Medical Management Guidelines for Carbon Disulfide
(CS2)
CAS#: 75-15-0
UN#: 1131
PDF Versionpdf icon[165 KB]
Synonyms include carbon bisulfide, carbon sulfide, and dithiocarbonic anhydride.
- Persons exposed only to carbon disulfide vapor pose no risk of secondary contamination. Persons whose skin or clothing is contaminated with liquid carbon disulfide can secondarily contaminate rescuers by direct contact or through off-gassing of vapor.
- At room temperature, carbon disulfide is a very flammable liquid that readily evaporates when exposed to
air. Gaseous carbon disulfide is more than twice as heavy as air. Pure carbon disulfide liquid is colorless with a
pleasant odor. Most industriallyused carbon disulfide is
yellowish in color and has an unpleasant sulfurous odor
imparted by impurities. Odors of carbon disulfide usually
provide adequate warning of its presence.
- Carbon disulfide is readily absorbed through the upper
respiratory tract. Carbon disulfide can also be readily
absorbed through the digestive tract or skin.
General Information
Description
At room temperature, carbon disulfide
is a very flammable liquid that readily evaporates when
exposed to air. Gaseous carbon disulfide is more than twice
as heavy as air. Pure carbon disulfide liquid is colorless
with a pleasant odor. Most industrially-used carbon
disulfide liquid is yellowish in color and has an unpleasant
foul-smelling odor, characteristic of hydrogen sulfide (a
contaminant of technical grade carbon disulfide). Most
people can smell carbon disulfide vapors at levels as low as
0.02 to 0.1ppm. Carbon disulfide is handled and transported
as a very flammable and explosive liquid.
Routes of Exposure
Inhalation
Inhalation is the major route of
exposure to carbon disulfide. The vapors are readily
absorbed by the lungs. The odor threshold is approximately
200 to 1,000 times lower than the OSHA PEL-TWA (20ppm).
Odors of pure or commercial grades of carbon disulfide
usually provide adequate warning of hazardous
concentrations. Significant exposures to carbon disulfide
occur primarily in occupational settings. Acute exposure to
carbon disulfide vapors can be irritating to the eye, mucous
membranes, and respiratory epithelium. Acute exposure to
concentrations that are orders of magnitude higher than the
OSHA exposure limit may cause severe neurological effects
such as headache, confusion, psychosis, coma, and even
death. Being more than twice as heavy as air, carbon
disulfide vapors may be more concentrated in low-lying
areas.
Children exposed to the same levels of
carbon disulfide as adults may receive larger doses because
they have relatively greater lung surface area: body weight
ratios and higher minute volume: weight ratios. In addition,
they may be exposed to higher levels than adults in the same
location because of their short stature and the higher
levels of carbon disulfide found nearer to the ground.
Skin/Eye Contact
Contact with liquid or concentrated
vapors of carbon disulfide may cause irritation of the skin,
eyes, and mucous membranes. In extreme exposure cases,
direct contact may cause chemical burning of skin, eyes, or
mucous membranes. Direct contact may result in significant
dermal absorption. Significant inhalation or dermal exposure
to carbon disulfide would most likely be encountered in an
industrial environment, particularly during rayon
production.
Because of their relatively larger
surface area:weight ratio, children are more vulnerable to
toxicants absorbed through the skin.
Ingestion
Ingestion of carbon disulfide in
amounts as small as 15 mL may result in the death of an
adult. Premortem symptoms include respiratory difficulty,
tremors, convulsions, and coma. Humans are unlikely to be
exposed to significant quantities of carbon disulfide in
food or water.
Sources/Uses
Carbon disulfide is a natural product
of anaerobic biodegradation. It is also synthesized via the
catalyzed reaction between sulfur and methane at 600°C.
Carbon disulfide is used in the manufacture of viscose
rayon, cellophane, carbon tetrachloride, dyes, and rubber.
Some solvents, waxes, and cleaners contain carbon disulfide.
It is also used as an insecticide.
Standards and Guidelines
OSHA PEL (permissible exposure limit) =
20ppm (averaged over an 8-hour workshift); 30 ppm
(acceptable ceiling concentration; 100 ppm (30-minute
maximum peak).
NIOSH IDLH (immediately dangerous to
life or health) = 500ppm.
