At the Laboratory after exposure to toxic cabin air:
After an incident with suspected cabin air contamination it is in your own best interest to compile a complete medical documentation, including diagnosis in case of subsequent medical problems that may require a work related injury record. Therefore:
1. have a complete blood count (CBC), white blood count (WBC) and differential done, plus liver transaminases, creatine kinase with isoenzymes (AChE determination) performed. Also ask for a CO-Hb (Carboxyhemoglobine) determination for forensic purposes and a blood gas analysis/earlobe blood gas analysis including CO-Hb and/or oxygen saturation. Warning: Smoking may impact the measurements.
2. have all symptoms such as of heart rhythm disorders, ECG recording, shortness of breath, lung function disorders examined by specialized medical personal and documented. Make sure to tell them it is in connection with a 'poisoning' by inhalation of Co and other (neurotoxic) gasses.
Body fluid tests should be done straight after, or latest within 48 hours of exposure. At least get the blood drawn and save some samples of blood and urine (see below) and store them in the deep-freeze compartment of your fridge.
After a fumes exposure a large, extensive standard laboratory protocol should be done:
Important: desinfection of the skin area should not be carried out with solvent-containing desinfectants before sample collection, but e.g. with a three-percent aqueous hydrogen peroxide solution. (AMR 6.2); if not available, please note the name of the disinfectant used.
Metabolic parameters such as cholesterol and sugar can be omitted.
Carbon monoxide-saturated hemoglobin for forensic purposes. > Important: This measurement must be taken on the day of the event, since the half-life is only 245 minutes and therefore the values may be back to normal the following day.
AChE > this measurement should not be an issue in a larger clinic/emergency room/university hospital and should also be done on the same day. Preferably previous measurements without exposure are available for comparison.
Further tests to be done:
In addition, 2x 30 ml EDTA blood should be taken in clinical chemistry tubes and stored in the deep-freezer for further ( later) toxicological analyses . 3 urine samples on the first day, then over the next 5 days one per day, also to be stored in freezer – special sterile cups can be optained in pharmacies, if not possible, use clean, closable bottles/cups/containers
Long-term effects of neurotoxicity can be
Fatigue, memory, concentration and speech disorders. Symptoms must be continuously documented and medically treated. A diary with copies of findings should be kept.
For long-term effects after 30 days: test for
When pneumatic tests become necessary:
It is possible to have so called BIO-MONITORING done after fumes exposure. These substances could be present:
In the blood:
In the urine:
Worn uniform shirts/blouses (also ties): do not wash, fold well and place it in an airtight packing. Pack samples separately. They can be tested for engine oil, hydraulic oil and glycol residues at various laboratories if necessary.
Additional possible tests:
Determination of organophosphate exposure and injury to the nervous system by Professor M. Abou-Donia:
Documentation of details:
> Time (if necessary with time zone)
> Type and extent of the fume event (smell?)
> Complaints/ symptoms
> Record the time of sampling of urine, blood, etc.
Send samples to a trusted laboratory in an uninterrupted frozen condition (e.g. on lots of dry ice in a styrofoam box).
*Samples for the Auto Antibodies Test must be taken and stored in a specific way. Information via email .