Occupational doctor: What to do on learning through an employee or the director that new chemical products are being used?

What can and what must a company doctor do on learning through an employee or the director that new products are being used?

He or she must take action at once, especially since a skull on the label frightens users.
There is no Material Safety Data Sheet, “It should arrive tomorrow!”
Don’t panic! The occupational physician knows the chemical name, even the CAS number and its proportion in the commercial product.

Thanks to this data, the doctor will be able to define the toxicity of the product (when ingested, inhaled or touched), as well as the precautions to be taken. With this information, the appropriate first aid treatment can be found.

Example n°1

There is a commercial product X that contains:

• 21 % of ISOOCTYL ACRYLATE

The labelling specifies that this product is an IRRITANT. Other associated products are not labelled.
Thus, I can deduct from this that the other products, which are unknown, are not dangerous products that have to be labelled according to the EC legislation.
I can focus on ISOOCTYL ACRYLATE. I am in possession of its CAS n°. It enables me to know that this product is an IRRITANT ( at a concentration level equal or above 10 %) for the eyes, the respiratory tract and the skin (R 36, 37, 38).
Moreover, I can learn from other risk sentences that this product is very toxic for aquatic organisms (R 50) and that, in the long term, it can lead to harmful effects for the aquatic environment (R 53).
Thus, I can immediately make it compulsory to wear protection, glasses, gloves, mask according to its use (dusts, liquids, vapours, etc.).
It is necessary and even compulsory, to have a shower room or eyewash according to the contamination risk (wide area, splashes of thin droplets, heated up or not product, ventilation). As a result, the nursing/medical care that will follow:

• Immediate washing with the DIPHOTERINE® solution or, failing that, with water,
• Evacuation from the smoke-filled premises or just the decision to increase ventilation by opening the windows,
• HOSPITALIZATION by ambulance in case of massive poisoning.

Concerning massive inhalation, in case of doubt, bronchial and pulmonary complications may be feared: order the subject to rest.

Example n°2

The 2nd product discovered is more worrying since we can see the SKULL and crossbones on the label. It can be:

Simply a question of a product which is:

• a TOXIC product
• or VERY TOXIC

or linked to the fact that it is CARCINOGENIC cat 1 & 2 (R 45 – 49) or MUTAGENIC cat 1 & 2 (r 46) or TOXIC for reproduction cat 1 & 2 (R 60 – 61).
The first step of the occupational health physician remains the same as the one described in the first example:
He or she has to know the name of the chemical product responsible for this labelling, its proportion and its association with other toxic, noxious, corrosive, irritant products that can require other specific precautions.

In this example, it is question of DINITROTOLUEN with a concentration of 1, 5 % to which is associated a 12% concentration of 5-BROMO-8-NAPHTOLACTAME.

Thanks to the CAS number, I know that with this concentration, it is sensitizing by skin contact.
This information enables me to infer that it is compulsory to take this element into account, common sense enabling me to say that the effects of the CMR product will be worse if there are already injuries…

Thanks again to the chemical name or the CAS n°, I learn that DINITROTOLUEN is noxious in case of ingestion at a concentration level equal or above 25 %, an effect that also has to be taken into account for the assessment of the toxicity. The EC general classification shows that it is CARCINOGENIC cat 2 (R45), MUTAGENIC cat 3 (possibility of irreversible effects) & TOXIC for reproduction cat 3 (R 62) (potential risk of deterioration of fertility).

So, this product is CARCINOGENIC (strong presumption), which justifies the fact that this product has to be the subject of research planning to replace it, that the employees have to be trained in the use of protective gear, etc.
Taking into account the other potential effects (mutagenic, toxic for reproduction), pregnant women must be assigned to other jobs and all the women of child-bearing age must be warned about the obligation to inform the company doctor as soon as possible about a potential pregnancy.

To sum up, reading and interpreting labelling enables one, in case of emergency, to know the risks according to the conditions of use and to quickly implement a safety and first aid program even if the chemical is not known. Of course, the company doctor should use all documentation available (OSHA’s or NIOSH’s documents or others data banks) to more precisely define the chemical concerned.

Dr Danièle Henny – Occupational health doctor – Uploaded on the 26th of May 2008