AIHA ERPG-2 (maximum airborne
concentration below which it is believed that nearly all
persons could be exposed for up to 1hour without
experiencing or developing irreversible or other serious
health effects or symptoms that could impair their abilities
to take protective action) = 50ppm.
Physical Properties
Description: Colorless to
slightly yellowish liquid at room temperature; volatile,
flammable, explosive in air.
Warning properties: Sweet odor
of pure carbon disulfide and foul odor of commercial and
technical grade carbon disulfide are usually adequate to
warn of acute exposure. Most people can detect carbon
disulfide at levels of 0.02 to 0.1 ppm (1 ppm is equivalent
to 3.1mg/m3).
Molecular weight: 76.14daltons.
Boiling point (760 mm Hg):
115.3°F (46.3°C)
Freezing point: -168.9°F
(-111.6°C)
Vapor pressure: 352.6mm Hg at
77°F (25°C)
Vapor density: 2.67g/mL (air =
1.00)
Water solubility: soluble in
ethanol, methanol, benzene, and ether; only slightly soluble
in water (0.23g/100mL at 71.6°F [22°C])
Flammability: LEL 1.3%;
Flashpoint -22°F (-30°C)
Incompatibilities
Carbon disulfide is incompatible with
air, alkali metals, aluminum, azides, many oxidants, and
phenyl copper-triphenylphosphine complexes. Such
incompatible mixtures may result in violent, and possibly
explosive, reactions.
Health Effects
- Carbon disulfide is irritating to the eyes, mucous
membranes, and skin. Acute neurological effects may result
from all routes of exposure and may include headache,
confusion, psychosis, and coma. Acute exposure to extremely
high levels of carbon disulfide may result in death.
- The neurotoxic effects caused by carbon disulfide may be
due, in part, to its metabolic conversion to
dithiocarbamates. Individuals especially susceptible to the
toxic effects of carbon disulfide include those with
existing disorders of the nervous system, respiratory
system, cardiovascular system, or eyes.
Acute Exposure
Mechanisms of toxicity have not been
clearly elucidated for carbon disulfide, but are thought to
be the result of the formation of carbon disulfide
metabolites such as dithiocarbamates and/or derivatives.
Most absorbed carbon disulfide is rapidly metabolized; there
appears to be no substantial delay in the onset of adverse
effects following acute exposure to high levels of carbon
disulfide. Direct contact with carbon disulfide results in
local irritation, which may be severe in cases of high-level
exposure. Acute exposure to high concentrations of carbon
disulfide may result in rapid onset of both local irritation
and concentration-dependent increased severity of
neurological symptoms such as nausea, dizziness, headache,
delusions, hallucinations, delerium, mania, psychosis,
blurred vision, convulsions, and coma.
Children do not always respond to
chemicals in the same way that adults do. Different
protocols for managing their care may be needed.
Cardiovascular
Chest pain and angina have been significantly related to acute carbon disulfide exposure (Poisindex, 2014)
CNS
Absorption of large amounts of carbon
disulfide results in rapid onset of severe neurological
symptoms such as nausea, dizziness, headache, delusions,
hallucinations, delerium, mania, psychosis, blurred vision,
convulsions, and coma. These symptoms are dependent upon
both exposure concentration and duration and may occur
following inhalation, oral, or dermal exposure. Death has
been reported from exposure to a vapor concentration of
4,815 ppm for 30 minutes. An exposure of 500 ppm for 30
minutes may cause a situation immediately dangerous to life
and health. Death due to carbon disulfide poisoning may
occur, in part, as a result of respiratory paralysis.
Respiratory
Acute exposure to carbon disulfide
vapor concentrations of several hundred parts per million
may result in irritation of the upper respiratory tract.
Children may be more vulnerable to gas
exposure because of higher minute ventilation per kg and
failure to evacuate an area promptly when exposed.
Ocular/Ophthalmic
Conjunctivitis and corneal burns can
result from the irritant effect of carbon disulfide vapor
and from direct exposure to the liquid. Degenerative changes
of the retina and optic nerve may also result from acute
exposure.
Dermal
Carbon disulfide is a skin irritant
that causes pain, redness, and blisters, especially on
mucous membranes. Carbon disulfide dissolves fatty layers of
the epidermis. Therefore, second and third degree chemical
burns may result from direct contact during high-level
exposure.
