The identification of specific chemical exposures can be difficult. Household products must list chemical ingredients on their labels, and this information may prove useful. In addition to providing information on chemical ingredients and percent composition, the material safety data sheets provide basic information on toxicity. This information is seldom adequate from a clinical perspective but may indicate the general type of toxicity to be anticipated. Given the wide variety of toxic exposures that may be uncovered during a workup, a clinician should routinely consult additional reference material to evaluate whether particular hazards may be associated with the illness at hand.
Many sources of information exist.
OSHA and some regional poison-control centers have extensive information on hazards and brief summary documents that can be transmitted by telephone or facsimile. Sophisticated computerized databases are also available, including detailed listings on CD-ROM information systems. Many of these databases can also be accessed through the Internet. As with any other illness, laboratory investigation may be crucial. For example, tests of carboxyhemoglobin level to document carbon monoxide exposure or of serum anticholinesterase level to document organophosphate pesticide absorption should be performed within hours of exposure.