Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Toxic Effects, Isopropyl Alcohol


Related Terms

  • 2-Hydroxypropane Poisoning
  • 2-Propanol Poisoning
  • Dimethylcarbinol Poisoning
  • Propanol-2 Poisoning
  • Sec-Propyl Alcohol Poisoning

Differential Diagnosis

Specialists

  • Medical Toxicologist
  • Pharmacologist
  • Preventive Medicine Specialist

Comorbid Conditions

  • Kidney disease
  • Pulmonary insufficiency

Factors Influencing Duration

Absorbed dose is the primary determinant of the severity of toxic effects and therefore the severity and duration of disability. Absorbed dose depends on environmental levels, routes of exposure (skin contact, inhalation, ingestion), and duration of exposure.

Age, general state of health, excessive use of alcoholic beverages, and liver and kidney diseases will limit response to treatment and slow recovery.

Medical Codes

ICD-9-CM:
980.2 - Toxic Effects, Isopropyl Alcohol

Overview

Isopropyl alcohol is a clear, colorless, bitter aromatic liquid that can be mixed with water, alcohol, and other common solvents. A solution of 70% isopropyl alcohol in water is used as a rubbing compound (rubbing alcohol). Isopropanol is a secondary alcohol, which is poisonous if taken internally. It is one of the cheapest alcohols and has replaced ethanol for many uses because of its similar solvent properties. Isopropanol was formerly obtained largely by catalytic reduction of acetone; oxidation of isopropanol is now the major source of acetone.

Isopropyl alcohol is used as a solvent in perfumery and in many personal cosmetic products and preparations. It is externally substituted for industrial methylated and surgical spirits. It is also used in the extraction of alkaloids; in quick-drying oils and inks; as an antiseptic, a de-icing agent for liquid fuels, a dehydrating agent, a window cleaner, and a disinfectant; and in pliable ice packs.

Isopropyl alcohol is an irritant of the skin, eyes, mucous membranes, and upper respiratory tract. Workers in industries in which isopropyl alcohol is used may be exposed to harmful levels via inhalation. Ingestion may occur through intentional or accidental consumption of products containing isopropyl alcohol in place of ethyl alcohol products. Poisoning by isopropyl alcohol may also occur by skin absorption due to excessive skin exposure.

Persons with allergies or who are hypersensitive to alcohol solvents may be adversely affected by skin contact with products containing isopropyl alcohol. Household and cosmetic products that contain isopropanol pose a hazard for accidental ingestion, and contribute to allergic and sensitivity reactions.

Incidence and Prevalence: In 2002, 8,998 people were exposed to isopropanol, according to the US poison centers. Fifty-nine people suffered a life-threatening toxic exposure that caused them to be disabled or have serious medical complications, and of these 59, three died (Watson).

Source: Medical Disability Advisor



Causation and Known Risk Factors

Children are at increased risk for accidental ingestion of isopropanol, especially those under the age of 5 (Egland).

Source: Medical Disability Advisor



Diagnosis

History: The individual will have a documented history of recent exposure to isopropyl alcohol. Symptoms of exposure may include dizziness, giddiness, headache, nausea, vomiting, and irritation of the skin, eyes, nose, and throat. The individual's eyes may be red and painful. The individual may appear to be inebriated, and drunkenness may occur. Repeated skin exposure can cause itching, redness, rash, drying, and cracking. Prolonged skin contact may cause corrosion. Effects may include reduced memory and concentration, personality changes (withdrawal, irritability), fatigue, sleep disturbances, reduced coordination, and / or effects on nerves supplying internal organs (autonomic nerves) and / or nerves to the arms and legs (weakness, "pins and needles").

Physical exam: Pulmonary examination of the individual may reveal irritation of the respiratory tract, respiratory depression, slow or labored breathing (dyspnea), or slurred speech. Flushing, an increase in pulse rate, unresponsive reflexes, lowered blood pressure, decreased body temperature, a decrease or increase in urine output, abdominal pain, and vomiting of bright red blood (hematemesis) may also be found. The individual may be comatose. An eye examination may reveal eye damage, constricted pupils, and nystagmus, and the individual may smell of acetone. Very infrequently individuals develop myoglobin in their urine, liver problems, hemolytic anemia, and acute tubular necrosis that damages the kidneys.

Tests: The amount of isopropyl alcohol in expired air may be measured. Whole blood analysis shows the level of both isopropyl alcohol and its metabolites, as well as low blood sugar levels. A routine urinalysis will also show the levels of isopropyl alcohol and its metabolites, as well as electrolyte levels.