Because of their relatively larger
surface area:body weight ratio, children are more vulnerable
to toxicants that affect the skin.
Gastrointestinal
Nausea, vomiting, and abdominal pain
have been reported after acute exposure to carbon disulfide.
Chronic Exposure
Chronic exposure to carbon disulfide
can result in neurological effects similar to those
experienced during acute exposure, but at much lower
exposure levels. In addition, chronic exposure may cause
effects such as permanent central and peripheral nervous
system damage, atherosclerotic tendencies, ECG
abnormalities, gastrointestinal disturbances, fatty
degeneration of the liver, kidney damage, sexual
dysfunction, hearing loss, visual disturbances, retinal
microaneurism, and blood dyscrasia. Chronic exposure may be
more serious for children because of their potential for a
longer latency period.
Carcinogenicity
A carcinogenicity classification for
carbon disulfide has not been established by the Department
of Health and Human Services, the International Association
for Research on Cancer, or the U.S. EPA.
Reproductive and Developmental Effects
Carbon disulfide is included in the
list of Reproductive and Developmental Toxicants, a
1991 report published by the U.S. General Accounting Office
that lists 30 chemicals of concern because of widely
acknowledged reproductive and developmental consequences.
Carbon disulfide-induced reproductive effects include
alterations of the menstrual cycle in women and altered
libido and abnormalities in spermatogenesis in men. Carbon disulfide is a genotoxin, inducing mutations in bacteria and human cells. (Micromedex Poisindex, exp. 2014).
Prehospital Management
- Persons exposed only to carbon disulfide vapor pose no
risk of secondary contamination to rescuers. Persons whose
skin or clothing is contaminated with liquid carbon
disulfide can secondarily contaminate response personnel by
direct contact or through off-gassing of vapor.
- Carbon disulfide is severely irritating to the eyes,
mucous membranes, and skin. Acute neurological effects may
result from all routes of exposure and may include headache,
confusion, psychosis, and coma. Acute exposure to extremely
high levels of carbon disulfide may result in respiratory
failure and death.
- There is no antidote for carbon disulfide. Treatment
consists of removal of the victim from the contaminated
area, support of respiratory and cardiovascular functions,
and irrigation of contaminated eyes or skin.
Hot Zone
Rescuers should be trained and
appropriately attired before entering the Hot Zone. If the
proper equipment is not available, or if the rescuers have
not been trained in its use, call for assistance from a
local or regional hazardous materials (HAZMAT) team or other
properly equipped response organization.
Rescuer Protection
Inhaled carbon disulfide is readily
absorbed and is a respiratory tract irritant. Contamination
of the skin or eyes can cause chemical burns. Carbon
disulfide is readily absorbed through the skin.
Respiratory protection:
Positive-pressure, self-contained breathing apparatus (SCBA)
is recommended in response to situations that involve
exposure to potentially unsafe levels of carbon disulfide
gas.
Skin protection: Fully
encapsulated chemical-protective clothing is recommended
because carbon disulfide can cause skin irritation and
burns.
ABC Reminders
Quickly establish a patent airway,
ensure adequate respiration and pulse. Maintain adequate
circulation. Provide supplemental oxygen if cardiopulmonary
compromise is suspected. If trauma is suspected, maintain
cervical immobilization manually and apply a cervical collar
and a backboard when feasible. Apply direct pressure to stop
bleeding.
Victim Removal
If victims can walk, lead them out of
the Hot Zone to the Decontamination Zone. Victims who are
unable to walk should be removed on backboards or gurneys.
If these are not available, carefully carry or drag victims
to safety.
Consider appropriate management of
anxiety in victims with chemically-induced acute disorders,
especially children who may suffer separation anxiety if
separated from a parent or other adult.
Decontamination Zone
Patients exposed only to carbon
disulfide gas who have no eye or skin irritation do not need
decontamination. They may be transferred immediately to the
Support Zone. Other patients will require decontamination as
described below.
Rescuer Protection
If exposure levels are determined to be
safe, decontamination may be conducted by personnel wearing
a lower level of protection than that required in the Hot
Zone (described above).
