HEALTH EFFECTS Of AMMONIA - TFI

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HEALTHEFFECTS ofAMMONIA

contentsIntroduction1Ammonia: An Essential Chemical1Summary of Health Effects1Uses of Ammonia2Sources of Ammonia3Metabolism3External Sources3How Does the Body Process Ammonia6The Liver Converts Ammonia to Urea6Elimination and Excretion6Health Effects Assessment7Acute Health Effects7Chronic Toxicity9Effects on Sensitive Individuals11Particulate Matter11How to Protect Yourself13Treatment of Burns and Blisters13Shelter-in-Place Procedures14

IntroductionAmmonia: An Essential ChemicalAmmonia is a naturally occurring chemical in the atmosphere, aswell as an essential man-made chemical. It is represented by thechemical formula NH3. Ammonia in this form is also known asammonia gas or anhydrous (“without water”) ammonia. At roomtemperature, ammonia is a colorless, pungent-smelling gas and islighter than air.At minus 28 degrees Fahrenheit (-33 degrees Celsius), ammoniabecomes a liquid. Ammonia easily dissolves in water. In this form,it is also known as liquid ammonia, aqueous ammonia or ammoniasolution. In water, most of the ammonia changes to ammoniumions, NH4 .Ammonia is an essential element for plant, animal and human life.It is found in water, soil and air, and is a source of much needednitrogen for plants and animals. Most of the ammonia in theenvironment comes from the natural breakdown of manure, deadplants and animals. Man-made sources of ammonia include fertilizers,power plants, mobile sources and other manufacturing emissions.Due to its widespread presence in the environment and its many uses,questions often arise about its potential impact on human health.Summary of Health EffectsThe human body has several ways to process the ammonia it producesand is capable of clearing large levels of ammonia from its system. Ammonia levels in the air as low as 5 parts per million (ppm) can be1

recognized by odor. An average person detects ammonia by odor ataround 17 ppm. A ccording to the World Health Organization (WHO),continuous exposure to 25 ppm of ammonia in the air does notresult in a significant increase in blood levels of ammonia in thebody. A ccording to the Occupational Safety and Health Administration(OSHA), the least amount of ammonia which is found to beirritating to the eyes, nose and throat of the most sensitiveindividuals is 50 ppm. There is no evidence that ammonia causes cancer. T here is no evidence that exposure to the levels of ammoniafound in the environment causes birth defects or otherdevelopmental effects. B ecause ammonia is present in the human body at all times, nolong-term health effects from inhalation exposure to low levelsof ammonia would be expected. B ecause ammonia is a respiratory tract irritant, persons whoare hyperreactive to other respiratory irritants, or who areasthmatic, may be expected to be more susceptible to inhalationof high concentrations of ammonia.Uses of AmmoniaAmmonia contributes to the nutritional needs of livingorganisms, and serves as a feedstock in the production of manyfertilizers and other important chemicals. Ammonia is oneof the most widely used industrial chemicals. It is preparedindustrially from natural gas, steam and air. More than 802

percent of manufactured ammonia is used as fertilizer. Some ofthis ammonia is chilled to a liquid form for direct injection intocroplands as a fertilizer. A large amount of industrial ammoniais reacted with carbon dioxide to make urea fertilizer or used tomake nitrate fertilizers.Most people are familiar with its use in a variety of household products,including cleaning products and smelling salts. Ammonia is alsoused in large-scale refrigeration systems; to make synthetic fibers,plastics and glues; in the treatment and refining of metals; and in avariety of other chemical production processes and foods. Anotherimportant use of ammonia is in selective catalytic reduction duringwhich ammonia is added to a stream of exhaust gas and absorbed into acatalyst, a technology which is utilized in power plant stacks, cars andtrucks to remove nitrogen oxide and sulfur oxide.Sources of AmmoniaMetabolismThe term metabolism refers to the ways in which chemicals arechanged to other chemicals by living organisms.Ammonia is a unique industrial chemical because it is also producedby the body and used by all mammalian species. It is producedby the breakdown of the proteins in food and from amino acids.Ammonia is essential to the synthesis of DNA and proteins, whichare the basic building blocks of life. In addition, bacteria in thedigestive tract break down other food compounds to form ammonia.About 17 grams ( 0.5 ounces) of ammonia are produced by thebody every day, of which approximately 4 grams are absorbed into3

