What Needs to be Done?

Chemical Hazards & their Adverse Health Effects

Relationships between monitoring of the environment,

biological monitoring, & health surveillance

Occupational Toxicology by Neill H. Stacey

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Who gets sick?

Host Factors Dose
• Age • Duration of exposure
• Health habits (e.g., smoking, • Concentration of agent
alcohol, drugs)
• Reproductive status • Route of exposure
• Medical history • Workplace hygiene
• Personal hygiene

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Contact Us
Our site:
oshc.dole.gov.ph

Our social media:

DOLE.OSHC
OSHCenter
Occupational Safety
and Health Center

LOCATION OUR EMAIL PHONE

North Avenue corner Agham Road, Diliman, Quezon City [email protected] (02) 8929-6036 to 39

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