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ACUTE EXPOSURE INFORMATION

  1. Tetraethyl lead is moderately to highly toxic. Acute or chronic EXPOSURE ROUTES include inhalation, ingestion or skin absorption. Exposure to tetraethyl lead often occurs through deliberate inhalation of leaded gasoline (substance abuse). Recent accidental exposure case reports have come from developing countries, such as China.
  1. The central nervous system is the main target organ affected. The effects of tetraethyl lead may be mixed with the effects of the solvent. The exposure-onset interval varies inversely with the dose; symptoms can begin within hours to days (usually within 1 to 5 days, up to as long as 14 days after exposure). Symptoms that begin within 24 hours usually indicate serious exposure or reflect intoxication due to the hydrocarbon (gasoline).
    1. Early exposure effects are generally those of hydrocarbon abuse. These include anorexia, nausea, vomiting, diarrhea, delirium, nervous irritability, headache, restlessness, pallor, tremor, euphoria, lethargy, insomnia, slurred speech and blurred vision.
    1. After the initial effects of asthenia, weakness, fatigue, headache, nausea, vomiting, diarrhea, anorexia and insomnia, the "tetraethyl lead triad" of central nervous system involvement (including ataxia, tremor and hypotonia), bradycardia and decreased body temperature may be noted.
  1. Mild exposure results in anxiety, lassitude, irritability, insomnia, excitement, confusion, lurid (violent or frightening) dreams, anorexia, nausea, vomiting, metallic taste, pallor, mild diarrhea, dizziness, tremulousness, lack of coordination and truncal ataxia.
  1. Moderate exposure can produce disorientation, hyperexcitability, tremors, twitching, chorea, increased reflexes, spasticity, fatigue, muscle pain, bradycardia, hypotension, hypothermia, limited upward gaze and rotary or horizontal nystagmus.
  1. Severe exposure leads to delusions, hallucinations, mania, psychotic behavior, seizures (maniacal, violent convulsions), intense hyperactivity, facial contortions, cerebral edema, coma and death. ENCEPHALOPATHY and vomiting result from severe intoxication; the effects of tetraethyl lead differ from those of inorganic lead poisoning in that metallic taste and hematologic abnormalities are unusual and encephalopathy predominates.
  1. Absorption of as little as 1 gm can be fatal within 3 to 30 days (as the compound slowly degrades to triethyl lead); acute intoxication can have a mortality rate as high as 20 percent.
  1. Effects unrelated to the central nervous system include irritation of the skin, eyes and mucous membranes. Dermal contact can result in dermatitis and burns. Eye exposure produces pain, burns, blurred vision and conjunctivitis. A metallic taste, sneezing, bronchitis and pneumonia have also been noted.
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