Biomedical Engineering Reference
In-Depth Information
sponginess were noted in optic chiasma. Severe renal tubular degener-
ation and necrosis were seen in all cases (Mittal et al., 1991).
In a recent large outbreak of methanol poisoning in Estonia, 154
people were reported to have consumed methanol. A total of 66
individuals died including 43 that did not try to get treatment. Eighteen
of the survivors suffered from impaired vision and three had permanent
brain damage. Treatment in five community hospitals was limited to
ethanol, bicarbonate, and ventilation (some by hand) and dialysis in
tertiary care centers (Paasma et al., 2007). In a six-year follow up to this
study, in addition to the 21 patients that were reported initially to have
permanent damage, new neurological effects were found in another
eight of these patients. Vision complications were noted in eight other
former patients that showed no permanent effects of methanol poison-
ing 6 years earlier. Many former patients had died (Paasma et al., 2009).
This outbreak illustrates that methanol poisoning of large populations
can still be a problem where medical care is limited.
In an individual found dead after consuming methanol, the kidney
had the highest level of methanol (5230mg/kg) followed by the liver,
vitreous humor, heart, pericardial fluid, and blood (2840mg/l) (Pla
et al., 1991).
In a study of four people, who ingested methanol copying fluid, three
reported nausea, abdominal pain, hypokalemia acidosis, and two had
ocular findings (they had the highest serum formate concentrations)
12-24 hours later. Hemodialysis was used as a treatment if blood
methanol levels were elevated. The authors concluded that increased
blood formate was correlated with clinical signs, but blood methanol
was not (Osterloh et al., 1986).
There are other reports of mass methanol poisoning in the literature
with similar results. A good recent review of some of these studies is
found in American Academy of Clinical Toxicity Practice Guidelines
on the Treatment of Methanol Poisoning (Barceloux et al., 2002).
The American Association of Poison Control Center reports on
average over 2000 potential cases of methanol intoxication in the recent
years. About 10% (
200 individuals) had major clinical signs of
methanol toxicity and mortality was seen in about 0.5% (
10 individ-
uals). A few of the deaths are considered suicides (Litovitz et al., 2001).