ABC Reminders
Quickly establish a patent airway,
ensure adequate respiration and pulse. Maintain adequate
circulation. If trauma is suspected, maintain cervical
immobilization manually and apply a cervical collar and a
backboard when feasible. Administer supplemental oxygen as
required or if cardiopulmonary compromise is suspected.
Assist ventilation with a bag-valve-mask device if
necessary. Apply direct pressure to control bleeding.
Basic Decontamination
Rapid skin decontamination is
critical. Victims who are able may assist with their own
decontamination. Remove contaminated clothing and personal
belongings and place them in double plastic bags.
Gently wash exposed skin and hair with
copious amounts of water (preferably under a cool shower).
Use caution to avoid hypothermia when decontaminating
victims, particularly children or the elderly. Use blankets
or warmers after decontamination as needed.
Irrigate exposed eyes with copious
amounts of tepid tap water for at least 15minutes.
Remove contact lenses if they are easily removable without
additional trauma to the eye. If pain or injury is evident,
continue irrigation while transferring the victim to the
Support Zone.
In cases of ingestion, do not induce
emesis. Rinse the mouth and administer water for
dilution if the patient can swallow, has a strong gag
reflex, and does not drool. If the victim is not
symptomatic, administer activated charcoal at a dose of 1
g/kg (infant, child, and adult dose). A soda can and straw
may be of assistance when offering charcoal to a child.
Consider appropriate management of
chemically contaminated children at the exposure site. Also,
provide reassurance to the child during decontamination,
especially if separation from a parent occurs.
Transfer to Support Zone
As soon as basic decontamination is
complete, move the victim to the Support Zone.
Support Zone
Be certain that victims have been
decontaminated properly (see Decontamination Zone,
above). Victims who have undergone decontamination or have
been exposed only to carbon disulfide vapors pose no serious
risk of secondary contamination to rescuers. In such cases,
Support Zone personnel require no specialized protective
gear. The Support Zone team should wear disposable aprons or
gowns and latex gloves.
ABC Reminders
Quickly establish a patent airway. If
trauma is suspected, maintain cervical immobilization
manually and apply a cervical collar and a backboard when
feasible. Ensure adequate respiration and pulse. Administer
supplemental oxygen as required and establish intravenous
access if necessary. Place on a cardiac monitor.
Additional Decontamination
Continue irrigating exposed skin and
eyes, as appropriate.
In cases of ingestion, do not induce
emesis. Rinse the mouth and administer water for
dilution if the patient can swallow, has a strong gag
reflex, and does not drool. If the victim is not
symptomatic, administer activated charcoal at a dose of 1
g/kg (infant, child, and adult dose). A soda can and straw
may be of assistance when offering charcoal to a child.
Advanced Treatment
In cases of respiratory compromise
secure airway and respiration via endotracheal intubation.
If not possible, perform cricothyroidotomy if equipped and
trained to do so.
Treat patients who have bronchospasm
with an aerosolized bronchodilator such as albuterol.
Patients who are comatose, hypotensive,
or having seizures or cardiac arrhythmias should be treated
according to advanced life support (ALS) protocols when
clinically indicated. Avoid epinephrine and related beta
agonists (unless patient is in cardiac arrest or has
reactive airways disease refractory to other treatment)
because of the possible irritable condition of the
myocardium, which may lead to ventricular fibrillation.
If evidence of shock or hypotension is
observed, begin fluid administration. For adults with
systolic pressure less than 80 mm Hg, bolus perfusion of
1,000mL/hour intravenous saline or lactated Ringer's
solution may be appropriate. Higher adult systolic pressures
may necessitate lower perfusion rates. For children with
compromised perfusion, administer a 20mL/kg bolus of normal
saline over 10 to 20minutes, then infuse at 2 to
3mL/kg/hour.
Transport to Medical Facility
Only decontaminated patients or
patients not requiring decontamination should be transported
to a medical facility. "Body bags" are not recommended.
Report the condition of the patient,
treatment given, and estimated time of arrival at the
medical facility to the base station and the receiving
medical facility.
If carbon disulfide has been ingested,
prepare the ambulance in case the victim vomits toxic
material. Have ready several towels and open plastic bags to
quickly clean up and isolate vomitus.
Multi-Casualty Triage
Consult with the base station physician
or the regional poison control center for advice regarding
triage of multiple victims.
