Some individuals exposed to xylene vapour,who subsequentlydrink alcohol, may experience dizziness and nausea. A flushingskin reaction has also been seen.
Clinical evidence,mechanism, importance and management
0.8 g/kg of alcohol found that about 10 to 20 % experienced dizziness and nausea (See reference number 1,2). One subject exposed to 300 ppm of m-xylene vapour developed a conspicuous dermal flush on his face,neck, chest and back. He also showed some erythema with alcohol alone (See reference number 3). A study using a population-based pharmacokinetic and pharmacodynamic model predicted that probability of experiencing CNS effects following exposure to xylene at current UK occupational exposure standard (100 ppm time-weighted average over 8 hours) increased markedly and non-linearly with alcohol dose (See reference number 4).
The reasons for these reactions are not fully understood, but it is possible that xylene plasma levels are increased because alcohol impairs its metabolic clearance by cytochrome P450 isoenzyme CYP2E1 (See reference number 4). After alcohol intake,blood xylene levels have been reported to rise about 1.5- to 2-fold;(See reference number 2) acetaldehyde levels may also be transiently increased (See reference number 2).
Alcoholic beverages are quite often consumed during lunchtime or after work, and since excretion of xylene is delayed by its high solubility and storage in lipid-rich tissues, simultaneous presence of xylene and alcohol in body is probably not uncommon and could result in enhancement of toxicity of xylene (See reference number 5).
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