Medical Management Guidelines for Xylene
(C6H4)(CH3)2
CAS#: 1330-20-7
UN#: 1307
PDF Versionpdf icon[70.8 KB]
Synonyms include dimethylbenzene, methyl toluene, xylol, and mixed xylenes.
- Persons exposed only to xylene vapor do not pose substantial risks of secondary contamination. Persons whose clothing or skin is contaminated with liquid xylene can cause secondary contamination by direct contact or through off-gassing vapor.
- Xylene is a clear, colorless liquid. It is volatile, readily producing flammable and toxic concentrations at room temperature. Its vapor is heavier than air and may accumulate in low-lying areas. Xylene's odor generally provides adequate warning of hazardous concentrations.
- Xylene is rapidly absorbed after inhalation and ingestion. Exposure via ingestion and inhalation produces systemic toxicity. Xylene is slowly absorbed through intact skin, but percutaneous absorption may contribute to total body burden.
General Information
Description
Xylene exists as three isomers (ortho-, meta-, and para-xylene), which can be found singly or, more commonly, mixed in varying proportions. Commercial grade xylene, in which m-xylene is usually the major constituent, is a clear,
colorless liquid with a sweet, aromatic odor. It is generally referred to as Mixed, Total or Technical-Grade Xylene. There is a fourth structural isomer,
ethylbenzene (C6H5)(C2H5) that may be present as a congener, but is not toxicologically distinct to a significant degree. Xylene is flammable at room temperature; therefore, it constitutes a fire hazard. It is insoluble in water, but mixes readily with many organic solvents. Xylene is less dense than water and will float on the surface of water.
Routes of Exposure
Inhalation
Most exposures to xylene occur by inhalation and xylene is readily absorbed from the lungs. Xylene's odor threshold is about 1 ppm, which is 100 times less than the OSHA PEL and generally provides adequate warning of acutely hazardous concentrations. Irritation of eye and throat occur at about 200 ppm. Xylene vapor is heavier than air and may cause asphyxiation in enclosed, poorly ventilated, or low-lying areas.
Children exposed to the same levels of xylene vapor as
adults may receive a larger dose because they have greater
lung surface area:body weight ratios and increased minute
volumes: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 xylene vapor
found nearer to the ground.
Skin/Eye Contact
Xylene vapor is only mildly irritating to mucous
membranes; however, xylene splashed in the eyes can result
in corneal injury. Repeated or prolonged skin contact with
liquid xylene can defat the skin, causing it to crack and
peel. Percutaneous absorption is slow through intact skin;
however, xylene absorbed through the skin may contribute to
body burden.
Children are more vulnerable to toxicants absorbed through the skin because of their relatively larger surface
area:body weight ratio.
Ingestion
Acute systemic toxicity can result from ingestion of xylene.
Sources/Uses
Xylene is among the 30 most abundantly produced chemicals in the United States. It is obtained primarily from crude petroleum. It is widely used as a degreasing agent and as a thinner and solvent in paints, inks, adhesives, and many other products. It is commonly found as a solvent in pesticide products.
Standards and Guidelines
OSHA PEL (permissible exposure limit) = 100 ppm (averaged over an 8-hour
workshift) NIOSH IDLH (immediately dangerous to life or health) = 900 ppm
Physical Properties
Description: Clear, colorless liquid
Warning properties: Adequate; sweet, aromatic odor
at 1 ppm
Molecular weight: 106.2 daltons
Boiling point (760 mm Hg)*: 292°F (144°C), 269°F (139°C), and 281°F (138°C)
Freezing point*: -13°F (-25°C), -54°F (-48°C), and 56°F (13°C)
Specific gravity*: 0.88, 0.86, and 0.86 (water = 1)
Vapor pressure*: 5, 6, and 6.5 mm Hg at 68°F (20°C)
Gas density: 3.8 (air = 1)
Water solubility: insoluble
Flammability*: 63°F (17°C), 81°F (27°C), 81°F (27°C)
Flammable range: 1.0% to 7.0% (concentration in air)
*ortho-, meta-, and para-xylene, respectively.
