Cyanide Toxicity: Case Study on Exposure, Effects, and Management

This case study examines cyanide toxicity through the lens of a medical emergency involving a 35-year-old woman and her 5-year-old son, both victims of smoke inhalation and potential exposure to cyanide. The assignment addresses various aspects of cyanide poisoning, including the sources of contamination, such as food sources like cassava and the combustion of household materials. It explores the physiological effects of cyanide, its impact on oxygen utilization, and the different exposure pathways. The case study also delves into the analysis of a neighbor's exposure through contaminated drinking water, the differences in cyanide levels between the victims, and other ways cyanide can enter the food chain. Furthermore, it discusses the mechanisms of cyanide's toxic action in the body, the role of hemoglobin, and the importance of recognizing and managing cyanide exposure to prevent adverse health outcomes. The document also touches upon the clinical evaluation, treatment, and management of cyanide poisoning.

Running head: CYANIDE TOXICITY
Cyanide Toxicity
Name of the Student
Name of the University
Author Note

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Answer to Question 1.
The term food contamination refers to the presence of microorganisms and chemical
substances that are capable of affecting the health condition of the individuals. The case of
food contamination can make the patients ill by causing infection in the body of the
individuals. The incident of the food contamination can occur by multiple ways and they are
mainly chemical contamination, biological contamination, physical contamination and cross
contamination of the food materials. Cyanide is one the most toxic chemicals that can harm
individuals as a part of the food contamination (Ballantyne, 2013).
Cyanide refers to a potentially deadly chemical that exists in the various forms in the
food products. It is stated that, the substance cyanide generally releases from various natural
foods and from some plants such as Cassava, almonds and lima beans. Not only that, a few
fruit seeds such as seeds of apricots, apples, and peaches may have substances that can
produce cyanide after the metabolism of the substances. However, the edible part of these
food products contain very low amount of such substances (CDC, 2019). The term cyanide
contamination refers to the contamination of the food particles due to the presence of cyanide
in the food components and the amount is above the permissible limit of the cyanide. In
natural resources, cyanide is present as cyanide glycosides in the seeds of fruits. The
metabolism of the cyanides causes formation of β-cyanoalanine and it is then transformed to
asparagine (Bernhardt et al., 2017).
The issue of the cyanide contamination in the food chain is mainly incorporated
through the soils, waters and other food products. It is stated that, the cyanide can easily
contaminate the water resources of the environment. Moreover, the cyanide from the
industrial waste products can assimilate with the water bodies of the urban areas. Not only
that, such cyanide components can also contaminate the soils. The cyanides in the soils can

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come from the metallurgic industry and galvanizing industry as well. In the soil, the cyanide
is mostly present as complexes such as Fe(CN)6 3− and Fe(CN)6 4− . Although the level of
toxicity is very much low, still it is deposited in the soil (Okike et al., 2015). After prolonged
period of time, this deposited cyanide particles present in the water and soil is absorbed by
the plants and those particles are transmitted in to the vegetables and crops. Whenever, an
individual eats those vegetables and crops, then the cyanide transfers into the body of the
individuals. Along with this, the animals who eats those crops and vegetables also have
cyanides in their body and when humans intake those animals as a non-vegetarian source of
foods, then the humans are also exposed to those cyanide ions. Apart from the aforesaid
ways, cyanide can enter in to the food chain through the human beings whenever they
touches soil containing the cyanide particles. Therefore, it can be said the cyanide poisoning
can enter into the natural food chains not only from the natural but from the artificial sources
as well (Mousavi et al., 2013).
It is reported that, one of the major reason of food contamination by the cyanide
compound is completely associated with the unconscious consumption of the large amount of
poorly processed foods such as Cassava. Not only this, another food component named
manioc, linamarin is present in the bitter variety of this components. The alteration of the
food safety by the cyanide is associated with formation of hydrogen cyanide (Bernhardt et
al.,2017). For example it can be said that decomposition of the amygdalin inside the human
body occurs due to the hydrolysis of the component by using the enzyme named β-
glucosidase and thereby causes the formation of α-hydroxynitrile. This compound at the high
pH values (More than 6) dissociates into ketone, sugar and hydrogen cyanide that is the
primary reason of food contamination (Anseeuw et al.,2013).
It is reported that, apple seeds contain a good amount of cyanide compound. It is
reported that apple seeds contain almost 700 milligrams of hydrogen cyanide per kilogram.

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On the other hand, another cyanide containing compound that is cherry contains almost 0.17
grams of lethal cyanide per gram of cherry seeds (CDC, 2019).
The cyanide contamination in the foods can highly affect the security of the foods
consumed by the individuals. Hence, it is reported that, the contamination of the foods can
alter the physical health of the individuals and various symptoms such as dizziness, headache,
weakness, restlessness, loss of consciousness, rapid heart rate (CDC, 2019). Thus it can be
said that, the alteration of the food safety can affect the human health by these ways.
Answer to Question 2.
The case study reported about the victims of cyanide poisoning and the woman was
approximately 35 years old. In various studies, it is reported that, the production of carbon
monoxide and hydrogen cyanide (HCN) is highly associated with the combustion of the
products that are generally present in the household area and during the fires in the house
high quantities of HCN is released. However, the presence and amount of the smoke content
is dependent on the nature of the fire substrates, temperature of the fire and rate of burning as
well. HCN is generally produced by the combustion of the synthetic products such as
acrylics, nylon , paints, foam (polyurethane), and plastics (polyacrylonitriles,
polyacrylamides), as well as natural materials such as silk, cotton, wool, paper and wood. In
this case scenario, it can be stated that due to the burning of plastic toys and other HCN
producing materials present in the house are responsible for cyanide production in the house
(MacLennan & Moiemen, 2015).
Answer to Question 3.
Apart from the case study, the experience of a neighbourhood family is also depicted
in the case study. A neighbour of the victimised family reported about their experience of
cyanide contamination. In the case of the neighbour family, it was reported that, they were

