SECTION IX TOXICOLOGY
C H A P T E R
Introduction to Toxicology:
Occupational &
Environmental
Daniel T. Teitelbaum, MD*
C A S E S T U D Y
A 6-year-old girl is brought to the emergency department by her parents. She is comatose, tachypneic (25 breaths per minute), and tachycardic (150 bpm), but she appears flushed, and fingertip pulse oximetry is normal (97%) breathing room air. Questioning of her parents reveals that they are homeless and have been living in their car (a small van).
Humans live in a chemical world. They inhale, ingest, and absorb through the skin many of these chemicals. The occupational-environmental toxicologist is primarily concerned with adverse effects in humans resulting from exposure to chemicals encountered at work or in the general environment. In clinical practice, the occupational-environmental toxicologist must identify and treat the adverse health effects of these
The author thanks the late Gabriel L. Plaa, PhD, previous author of this chapter, for his enduring contributions.
The nights have been cold, and they have used a small charcoal burner to keep warm inside the vehicle. What is the most likely diagnosis? What treatment should be instituted immediately? If her mother is pregnant, what additional measures should be taken?
exposures. In addition, the trained occupational-environmental toxicologist will be called upon to assess and identify hazards associated with chemicals used in the workplace or introduced into the human environment.
Occupational and environmental toxicology cases present unusually complex problems. Occupational and environmental exposure is rarely limited to a single type of molecule. Most workplace or environmental materials are compounds or mixtures, and the ingredients are often poorly described in the documentation that is available for physician review. Moreover, although
