Human Health Effects of Sodium Azide Exposure: A Literature Review and Analysis

Abstract

Sodium azide, used mainly as a preservative in aqueous laboratory reagents and biologic fluids and as a fuel in automobile airbag gas generants, has caused deaths for decades. Its exposure potential for the general population increases as the use of airbags increase. In order to characterize the known health effects of sodium azide in humans and the circumstances of their exposure, the authors conducted a systematic review of the literature from 1927 to 2002 on human exposure to sodium azide and its health effects. The most commonly reported health effect from azide exposure is hypotension, almost independent of route of exposure. Most industrial exposures are by inhalation. Most laboratory exposures or suicide attempts are by ingestion. Most of the reported cases involved persons working in laboratories. The time between exposure and detection of hypotension can predict outcome. Fatal doses occur with exposures of >or=700 mg (10 mg/kg). Nonlethal doses ranged from 0.3 to 150 mg (0.004 to 2 mg/kg). Onset of hypotension within minutes or in less than an hour is indicative of a pharmacological response and a benign course. Hypotension with late onset (>1 hour) constitutes an ominous sign for death. All individuals with hypotension for more than an hour died. Additional health effects included mild complaints of nausea, vomiting, diarrhea, headache, dizziness, temporary loss of vision, palpitation, dyspnea, or temporary loss of consciousness or mental status decrease. More severe symptoms and signs included marked decreased mental status, seizure, coma, arrhythmia, tachypnea, pulmonary edema, metabolic acidosis, and cardiorespiratory arrest. The signs and symptoms from lower exposures (<700 mg) are physiological responses at the vascular level and those at or above are toxicological responses at the metabolic level. There is no specific antidote for sodium azide intoxication. Recommended preventive measures for sodium azide exposure consist of education of people at high risk, such as laboratory workers, regarding its chemical properties and toxicity, better labeling of products containing sodium azide, and strict enforcement of laboratory regulations and access control.

Surviving a Massive Sodium Azide Poisoning with Toxic Cardiomyopathy

“…A systematic review reported the fatal dose in humans to be over 10 mg/kg 1 . A 69 year-old female was admitted to our hospital for voluntary sodium azide poisoning.…”

“…Depending on the dose ingested patients most commonly suffer from vomiting, altered consciousness, diaphoresis, acute respiratory distress, acidosis, ventricular fibrillation, hypotension and shock, cerebral edema and ultimately death 1 . Surprisingly our patient had no hypotension.…”

FeOx magnetization enhancing E. coli inactivation by orders of magnitude on Ag-TiO2 nanotubes under sunlight

“…2 shows that the amount of Fe-ions released was far below the cytotoxicity levels for Fe(II)Fe(III) ions [40,41]. The small dissolution of the nanotube surface in the presence of bacteria has been reported due to the presence of Fe 3+ -siderophores presenting a big affinity for Fe and ability to chelate Fe-ions [42,43]. The oxygenated solution in Fig.…”

Evaluation of an alternative chromogenic method for the detection and enumeration of enterococci in waters

“…Importantly, with the alternative method only one medium and a rapid test for target bacteria confirmation were necessary. This full procedure requires only 24 h to produce results, in contrast with ISO 7899:2 that takes 48 h and uses two expensive culture media, containing sodium azide, an inhibitor highly harmful to health (Chang and Lamm, 2003;Demircan et al, 2011). Moreover, the chromogenic method can be used for the examination of several types of water samples, such as potable, industrial, and recreational waters, showing a good selectivity and a high efficiency.…”