Toxic Haemolytic Anaemia in Pregnancy Due to a Pica for Paradichlorobenzene

Campbell, Doris M.; Davidson, R. J. L.

doi:10.1111/j.1471-0528.1970.tb03588.x

Cited by 25 publications

(11 citation statements)

References 4 publications

(3 reference statements)

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“…Similar reversible neurological symptoms developed in a woman who intentionally inhaled p-dichlorobenzene vapor from deodorizer blocks for several months and had verified exposure (her urine had a characteristic aromatic odor and contained the p-dichlorobenzene metabolite 2,5-dichlorophenol) (Reygagne et al, 1992). Information on human effects of oral exposure was reported in the case of a pregnant woman who had eaten 1-2 blocks of p-dichlorobenzene toilet bowl deodorizer per week throughout pregnancy (Campbell & Davidson, 1970). The women developed severe microcytic, hypochromic anemia from which she recovered following cessation of exposure, and neonatal examination of the child showed no abnormalities.…”

Section: P-dichlorobenzenementioning

confidence: 97%

“…Developmental Toxicity Information on possible developmental effects in humans is limited to observations on a child born to a woman who consumed toilet air freshener (composed mainly of p-dichlorobenzene) at a rate of 1 or 2 blocks of per week throughout pregnancy until about 38 wk of gestation (Campbell & Davidson, 1970). Neonatal examination of the child showed no abnormalities.…”

Section: P-dichlorobenzenementioning

confidence: 99%

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A Comparative Human Health Risk Assessment ofp-Dichlorobenzene-Based Toilet Rimblock Products Versus Fragrance/Surfactant-Based Alternatives

Aronson

Bosch

Gray

et al. 2007

Journal of Toxicology and Environmental Health, Part B

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A comparison of the human health risk to consumers using one of two types of toilet rimblock products, either a p-dichlorobenzene-based rimblock or two newer fragrance/surfactant-based alternatives, was conducted. Rimblock products are designed for global use by consumers worldwide and function by releasing volatile compounds into indoor air with subsequent exposure presumed to be mainly by inhalation of indoor air. Using the THERdbASE exposure model and experimentally determined emission data, indoor air concentrations and daily intake values were determined for both types of rimblock products. Modeled exposure concentrations from a representative p-dichlorobenzene rimblock product are an order of magnitude higher than those from the alternative rimblock products due to its nearly pure composition and high sublimation rate. Lifetime exposure to p-dichlorobenzene or the subset of fragrance components with available RfD values is not expected to lead to non-cancer-based adverse health effects based on the exposure concentrations estimated using the THERdbASE model. A similar comparison of cancer-based effects was not possible as insufficient data were available for the fragrance components.

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Section: P-dichlorobenzenementioning

confidence: 97%

Section: P-dichlorobenzenementioning

confidence: 99%

A Comparative Human Health Risk Assessment ofp-Dichlorobenzene-Based Toilet Rimblock Products Versus Fragrance/Surfactant-Based Alternatives

Aronson

Bosch

Gray

et al. 2007

Journal of Toxicology and Environmental Health, Part B

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“…Anemias were evident in early reports of PDCB toxicity in humans [95,98]. A 3-year-old boy ingested PDCB demothing crystals and a 21-year-old postpartum female ingested PDCB toilet-freshener blocks [101,102]. In both cases, there was complete recovery with removal from PDCB exposure.…”

Section: Case Continuationmentioning

confidence: 99%

Case Files of the New York City Poison Control Center: Paradichlorobenzene-Induced Leukoencephalopathy

