Hydrocarbon poisoning may result from ingestion or inhalation. Ingestion, most common among children lt; 5 years, can result in aspiration pneumonitis. Inhalation, most common among adolescents, can result in ventricular fibrillation, usually without warning symptoms. Diagnosis of pneumonitis is by clinical evaluation, chest x-ray, and oximetry. Gastric emptying is contraindicated because aspiration is a risk. Treatment is supportive.
(See also General Principles of Poisoning.)
Ingestion of hydrocarbons, such as petroleum distillates (eg, gasoline, kerosene, mineral oil, lamp oil, paint thinners), results in minimal systemic effects but can cause severe aspiration pneumonitis. Toxic potential mainly depends on viscosity, measured in Saybolt seconds universal (SSU). Hydrocarbon liquids with low viscosity (SSU lt; 60), such as gasoline and mineral oil, can spread rapidly over large surface areas and are more likely to cause aspiration pneumonitis than are hydrocarbons with SSU gt; 60, such as tar. Hydrocarbons, if ingested in large amounts, may be absorbed systemically and cause central nervous system (CNS) or hepatic toxicity, which is more likely with halogenated hydrocarbons (eg, carbon tetrachloride, trichloroethylene).
Recreational inhalation of halogenated hydrocarbons (eg, glues, paint, solvents, cleaning sprays, gasoline, fluorocarbons used as refrigerants or propellants in aerosols—see Volatile Solvents), called huffing or bagging, is common among adolescents. It can cause euphoria and mental status changes and can sensitize the heart to endogenous catecholamines. Fatal ventricular arrhythmias may result; they usually occur without premonitory palpitations or other warning, often when patients are startled or chased.
Chronic toluene ingestion can cause long-term CNS toxicity, characterized by periventricular, occipital, and thalamic destruction.