Incompatibilities
Xylene reacts with strong oxidizers and strong acids.
Health Effects
- Xylene is irritating to the skin, eyes, and respiratory tract. It can cause systemic toxicity by ingestion or inhalation. The most common route of exposure is via inhalation.
- Symptoms of xylene poisoning include CNS effects (headache, dizziness, ataxia, drowsiness, excitement, tremor, and coma), ventricular arrythmias, acute pulmonary edema, respiratory depression, nausea, vomiting, and reversible hepatic impairment.
- The mechanism by which xylene produces toxicity is not known.
Acute Exposure
The mechanism by which xylene produces toxicity is not known. CNS toxicity may be due to the liposolubility of xylene in the neuronal membrane. It has been suggested that xylene interferes with the normal function of neuronal proteins. It has also been suggested that the toxicity of xylene may be due to some of its metabolic intermediates. CNS toxicity is generally discernible within a short time of exposure, but pulmonary edema may not appear for up to 72 hours after exposure. No information was found as to whether the health effects of xylene in children are different than in adults.
Children do not always respond to chemicals in the same way that adults do. Different protocols for managing their care may be needed.
CNS
Generally, symptoms of CNS toxicity are apparent immediately after inhalation of high xylene concentrations and 30 to 60 minutes after ingestion. Effects of mild CNS depression include headache, lightheadedness, dizziness, confusion, nausea, impaired gait, and blurred vision. More severe effects include tremors, rapid respiration, paralysis, loss of consciousness, coma, and death. Coma may be prolonged, although most victims regain consciousness rapidly after they are removed from exposure.
Respiratory
Acute exposure to xylene vapor may irritate the mucous membranes of the respiratory tract. With massive exposure, accumulation of fluid in the lungs and respiratory arrest may ensue. Pulmonary aspiration of toxic vomitus or ingested liquid xylene may cause inflammation of the lungs.
Exposure to certain chemicals can lead to Reactive Airway Dysfunction Syndrome (RADS), a chemically- or irritant-induced type of asthma.
Children may be more vulnerable because of relatively increased minute ventilation per kg and failure to evacuate an area promptly when exposed.
Hydrocarbon pneumonitis may be a problem in children.
Cardiovascular
Inhalation of massive doses of xylene can cause cardiac abnormalities. Xylene lowers the threshold of the heart to the effects of epinephrine, partially disrupting the rhythm. Irregular heart rhythm leading to cardiac arrest has occurred in solvent abusers, often immediately after intense physical activity.
Renal
High-level xylene exposure may lead to acid-base imbalance. In solvent abusers, electrolyte and acid-base disturbances can cause renal-tubular acidosis, inadequate amounts of potassium in the blood, and low blood phosphate. Ethanol or aspirin may prolong the half-life of xylene in the body.
Because of their higher metabolic rates, children may be more vulnerable to toxicants interfering with basic metabolism.
Dermal
Xylene can cause skin inflammation and defatting, particularly after prolonged or repeated contact with the liquid. Redness of the skin and blisters may occur.
Because of their relatively larger surface area:body weight ratio, children are more vulnerable to toxicants absorbed through the skin.
Hepatic
Reversible liver damage has been reported in some individuals exposed to xylene.
Ocular
High concentrations of xylene vapor may cause eye irritation, but ophthalmic injury is rare. When splashed in the eyes, xylene may cause burning pain, conjuctivitis, corneal vacuolation, and keratitis.
Gastrointestinal
If swallowed, xylene can irritate the stomach, causing nausea, vomiting, and diarrhea.
Potential Sequelae
During recovery, patients may continue to experience impaired gait, lightheadedness, dilated and poorly responsive pupils, and decreased or absent deep-tendon reflexes. Anxiety, fatigue, and insomnia may last several days. No long-term effects due to acute xylene exposure have been reported.
Chronic Exposure
Repeated exposure to xylene due to solvent abuse can result in progressive and permanent neuropsychiatric manifestations. In its more severe form this has been called "chronic toxic encephalopathy."