the body’s circulation system. The rest is excreted through urine.External SourcesExternal Exposures – The average human intake of ammonia fromexternal sources is about 18 milligrams per day (mg/day). E xposure to ammonia from sources outside the body come fromeating proteins and certain foods containing ammonium saltadditives and from air, water and direct contact with the skin.Ammonia is used in food preparation as a stabilizer, leaveningagent and food additive. E stimates of the average global atmospheric ammoniaconcentration range from 0.6 - 3 parts per billion (ppb).Concentrations of ammonia in the atmosphere vary acrossthe United States, with geography, altitude, season and manmade activities contributing to the difference. In general,concentrations are higher in the Midwest compared to eitherthe west or east coasts, with a nationwide average of 3.3 ppb.Typical large cities have estimated airborne ammonia levels ofapproximately 0.03 ppm, which means that an individual willtypically breathe in about 0.4 mg/day of ammonia.In rural areas, a person will take in about 0.1 mg/day. A mmonia concentrations in water vary seasonally and regionally,and are also affected by surrounding land use, temperature andpH. The average human intake from drinking water is about 1mg/day in cities and less than 0.4 mg/day in rural areas. C igarette smokers inhale an additional 0.8 mg/day of ammonia(based on 20 cigarettes per day).[See Daily Ammonia Intake Table on right.]4

Daily Ammonia IntakeTotal Production by the BodyContinuously Breathing 25 ppmEating a 7 ounce Steak17,000 mg379 mg13,000 mgFood Additives18 mgDrinking WaterCityRural1.0 mg0.4 mgNormal BreathingCityRural0.4 mg0.1 mgCigarette Smoking (one pack per day)0.8 mg5

ow does the bodyHprocess ammonia?Because ammonia is very water soluble, inhaled ammoniadissolves into the lining of the nasal passages and is swallowed.Consequently, very little inhaled ammonia reaches the lungs.According to WHO estimates, continuous inhalation of lowconcentrations of ammonia – 25 ppm, equivalent to about 379 mg/day – would only result in a 10 percent increase in blood-ammoniaconcentration.It is important to note that individual blood ammonia levels varyconsiderably due to dietary fluctuations. For example, eating ameal rich in protein will produce changes in blood ammonia levelsconsiderably higher than 10 percent.The Liver Converts Ammonia to UreaHuman bodies use ammonia in a number of ways, including for themaintenance of the normal pH balance necessary to sustain life.Ammonia is processed in the liver, kidneys and skeletal muscle.The two main modes for the body to process ammonia involve itsconversion to urea and to glutamine.The human liver has the capacity to convert as much as 130 gramsof ammonia into urea each day although it normally operates at lessthan one eighth of that capacity. Thus, the human body has a largecapacity for handling any excess ammonia that may be introducedfrom a protein-rich meal or from environmental exposures.Elimination and ExcretionWhile ammonia is mainly eliminated in the urine, ammonia is also6

present in exhaled air. Humans exhale between 0.1 and 3.2 ppm ofammonia through their breath.Health Effects AssessmentIn order to assess how exposure to ammonia might affect humanhealth, changes in various organs; decreases in lung function;changes in cilia beating in the trachea; effects on nerve conditions;and the ability to fight bacterial lung infections have been evaluatedduring laboratory studies and from observation of people exposedto ammonia. Carcinogenicity, mutagenicity – damage to thegenetic material of cells – and damage to the reproductive systemor fetus have also been studied. The following sections discuss themajor findings on ammonia from several human and animal studiesconducted by the WHO, the Agency for Toxic Substances andDisease Registry (ATSDR), the Environmental Protection Agency,the Occupational Safety and Health Administration, the AmericanConference of Industrial Hygienists (ACGIH), and TFI.Acute Health EffectsAmmonia, in both its gaseous and liquid form, can be irritating tothe eyes, respiratory tract and skin due to its alkaline nature. Thebiological effects of ammonia in humans after acute exposuresare dose-related – they depend on the ambient concentration, theamount taken in by the body and the duration of exposure. A mmonia levels in the air as low as 5 ppm can be recognized byodor. An average person detects ammonia by odor at around 17ppm. Most people can taste ammonia in water at levels of about35 ppm.7

