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|Example of Acute Exposure data from MEDITEXT.|
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ACUTE EXPOSURE INFORMATION
- USES: Acetonitrile (CH3CN) is a by-product of acrylonitrile manufacture. It is a liquid with an ether-like odor. Acetonitrile is a volatile, highly polar solvent used to extract fatty acids and animal and vegetable oils. It is used in the petrochemical industry in extractive distillation based on its selective miscibility with water and organic compounds. It is used as a solvent for spinning synthetic fibers and in casting and molding plastics. In laboratories, it is widely used in high-performance liquid chromatographic (HPLC) analysis and as a solvent for DNA synthesis and peptide sequencing. It may be encountered in the home in high concentrations in certain glues and artificial nail removers.
- TOXICOLOGY: Acetonitrile is readily absorbed in the lungs, skin, and gastrointestinal tract. All three routes have been implicated in human toxicity. Acetonitrile is metabolized in the liver in the cytochrome P450 system to cyanide. The liberation of cyanide accounts for the toxicity of acetonitrile. This metabolism also accounts for the delay in toxicity after exposure. Typically, toxic effects begin 2 to 13 hours after exposure as cyanide accumulates in the body.
- EPIDEMIOLOGY: Exposures are uncommon, but deaths have been reported. Toxicity can occur after ingestion, inhalation, or dermal exposure. Occupational/industrial outbreaks have occurred and typically involve inhalational exposure. While acetonitrile containing glues and artificial nail removers have been banned by the European Economic Area since 2000, they may still be available in North America.
- WITH POISONING/EXPOSURE
- MILD TO MODERATE POISONING: Headache, nausea, vomiting, and dizziness may develop.
- SEVERE POISONING: Severe manifestations may take 2 to 13 hours to develop and are due to cyanide accumulation. Vomiting usually precedes severe toxicity by at least 2 hours. Hypotension, acidosis, altered mental status, coma, Kussmaul respirations, respiratory failure, seizures, and cardiovascular collapse may occur. Gastrointestinal symptoms may also be present, especially with ingestions.
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