We urge the Occupational Safety and Health Administration to adopt workplace standards for the maximum ambient air concentrations for propionitrile.This memo is in response to your correspondence of April 27, regarding updated information on Cyanide Antidote Kits since my August, 1986 letter.Īs per my 1986 memo, Amyl Nitrite continues to require a physician's prescription and the administration of this drug in an emergency situation by the designated first aide responder is the medically accepted initial response.

Because of continued endogenous generation of cyanide from the metabolism of the parent compound, hyperbaric oxygen may be a valuable adjunctive therapy to consider, in addition to the immediate use of the cyanide antidote kit, in cases of poisoning by propionitrile or other substituted nitrile compounds.

In occupational situations in which workers exhibit rapidly progressive symptoms of headache, dizziness, collapse, and coma, and where substituted nitriles are known to be on site, acute cyanide poisoning should be strongly considered. The ambient concentration of propionitrile in air samples at the work site shortly after the exposure was 77.5 μmg/m³. His measured blood cyanide concentration was 3.5 μg/ml. The second victim, who complained only of nausea, dizziness, and headache and who never lost consciousness, was treated with sodium nitrite/sodium thiosulfate. Continued symptoms were treated with hyperbaric oxygen at 2 atmospheres for a total of 4 hours. He responded to sodium nitrite/sodium thiosulfate therapy by regaining consciousness. One victim was comatose, acidotic, and hypotensive his blood cyanide level was later measured at 5.0 μg/ml. We report two workers at an organic chemical manufacturing plant who were overcome by fumes while treating a waste slurry into which unreacted propionitrile was discharged by mistake.

However, there are few reports of human intoxication involving propionitrile. Propionitrile, a substituted aliphatic nitrile commonly used in the chemical manufacturing industry, is capable of generating cyanide.

Lilly cyanide antidote kit