There is some evidence from human epidemiological studies that occupational exposure to solvents including xylene may be associated with proliferative glomerulonephritis. However, individuals were exposed to mixtures of solvents and so it is not possible to attribute this effect solely to xylene exposure.
Chronic exposure may be more serious for children because of their potential longer latency period.
Carcinogenicity
The International Agency for Research on Cancer has determined that xylene is not classifiable as to its carcinogenicity to humans. The EPA has determined that xylene is not classifiable as to its human carcinogenicity.
Reproductive and Developmental Effects
Xylene is not included in Reproductive and Developmental Toxicants, a 1991 report published by the United States General Accounting Office (GAO) that lists 30 chemicals of concern because of widely acknowledged reproductive and developmental consequences. Xylene has been reported to cross the placenta in humans. Limited human developmental data are available, but animal studies suggest that exposure to high doses of xylene may be fetotoxic.
Prehospital Management
Victims exposed only to xylene vapor do not pose significant risks of secondary
contamination to rescuers outside the Hot Zone. Victims whose clothing or skin is
contaminated with liquid xylene can secondarily contaminate response personnel by
direct contact or through off-gassing vapor. Xylene vapor may also off-gas from the
toxic vomitus of victims who have ingested xylene.
Xylene is irritating to the skin, eyes, and respiratory tract. It can cause systemic
toxicity by ingestion or inhalation. The most common route of exposure is via
inhalation. Symptoms of xylene poisoning include CNS effects (headache, dizziness,
ataxia, drowsiness, excitement, tremor, and coma), ventricular arrythmias, acute
pulmonary edema, respiratory depression, nausea, vomiting, and reversible hepatic
impairment.
There is no antidote for xylene. Treatment consists of support of respiratory and
cardiovascular functions.
Hot Zone
Rescuers should be trained and appropriately attired before entering
the Hot Zone. If the proper equipment is not available, or if rescuers
have not been trained in its use, assistance should be obtained from
a local or regional HAZMAT team or other properly equipped
response organization.
Rescuer Protection
Xylene vapor is a mild respiratory-tract irritant. The liquid is a mild
skin irritant with slow skin absorption.
Respiratory Protection: Positive-pressure, self-contained breathing
apparatus (SCBA) is recommended in response situations that
involve exposure to potentially unsafe levels of xylene vapor.
Skin Protection: Chemical-protective clothing is not generally
required when only vapor exposure is expected because xylene
vapor is neither irritating nor absorbed well through the skin.
Chemical-protective clothing is recommended when repeated or
prolonged contact with the liquid is anticipated because skin
irritation and dermal absorption may occur.
ABC Reminders
Quickly access for a patent airway, ensure adequate respiration and
pulse. If trauma is suspected, maintain cervical immobilization
manually and apply a cervical collar and a backboard when feasible.
Victim Removal
If victims can walk, lead them out of the Hot Zone to the
Decontamination Zone. Victims who are unable to walk may be
removed on backboards or gurneys; if these are not available, carefully carry or drag victims to safety. Care should be taken that
the victims (particularly children) do not have problems due to
xylene being heavier than air and settling in pockets close to the
ground.
Consider appropriate management of chemically contaminated
children, such as measures to reduce separation anxiety if a child is
separated from a parent or other adult.
Decontamination Zone
Patients exposed only to xylene vapor who have no skin or eye
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 worn in the Hot Zone (described above).
ABC Reminders
Quickly access for a patent airway, ensure adequate respiration and
pulse. Stabilize the cervical spine with a collar and a backboard if
trauma is suspected. Administer supplemental oxygen as required.
Assist ventilation with a bag-valve-mask device if necessary.
Basic Decontamination
Victims who are able may assist with their own decontamination.
Quickly remove and double-bag contaminated clothing and
personal belongings.
Flush exposed skin and hair with plain water for 3 to 5 minutes,
then wash with mild soap. Rinse thoroughly with water. Use
caution to avoid hypothermia when decontaminating children or the
elderly. Use blankets or warmers when appropriate.
Flush exposed or irritated eyes with plain water or saline for at least
5 minutes or until pain resolves. Remove contact lenses if easily
removable without additional trauma to the eye. If a corrosive
material is suspected or if pain or injury is evident, continue
irrigation while transferring the victim to the Support Zone.
