Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM)
Benzene Toxicity
Treatment and Management
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There is no antidote for acute benzene poisoning.
- Treatment for benzene toxicity is supportive and symptomatic.
There is no antidote for benzene poisoning; therefore, treatment for persons acutely exposed to benzene is generally supportive and symptomatic. Immediate removal of the patient from exposure, administration of oxygen, and monitoring and treatment of cardiopulmonary status are the first considerations. In cases of ingestion, respiratory distress may indicate pulmonary aspiration of gastric contents.
Contaminated clothing and shoes should be removed from an exposed person as soon as possible. If liquid benzene has contacted the skin or eyes, immediately wash the exposed skin with soap and copious water, and irrigate the eyes with running water for 3 to 5 minutes or until irritation ceases.
In cases of ingestion, do not induce emesis. Care must be taken to avoid aspiration of stomach contents during vomiting because benzene can produce a severe chemical pneumonitis. Ensure that the patient's airway is properly controlled and maintained before initiating orogastric tube lavage. Gastric lavage is indicated if large amounts of benzene have been ingested or if the patient is seen more than 1 hour after ingestion. Activated charcoal may be used; it decreases benzene absorption in experimental animals, and the benefits are likely to be similar in humans. Monitor the cardiac status of the patient: benzene is one of several solvents that may increase the susceptibility of the myocardium to the dysrhythmogenic effects of catecholamines.
Epinephrine should be used only in the setting of cardiac arrest or severe refractory reactive airway disease because its use may lead to ventricular fibrillation secondary to the irritability of the myocardium.
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Once chronic exposure to benzene ceases, hematologic test results typically return to normal.
In treating persons chronically exposed to benzene, the most important actions are to remove the patient from the source of benzene exposure and to prevent further exposure. Benzene-induced depression of blood elements generally reverses after exposure is terminated. Chronically exposed patients whose hematologic results do not return to normal despite removal from exposure should be managed in consultation with a hematologist or oncologist. Chemotherapy and bone marrow transplants are therapeutic options for leukemia and aplastic anemia, respectively.
- What are some key considerations in the treatment for the patient in the case study?
- What is the prognosis for this patient? What follow-up care should he receive?
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