Human Health Effects:
Human Toxicity Excerpts:
... A CENTRAL NERVOUS STIMULANT ... LINDANE HAS HIGHEST ACUTE TOXICITY /OF BHC
ISOMERS/; ITS LETHAL DOSE IS PERHAPS 125 MG/KG. ... FEW HUMAN FATALITIES HAVE
BEEN ASCRIBED TO ... LINDANE, BUT MANY
NONFATAL POISONINGS HAVE BEEN REPORTED. IN U.S. MANY OF THESE ... OCCURRED IN
CHILDREN WHO SWALLOWED LINDANE PELLETS
INTENDED FOR USE IN VAPORIZERS. ... WITHIN 30 MIN AFTER INGESTING AN EST 1.5 G
LINDANE, A 2.5 YR OLD GIRL EXHIBITED
IRRITABILITY & GRAND MAL CONVULSIONS. WITH SUPPORTIVE CARE SHE RECOVERED
WITHIN 24 HR. SERUM LEVELS OF LINDANE
WERE HIGH INITIALLY BUT FELL RAPIDLY. CONSIDERABLE AMT WERE RECOVERED IN 1ST
STOOL SAMPLES.
... REFRESHMENT STAND OPERATORS SUFFERED SEVERE HEADACHE, NAUSEA, &
IRRITATION OF EYES, NOSE, & THROAT SHORTLY AFTER EXPOSURE TO VAPORS FROM A
DISPENSER IN WHICH LINDANE ... BECAME
OVERHEATED. SYMPTOMS ABATED 2 HR AFTER DEVICE WAS REMOVED. ... WOMAN ...
DEVELOPED URTICARIA SOON AFTER VAPORIZER WAS INSTALLED IN HER PLACE OF
EMPLOYMENT. DERMATITIS IMPROVED DURING WEEKENDS BUT RECURRED WHEN SHE RETURNED
TO WORK. ... COMPLETE RECOVERY FOLLOWED REMOVAL OF VAPORIZER.
Chronic exposure to vapors of ... /lindane/ has resulted in fatal aplastic anemia
& other hematologic disorders. These adverse effects have not been reported
following use of 1% lindane lotion,
cream, or shampoo.
DERMAL APPLICATION OF 1% LOTIONS OF LINDANE (KWELLADA), FOR TREATMENT OF SCABIES
RESULTED IN SEVERE INTOXICATIONS IN SOME CHILDREN & INFANTS. MARKED MENTAL
& MOTOR RETARDATION ... NOTED 2 DAYS AFTER TREATMENT IN 4 MO OLD CHILD.
LOCAL APPLICATION OF 1% ... PROVED PARTICULARLY DANGEROUS FOLLOWING HOT SOAPY
BATH, SINCE THIS INCREASED PERCUTANEOUS ABSORPTION OF THE CMPD. ACCIDENTAL
INGESTION BY 1 YR OLD BOY OF 1 TEASPOON OF 1% LINDANE SOLN, IN ADDN TO LOCAL APPLICATION OF
THIS SOLN ... RESULTED IN IRRITABILITY, HYPERACTIVITY, & VOMITING, FOLLOWED
BY RECOVERY. ...
A 2 MONTH OLD, 4.5 KG, MALE INFANT WAS FOUND DEAD IN HIS CRIB AFTER EXCESSIVE
APPLICATION OF 1% LINDANE LOTION. IT WAS
IDENTIFIED IN BRAIN AT CONCN OF 110 PPB WHICH WAS 3 TIMES GREATER THAN LEVELS
FOUND IN BLOOD.
SIXTY MALE WORKERS BETWEEN 24 & 62 YR OLD EMPLOYED 1 TO 30 YR IN LINDANE PRODUCING FACTORY WERE EXAMINED WITH
REGARDS TO FUNCTIONS OF NERVOUS SYSTEM IN COMPARISON WITH 2 EXTERNAL CONTROL
GROUPS (20 CLERKS & 20 DAIRY WORKERS OF SAME AGE DISTRIBUTION) HAVING NO
CONTACT WITH HAZARDOUS SUBSTANCES. NO SIGNS OF NEUROLOGICAL IMPAIRMENT OR
PERTUBATION OF "NEUROMUSCULAR FUNCTION" COULD BE ASCERTAINED.