In cases of ingestion, do not induce emesis. The use of activated
charcoal for hydrocarbon absorption is limited, but it may have
some effect, especially in cases of mixed overdose. If the victim is
alert, asymptomatic, and has a gag reflex, administer a slurry of
activated charcoal at 1 gm/kg (usual adult dose 60-90 g, child dose
25-50 g). A soda can and a straw may be of assistance when
offering charcoal to a child.
Consider appropriate management of chemically contaminated
children at the exposure site. 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 vapor pose no
serious risks of secondary contamination to rescuers. In such cases,
Support Zone personnel require no specialized protective gear.
ABC Reminders
Quickly access for 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. Observe
for cardiac arrhythmias.
Additional Decontamination
Continue irrigating exposed skin and eyes, as appropriate.
In cases of ingestion, do not induce emesis. The use of activated
charcoal for hydrocarbon absorption is limited, but it may have
some effect, especially in cases of mixed overdose. If activated
charcoal has not been given previously and if the patient is alert,
asymptomatic, and has a gag reflex, administer a slurry of activated
charcoal at 1 gm/kg (usual adult dose 60-90 g, child dose 25-50 g).
A soda can and a 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.
Patients who have bronchospasm may be treated with aerosolized
bronchodilators. However, the use of sympathomimetic agents such
as epinephrine and isoproterenol could precipitate fatal arrhythmias
and should be avoided. Selective beta-2 agonists would be
preferred, but clinical reports of their use are lacking. Theophylline
derivatives have not been studied. Use all catecholamines with
caution because of the enhanced risk of cardiac arrhythmias. Also
consider the health of the myocardium before choosing which type
of bronchodilator should be administered.
Patients who are comatose, hypotensive, or having seizures or
cardiac arrhythmias should be treated according to advanced life
support (ALS) protocols.
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 to the base station and the receiving medical facility the
condition of the patient, treatment given, and estimated time of
arrival at the medical facility.
If xylene 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 with evidence of significant inhalation exposure such as
CNS depression and all persons who have ingested xylene should be
transported to a medical facility for evaluation. Others may be
discharged at the scene after their names, addresses, and telephone
numbers are recorded. Those discharged should be advised to seek
medical care promptly if symptoms develop (see Patient
Information Sheet below).
Emergency Department Management
-
Hospital personnel can be secondarily contaminated by direct contact or by vapor
off-gassing from heavily soaked clothing or skin. Patients do not pose contamination
risks after clothing is removed and the skin is washed. Toxic vomitus from patients
who have ingested xylene may also off-gas xylene vapor.
- Xylene is irritating to the skin, eyes, and respiratory tract. It can cause systemic
toxicity by ingestion or inhalation. The most common route of exposure is via
inhalation. Symptoms of xylene poisoning include CNS effects (headache, dizziness,
ataxia, drowsiness, excitement, tremor, and coma), ventricular arrythmias, acute
pulmonary edema, respiratory depression, nausea, vomiting, and reversible hepatic
impairment.
- There is no antidote for xylene. Treatment consists of support of respiratory and
cardiovascular functions.
Decontamination Area
Unless previously decontaminated, all patients suspected of contact
with liquid xylene and all victims with skin or eye irritation require
decontamination as described below. All other patients may be
transferred to the Critical Care area.
Be aware that use of protective equipment by the provider may
cause fear 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 toxicants absorbed through the skin.
Also emergency room personnel should examine children's mouths
because of the frequency of hand-to-mouth activity among children.
ABC Reminders
Evaluate and support airway, breathing, and circulation. In cases of
respiratory compromise secure airway and respiration via
endotracheal intubation. If not possible, surgically create an airway.
Patients who have bronchospasm may be treated with aerosolized
bronchodilators. However, the use of sympathomimetic agents such
as epinephrine and isoproterenol could precipitate fatal arrhythmias
and should be avoided. Selective beta-2 agonists would be
preferred, but clinical reports of their use are lacking. Theophylline
derivatives have not been studied. Use all catecholamines with
caution because of the enhanced risk of cardiac arrhythmias. Also
consider the health of the myocardium before choosing which type
of bronchodilator should be administered.
