Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Ethylene Glycol and Propylene Glycol Toxicity
How to Use This Course

Introduction

The goal of Case Studies in Environmental Medicine (CSEM) is to increase the primary care provider’s knowledge of hazardous substances in the environment and to help in evaluation and treating of potentially exposed patients. This CSEM focuses on ethylene glycol and propylene glycol toxicity.

Available Versions

Two versions of the Ethylene Glycol and Propylene Glycol Toxicity. CSEM are available

• the HTML version http://www.atsdr.cdc.gov/csem/egpg/ provides content through the Internet;
• the downloadable PDF version provides content in an electronic, printable format, especially for those who may lack adequate Internet service.

Instructions

To make the most effective use of this course, we recommend that you

• take the Initial Check to assess your current knowledge about ethylene glycol and propylene glycol toxicity
• read the title, learning objectives, text, and key points in each section
• complete the progress check exercises at the end of each section and check your answers
• complete and submit your assessment and posttest response online if you wish to obtain continuing education credit. Continuing education certificates can be printed immediately upon completion.

Instructional Format

This course is designed to help you learn efficiently. Topics are clearly labeled so that you can skip sections or quickly scan sections you are already familiar with. This labeling will also allow you to use this training material as a handy reference. To help you identify and absorb important content quickly, each section is structured as follows

Title

Serves as a “focus question” that you should be able to answer after completing the section

Learning Objectives

Describes specific content addressed in each section and focuses your attention on important points

Text

Provides the information you need to answer the focus question(s) and achieve the learning objectives

Key Points

Highlights important issues and helps you review

Progress Check exercises

Enables you to test yourself to determine whether you have mastered the learning objectives

Progress Check answers

Provides feedback to ensure you understand the content and can locate information in the text

Learning Objectives

Upon completion of the Ethylene Glycol and Propylene Glycol Toxicity CSEM, you will be able to

What is ethylene glycol?

• Describe the properties of ethylene glycol

Where is ethylene glycol found?

• Identify sources of ethylene glycol exposure

How are people exposed to ethylene glycol?

• Identify the primary route of exposure to ethylene glycol

What Are the U.S. Standards for ethylene glycol exposure levels?

• Identify the American Conference of Governmental Industrial Hygienists (ACGIH) ceiling exposure limit for ethylene glycol
• Identify the U.S. Environmental Protection Agency’s (EPA) guidelines for ethylene glycol in drinking water

What is the biologic fate of ethylene glycol?

• Describe why individuals with impaired liver function are more likely to suffer less toxicity but greater intensity of the initial central nervous system (CNS) effects caused by ethylene glycol exposure

What are the stages of ethylene glycol intoxication?

• Explain the mechanism of ethylene glycol toxicity
• Describe the three stages of ethylene glycol toxicity

What are the physiologic effects of ethylene glycol poisoning?

• Describe the physiologic effects of ethylene glycol poisoning

How should patients exposed to ethylene glycol be evaluated?

• Describe the primary focus of the exposure history
• Describe how the actual clinical presentation changes over time as intoxication evolves

What laboratory tests can help in evaluating patients exposed to ethylene glycol?

• Identify the abnormal laboratory findings associated with ethylene glycol poisoning.
• List three measurements that can assist with diagnosis of ethylene glycol poisoning

How should patients exposed to ethylene glycol be treated?

• Identify the primary treatment strategy for managing ethylene glycol poisoning case

What is propylene glycol?

• Describe the properties and uses of propylene glycol

What instructions should be given to patients?

• Explain advice on self care and follow-up care to patients who are exposed to ethylene glycol or propylene glycol