A CGIH recommends a threshold limit value (TLV) of 35 ppmas a short-term exposure limit (STEL) and 25 ppm on a timeweighted average (TWA) to avoid irritation of the eyes, noseand throat. ACGIH develops TLVs as guidelines to assist inthe control of occupational health hazards. While TLVs arerecognized guidelines around the world, they are not law andcarry no legal enforcement. I n addition, other applicable exposure limits are required byspecific states, and other organizations have developed alternateammonia exposure limit guidelines for specific scenarios, suchas public health assessment and emergency response. A ccording to OSHA, the smallest amount of ammonia that hasbeen found to be irritating to the eyes, nose and throat of themost sensitive individuals is 50 ppm. W ithout personal protective equipment (PPE), the maximumairborne concentration below which it is believed that nearlyall individuals could be exposed for up to one hour withoutexperiencing or developing irreversible or other serious healtheffects or symptoms which could impair an individual’s ability totake protective action is 100 ppm. O SHA also sets 300 ppm as the exposure concentration ofammonia causing no escape-impairing symptoms and noirreversible effects. W ithout protective equipment, the maximum airborneconcentration below which it is believed that nearly allindividuals could be exposed for up to 30 minutes withoutexperiencing or developing life-threatening health effects is500 ppm.8

B reathing 700 to 1,700 ppm results in coughing,bronchospasm and chest pain along with severe eye irritationand tearing. A t levels greater than 5,000 ppm, ammonia causes chemicalbronchitis, fluid accumulation in the lungs, chemical burns ofthe skin and is potentially fatal. B ased on information provided by ATSDR, permanent lungdamage has not been associated with acute ammonia exposuresunless the exposure concentrations were near lethal levels.Chronic ToxicityFew studies of longer duration – chronic studies – have beenconducted with animals primarily because there is no scientific beliefthat persistent, low level exposure to ammonia would be harmful, asammonia is naturally present at relatively high levels in humans.A study conducted on workers exposed to ammonia for 10 to 15years at levels up to and exceeding 24 ppm did not find adverseeffects. In additional occupational studies, no relationship wasfound between exposure to ammonia and cancer or carcinogenicity.According to the ATSDR and TFI studies, chronic exposure toammonia did not result in harm to genetic material or damage thereproductive system or a developing fetus.9

Table 1: Concentration/Duration/Effect (without protective clothing)Concentration / Time10,000 ppm5,000 – 10,000 ppm700 – 1700 ppmEffectPromptly lethalRapidly fatalIncapacitation from tearing of the eyes and coughing500 ppm for 30 minutesUpper respiratory tract irritation, tearing of the eyes134 ppm for 5 minutesTearing of the eyes, eye irritation, nasal irritation, throat irritation, chestirritation140 ppm for 2 hoursSevere irritation, need to leave exposure area100 ppm for 2 hoursNuisance eye and throat irritation50 – 80 ppm for 2 hours20 – 50 ppmPerceptible eye and throat irritationMild discomfort, depending on whether an individual is accustomedto smelling ammoniaTable 2: Effects of Ammonia Exposure for “A Few Minutes” (without protective cesLess than5000Stinging in eyes andmouth, pain whenswallowing, hoarseness,tightness of throat, coughReddening ofconjunctivae, lips,mouth and tongue,swelling of eyelids,edema of throatUsually recovery withoutpulmonary complicationsExaggeration of abovesymptoms, tightness inchest, difficulty swallowing,loss of voice, cough withsputum and sometimesbloodDistress, increase inpulse and respirationrates, swelling ofeyelids, burning ofmucous membranesFatalities due toobstruction of airwaysSimilar to above symptoms,persistent cough withcopious frothy sputumShock, restlessness,distress, rapid pulseof poor volume,cyanosis, difficultybreathingDeath as result ofasphyxiation; survivorsmay die later a result ofcomplications5000 – 10,000Greater than10,00010

Effects on Sensitive IndividualsThere is no scientific consensus that children are more susceptibleto the effects of ammonia than adults. Persons who suffer fromsevere liver or kidney disease may be more sensitive to exposureto higher concentrations of ammonia, because of the importanceof these organs in transforming and excreting ammonia. However,levels likely to be encountered normally in the environment,with the exception of those resulting from high-level accidentalexposures, are not generally of concern, due to the lowabsorption rate compared with levels produced within the body.Because ammonia is a respiratory tract irritant, persons who arehyperreactive to other respiratory irritants, or who are asthmatic,would be expected to be more susceptible to inhalation of highconcentrations of ammonia.Particulate MatterQuestions are sometimes raised regarding ammonia’s role in thetoxicity of airborne particulate matter. Particulate matter, alsoknown as particle pollution or PM 2.5 and PM 10 depending onparticle size – with 2.5 being the smaller value – is a complexmixture of extremely small particles and liquid droplets includingacids (such as nitrates and sulfates), organic chemicals, metals, andsoil or dust particles.Particle pollution contains microscopic solids or liquid droplets sosmall that they potentially could get deep into the lungs and causeserious health problems. The size of particles is directly linked totheir potential for causing health problems – the smaller particles,PM 2.5, can travel deeper into the lungs.Inhalable coarse particles, such as those found near roadways anddusty industries, are larger than 2.5 micrometers and smaller than11

