Chemical Abstracts Service Registry Number 97-77-8
NIOSH RTECS Number J012250
Chemical Formula C10H20N2S4
Abstensil Abstinil Abstinyl Alcophobin Alk-aubs Antabus Antabuse Antadix Antaenyl Antaethan Antaethyl Antaetil Antalcol Antetan Antetil Anteyl Antiaethan Antietanol Anti-ethyl Antietil Antikol Antivitium Aversan Averzan Bis(diethylthiocarbamoyl) disulfide Bis(N,N-diethylthiocarbamoyl) disulfide Bonibal Contralin Contrapot Cronetal Dicupral Disetil Disulfan Disulfiram Disulfuram 1,1'-Dithiobis(N,N-diethylthioformamide) Ekagom TEDS Ekagom TETDS Ephorran Espenal Esperal Etabus |
Ethyl Thiram Ethyl Thiudad Ethyl Thiurad Ethyl Tuads Ethyl Tuex Ethyldithiourame Ethyldithiurame Exhorran Hoca Krotenal Nocbin Noxal Refusal Ro-Sulfiram Stopaethyl Stopethyl Stopetyl TATD Tenurid Tenutex TETD Tetidis Tetradin Tetradine Tetraethylthioperoxydicarbonic diamide Tetraethylthiram disulfide Tetraethylthiuram Tetraethylthiuram disulfide N,N,N'N'-Tetraethylthiurarn disulfide Tetraetil Teturam Teturamin Thiocid Thiosan Thioscabin Thireranide Thiuram E Thiuranide Tillram Tiuram TTD TTS |
Aadibroom Bromofume Celmide Dibromoethane 1,2-Dibromoethane a, B-Dibromoethane sym-Dibromoethane Dowfume EDB Dowfume MC-2 Dowfume W-8 Dowfume W-85 Dowfume 40 E-D-BEE EDB EDB-85 |
ENT 15,349 Ethylene Bromide Ethylene Dibromide Fumo-Gas Glycol Dibromide Iscobrome D Kopfume Nefis Pestmaster Pestmaster EDB-85 Sanhyuum Soilbrom-40 Soilbrom-85 Soilfume Unifume |
This Bulletin summarizes the current status of the NIOSH study, other pertinent data, occupational health implications, and NIOSH recommendations for reducing the risk from the toxic interaction.
An employee exposure ceiling of 0.13 ppm (1.0 mg/m3), as determined over any fifteen-minute sampling period, was recommended by NIOSH in August 1977 for ethylene dibromide.1 However, toxic interaction effects with other chemicals were not considered in the development of this recommended standard. The current Occupational Safety and Health Administration, Department of Labor, standard for occupational exposure to ethylene dibromide is 20 ppm (8-hour time-weighted average).
Ethylene dibromide itself is a very toxic compound. Reported adverse health effects of employees chronically exposed to ethylene dibromide may include the induction of cancer and sterility as well as malformations and heritable changes in offspring. Ethylene dibromide may also cause adverse effects to the liver, kidneys, heart, and other internal organs and systems. Skin contact with ethylene dibromide may cause chemical burns as well as systemic effects due to absorption of ethylene dibromide through the skin. A summary of the health effects of ethylene dibromide may be found in the NIOSH Criteria Document.1
Disulfiram is widely used in alcoholism control programs under the tradenames Antabuse® and Ro-Sulfiram®. The intake of even small quantities of ethanol (ethyl alcohol) while on disulfiram results in flushing, breathing difficulty, nausea, vomiting, and low blood pressure. This violent and unpleasant reaction reinforces an individual's resolve to abstain from alcohol. The human therapeutic dose of disulfiram ranges from 125 to 500 mg/day; disulfiram therapy may continue for many months, even years.
Although the literature does contain reports of carcinogenic effects of disulfiram in laboratory animals, the International Agency for Research in Cancer (IARC) has concluded that, "the limited data available do not allow an evaluation of the carcinogenicity of disulfiram to be made."3 Disulfiram is currently being tested for carcinogenicity by the National Cancer Institute.
NIOSH estimates that approximately 70,000 workers have occupational exposure to disulfiram. This estimate is based on the NIOSH National Occupational Hazard Survey which was conducted between 1972 and 1974, and included over 500,000 employees at 4,775 facilities. In addition, there may be as many as 100,000 people on disulfiram therapy for alcoholism.
The NIOSH-sponsored research is being conducted by Midwest Research Institute, Kansas City, Missouri, under NIOSH contract #210-76-0131 (September 29, 1976 to January 31, 1979). Four groups of animals are in the study, each group comprised of 48 male and 48 female Sprague-Dawley rats. After approximately thirteen months of exposure, 45 of the 48 male and 47 of the 48 female rats exposed simultaneously to ethylene dibromide and disulfiram have died or have been terminated because they were dying (due to the formation of tumors.) A description of the four groups as well as a summary of their mortality experience at the end of approximately thirteen months of treatment is presented in Table 1.
The extent to which this toxic interaction is specific for ethylene dibromide and disulfiram is not known. Similar toxic interactions may occur between disulfiram, as well as chemicals structurally related to disulfiram, and other halogenated hydrocarbons.
Workers should not be exposed to ethylene dibromide durining the course of disulfiram therapy. Disulfiram (Antabuse®, Ro-Sulfiram®) should not be administered to workers having potential occupational exposure to ethylene dibromide except in those cases where, in the best judgment of the responsible physician, the benefit of disulfiram therapy strongly outweighs the risk to the particular patient.
Whenever disulfiram [bis(diethylthiocarbamoyl) disulfide, tetraethylthiuram disulfide] is used in the workplace (e.g., as an accelerator in rubber production, as a fungicide or insecticide), precautions should be taken so that no worker is exposed to both ethylene dibromide and disulfiram.
Although NIOSH recognizes the complexity and many combinations possible in evaluating toxic interactions between various agents, NIOSH believes this is an area in need of further attention and study.
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[signature] J. Donald Millar, M.D. Assistant Surgeon General Acting Director |
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This page was last updated: 27, 1997
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