++
Toxicology is the branch of pharmacology that concerns the study, regulation, and treatment of adverse effects in humans resulting from exposure to chemicals encountered at work or in the general environment.
+++
A. Classification and Prototypes
++
The major air pollutants in industrialized countries include carbon monoxide (CO) (which accounts for about 50% of the total amount of air pollutants), sulfur oxides (18%), hydrocarbons (12%), particulate matter (eg, smoke particles, 10%), and nitrogen oxides (6%). Air pollution appears to be a contributing factor in bronchitis, obstructive pulmonary disease, and lung cancer. Air contaminants are regulated in the United States by the Environmental Protection Agency (EPA).
++
CO is an odorless, colorless gas that competes avidly with oxygen for hemoglobin. The affinity of CO for hemoglobin is more than 200-fold greater than that of oxygen. The threshold limit value of CO for an 8-h workday is 25 parts per million (ppm); in heavy motor vehicle traffic, the concentration of CO may exceed 100 ppm. CO is slightly lighter than air but mixes homogeneously in room air.
++
CO causes tissue hypoxia. Headache occurs first, followed by confusion, decreased visual acuity, tachycardia, syncope, coma, seizures, and death. Collapse and syncope occur when approximately 40% of hemoglobin has been converted to carboxyhemoglobin. Prolonged hypoxia can result in irreversible damage to the brain and the myocardium. Exposure of a pregnant woman to elevated CO levels at critical fetal developmental periods may cause fetal death or serious and irreversible but survivable birth defects.
++