10 micrometers in diameter. Fine particles, such as those foundin smoke and haze, are 2.5 micrometers in diameter and smaller.These particles can be directly emitted from sources such as forestfires, or they can form when gases emitted from power plants,industries and automobiles react in the air.Because ammonia is found naturally in ambient air, as well asemitted from industrial and agricultural sources, it can interactwith other airborne gases, especially sulfates and nitrates, toproduce particulate matter. The amount of ammonia in air maybe a factor in determining the final form of particulate matter in ageographic area by influencing the conversion of acid gases totheir ammonium salts.Current scientific research into the toxicity of particulate matter isfocused on the effects of combustion byproducts, such as carbon andvolatile organic compounds, on human health. While there are nodefinitive answers, there is little evidence to indicate that ammoniacontained in particulate matter increases the risk to human healthbeyond those effects discussed earlier in this document.Short-term exposures to particles (hours or days) can aggravatelung disease, causing asthma attacks and may also increasesusceptibility to respiratory infections. In people with heartdisease, short-term exposures have been linked to heart attacksand arrhythmias. Healthy children and adults have not beenreported to suffer serious effects from short-term exposures,although they may experience temporary minor irritation whenparticle levels are elevated.Long-term exposures to particulate matter, such as thoseexperienced by people living for many years in areas with highparticle levels, have been associated with problems such as reducedlung function, the development of chronic bronchitis and even12

premature death. Ammonia may also contribute to regional hazeand reduced visibility in parts of the United States.How to Protect YourselfBefore working with ammonia, personnel should review the materialsafety data sheet. Personnel handling anhydrous or strong aquaammonia where skin or eye contact is likely to occur should weargloves, shoe covers and aprons impervious to ammonia. Unless eyeand face protection is afforded by a respirator hood or face piece,chemical goggles and face shields should be worn at all times. TheNational Institute for Occupational Safety and Health recommendswearing gloves made of Butyl, Teflon or Viton for up to eight hoursof exposure and Nitrile gloves for up to four hours of exposure.Any personnel required to enter atmospheric ammoniaconcentration likely to be more than 10,000 ppm must weara self-contained breathing apparatus with a positive pressurein a full face piece under an impervious full body suit or othercombination of continuous-flow supplied air, and impervious suit.When the worker is using the impervious suit over a self-containedbreathing apparatus, stay-time in the area should be limited due toconsideration of the heat stress factors involved.Treatment of Burns and BlistersMost material safety data sheets state that burns should be treatedby flushing with water for a minimum of 20 to 30 minutes, whileremoving contaminated shoes, clothing and constrictive jewelry oncethe person has been removed from any additional exposure. If the13

skin surface is damaged, apply a clean dressing and seek immediatemedical attention. If the skin surface is not damaged, cleanse theaffected area(s) thoroughly by washing with mild soap and water.Never apply salves or ointments to chemical burns. The applicationof these products can worsen the burn by holding in chemicals notwashed off of the skin that need to be released from the wound.If salves or ointments are applied, there is a greater potential forcausing more severe burns. Once the wound is fully cleansed, adoctor or burn specialist may apply one percent silver sulfadiazinecream directly to the skin.Shelter-in-Place ProceduresWhat should you do if there’s been an ammonia release from aretail or manufacturing facility in your area and it’s coming yourway? Because ammonia is primarily an acute health hazard whichrapidly disperses in the atmosphere, sheltering is almost alwaysthe best short and long-term response. Shelter-in-place meansto get inside a building (even a car if no building is available) andtake certain steps described here. In almost all fatalities involvingammonia releases, those killed or even seriously injured were in theimmediate area of the release and were most often affected by theimpact of sudden pressure, rather than by exposure to ammonia.Those nearby who quickly found shelter were usually spared seriouslong-term effects.Only when deemed appropriate by the public emergencyresponse official in charge, evacuation can

Ammonia: An Essential Chemical Ammonia is a naturally occurring chemical in the atmosphere, as well as an essential man-made chemical. It is represented by the chemical formula nH 3. Ammonia in this form is also known as ammonia gas or anhydrous (“without water”) ammonia. At room temperature, amm

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