Side Effects of Hydrazine Exposure
Hydrazine exposure can cause significant toxicity including mucosal irritation, pulmonary injury, neurological symptoms, elevated liver enzymes, and rhabdomyolysis, requiring prompt decontamination and supportive care.
Common Side Effects
- Respiratory symptoms are among the most common manifestations, including dyspnea, throat irritation, and cough 1
- Ocular irritation and headache are frequently reported following hydrazine exposure 1
- Elevated muscle enzymes (CPK) can occur even after brief exposures, with levels potentially rising dramatically (up to 20,960 U/L) within 36 hours of exposure 2
- Liver enzyme abnormalities (elevated SGOT/SGPT) may develop even in asymptomatic individuals 2
Severe Toxicity
- Significant soft tissue injury can occur even with exposure to small amounts of hydrazine 3
- Pulmonary injury ranging from irritation to more severe damage may develop following inhalation 3, 1
- Neurological manifestations can include seizures and coma in cases of significant exposure 3
- Death can occur in severe cases, though this is rare with prompt decontamination and treatment 3
Exposure Routes
- Inhalation is the most common route of occupational exposure, particularly in aerospace and military settings 1
- Dermal absorption can occur through direct contact with liquid hydrazine 4
- Ingestion of contaminated water or swallowing contaminated dust are potential exposure routes in environmental settings 4
Long-Term Concerns
- Hydrazines have been classified as possible carcinogens by multiple agencies including the EPA, DHHS, IARC, and WHO 4
- Animal studies have demonstrated carcinogenic potential following both acute and intermediate-duration exposure via oral and inhalation routes 4
Management of Hydrazine Exposure
- Immediate decontamination is critical and should be the first step in management 5
- For seizures, benzodiazepines (midazolam) should be administered intramuscularly prior to decontamination 5
- After decontamination, provide supplemental oxygen and consider advanced airway management when indicated 5
- For bronchospasm, administer inhaled beta-agonists (salbutamol/albuterol) 5, 1
- High-dose intravenous pyridoxine has been suggested for hydrazine-related neurologic toxicity, though this recommendation is based on limited human data 3, 5
- Laboratory monitoring is important even in asymptomatic patients, particularly for liver function tests and CPK levels 2
Special Considerations
- Most patients (57%) remain asymptomatic following exposure, but should still undergo decontamination and observation 1
- The majority of patients with mild symptoms recover quickly and can be released after brief evaluation 1
- Delayed symptoms are uncommon after initial evaluation 1
- Contrary to historical concerns about severe toxicity, recent data suggests that occupational exposures in aerospace settings typically result in milder symptoms than previously expected 1