... Therapeutic doses used in treatment of scabies have been found to have
neurotoxic & other effects (ie, nausea, convulsions, cyanosis). Ingestion of
large (unspecified) doses has led to muscle & kidney necrosis &, in 1
case, to pancreatitis. Digestive tract inflammation, hemorrhage, coma, &
death have been reported after lindane
poisoning.
CONCN OF 5-10 UG/ML LINDANE INHIBITED
CELL DIVISION IN HUMAN PERIPHERAL BLOOD LYMPHOCYTES IN VITRO & CAUSED
CONCENTRATION-RELATED INCR IN FREQUENCY OF CHROMATID BREAKS. IN SV40-TRANSFORMED
HUMAN FIBROBLASTS (VA-4), 1 OR 1000 UMOLAR LINDANE FAILED TO INDUCE UNSCHEDULED DNA
SYNTHESIS ... IN PRESENCE OR ABSENCE OF RAT LIVER MICROSOMAL ACTIVATION SYSTEM.
Toxic concn of lindane found in human
blood: 0.050 mg % or 0.50 ug/ml.
Kwell, a pediculicide for external use, contains a solid organochlorine, 1%
lindane (BHC). In six months, ... five
cases of accidental ingestions of Kwell /have been treated/. Case #1 occurred in
a mental institution, #2 and #3 involved misunderstanding by a Spanish speaking
mother and #4 and #5 were a mother and child who mistook Kwell for a bottle of
cough syrup. The first case was given ipecac but seized while vomiting and
aspirated, seized several more times and arrested. He suffered anoxic brain
damage when resuscitated, developed rhabdomyolysis and died in one week. Treated
with cholestyramine, his BHC blood level fell from 1.3 mg/l to 0.11 mg/l on the
fifth day. BHC tissue levels were measured at autopsy. /Cases/ #2, #3, ingested
30 to 60 ml each, #3 seizing initially was not given ipecac. Their BHC levels
were 0.22 and 0.48 mg/l, respectively. Cases #4 and #5 took a teaspoon each and
were managed at home with poison center /consultation/.
The rapidity with which symptoms develop after the ingestion of BHC varies
with the isomer: the gamma isomer is fastest (within 1 hr) and the alpha isomer
/is the slowest/ (within 24 hours), and the technical or commercial mixture is
intermediate (usually within 2 hours but sometimes as late as 12 hours). Death
from the pure gamma isomer is usually prompt (24 hr), whereas from the others it
may be several days.
QUANTITATIVELY, THE ACUTE TOXICITY ... IS SOMEWHAT GREATER THAN THAT OF
TECHNICAL BENZENE HEXACHLORIDE.
CHRONICALLY, HOWEVER, THE TECHNICAL BENZENE HEXACHLORIDE IS SOMEWHAT MORE TOXIC
THAN LINDANE.
Target organs /include/: Eyes, CNS, blood, liver, kidneys, and skin.
Lindane is a convulsant.
The use of thermal vaporizers with lindane has caused acute poisoning by
inhalation.
The gamma (lindane) and alpha isomers
are central nervous system stimulants.
Lindane levels in human blood and
placental and fetal tissues are higher in cases of spontaneous abortion and
prematurity than in normal-term pregnancies. Tissues from stillborn babies show
the same range of lindane values as
adult tissues.
... lindane crosses the placenta, is
excreted in human breast milk, and may be fetotoxic.
Lindane used in malaria control in
India in 1975-77 caused no skin and coordination problems in 464 sprayers, nor
did it cause higher SGPT and serum alkaline phosphatase activities or serum
whole cell counts relative to 201 controls. ... Serum protein concentration was
affected, as was serum glucose.
In the biopsy report of one man who had eaten lindane-contaminated foods and who had
experienced grand mal seizures for 2 hr, /observers/ described widespread muscle
necrosis that followed acidemia, hypertension, myoglobinuria, anemia, and acute
renal failure.
