Acetic anhydride

Direct observations: clinical cases, poisoning incidents and other

Administrative data

Endpoint:

direct observations: clinical cases, poisoning incidents and other

Type of information:

experimental study

Adequacy of study:

key study

Reliability:

2 (reliable with restrictions)

Rationale for reliability incl. deficiencies:

other: scientifically acceptable publication

Data source

Reference

Reference Type:

publication

Title:

Fatal inhalation injury following an industrial accident involving acetic anhydride.

Author:

Sinclair JS et al.

Year:

1994

Bibliographic source:

Burns 20 (5): 469-470

Materials and methods

Study type:

poisoning incident

Endpoint addressed:

acute toxicity: inhalation

skin irritation / corrosion

Test guideline

Qualifier:

no guideline required

Test material

Test material information

Constituent 1

Reference substance name:

Acetic anhydride

EC Number:

203-564-8

EC Name:

Acetic anhydride

Cas Number:

108-24-7

Molecular formula:

C4H6O3

IUPAC Name:

acetyl acetate

Details on test material:

- Name of test material (as cited in study report): acetic anhydride

Method

Type of population:

occupational

Subjects:

- Number of subjects exposed: 1
- Age: 22 years

Route of exposure:

dermal

inhalation

Reason of exposure:

accidental

Details on exposure:

A 22-year old dye operator was working with a drum of acetic anhydride when it exploded around him, resulting in 35 per cent burns to his skin.

Medical treatment:

He attended the Accident and Emergency Department within 30 min of the injury and irrigation of the affected skin was carried out for 15-20 min. He was transferred to the Burns Unit where further irrigation of the affected skin was continued for 1.5-2 h (contact between rubber gloves and affected skin resulted in burning of the gloves even after 1 h of irrigation). An inhalation injury became apparent within 1.5 h of admission. He was intubated and ventilated in the intensive car unit. He developed non-cardiogenic pulmonary edema within 24 h of injury. The skin burns were treated with occlusive dressings containing silver sulphadiazine and healed within 3 weeks. Attempts to wean the patient from ventilation failed due to the development of tachypnoea and hypercarbia and he was placed on the waiting list for lung transplantation. He subsequently developed bilateral pneumothoraces and bilateral bronchopulmonry fistulae, so that ventilation of these lungs could not be maintained. He died 67 days following the injury.

Results and discussion

Any other information on results incl. tables

At autopsy there were extensive fibrous adhesions within the pleural cavities. On section of the lungs, the bronchi were dilated and surrounded by zones of hemorrhagic congestion. The intervening lung parenchyma was edematous. Histological examination revealed widespread ulceration of the bronchial mucosa with adherent fibrinous exudate. In many of the smaller bronchi this was associated with coagulative necrosis of the walls accompanied by dilatation of the lumina. The appearances were those of a necrotizing bronchiectasis, consistent with inhalation of a corrosive chemical. There was pulmonary oedema with numerous intra-alveolar macrophages and early regeneration and hyperplasia of type II pneumocytes. Focally there was evidence of persistent interstitial pulmonary emphysema in which foreign body giant cells surrounded irregularly dissected air spaces within the interstitium.