Effects on humans
In its acute form, hydrogen sulfide intoxication is mainly the result of action on the nervous system. At concentrations of 15 mg/m3 and above,
hydrogen sulfide causes conjunctival irritation, because sulfide and hydrogen sulfide anions are strong bases (11). Hydrogen sulfide affects the
sensory nerves in the conjunctivae, so that pain is diminished rapidly and the tissue damage is greater (11). Serious eye damage is caused by a
concentration of 70 mg/m3. At higher concentrations (above 225 mg/m3, or 150 ppm), hydrogen sulfide has a
paralysing effect on the olfactory perception (2), so that the odour can no longer be recognized as a warning signal. At higher concentrations,
respiratory irritation is the predominant symptom, and at a concentration of around 400 mg/m3 there is a risk of pulmonary oedema. At even higher
concentrations there is strong stimulation of the central nervous system (CNS) (2), with hyperpnoea leading to apnoea, convulsions, unconsciousness,
and death. At concentrations of over 1400 mg/m3 there is immediate collapse. In fatal human intoxication cases, brain oedema, degeneration and
necrosis of the cerebral cortex and the basal ganglia have been observed (11).
If respiration can be maintained, the prognosis in a case of acute hydrogen sulfide intoxication, even a severe one, is fairly good. There are reports
of neurasthenic symptoms after severe acute intoxication, such as amnesia, fatigue, dizziness, headache, irritability, and lack of initiative (11). A
decrease of delta-aminolaevulinic acid dehydrase (ALAD) synthase and haem synthase activity in reticulocytes one week after hydrogen sulfide
intoxication has been reported (12), together with low levels of erythrocyte protoporphyrin. The ALAD and haem synthase activities returned to normal
two months after the accident, erythrocyte protoporphyrin remaining low. Changes in the electrocardiogram have been reported after acute hydrogen
sulfide intoxication, these changes being reversible (11). No tolerance to the acute effects of hydrogen sulfide has been reported to develop (11).
The mortality in acute hydrogen sulfide intoxications seems to be lower than that reported in 1977; according to a recent Canadian report it is now
2.8% (13), whereas formerly it was 6% (2). This may be a result of improved first-aid procedures and increased awareness of the dangers of hydrogen
sulfide.
Information about longer-term exposures to hydrogen sulfide is scanty. Eighty-one Finnish pulp mill workers who were exposed to hydrogen sulfide
concentrations of less than 30 mg/m3 (20 ppm) and to methyl mercaptan concentrations of less than 29.6 mg/m3 (15 ppm), displayed loss of concentration
capacity and chronic or recurrent headache more often than a nonexposed control group of 81 workers. Restlessness and lack of vigour also appeared
more often, but the findings were not statistically significant. There was also a tendency towards more frequent sick leave among the exposed group
(6). One report cites decreased activity of haem synthesizing enzymes in reticulocytes of pulp mill workers exposed for years to organic and inorganic
sulfides, with hydrogen sulfide concentrations of between 0.075 mg/m3 and 7.8 mg/m3 (12). No information is available as to whether the observed
effect was related to peak concentrations or average concentrations. It can, however, be assumed that average exposure was considerably higher than
0.075 mg/m3 (around 1.5-3 mg/m3). Furthermore, there is no firm proof that hydrogen sulfide was the causative agent, as there may be confounding
factors (other substances).
Epidemiological data concerning longer-term exposures are limited. Seventy per cent of workers exposed to hydrogen sulfide daily, often at 30 mg/m3 or
more, complained of such symptoms as fatigue, somnolence, headache, irritability, poor memory, anxiety, dizziness, and eye irritation (14). In a
Finnish mortality study workers in a sulfate pulp mill showed excess mortality from cardiovascular diseases (standardized mortality rate 140), and
especially from heart infarction (standardized mortality rate 142). The findings were statistically significant. In the same study population, cancer
incidence was not significantly different from, that of the general Finnish population (15). |