Skin, Eye and Respiratory Irritations:
VAPORS MAY IRRITATE EYES, NOSE, & THROAT.
Drug Warnings:
IN PATIENTS, ATTEMPTS TO TREAT BLEPHARITIS & DEMODEX FALLICULORUM OF LIDS
... HAVE CAUSED EXCESSIVE IRRITATION OF EYES, EVEN WHEN CONCN AS LOW AS 0.1%
WERE EMPLOYED IN COMBINATION WITH TOPICAL CORTICOSTEROIDS. ... KWELL OINTMENT
CONTAINING 1% LINDANE HAS CAUSED
CONJUNCTIVITIS WHEN APPLIED TO EYELASHES. AS DUST, LINDANE ... CAUSED IRRITATION OF EYES &
RESPIRATORY PASSAGES IN PARTICULARLY SENSITIVE INDIVIDUALS.
THE DRUG IS HIGHLY TOXIC & MUST BE USED WITH CARE. IT IS IRRITATING TO
MUCOUS MEMBRANES & SHOULD NOT BE PERMITTED TO COME IN CONTACT WITH THE EYES.
THE PRESENCE OF SECONDARY INFECTION DOES NOT INTERFERE WITH ITS USE.
Allergic contact dermatitis has not been documented, but irritant contact
dermatitis has been reported when ... applied excessively, too frequently, or
for extended periods.
LINDANE APPLICATIONS SHOULD NOT BE
ADMIN TO PREGNANT WOMEN, SMALL INFANTS OR INDIVIDUALS WITH EXTENSIVELY
EXCORIATED SKIN. PATIENTS OF ANY AGE SHOULD NOT RECEIVE MORE THAN 2 COURSES OF
TREATMENT WITHIN A MONTH, & EACH COURSE SHOULD INCL ONLY 2 APPLICATIONS AT
LEAST 1 WK APART. IT SHOULD NOT BE APPLIED AFTER A HOT BATH. CREAM OR LOTION
SHOULD BE REMOVED BY BATHING AFTER 6 HR. IT SHOULD BE THOROUGHLY WASHED OFF
SCROTAL SKIN. INFANTS MUST BE PREVENTED FROM LICKING CREAM OR LOTION FROM SKIN.
FOR INFANTS & PRESCHOOLERS ALTERNATIVE DRUGS INCL CROTAMITON, BENZYL
BENZOATE & SULFUR.
Lindane should be used with caution
in pregnant or nursing women since the drug can be absorbed systemically
following topical application. The Centers for Disease Control (CDC) currently
states that lindane is not recommended
for use in pregnant or nursing women.
Resistance to lindane may develop in
strains of Pediculus capitis /causative organism of scabies/.
Medical Surveillance:
A complete history and physical examination: The purpose is to detect
pre-existing conditions that might place the exposed employee at an increased
risk from exposure. Examination of the eyes, central nervous system, blood,
liver, and kidneys should be stressed. The skin should be examined for evidence
of chronic disorders. Lindane may cause
aplastic anemia; A complete blood count should be performed, including a red
cell count, a white cell count, and a differential count of a stained smear, as
well as a hemoglobin and hematocrit. The concentration of lindane in the blood is an indication of the
extent of absorption. ... Medical examinations should be repeated on an annual
basis.
