HYDROGEN-SULFIDE POISONING

Poisoning by hydrogen sulfide has been recognized as an occupational hazard lor at least two centuries. The tlvwlopmenl oi alternative sources ol energy in North America may increase the incidence ol this medical emergency in the future. Until recently, no specific antidote lo sulfide was recognized. We have compared sullide poisoning to cyanide poisoning and documented recent findings that indicate many similarities between the two. The therapeutic induction ol mcthemoghbincmia, as by the intravenous administration oi sodium nitrite, has both protective and antidotal effects against sulfide as well as against cyanide in laboratory animals. This procedure has hocn used successfully in at least one severe human oi.se ol wlikle poisoning. Industries at risk should he prepared to initiate this form oi therapy in addition to the usual measures for cardiopulmonary resuscitation. No evidence exists to suggest that sullide. poisoning results in an im-imment ol the oxygen transport capability oi blood. On ific other hand, some victims oi hydrogen sullide poisoning exhibit Irank cyanosis, suggesting that the respiratory trad distinction is more common in this condition than is morally recognized. Suction ol the upper tract and the administration of oxygen may be important ancillary procedures to the administration ol sodium nitrite. © 1979 The American College of Occupational and Environmental Medicine.