Chapter 193

Hydrocarbons are a diverse group of organic compounds consisting primarily of carbon and hydrogen atoms. The two basic forms of hydrocarbons are aliphatic (straight- or branched-chain) and cyclic configurations. Halogenated (halogen group) and aromatic (benzene ring) hydrocarbons are two examples of aliphatic and cyclic hydrocarbon subclassifications, respectively. Products containing hydrocarbons are found in many household and occupational settings (Table 193-1).

Table 193-1 Common Products That Contain Hydrocarbons

Most hydrocarbons are produced by petroleum distillation, which results in predominantly aliphatic mixtures of hydrocarbons of different chain lengths. Chain length and branching determine the phase of the hydrocarbon at room temperature. Short-chain aliphatic compounds (up to 4 carbons), such as methane, ethane, propane, and butane, are gases; intermediate-chain aliphatic compounds (5 to 19 carbons), such as solvents, lamp oil, lighter fluid, and gasoline, are liquid; and long-chain aliphatic compounds (>19 carbons), such as waxes, are solids. Liquid hydrocarbons account for most exposures seen in the emergency department.1

Exposures to hydrocarbons and volatiles most commonly occur as ingestions or inhalations. Most hydrocarbon exposures have a benign clinical course. During 2008, the American Association of Poison Control Centers’ Toxic Exposure Surveillance System received reports of 46,418 exposures to hydrocarbons.1 Significant toxicity was uncommon; only 2267 patients experienced moderate or major effects. There were 17 deaths where hydrocarbons were mentioned; 13 of which were isolated exposures to a hydrocarbon. Ingestions were more likely than inhalation to produce serious toxicity. Hydrocarbon aspiration accounts for 20% of aspiration accidents in children <5 years of age.2 Pulmonary symptoms and signs develop in 40% to 50% of the children who ingest hydrocarbons.3–5 Rare cases of suicidal injection of gasoline or kerosene with severe multi-organ toxicity have been reported.6,7

Volatile solvent abuse most often occurs in teenagers and younger adults, especially those in lower socioeconomic groups, who abuse volatile liquid chemicals or gases for the euphoric effects (Table 193-2).8 Hydrocarbons can be abused in different ways: (1) in “huffing” the individual soaks a rag with the inhalant and then places it ...

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