US EPA

2241507 

Journal Article 

The cause, relief and prevention of headaches arising from contact with dynamite 

Schwartz, AM 

1946 

1 

New England Journal of Medicine
ISSN: 0028-4793
EISSN: 1533-4406 

NIOSH/00132394 

235 

15 

541-544 

English 

21000388 

10.1056/nejm194610102351503 

The cause, treatment, and prophylaxis of headache induced by exposure to dynamite were investigated. Sensitivity was tested by injecting ten dynamite workers with 0.01 milligrams (mg) histamine (51456). Treatments with 0.5 cubic centimeters (cc) adrenalin (51434) 0.1mg ergotrate (129511), 0.25mg ergotamine-tartrate (379793) subcutaneously, and 0.5 grams caffeine-sodium-benzoate (8000951) intramuscularly followed in 15 minutes by 5 to 10mg oral amphetamine-sulfate (60139) were tested. Prophylactic desensitization was attempted with 5mg in the morning and 10mg at noon of amphetamine-sulfate for 3 days before handling dynamite. Increasing doses of prostigmine-bromide (114807) were given 3 times a day until 30 drops per day of 45mg of drug in 60cc of water were consumed. The 30 drop dose was continued for 1 week, then dropped to 3 days a week, at which time the workers handled dynamite without gloves. Histamine injection produced an erythematic reaction in 90 percent of the subjects. One subject complained of headaches similar to those experienced from dynamite. Adrenalin and ergotrate gave only transitory relief from dynamite induced headaches. Nausea and abdominal cramps were experienced with ergotrate. Ergotamine-tartrate gave lasting relief to 40 percent of the subjects and transitory relief in the remainder. Amphetamine-sulfate caused increased blood and cerebrospinal fluid pressure and produced headache relief in about 1 hour for 95 percent of subjects. Amphetamine-sulfate also gave protection in all subjects. Prostigmine-bromide protected 80 percent of the workers fully. The remaining 20 percent had mild headaches not requiring treatment. When these subjects were retested for histamine reaction, sensitivity was reduced significantly. The author concludes that desensitization causes a gradual release of acetylcholine, causing dilatation of intracerebral vessels.