WHOLE BLOOD: The assessment of gamma-HCH exposure can be accomplished through
measurement of gamma-HCH. Reference ranges: Normal - None detected; Exposed -
BAT (gamma HCH) (sampling time is end of exposure or end of shift): 20 ug/l;
Toxic - Not established. /Hexachlorocyclohexane/
SERUM OR PLASMA: The assessment of HCH exposure can be accomplished through
measurement of the individual HCH isomer. The level of gamma-HCH is considered
only to reflect recent exposure. Limited information was located which
demonstrated a correlation between gamma-HCH serum levels and the onset of
adverse health effects. Beta-HCH levels, however, have been shown to reflect
both intensity and duration of exposure and can be used to assess past or recent
exposure. Reference Ranges: Normal - gamma-HCH: none detected; Exposed - BAT
(gamma-HCH) (sampling time is end of exposure or end of shift): 25 ug/l. Levels
of beta-HCH have been found to increase approximately 10 ug/l for each year of
exposure to beta-HCH air concentrations ranging from 0.001 to 0.38 mg/cu m;
Toxic - Not established. /Hexachlorocyclohexane/
URINE: The assessment of HCH exposure can be accomplished through measurement
of the phenolic metabolites of gamma-HCH, including pentachlorophenol. However,
exposure to chlorobenzene can result in the appearance of some of the same
metabolites as those seen with HCH exposure. In addition, detection of
pentachlorophenol in the urine may also be an indication of exposure to
pentachlorophenol or other compounds that are similar to gamma-HCH. Reference
Ranges: Normal - not established; Exposed - not established; Toxic - not
established. /Hexachlorocyclohexane/
OTHER TISSUES: The assessment of HCH exposure can be accomplished through
measurement of the HCH isomers in adipose tissue. This test may be useful for
identification of exposure, but it has not been shown to be useful for
predicting adverse health effects. Levels of beta-HCH in adipose tissues have
been found to be approximately 300 times higher than blood levels. /Hexachlorocyclohexane/
Populations at Special Risk:
LINDANE SHOULD NOT BE USED TO TREAT
PREGNANT WOMEN, SMALL INFANTS OR INDIVIDUALS WITH EXTENSIVELY EXCORIATED SKIN.
Preclude from exposure individuals with liver, or kidney /diseases/.
Formulators, distributors ... and agricultural workers.
Probable Routes of Human Exposure:
Inhalation ... eye contact ... /dermal exposure/.
Air samples collected within a South Florida formulating plant and storage
shed in 1974 contained 2082.0 and 1.1 ng/cu m lindane, respectively(1).
NIOSH (NOES Survey 1981-1983) has statistically estimated that 9,509 workers
(3,162 of these are female) are potentially exposed to lindane in the US(1). The NOES Survey does not
include farm workers. Occupational exposure to lindane may occur through inhalation of dust
particles and dermal contact with this insecticide during or after its
application or at workplaces where lindane is produced(SRC). The general
population may be exposed to lindane via
inhalation of ambient air, ingestion of contaminated food and drinking water, or
dermal contact with medicinal products containing this insecticide(SRC). Infants
may be exposed lindane via ingestion of
contaminated breast milk(SRC).
Body Burden:
In a cross-sectional study serum hexachlorocyclohexane (HCH) residues were
studied in 64 employees of a pesticide manufacturing plant in India. The control
group was made up of 14 workers with no occupational exposure to HCH. No
quantitative information is provided on exposure levels. Duration of exposure
ranged from 0-30 yr. Serum HCH concentrations were estimated by quantifying
alpha, beta, gamma, and delta isomers with gas-liquid chromatography (GLC). The
range of total HCH residues in the sera studied was 0.143-1.152 ppm. Total HCH
residue levels and also the values for the alpha, beta, and gamma isomers in the
exposed group were significantly higher than the respective values in the
controls (p<0.01). Maintenance workers had mean serum levels 3 times higher
than controls (0.1436 ppm versus 0.0514 ppm controls). Mean HCH serum levels
were 5 times higher than controls in plant operators and supervisors (0.2656 ppm
versus 0.0154 ppm controls). The maximum concentration of total serum HCH was
obtained in those directly handling and packing the insecticide. The mean serum
HCH level (0.6040 ppm) in this group was 12 times that of the controls.
