Methemoglobinemia: an occupational hazard of phenylpropanolamine production.

Two workers from the same factory presented to the same emergency department within six weeks of one another with moderate (Case 1) and severe (Case 2) methemoglobinemia. Subsequent investigation revealed that the factory produces phenylpropanolamine and that both patients, shortly before becoming ill, were inadvertently exposed to methyl nitrite, a critical reagent in this production. Although other nitrites induce methemoglobinemia, exposure to methyl nitrite during phenylpropanolamine production appears to be a new cause of occupational methemoglobinemia.

[1]  Guo Yan-sheng,et al.  Acute nitrate poisoning: a report of 80 cases. , 1991 .

[2]  R. Forsyth,et al.  Methaemoglobinaemia after ingestion of amyl nitrite. , 1991, Archives of disease in childhood.

[3]  B. Joffe,et al.  Methaemoglobinaemia due to accidental sodium nitrite poisoning. Report of 10 cases. , 1990, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[4]  M. McCarron,et al.  Ammonium nitrate cold pack ingestion. , 1988, The Journal of emergency medicine.

[5]  A. Nash.  Clinical features and management , 1987, The Journal of Small Animal Practice.

[6]  K. Kulig,et al.  Drug- and Chemical-Induced Methaemoglobinaemia , 1986, Medical toxicology.

[7]  P. Pentel.  Toxicity of over-the-counter stimulants. , 1984, JAMA.

[8]  F. Ittleman,et al.  Methemoglobinemia produced by high-dose intravenous nitroglycerin. , 1982, Annals of internal medicine.

[9]  R. Shesser,et al.  Methemoglobinemia from isobutyl nitrite preparations. , 1981, Annals of emergency medicine.

[10]  B. Rumack,et al.  Methemoglobinemia resulting from absorption of nitrates. , 1979, JAMA.

[11]  M. Waterman,et al.  Methemoglobinemia from sniffing butyl nitrite. , 1979, Annals of internal medicine.

[12]  R. Baehner,et al.  Sudden death in an infant from methemoglobinemia after administration of "sweet spirits of nitre". , 1977, Pediatrics.

[13]  W. Grey,et al.  Successful treatment of methemoglobinemia secondary to silver nitrate therapy. , 1969, The New England journal of medicine.

[14]  W. M. Wallace.  Methemoglobinemia in an infant as a result of the administration of bismuth subnitrate. , 1947, Journal of the American Medical Association.

[15]  H. H. Comly.  Cyanosis in Infants caused by Nitrates in Well Water. , 1945 .

[16]  F. Alderson.  SWEET SPIRITS OF NITRE. , 1874 .

[17]  B. Joffe,et al.  Methaemoglobinaemia due to accidental sodium nitrite poisoning , 1990 .