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Medical Diagnosis and Treatment

Below you will find publications concerning triage, diagnosis using biomarkers and Medical treatment after exposure to Chemicals that affect lung functions or other organs. The publications are grouped into: Irritant gases, Cyanide, Chemical Warfare Agents and Triage.

Irritant gases 

Exposure to irritant gases can result in acute and chronic effect. The projects aim at 1) identifying biomarkers that can be used to identify if exposed individuals are at risk of developing chronic injuries and 2) for various treatments examine if an early medical intervention can reduce such damages.

  • N-acetyl cysteine improves the effects of corticosteroids in mouse model of chlorine-induced acute lung injury (2015) Wigenstam E, Koch B, Bucht A, Jonasson S. Toxicol 328:40-7
  • Medical intervention after inhalation of irritant gases (2014) Elfsmark L, Nyberg AG, Wigenstam E. FOI-R--3922--SE
  • Early treatment of chlorine-induced airway hyperresponsiveness and inflammation with corticosteroids (2013) Jonasson S, Wigenstam E, Koch B, Bucht A. Toxicol. Appl. Pharmacol. 271:168-74
  • Inhalation of chlorine causes long-standing lung inflammation and airway hyperresponsiveness in a murine model of chemical-induced lung injury (2013) Jonasson S, Koch B, Bucht A. Toxicol 303:34-42
  • Acute respiratory changes and pulmonary inflammation involving a pathway of TGF-Beta1 induction in a rat model of chlorine-induced lung injury (2016) Wigenstam E, Elfsmark L, Koch B, Bucht A, Jonasson S. FOI-S--5499--SE
  • Inhaled sulfur dioxide causes pulmonary and systemic inflammation leading to fibrotic respiratory disease in a rat model of chemical-induced lung injury (2016) Wigenstam E, Elfsmark L, Bucht A, Jonasson S FOI-S--5501--SE


Up to 80% of all deaths in fires are estimated to be due to exposure of fumes. Carbon monoxide is probably the most important, but evidence suggests that hydrogen cyanide, HCN, is a strong contributor. Although access to antidotes, people with symptoms of exposure to fire fumes are rarely treated for cyanide poisoning. Ths may be due to lack of an easy and rapid method for diagnosis. The project studied if a rapid method for diagnosing cyanide poisoning could be developed by measuring levels in exhaled are for use on-site by first responders.

  • Physiologically based pharmacokinetic modeling of hydrogen cyanide levels in human breath (2015) Stamyr K, Mörk AK, Johansson G. Arch Toxicol. 89:1287-96
  • Swedish forensic data 1992-2009 suggest hydrogen cyanide as an important cause of death in fire victims (2012) Stamyr K, Thelander G, Ernstgård L, Ahlner J, Johanson G. Inhal Toxicol 24(3):194-9
  • Cyanide in breath as a marker for cyanide poisoning (2011) Stamyr K. Doctoral thesis, Karolinska institutet
  • Background levels of hydrogen cyanide in human breath measured by infrared cavity ring down spectorscopy (2009) Stamyr K, Vaittinen O, Jaakola J, Guss J, Metälä M, Johanson G, Halonen L. Biomarkers 14:285-91
  • Washout kinetics of inhaled hydrogen cyanide in breath (2008) Stamyr K, Nord P, Johanson G. Toxicol Lett. 179:59-62

Chemical warfare agents

Reports describing research and new understanding of chemical warfare agent toxicity and medical countermeasures are given below.

  • Symptom-based treatment following organophosphorus poisoning (2014) Wigenstam E, Bergström U, Thors L, Bucht A. FOI-R--3906--SE
  • Corticosteriod treatment inhibits airway hyperresponsiveness and lung injury in a murine model of chemical-induced airway inflammation (2012) Wigenstam E, Jonasson S, Koch B, Bucht A. Toxicol 301:66-71
  • Patogenesis and treatment of chemical-induced lung injury (2012) Wigenstam E. Doctoral thesis, Umeå university
  • Inhalation of alkylating mustard causes long-term T cell-dependent inflammation in airways and growth of connective tissue (2011) Ekstrand-Hammarström B, Wigenstam E, Bucht A. Toxicol 280:88-97
  • Treatment with dexamethasone or liposome-encapsuled vitamin E provides beneficial effects after chemical-induced lung injury (2009) Wigenstam E, Rocksén D, Ekstrand-Hammarström B, Bucht A. Inhal. Toxicol. 21:958-64

Triage of chemically exposed patients

Rapid and accurate triage of affected individuals is of crucial importance for the medical management at large scale chemical exposures.

  • Mass casualties and health care following the release of toxic chemicals or radioactive material - Contribution of modern biotechnology (2011) Göransson Nyberg A, Stricklin D, Sellström Å. Int. J. Res.Public Health 8:4521-49 

FOI, Swedish Defence Research Agency

Swedish Defence Research Agency
SE-164 90 Stockholm

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