Twenty two fatalities from trinitrotoluene (118967) (TNT) exposure in government explosives facilities during World War II were characterized. Eight persons (average age, 30) died of toxic hepatitis; 13 (average age, 45) died of aplastic anemia; and 1 had both conditions. Thirty three percent of the fatalities were exposed to concentrations of TNT above the maximum allowable concentration of 1.5 milligrams per cubic meter, but unaffected personnel were similarly exposed. The median exposure period was 63 days for the hepatitis cases and 216 days for the aplastic anemia cases. Early symptoms of hepatitis, when present, were nausea, vomiting, drowsiness, and general malaise. Early aplastic anemia symptoms were weakness, loss of appetite and weight, mild cough, and bleeding nose and gums. In fatal hepatitis cases, an initially high icterus index rose rapidly. Jaundice, severe weakness, and stupor were rapidly followed by death. In fatal aplastic anemia cases, erythrocyte counts and hemoglobin rapidly decreased. Depression of all cellular elements, hypoplastic or aplastic bone marrow, and petechiae were commonly seen. The median time from onset of definite aplastic anemia symptoms until death was 40 days. Hepatitis cases showed degenerative liver damage with decreased size and weight. Atrophy with complete destruction of parenchymal cells and hemorrhagic areas, or perivascular infiltration of lymphocytes and polymorphonuclear leukocytes was found. Pathology of aplastic anemia cases found liver destruction in some cases; multiple petechiae and diffuse hemorrhage in all organs, skin, and mucous and serous membranes; degenerative kidney and spleen; and terminal pneumonia.