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ACUTE EXPOSURE INFORMATION

1. USES: Carbon disulfide is a volatile organic solvent used most commonly in the rubber industry, but used in a variety of laboratory settings. It is also a metabolite of disulfiram and other dithiocarbamates.

2. TOXICOLOGY: Acute topical exposure can cause topical irritation to skin and mucosa and, in severe cases, full thickness burns. It can also cause a defatting injury. Short term inhalation exposures can present with headache, nausea, vomiting, and dizziness. It can initially cause central nervous system excitement followed by CNS depression. Chronic exposure can lead to parkinsonian effects, ototoxicity, visual impairment and optic neuritis, peripheral neuropathy, and hepatotoxicity. It has also been associated with male infertility.

3. EPIDEMIOLOGY: Exposure to carbon disulfide is common in certain industries. Toxicity is most common after inhalation, but can occur with topical exposure or ingestion. However, with proper personal protective equipment (PPE) regulations, severe toxicity is uncommon/rare, but deaths have been reported.

4. WITH POISONING/EXPOSURE
   1. MILD TO MODERATE TOXICITY: Mild toxicity from topical exposures consists of skin, eye, and mucosal irritation. Patients can develop dizziness, headache, fatigue, nervousness, restlessness, and nausea and vomiting after inhalation.
   2. SEVERE TOXICITY: CNS excitation (seizures) and depression (coma) can occur. Agitation, delirium, hallucinations, tremor, muscle spasticity, and psychosis can also develop. Cardiopulmonary effects can include dyspnea, dysrhythmias, respiratory failure, and cardiovascular collapse. Long-term severe toxicity may result in a parkinsonian-like syndrome (speech disturbances, spasticity, tremor), neuropathy, fatigue, and irritability. Severe topical exposures can result in vesicular formation, and possibly partial and full thickness burns. Ingestion of small amounts can cause respiratory failure, mydriasis, tremors, seizures, coma, and death.
   3. CHRONIC: Chronic exposures can produce permanent central and peripheral nervous system damage. Other consequences include atherosclerotic tendencies, ECG abnormalities, gastrointestinal disturbances, fatty degeneration of the liver (with jaundice), renal damage, fatigue, memory loss, insomnia, melancholia, mania, hallucinations, increased suicide rate, sexual dysfunction, cranial nerve damage, hearing loss, visual disturbances, altered pupillary reaction to light, retinal microaneurysms, optical, otic, and peripheral neuropathies, loss of reflexes, tremors, and blood dyscrasias.

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