2010

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A 44-year-old man was brought to the emergency department by emergency medical services after he was discovered lying supine on his apartment floor. He was accompanied by his sister, who had decided to visit him after his absence from a family function. Worsening "bizarre" behavior had been noted by family members for 4 weeks, characterized by anorexia, social withdrawal, flat affect, and alogia. Prior to his illness, he was described as functional, independent, gainfully employed, and social.The patient had mild mental retardation and hypertension. There was no history of diagnosed psychiatric illness, although his family suspected pica. Medications included an unknown antihypertensive with which he was not compliant. He occasionally used marijuana and alcohol, without history of other abused drugs. The patient's sister reported significant weight loss over several months. There had been no apparent fevers, cough, vomiting, diarrhea, or convulsions. On physical examination, he appeared drowsy, was markedly cachectic, and emanated an atypical aromatic body odor. Initial vital signs were: blood pressure 154/90 mmHg, heart rate 98/min, respiratory rate 20/min, rectal temperature 37.4°C, and room air oxygen saturation 97%. Head, neck, chest, and abdominal examinations were unremarkable. He had dry, scaling, and ichthyotic skin. He was oriented to person and place, but not to time, date, or indication for hospitalization. Limited cranial nerve evaluation was normal. Pain and light-touch sensation were unaffected. Hyperreflexia (without clonus) and cogwheel rigidity were noted in both lower extremities; upper extremities were normal. Plantar reflexes were normal bilaterally. Muscle bulk, tone, and strength were normal. The patient was unable to stand without support and unable to ambulate, apparently due to impaired equilibrioception. He could follow simple one-step commands. He would speak a few words when asked simple questions, and he avoided eye contact.Serum electrolytes (sodium, potassium, chloride, calcium, and magnesium) and serum glucose were normal. Tests of hepatic and renal function were: AST 53

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“…However, adverse health effects attributed to 1,4-DCB in humans were reported in the literature (Berliner, 1939;Weller & Crellin, 1953;Cotter, 1953;Campbell & Davidson, 1970;Miyai et al, 1988). The human responses to 1,4-DCB are often of limited use because the responses resulting from accidental exposure and exposure concentrations are not reported (Meek et al, 1994;NICNAS, 2000).…”

mentioning

confidence: 92%

Health Risk Assessment of Chlorobenzenes in the Air of Residential Houses Using Probabilistic Techniques

Djohan¹,

Qian²,

Connell³

et al. 2007

Journal of Toxicology and Environmental Health, Part A

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A human health risk assessment was performed to evaluate the risks due to chlorobenzenes in the air of residential houses. Chlorobenzenes found in the air in the toilets, rooms, and outdoors of three houses in Brisbane, Australia, were sampled by trapping on Tenax TA and analyzed using an automated thermal desorption (ATD)-gas chromatography/mass spectrometry (GC/MS) method. Concentrations of 1,4-dichlorobenzene (1,4-DCB) in the rooms, toilets, and outdoors were used as the exposure concentrations (E), while those in the toilets (microg/m3) were used as the high-exposure concentrations (HE). The exposure concentrations were transformed into exposure doses (EXD(E) and EXD(HE)). Dose-response data from the literature for a range of adverse effects in animals were obtained and exposure doses were expressed as human equivalent dose (HED). The HED values were higher than the EXD(E) and EXD(HE) values for all adverse effects, and a hazard quotient was calculated that indicated a low level of risk with the high-exposure environment. The lifetime average daily doses (LADDs) for a wide range of adverse effects observed in human case studies were estimated and compared to the doses in the high-exposure (HE) situation. Using the Monte Carlo simulation technique the probabilities of risk quotients higher than unity ranged from 0.02 to 0.26. This evaluation indicated that 1,4-DCB posed low risks to general residents; however, for individuals with susceptible characteristics and exposure to elevated 1,4-DCB, the probability of adverse responses was moderate to high.

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Toxic Haemolytic Anaemia in Pregnancy Due to a Pica for Paradichlorobenzene

Abstract: A pregnant woman developed toxic haemolytic anaemia as a result of a pica for toilet air-freshener blocks whose chief constituent is paradichlorobenzene.

Cited by 25 publications

References 4 publications

A Comparative Human Health Risk Assessment ofp-Dichlorobenzene-Based Toilet Rimblock Products Versus Fragrance/Surfactant-Based Alternatives

A Comparative Human Health Risk Assessment ofp-Dichlorobenzene-Based Toilet Rimblock Products Versus Fragrance/Surfactant-Based Alternatives

Case Files of the New York City Poison Control Center: Paradichlorobenzene-Induced Leukoencephalopathy

Health Risk Assessment of Chlorobenzenes in the Air of Residential Houses Using Probabilistic Techniques

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