Patients who are comatose, hypotensive, or have seizures or
ventricular arrhythmias should be treated in the conventional
manner.
Basic Decontamination
Patients who are able may assist with their own decontamination.
Remove and double-bag contaminated clothing and personal
belongings.
Flush liquid-exposed skin and hair with plain water for 3 to
5 minutes, then wash with mild soap. Rinse thoroughly with water.
Use caution to avoid hypothermia when decontaminating children
or the elderly. Use blankets or warmers when appropriate.
Flush exposed or irritated eyes with plain water or saline for at least
5 minutes or until pain resolves. Remove contact lenses if easily
removable without additional trauma to the eye. If a corrosive
material is suspected or 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. The use of activated
charcoal for hydrocarbon absorption is limited, but it may have
some effect, especially in cases of mixed overdose. If the victim is
alert, asymptomatic, and has a gag reflex, administer a slurry of
activated charcoal at 1 gm/kg (usual adult dose 60-90 g, child dose
25-50 g). A soda can and a straw may be of assistance when
offering charcoal to a child.
Critical Care Area
Be certain that appropriate decontamination has been carried out
(see Decontamination Area above).
ABC Reminders
Evaluate and support airway, breathing, and circulation as in ABC
Reminders above. Establish intravenous access in seriously ill
patients if this has not been done previously. Continuously monitor
cardiac rhythm.
Patients who are comatose, hypotensive, or have seizures or cardiac
arrhythmias should be treated in the conventional manner.
Inhalation Exposure
Administer supplemental oxygen by mask to patients who have
respiratory complaints. Patients who have bronchospasm may be
treated with aerosolized bronchodilators. However, the use of
sympathomimetic agents such as epinephrine and isoproterenol
could precipitate fatal arrhythmias and should be avoided. Selective
beta-2 agonists would be preferred, but clinical reports of their use
are lacking. Theophylline derivatives have not been studied. Use all
catecholamines with caution because of the enhanced risk of cardiac arrhythmias. Also consider the health of the myocardium before
choosing which type of bronchodilator should be administered.
Skin Exposure
If liquid xylene was in prolonged 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 absorbed through the skin.
Eye Exposure
Ensure that adequate eye irrigation has been completed. Examine
the eyes for corneal damage and treat appropriately. Immediately
consult an ophthalmologist for patients who have severe corneal
injuries.
Ingestion Exposure
Do not induce emesis.
The use of activated charcoal for hydrocarbon absorption is limited,
but it may have some effect, especially in cases of mixed overdose.
If activated charcoal has not been given previously and if the patient
is alert, asymptomatic, and has a gag reflex, administer a slurry of
activated charcoal at 1 gm/kg (usual adult dose 60-90 g, child dose
25-50 g). A soda can and a straw may be of assistance when
offering charcoal to a child.
Consider endoscopy to evaluate the extent of gastrointestinal-tract
injury. Extreme throat swelling may require endotracheal intubation
or cricothyroidotomy. Gastric lavage is useful in certain
circumstances to remove toxic material and prepare for endoscopic
examination. Consider gastric lavage with a small nasogastric tube
if: (1) a large dose has been ingested; (2) the patient's condition is
evaluated within 30 minutes; (3) the patient has oral lesions or
persistent esophageal discomfort; and (4) the lavage can be
administered within one 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.
Because of the risk of perforation from NG intubation, lavage is
discouraged in children unless performed under endoscopic
guidance.
Toxic vomitus or gastric washings should be isolated (e.g., by
attaching the lavage tube to isolated wall suction or another closed
container).
If the patient who has ingested xylene is coughing or is dyspneic,
pulmonary aspiration may have occurred. Patients who show no clinical signs of pulmonary aspiration within 6 hours are not likely
to develop aspiration chemical pneumonitis.
Antidotes and
Other Treatments
There is no antidote for xylene. Hemodialysis and hemoperfusion
are ineffective.
