Hematological abnormalities of acute exposure to hexachloroethane smoke inhalation

Abstract

There has been no human epidemiological data regarding potential hematological effects of hexachloroethane-zinc oxide (HC/ZnO) inhalation. This is the first epidemiological study to investigate whether HC/ZnO inhalation exposure can induce hematological abnormalities in exposed soldiers. Twenty soldiers, who were exposed to a high concentration of HC/ZnO smoke for 3-10 min in a narrow tunnel (0.6 m in width) during military training, were recruited as the exposed group (n = 20). Another 64 soldiers, who were not visiting the explosion areas, were recruited as controls. Venous blood was collected from all participants for analyses of hematological parameters. After adjustment for potential confounders, there were significant differences in weekly mean hemoglobin (HB), red blood cell count (RBC), and hematocrit (HCT) between exposed soldiers and controls (p < .01) at the first follow-up through the first 4 weeks following exposure. In addition, mean white blood cell count (WBC) of exposed soldiers was significantly higher than that of controls at the 4-week follow-up. Further analysis showed HB, RBC, and HCT changes during the 1st week after exposure and reach lowest levels during the 2nd week. HB, RBC, HCT, and WBC returned to normal within 11 weeks after the HC/ZnO smoke exposure. All other hematological parameters remained unchanged at 72 weeks after the event. The authors concluded that inhalation of HC/ZnO smoke can induce acute, temporally related hematological abnormalities.

The toxicology of zinc chloride smoke producing bombs and screens

“…Huang et al linked systemic inflammation to ZnCl 2 exposure in this cohort, in which tumour necrosis factor a concentrations increased and all patients had leucocytosis [30]. Furthermore, temporarily decreased haemoglobin levels, haematocrit and red blood cell counts associated also with ZnCl 2 fume exposure in this cohort [32].…”

“…Two reports described one incident involving two Danish soldiers [19,20]. Six reports covered the same set of 20 Taiwanese soldiers exposed in a military training exercise [27][28][29][30][31][32]. The best studied cohort hitherto consists of the Taiwanese soldiers [27][28][29][30][31][32].…”

“…A total of 23 reports include data from chest radiograph examinations of patients following exposure to ZnCl 2 smoke [5,6,8,[11][12][13][14][15][16][18][19][20][21][22][23][25][26][27][28][30][31][32][33]. These radiographs showed an interesting pattern when ordered chronologically.…”

“…Systemic factors are, however, likely involved in the development of later symptoms. For example, a rapid increase in the pro-inflammatory cytokine TNF-a, haematological changes (i.e., temporary reduction of haemoglobin, red blood cell count and haematocrit) and transaminase elevations associated with fume exposure from ZnCl 2 smoke producing bombs [26,28,30,32]. These findings as well as the associated temperature rise in many cases, suggest the involvement of systemic inflammation.…”