Lindane was detected in the blood of
12.5% of male formulators in Weld County, CO in 1968 at concns ranging from 7 to
23 ppb, mean 16.8 ppb; it was detected in 1 of 87 blood samples from female
formulators at a concn of 5 ppb(1). Lindane was detected in 86.6% of 142 blood
samples from persons living in the Jackson and Mississippi delta areas in 1973
to 1974 at concns ranging from 0 to 5 ppb, 0.99 ppb mean(2); in 94% of 199 blood
samples from Spain at a mean concn of 0.066 ppb(3); and in 8.3% of 497 blood
samples from persons living in Virginia at concns ranging from 1 to 17 ppb, mean
3.5 ppb(3). It was detected in 3% of 59 samples of human milk from Alberta,
Canada in 1966 to 1970 at concns ranging from not detected to 0.340 ppm, 0.006
ppm mean(4); in milk samples from Italy at concns ranging from 0.08 to 0.88
ppm(3); in milk samples from the Netherlands at a median concn of 0.02 ppm(3);
in samples of milk fat from Austria at a mean concn of 0.048 ppm(3); in milk
from Greece at a mean concn of 0.015 ppb (fat basis)(5); and in samples from
Germany at a mean concn of 0.09 ppb (fat basis)(5). Lindane was detected in 90% of 99 fat samples
from Canada at concns ranging from 0.001 to 0.030 ppb, 0.003 ppb mean(6); in 94%
of 52 fat samples from Argentina at a mean concn of 0.09 ppm(3); and in 241 fat
samples from Japan at a mean concn of 0.12 ppm(3). Lindane was detected in fat tissue of 183
healthy children, age 0 to 15.6 years, from Germany from Feb 1985 to Mar 1988 at
a mean concn of 0.038 mg/kg fat tissue, median 0.019 mg/kg fat tissue(7). Lindane was detected in 32.2% of adipose
tissue samples obtained during autopsies in Veracruz, Mexico in 1988 at a mean
concn of 0.58 mg/kg, range 0.13 to 0.69 mg/kg; it was detected in 16.2% adipose
tissue samples collected in 1991 at a mean concn of 0.27 mg/kg, range 0.14 to
0.38 mg/kg(8).
Lindane was detected in whole blood
of occupationally-exposed persons and the general population in India at mean
concns of 0.32 and 0.20 mg/l, respectively; the mean concn of lindane in lipids from occupationally exposed
persons and the general population was 12.00 and 3.54 mg/kg, respectively(1).
Whole blood samples collected from 47 Indian workers involved in spraying hexachlorocyclohexane in 1992 contained lindane at a mean concn of 8.50 ug/l, concns
ranged from not detected to 61.67 ug/l; whole blood samples from the general
population contained lindane at a mean
concn of 1.75 ug/l, concn ranged from not detected to 12.15 ug/l(2). Lindane was detected in blood of neonates from
the Yaqui Valley, Sonora at an avg concn of 0.0430 ug/l; it was detected in
blood from the umbilical cord at a concn of 0.0844 ug/l(3). Lindane was detected in blood serum, breast
milk, and adipose tissue collected from persons living in Delhi, India during
1988 to 1989 at mean concns of 1.12 mg/l, 0.012 mg/l, and 0.09 mg/kg,
respectively(4). Lindane was detected in
breast milk, maternal serum, and umbilical cord serum collected from 25 mothers
and newborns in Delhi, India, at mean concns of 0.084, 0.004, and 0.004 mg/l,
respectively(5). Lindane was detected in
3.3% of adipose tissue samples collected in Ankara, Turkey in 1991 and 1992 at a
mean concn of 0.002 mg/kg extracted fat basis, range not detected to 0.062 mg/kg
extracted fat basis(6). It was detected in 27.9% of adipose tissue samples
collected from Tebriz, Iran in 1991 and 1992 at a mean concn of 0.018 mg/kg
extracted fat basis, range not detected to 0.267 mg/kg extracted fat basis(7).
Lindane was detected in human adipose
tissue samples collected from four areas in Catalonia, Spain at mean concns
ranging from 0.05 to 0.08 ug/g extracted lipid(8). Human adipose tissue samples
collected in Greece during 1995 to 1996 contained lindane at an avg concn of 0.008 ug/g
extractable lipid; the avg concn of lindane in adipose tissue samples from males
was 0.009 ug/g extracted lipid, while the avg concn in females was 0.005 ug/g
extracted lipid(9). Lindane was detected
in human adipose tissue samples collected in Poland between 1989 and 1992 at a
mean concn of 0.074 mg/kg fat, median 0.03 mg/kg fat, max 2.727 mg/kg fat(10).
96% of adipose tissue samples collected from persons living in El Paso, TX
contained lindane at a mean concn of
0.20 ppm(11).