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consuming cyanide through drinking water and they found that, they were consuming the
drinking water containing approximately 212 parts per billion (ppb) cyanide. According to
the study of Jaszczak et al. (2017), it is reported that, the permissible limit of cyanide that is
maximum contamination level (MCL) in the drinking water is approximately 0.2 mg/L or 200
ppb. Therefore, it can be said that, the neighbour family was consuming the cyanide at a risky
level for the last two years.
Answer to Question 4.
From the case study, it is reported that, the one of the victim is 35 years old and
another victim is only 5 years old. Although, both the victims survived from this mishap, still
the amount of cyanide in the blood is not same for the both victims. It is reported that, the
blood haemoglobin level of the children is not same with the blood haemoglobin levels of an
elder one. According to the study of Jaszczak et al. (2017), in case of 5-11 years male
children the blood haemoglobin level should be 11.9-15 g/dL. On the other hand, it is
reported that, in case of an adult female, the normal haemoglobin level is almost 12.5- 14.5
g/Dl. Hence, the HCN can bind more amount of haemoglobin in the children’s body while
comparing with the haemoglobin amount of the adult female. So, it can be stated that, in this
case study, the children may have more cyanide content in the blood than that of his mother
as she had low amount of blood haemoglobin in her body.
Answer to Question 5.
Apart from the inhalation of cyanides, there are various other ways of having the
cyanide exposures. It is reported that, cyanide is one of the most rapidly causing poisonous
substances which is associated with the homicidal deaths and suicidal deaths. The
consumption of the cyanide salts (potassium cyanide, sodium cyanide, calcium cyanide) is
capable of releasing the HCN after combining with the acids inside the body. Along with this,

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it is reported that hepatic metabolism of a few aliphatic thiocyanates and aliphatic nitrile
compounds (i.e. acetonitrile, proprionitrile, acrylonitrile) can release cyanide and after the
absorption of cyanide delayed onset of cyanide poisoning may occur (Ballantyne, 2013). In
case of children, cyanide poisoning may happen after drinking the acetonitrile-based artificial
nail remover as well. Not only this, cyanide poisoning can happen due to the natural
resources consumptions. Therefore, it can be stated that consumption of huge amounts of
seeds, pits and stone fruits of certain plants can cause cyanide poisoning among the children
and it may even cause deaths of the children. The oral intake of Laetrile can release cyanide
in the body and thereby causing the cyanide contamination in the body. Contamination of
water by cyanide from industrial resources can also cause cyanide poisoning in the body
(Mousavi et al., 2013).

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References
Anseeuw, K., Delvau, N., Burillo-Putze, G., De Iaco, F., Geldner, G., Holmström, P., ... &
Sabbe, M. (2013). Cyanide poisoning by fire smoke inhalation: a European expert
consensus. European Journal of Emergency Medicine, 20(1), 2-9.
Ballantyne, B. R. Y. A. N. (2013). The forensic diagnosis of acute cyanide
poisoning. Forensic toxicology. John Wright and Sons Limited, Bristol, 99-113.
Bernhardt, E. S., Rosi, E. J., & Gessner, M. O. (2017). Synthetic chemicals as agents of
global change. Frontiers in Ecology and the Environment, 15(2), 84-90.
CDC (2019). Facts about Cyanide. CDC. Retrieved from-
https://emergency.cdc.gov/agent/cyanide/basics/facts.asp [Accessed on 28th August
2019].
Jaszczak, E., Polkowska, Ż., Narkowicz, S., & Namieśnik, J. (2017). Cyanides in the
environment—analysis—problems and challenges. Environmental Science and Pollution
Research, 24(19), 15929-15948.
MacLennan, L., & Moiemen, N. (2015). Management of cyanide toxicity in patients with
burns. Burns, 41(1), 18-24.
Mousavi, S. R., Balali-Mood, M., Riahi-Zanjani, B., & Sadeghi, M. (2013). Determination of
cyanide and nitrate concentrations in drinking, irrigation, and wastewaters. Journal of
research in medical sciences: the official journal of Isfahan University of Medical
Sciences, 18(1), 65.
Okike, I., Samireddypalle, A., Kaptoge, L., Fauquet, C., Atehnkeng, J., Bandyopadhyay,
R., ... & Blummel, M. (2015). Technical innovations for small-scale producers and

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households to process wet cassava peels into high quality animal feed ingredients and
aflasafe™ substrate. Food Chain, 5(1-2), 71-90.

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Q.6 The cyanide poisoning in the body is associated with the prevention of the use of
oxygen by the cells of the body. As a result, more amount of oxygen is present in the blood
flow and they cannot be used at all. As a result, it can be said that, the oxygen saturation level
of the blood is enhanced and thereby the venous pressure of the body will be enhanced
(Ballantyne, 2013).