Patients who have histories or evidence
suggesting significant exposure (e.g., altered behavior,
respiratory distress, or chemical burns) should be
transported to a medical facility for evaluation. Patients
who have a history of chronic pulmonary disease should be
clinically evaluated for airflow obstruction.
Patients who have symptoms of mild or
transient skin, nose, or eye irritation may be discharged
from the scene after their names, addresses, and telephone
numbers are recorded. They should be advised to rest and to
seek medical care promptly ifsymptoms develop or recur (see
Patient Information Sheet below).
Emergency Department Management
- Persons exposed only to carbon disulfide vapor pose no
risk of secondary contamination to rescuers. Persons whose
skin or clothing is contaminated with liquid carbon
disulfide can secondarily contaminate response personnel by
direct contact or through off-gassing of vapor.
- Carbon disulfide is severely irritating to the eyes,
mucous membranes, and skin. Acute neurological effects may
result from all routes of exposure and may include headache,
confusion, psychosis, and coma. Acute exposure to extremely
high levels of carbon disulfide may result in respiratory
failure and death.
- There is no antidote for carbon disulfide. Treatment
consists of removal of the victim from the contaminated
area, support of respiratory and cardiovascular functions,
and irrigation of contaminated eyes or skin.
Decontamination Area
Previously decontaminated patients and
those exposed only to carbon disulfide vapor who have no
skin or eye irritation may be transferred immediately to the
Critical Care Area. Others require decontamination as
described below.
Be aware that use of protective
equipment by the provider may cause anxiety, particularly in
children, resulting in decreased compliance with further
management efforts.
Because of their relatively larger
surface area:body weight ratio, children are more vulnerable
to toxins absorbed through the skin. Also emergency
department personnel should examine children's mouths
because of the frequency of hand-to-mouth activity among
children.
ABC Reminders
Evaluate and support the airways,
breathing, and circulation. Provide supplemental oxygen if
cardiopulmonary compromise is suspected. In cases of
respiratory compromise secure airway and respiration via
endotracheal intubation. If not possible, perform
cricothyrotomy if equipped and trained to do so.
Treat patients who have bronchospasm
with an aerosolized bronchodilator such as albuterol.
Patients who are comatose, hypotensive,
or are having cardiac arrhythmias should be treated
according to established emergency department protocols.
Treat seizures with diazepam.
Basic Decontamination
Patients who are able may assist with
their own decontamination.
Because carbon disulfide can cause
burns, ED staff should don chemical-resistant jumpsuits
(e.g., of Tyvek or Saranex) or butyl rubber aprons, rubber
gloves, and eye protection if the patient's clothing or skin
is wet. After the patient has been decontaminated, no
special protective clothing or equipment is required for ED
personnel.
Quickly remove contaminated clothing
while gently washing the skin with water (preferably under a
cool shower). Double-bag the contaminated clothing and
personal belongings. Carbon disulfide dissolves fatty layers
of the epidermis; therefore, chemical burns are likely.
Handle burned skin with caution.
Wash exposed skin and hair thoroughly
with soap and cool water. If pain or injury is evident,
continue irrigation while transferring the victim to the
Critical Care Area. Use caution to avoid hypothermia when
decontaminating victims, particularly children or the
elderly. Use blankets or warmers after decontamination as
needed.
Flush exposed or irritated eyes with
copious amounts of tepid water for at least 15 minutes.
Remove contact lenses if easily removable without additional
trauma to the eye. If pain or injury is evident, continue
irrigation while transferring the victim to the Critical
Care Area.
In cases of ingestion, do not induce
emesis. Rinse the mouth and administer water for
dilution if the patient can swallow, has a strong gag
reflex, and does not drool. If the victim is not
symptomatic, administer activated charcoal at a dose of 1
g/kg (infant, child, and adult dose). A soda can and straw
may be of assistance when offering charcoal to a child.
Critical Care Area
Be certain that appropriate
decontamination has been carried out.
ABC Reminders
Evaluate and support the airways,
breathing, and circulation as in ABC Reminders above.
Establish intravenous access in seriously ill patients.
Continuously monitor cardiac rhythm.
Patients who are comatose, hypotensive,
or are having seizures or cardiac arrhythmias should be
treated in the conventional manner.
Inhalation Exposure
Administer supplemental oxygen by mask
to patients who have respiratory complaints. Treat patients
who have bronchospasm with an aerosolized bronchodilator
such as albuterol.