Lindane was detected in human milk
fat samples collected in The Netherlands in 1988 at concns ranging from 0.01
(detection limit) to 0.24 mg/kg(1). Lindane was detected in human milk from the
Yaqui Valley, Sorona at an avg concn of 0.671 ug/g fat basis(2). 15 of 30 human
milk samples collected from Porto Alegre, Rio Grande do Sul, Brazil in 1987 and
1988 contained lindane at concns ranging
from <0.01 to 0.21 ug/g fat, mean 0.02 ug/g fat(3). 104 samples of human
breast milk collected between May 1995 and Dec 1996 from mothers living in Van
province and Manisa province, Turkey contained lindane at mean concns of 0.016 and 0.017
mg/kg fat basis, respectively(4). Lindane was detected (limit of quantitation
0.50 ppb) in 5 of 31 human milk samples collected in Cairo, Egypt in May 1987 at
a mean concn of 0.72 ppb, range 0.50 to 2.70 ppb(5). Lindane was detected in 7 of 31 human milk
samples collected from Kafr El-Zayat, Egypt in 1994 at a mean concn of 2.55 ppb,
range 0.06 to 4.69 ppb(6). Lindane was
detected in 2 of 143 samples of mothers' milk collected in the Kampala City and
Iganga District of Uganda between Oct 1992 and Jan 1993 at concns of 0.87 and
0.01 mg/kg milk fat, respectively(7). Lindane was detected in 80% of 47 human milk
samples collected from lactating women in Ludhiana, Punjab, India at a mean
concn of 0.004 ug/g whole milk basis; it was detected in 91% of 82 human milk
samples collected from lactating women in Faridkot, Punjab, India at a mean
concn of 0.11 ug/g whole milk basis(8). Lindane was detected in 52% of human breast
milk samples collected from 43 mothers living in the Veracruz, Mexico area
between Nov 1994 and March 1995 at concns ranging from 0.001 to 0.082 mg/kg fat
weight, mean 0.022 mg/kg fat weight(9). Lindane was detected in 22 of 59 human milk
samples collected from women living in Amman, Jordan during 1989 and 1990 at a
median concn of 0.23 mg/kg milk fat basis, range 0.06 to 0.50 mg/kg milk fat
basis(10). Lindane was detected in 20 of
20 human milk samples collected in France in 1991 at concns ranging from 8 to
132 ng/g milk fat(11). Lindane was
detected in 46 of 60 samples of breast milk from women in Victoria, Australia at
concns ranging from 0.003 to 0.48 ug/g fat, mean 0.108 ug/g fat(12).
Average Daily Intake:
... US DHEW MONITORED LEVELS OF LINDANE IN FOODS DURING ... 1965-1974 &
CALCULATED THE AVERAGE DAILY INTAKE. FOR PERIOD 1965-1970, ADI OF LINDANE WAS 3 UG/DAY; IN 1973, THIS DROPPED TO
0.2223 UG/DAY, & ... ROSE SLIGHTLY IN 1974 TO 0.5856 UG/DAY.
In total diet studies in Spain in 1971-1972, the estimated per capita intake
of ... lindane was 13.78 ug/day. In
German Democratic Republic, the estimated average daily intake of lindane for an adult male in 1971 was 10 ug,
& that of nursery school children was 7 ug. ... A model daily diet for adult
Japanese contained an average of 3.5 ug lindane.
WATER INTAKE: Assume 0.2 to 163 parts per trillion(1,2), 0.4 to 326 ng(SRC).
FOOD INTAKE: Assume 0.0012 ug/g(3), 1.92 ug(SRC). AIR INTAKE: Assume 58 pg/cu m
to 11.7 ng/cu m(4,5), 1.160 to 234 ng(SRC).
Average dietary intake 4 ng/kg body weight/day(1). Year-positive composites
(%) (daily intake in ug): 1971 - 7.8% (0.3), 1972 - 3.8% (0.1), 1973 - 10.8%
(0.2), 1974 - 14.4% (0.6), 1975 - 7.5% (0.2), 1976 - 10.0 (0.2)(1).
Minimum Fatal Dose Level:
The fatal dose in adults is approximately 10-30 g ...
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