Laboratory Tests
Routine laboratory studies for all exposed patients include CBC,
glucose, and electrolyte determinations. Additional studies for
patients exposed to xylene include ECG monitoring, renal-function
tests, and liver-function tests. Chest radiography and pulse oximetry
(or ABG measurements) are recommended for severe inhalation
exposure or if pulmonary aspiration is suspected.
Blood levels of xylene may be used to document exposure,
although they are not useful clinically. Xylene is metabolized to
methylhippuric acid, which is excreted in urine. Xylene is almost
completely excreted within 24 hours. Urinary methylhippuric acid
levels do not correlate well with systemic effects and are not
available on an emergency basis; however, methylhippuric acid
levels can help confirm the diagnosis or etiology.
Disposition and
Follow-up
Consider hospitalizing symptomatic patients who have significant
inhalation or ingestion exposure with symptoms of CNS depression
or respiratory distress.
Delayed Effects
Observe hospitalized patients for signs of acute tubular necrosis,
encephalopathy, and arrhythmias. In addition, patients exposed by
inhalation should be watched for signs of pulmonary edema, and
those who have ingested xylene should be watched for signs of
aspiration pneumonitis.
Patient Release
atients who remain asymptomatic 6 to 12 hours after exposure
may be discharged with instructions to seek medical care promptly
if symptoms develop (see the Xylene-Patient Information Sheet
below).
Follow-up
Obtain the name of the patient's primary care physician so that the
hospital can send a copy of the ED visit to the patient's doctor.
Patients who have corneal injuries should be reexamined within
24 hours. No long-term sequelae due to a single acute exposure to
xylene have been reported.
Reporting
If a work-related incident has occurred, you may be legally required
to file a report; contact your state or local health department.
Other persons may still be at risk in the setting where this incident
occurred. If the incident occurred in the workplace, discussing it
with company personnel may 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 OSHA
or NIOSH. See Appendices III and IV for a list of agencies that
may be of assistance.
Patient Information Sheet
This handout provides information and follow-up instructions for persons who have been exposed to xylene.
Print this handout only.pdf icon[44 KB]
What is xylene?
When pure, xylene is a clear, colorless liquid with a sweet odor. It burns readily. Xylene is obtained from
crude petroleum and is used widely in many products such as paints, glues, and pesticides. It is
found in small amounts in gasoline.
What immediate health effects can be caused by exposure to xylene?
Breathing xylene vapors in small amounts can cause headache, dizziness, drowsiness, and nausea. With more
serious exposure, xylene can cause sleepiness, stumbling, irregular heartbeat, fainting, or even death. Xylene
vapors are mildly irritating to the skin, eyes, and lungs. If liquid xylene is held against the skin, it may cause
burning pain. Liquid xylene splashed in the eyes can damage the eyes. Generally, the more serious the
exposure, the more severe the symptoms.
Can xylene poisoning be treated?
There is no antidote for xylene, but its effects can be treated, and most exposed persons get well. Persons
who have experienced serious symptoms may need to be hospitalized.
Are any future health effects likely to occur?
A single small exposure from which a person recovers quickly is not likely to cause delayed or long-term
effects. After a serious exposure, some symptoms may take a few days to develop. Repeated sniffing of
xylene can cause permanent damage to the brain, muscles, heart, and kidneys.
What tests can be done if a person has been exposed to xylene?
Specific tests for the presence of xylene in blood and urine generally are not useful to the doctor.
Methylhippuric acid, a metabolite of xylene, may be measured in urine if the xylene dose was high. If a severe
exposure has occurred, blood and urine analyses and other tests may show whether the brain, heart, or
kidneys have been injured. Testing is not needed in every case.
Where can more information about xylene be found?
More information about xylene can be obtained from your regional poison control center; the 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[44 KB]
[ ] Call your doctor or the Emergency
Department if you develop any unusual signs or symptoms
within the next 24 hours, especially:
- coughing
- shortness of breath or wheezing
- chest pain or tightness
- increased pain or a discharge from exposed eyes
- increased redness or pain or a pus-like discharge in the
area of a skin burn
- fever
[ ] 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.