Source: Medical Disability Advisor



Treatment

The first step is to remove the individual from further exposure. Further treatment depends on the extent of exposure and the organ system affected. When isopropyl alcohol has been ingested, the stomach should be emptied, except for very small amounts, via flushing out with water (gastric lavage). Laxatives and activated charcoal may be administered. Vomiting should not be induced, because volatile chemicals have a high-risk of being aspirated into the individual's lungs during vomiting, which increases the number of medical problems the patient may endure. Individual who are conscious and not convulsing should drink one to two glasses of water to dilute the chemical. Dehydration and electrolyte changes should be corrected. Blood pressure should be monitored. Kidney dialysis may be necessary.

Following inhalation exposure, the individual should be moved into the open air. Respiratory support should be provided, along with oxygen and fluids when high-level inhalation exposure has occurred. When contact with the skin has occurred, the affected skin should be flooded with water and then gently and thoroughly washed with soap and water.

If the affected individual is wearing contact lenses, they need to be removed. The eyes should then be flushed with water or normal saline solution for 20 to 30 minutes or longer if necessary, lifting the upper and lower lids occasionally.

Source: Medical Disability Advisor



Prognosis

The prognosis for full recovery is good when appropriate treatment begins immediately. Age, general physical condition, and attitude will have an important influence on the individual's progress to recovery. In cases in which severe, irreversible damage has been done to the kidney and liver, long-term disability may be anticipated. There is an increased incidence of nasal sinus cancer in workers involved in the manufacture of isopropyl alcohol by the strong-acid process.

Source: Medical Disability Advisor



Rehabilitation

Should poisoning by ingestion have been done intentionally, a psychological counseling and supportive therapy program would be useful. Physical therapy of an indefinite length may be necessary where impaired motor functions are present.

Source: Medical Disability Advisor



Complications

Heavy use of alcoholic beverages enhances the harmful effect of isopropyl alcohol. Isopropyl alcohol has not been adequately evaluated to determine whether brain or nerve damage could occur with repeated exposure. However, many solvents and other petroleum-based chemicals that contain it have been shown to cause such damage.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

The Occupational Safety and Health Administration (OSHA) has set the legal airborne permissible exposure limit (PEL) at 400 parts per million of isopropyl alcohol averaged over an 8-hour work shift.

The National Institute of Occupational Safety and Health (NIOSH) has recommended an airborne exposure limit of 400 parts per million of isopropyl alcohol averaged over a 10-hour work shift, not to exceed 500 parts per million of isopropyl alcohol during any 15-minute work period.

The American Conference of Governmental Industrial Hygienists (ACGIH) has recommended an airborne exposure limit of 400 parts per million of isopropyl alcohol averaged over an 8-hour work shift, not to exceed 500 parts per million of isopropyl alcohol as a short-term exposure limit (STEL).

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Is individual exposed to isopropyl alcohol as a solvent, an antiseptic, an extracting agent, a dehydrating agent, or as a disinfectant?
  • Does individual have allergies to alcohol solvents?
  • Does individual complain of dizziness, giddiness, headache, nausea, vomiting, or irritation of the skin, eyes, nose, or throat?
  • Does individual complain of itching, redness, rash, drying, and cracking of the skin?
  • Does individual note memory, concentration, or personality changes (withdrawal, irritability)?
  • Does individual report fatigue, sleep disturbances, reduced coordination and / or weakness, or pins and needles in the extremities?
  • Was the amount of isopropyl alcohol in expired air, in blood, and in urine measured?

Regarding treatment:

  • Has individual been removed completely from further exposure?
  • If isopropyl alcohol was ingested, did individual require stomach pumping (gastric lavage) or administration of laxatives or activated charcoal?
  • Following inhalation exposure, was respiratory support required? If so, was it provided quickly?
  • Where contact with the skin occurred, was the affected skin flooded with water, then gently and thoroughly washed with soap and water?
  • If eye contact occurred, were the eyes flushed with water or normal saline solution for at least 20 to 30 minutes?
  • Did treatment resolve all symptoms?

Regarding prognosis:

  • What were the level, duration, and route of exposure?
  • Was treatment begun immediately and appropriately?
  • Has individual's age, general physical condition, or attitude affected prognosis?
  • Does individual understand that alcoholic beverages enhance the harmful effect of isopropyl alcohol?
  • Has individual experienced severe, irreversible damage to kidneys or liver?
  • Are there special attributes of the particular individual that make it more or less likely that he or she would be so affected?
  • Are there additional lifestyle or behavioral factors that may potentially contribute to this condition?
  • Where there remains significant uncertainty about the cause, how important is it to be certain?

Source: Medical Disability Advisor



References

Cited

Egland, Ann G., and Douglas R. Landy. "Toxicity, Alcohols." eMedicine. Eds. Jeffrey Glenn Bowman, et al. 24 Apr. 2002. Medscape. 23 Nov. 2004 <http://emedicine.com/emerg/topic19.htm>.

Watson, William A., et al. "2002 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System." American Journal of Emergency Medicine 21 5 (2003): 353-421. MD Consult. Elsevier, Inc. <http://home.mdconsult.com>.

Source: Medical Disability Advisor






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