[Acute lethal respiratory distress syndrome after accidental immersion in mineral oil]

Short-term adverse effects in humans of ingested mineral oils, their additives and possible contaminants--a review

The toxicological databases for petroleum refinery products such as mineral oils, as well as for their potential contaminants and additives, were reviewed for human cases of poisoning by the oral route. The aim was to determine whether any overlooked adulterant in the oil implicated as the cause of the 1981 outbreak of Toxic Oil Syndrome (TOS) in Spain, may have been responsible for the unusual symptomatology characterizing this disease. The essential features of TOS were peripheral eosinophilia, pulmonary oedema and endothelial damage in the acute phase; myalgia, sensory neuropathy, hepatic injury, skin oedema and sicca in the intermediate phase; and peripheral neuropathy, muscle wasting, scleroderma and hepatopathy in the chronic phase. Of the more than 70 chemical entities and mixtures reviewed here, none had been reported as producing adverse toxic effects upon ingestion resembling the specific set of symptoms and progression that characterized TOS. Because of their viscosity, the most commonly recorded disease process associated with oral ingestion of petroleum refinery products was lipid pneumonia, implicating lung exposure via aspiration. The mineral oil additives and contaminants comprised a highly diverse range of chemical entities, producing a variety of symptoms in instances of poisoning. Specifically, no chemical entity amongst the refinery products, additives or contaminants was described as inducing a syndrome involving vasculitis accompanied by thrombotic events, along with immunological consequences (such as T-lymphocyte activation and cytokine release), as is considered to be the cellular basis of TOS.

Severe lipoid pneumonia following attempted suicide by mineral oil immersion

Following an attempted suicide by drowning in a vat of mineral oil, a previously fit man survived the usually fatal lipoid pneumonia resulting from total immersion after intensive support and prolonged steroid therapy with recovery of chest radiography and pulmonary function at one year.