title: Hydrogen sulfide poisoning: clarification of some controversial issues.
abstract: BACKGROUND
  Hydrogen sulfide is a toxic gas about which much has been written. We discuss here several issues we believe would benefit from further clarification.
  
  
  CONCLUSIONS
  We conclude that: 1) Certain neurotoxic effects of exposure are probably due to a direct toxic effect on the brain, while others are almost certainly a result of hypoxia secondary to H2S-induced respiratory insufficiency; 2) pulmonary edema is a common consequence of poisoning and there is suggestive evidence of hyperactive airway responses in some individuals following brief H2S-induced unconsciousness (knockdown); 3) criteria for acceptable community levels are very different than those governing occupational standards; 4) urinary thiosulfate determinations can be useful for monitoring occupational exposure; and 5) determination of sulfide ion concentrations in blood or major organs can be useful in corroborating a diagnosis of fatal H2S toxicity, but there are many pitfalls in collecting, storing, and analyzing tissue and fluid samples.
authors.affiliation: Chemical Toxicology Institute, Foster City, California, USA. tmilby@aol.com
authors.forename: T H
authors.initials: TH
authors.lastname: Milby
authors.forename: R C
authors.initials: RC
authors.lastname: Baselt
mesh_terms: D000393:Air Pollutants / Q000506:poisoning*; D001921:Brain / Q000187:drug effects; D016535:Bronchial Hyperreactivity / Q000139:chemically induced; D004777:Environment; D006801:Humans; D006862:Hydrogen Sulfide / Q000506:poisoning*; D000860:Hypoxia / Q000139:chemically induced; D016273:Occupational Exposure; D011654:Pulmonary Edema / Q000139:chemically induced; D012131:Respiratory Insufficiency / Q000139:chemically induced; D013440:Sulfides / Q000097:blood; D013885:Thiosulfates / Q000652:urine; D014474:Unconsciousness / Q000139:chemically induced
chemical_list: D000393:Air Pollutants; D013440:Sulfides; D013885:Thiosulfates; D006862:Hydrogen Sulfide