Skin Exposure
If concentrated carbon disulfide is in
contact with the skin, chemical burns may result; treat as
thermal burns.
Because of their relatively larger
surface area:body weight ratio, children are more vulnerable
to toxicants that affect the skin.
Eye Exposure
Continue irrigation for at least
15minutes. Test visual acuity. Examine the eyes for
corneal injury (burn) and treat appropriately. Immediately
consult an ophthalmologist for patients who have suspected
severe corneal injuries.
Ingestion
Do not induce emesis. Consider
endoscopy to evaluate the extent of gastrointestinal-tract
injury. Extreme throat swelling may require endotracheal
intubation or cricothyrotomy. Gastric lavage is useful in
certain circumstances to remove caustic material and prepare
for endoscopic examination. Consider gastric lavage with a
small nasogastric (NG) tube if: (1) a large dose has been
ingested; (2) the patient is evaluated within 30 minutes;
(3) the patient has oral lesions or persistent esophageal
discomfort; and (4) the lavage can be administered within 1
hour of ingestion. Care must be taken when placing the
gastric tube because blind gastric-tube placement may
further injure the chemically damaged esophagus or stomach.
If the victim is not symptomatic,
administer activated charcoal at a dose of 1 g/kg (infant,
child, and adult dose). A soda can and straw may be of
assistance when offering charcoal to a child.
Antidotes and Other Treatments
There is no antidote for carbon
disulfide. Treatment is supportive of respiratory and
cardiac function.
Laboratory Tests
Routine laboratory studies include
chest radiography, electrocardiogram, blood chemistry, and
arterial blood gases.
Disposition and Follow-up
Consider hospitalizing symptomatic
patients who have evidence of respiratory or cardiac
distress, seizures, changes in mental status, or significant
chemical burns.
Delayed Effects
Acute exposure to high concentrations
of carbon disulfide result in immediate adverse effects.
However, some of the common manifestations of acute
high-level exposure may be delayed.
Patient Release
Patients who become totally
asymptomatic in terms of pulmonary complaints in a 6- to
8-hour observation period are not likely to develop
complications. They may be released and advised to rest and
to seek medical care promptly if symptoms develop (see the
Carbon Disulfide--Patient Information Sheet below).
Cigarette smoking can exacerbate pulmonary injury and should
be discouraged for 72hours after exposure.
Follow-up
Obtain the name of the patient's
primary care physician so that the hospital can send a copy
of the record of the ED visit to the patient's doctor.
Follow-up evaluation of respiratory
function should be arranged for severely exposed patients.
Patients who have skin or corneal injuries should be
reexamined within 24hours.
Reporting
If a work-related incident has
occurred, you might be legally required to file a report;
contact your state or local health department.
Other persons might still be at risk in
the setting where this incident occurred. If the incident
occurred in the workplace, discussing it with company
personnel might prevent future incidents. If a public health
risk exists, notify your state or local health department or
other responsible public agency. When appropriate, inform
patients that they may request an evaluation of their
workplace from the Occupational Safety and Health
Administration (OSHA) or the National Institute for
Occupational Safety and Health (NIOSH).
Patient Information Sheet
This handout provides information and
follow-up instructions for persons who have been exposed to
carbon disulfide.
Print this handput only.pdf icon[55 KB]
What is carbon disulfide?
Carbon disulfide is a very flammable
liquid that readily evaporates when exposed to air. Pure
carbon disulfide liquid is colorless with a pleasant odor.
Most industrially-used carbon disulfide liquid is yellowish
in color and has an unpleasant foul-smelling odor. Carbon
disulfide has many industrial and agricultural uses. Most
potential for exposure comes from its use in the
rayon-producing industry. It is shipped and handled as a
flammable and explosive liquid in a special container.
What immediate health effects can be caused by exposure to carbon disulfide?
Inhaling carbon disulfide causes
irritation to the nose, eyes, throat, and lungs. Typical
symptoms include sore throat, runny nose, burning eyes, and
cough. Inhaling high levels can cause difficulty breathing.
Skin contact with carbon disulfide vapor or liquid can cause
irritation or burns. Acute neurological effects may result
from inhalation, ingestion, or skin contact and may include
headache, confusion, psychosis, and coma. Acute exposure to
extremely high levels of carbon disulfide may result in
death.
Can carbon disulfide poisoning be treated?
There is no antidote for carbon
disulfide, but its effects can be treated and most
acutely-exposed persons recover completely. Persons who have
inhaled large amounts of carbon disulfide might need to be
hospitalized. Persons who have come into direct skin or eye
contact with carbon disulfide liquid or vapors may need to
be treated for skin or eye chemical burns.
Are any future health effects likely to occur?
A single exposure from which a person
recovers quickly is not likely to cause delayed or long-term
effects.
What tests can be done if a person has been exposed to ethylene glycol?
Ethylene glycol and its breakdown products can be measured
in blood and urine. After significant exposure, diagnostic
tests are needed to measure kidney function and the levels
of the toxicant in the blood.
What tests can be done if a person has been exposed to carbon disulfide?
Specific tests for the presence of
carbon disulfide in blood or urine are not generally useful.
If a severe exposure has occurred, blood analyses, x-rays,
and breathing tests might show whether the lungs have been
injured. The level of a metabolite of carbon disulfide
(2-thiazolidine-4-carboxylic acid) can be measured in the
urine, but can not be used to determine the degree of
exposure to carbon disulfide.
Where can more information about carbon disulfide be found?
More information about carbon disulfide
can be obtained from your regional poison control center;
your state, county, or local health department; the Agency
for Toxic Substances and Disease Registry (ATSDR); your
doctor; or a clinic in your area that specializes in
occupational and environmental health. If the exposure
happened at work, you may wish to discuss it with your
employer, the Occupational Safety and Health Administration
(OSHA), or the National Institute for Occupational Safety
and Health (NIOSH). Ask the person who gave you this form
for help in locating these telephone numbers.
Follow-up Instructions
Keep this page and take it with you to
your next appointment. Follow only the instructions
checked below.
Print instructions only.pdf icon[55 KB]
[ ] Call your doctor or the Emergency
Department if you develop any unusual signs or symptoms
within the next 24 hours, especially:
- eye, nose, throat irritation
- coughing or wheezing
- difficulty breathing or shortness of breath
- chest pain or tightness
- nausea, vomiting, diarrhea, or stomach pain
- dizziness, incoordination, blurred vision
- mood or behavioral changes
- headache
[ ] No follow-up appointment is
necessary unless you develop any of the symptoms listed
above.
[ ] Call for an appointment with
Dr.____ in the practice of ________.
When you call for your appointment,
please say that you were treated in the Emergency Department
at _________ Hospital by________and were advised to be seen
again in ____days.
[ ] Return to the Emergency
Department/Clinic on ____ (date) at _____ AM/PM for a
follow-up examination.
[ ] Do not perform vigorous physical
activities for 1 to 2 days.
[ ] You may resume everyday activities
including driving and operating machinery.
[ ] Do not return to work for
_____days.
[ ] You may return to work on a limited
basis. See instructions below.
[ ] Avoid exposure to cigarette smoke
for 72 hours; smoke may worsen the condition of your lungs.
[ ] Avoid drinking alcoholic beverages
for at least 24 hours; alcohol may worsen injury to your
stomach or have other effects.
[ ] Avoid taking the following
medications: ________________
[ ] You may continue taking the
following medication(s) that your doctor(s) prescribed for
you: _______________________________
[ ] Other instructions:
____________________________________
_____________________________________________________
- Provide the Emergency Department with the name and the
number of your primary care physician so that the ED can
send him or her a record of your emergency department visit.
- You or your physician can get more information on the
chemical by contacting: ____________ or _____________, or by
checking out the following Internet Web sites:
___________;__________.
Signature of patient _______________ Date ____________
Signature of physician _____________ Date ____________
Where can I get more information?
If you have questions or concerns, please contact your community or state health or environmental quality department or:
For more information, contact:
Agency for Toxic Substances and Disease Registry
Division of Toxicology and Human Health Sciences
4770 Buford Highway
Chamblee, GA 30341-3717
Phone: 1-800-CDC-INFO 888-232-6348 (TTY)
Email: Contact CDC-INFO
ATSDR can also tell you the location of occupational and environmental health clinics. These clinics specialize in recognizing, evaluating, and treating illnesses resulting from exposure to hazardous substances.