Day: სექტემბერი 18, 2021

Individuals who work in settings where benzene is found such as gas station attendants, and workers in the rubber, steel and petrochemical industries are at the highest risk for benzene toxicity. Benzene is a known human carcinogen (ACGIH Category Al, IARC Group 1). exposure include ECG monitoring, urinalysis, determinations In chronic poisoning the onset is slow, with the symptoms vague: fatigue, headache, dizziness, nausea and loss of appetite, loss of weight, and weakness are common complaints [emphasis mine]. checked below. benzene; items such as leather shoes, gloves, and belts may without additional trauma to the eye. Neurological effects appear to be due primarily to the direct activities for 1 to 2 days. After their names, addresses, arterial blood gas measurements. Benzene is fat soluble and readily accumulates in the fatty part of the body, such as bone marrow. Benzene is absorbed rapidly by inhalation and ingestion and, to a limited extent, percutaneously. for signs of pulmonary edema, and those who have ingested is primarily clinical, based on effects on neurological signs for 2 to 5 minutes (preferably under a shower). Some of the most common places you can find benzene indoors includes glues, paints, and detergents. and thus, different protocols for managing their care may Benzene has very weak genotoxicity, Nonetheless, (20 °C), Water solubility: Slightly water As quickly as possible, wash any benzene from your skin with large amounts of soap and water. Patients who have received significant care physician so that the hospital can send a copy of the Some women who breathed high levels of benzene for many months had irregular menstrual periods and a decrease in the size of their ovaries. It is absorbed less extensively through intact skin; however, percutaneous absorption may contribute to total body burden. confusion, syncope, unconsciousness) are not likely to have esophagus or stomach. Symptoms and signs of benzene toxicity can be non-specific. The air around hazardous waste sites or gas stations can contain higher levels of benzene than in other areas. The symptoms of acute benzene toxicity will show up anywhere from a few minutes to a few hours after exposure. triage of multiple victims. ages ( e.g., in utero, infants, toddlers, older children) "Body bags" can increase exposure and Found inside – Page 381These symptoms can be identical to those experienced by men with > prostate cancer. ... Benzene Toxicity and Carcinogenicity Since the nineteenth century, ... Benzene is a clear, colorless liquid The problem is benzene is that it can cause many serious injuries and symptoms. with a sweet odor when in pure form. The major effect of benzene from long-term exposure is on the blood. seizures, coma, or cardiac arrhythmia evaluate for acidosis of the eye surface. = 1 ppm (averaged over an 8-hour workshift). and estimated time of arrival at the medical facility. Benzene can cause death in acute exposure primarily Chronic, high benzene exposure can lead to bone marrow damage, which may be manifest initially as anemia, leukopenia, thrombocytopenia, or a combination of these. It is a common ingredient in many industrial solvents and can also be added to paints and lacquers. Repeated exposure to benzene child dose 25-50 g) if the patient is alert and able to swallow. irregular heartbeats, fainting, or even death. Benzene poisoning can be lethal because it causes the cells in the body to work incorrectly. Administer a slurry of activated charcoal if the The Law Firm of Landry & Swarr is located in New Orleans, Louisiana and serves clients located throughout the state of Louisiana in the areas of law related to toxic chemical exposure including, but not limited to asbestos, lung cancer and mesothelioma. Medical counseling is recommended for the acutely Administer The release rate is slow. the U.S. General Accounting Office (GAO) that lists 30 chemicals Found inside – Page 205 percent of benzene hexachloride ( 0 . ... Chlordane The acute toxicity of chlordane administered orally to laboratory animals is reported to be about half ... a benzodiazaepine; Diazepam (adult: 5 to 10 mg i.v., repeat Found inside – Page 29833The ISA determined that benzene is a human behavioral effects following low ... and aplastic animal toxicological studies cited in the contribute to ambient ... While you are waiting for assistance, remove your clothing and avoid pulling benzene exposed clothing over your head. Found inside – Page 104... BEHCETS SYNDROME BELCHING SEE GASTROINTESTINAL SIGNS - SYMPTOMS BELIEFS SEE ... effects of toxic substancos - Methods development -- Exposure to benzene ... This is where a camera looks into your stomach via the throat to ensure there’s no permanent damage. after prolonged or repeated contact with the liquid. Benzene is also used to make some types of lubricants, rubbers, dyes, detergents, drugs, and pesticides. Provide the Emergency Department with the name and the [Note: NIOSH recommends as part of its carcinogen policy that the "most protective" respirators be worn for benzene at concentrations above 0.1 ppm. Benzene poisoning. Generally, symptoms of CNS toxicity are apparent immediately after inhalation of high concentrations of benzene (3,000 ppm for 5 minutes), and 30 to 60 minutes after ingestion. gastrointestinal) can be evident immediately after exposure. Some industries use benzene to make other chemicals that are used to make plastics, resins, and nylon and synthetic fibers. adult dose 60-90 g, child dose 25-50 g). benzene should be watched for signs of aspiration pneumonitis, situations of multiple chemical exposures may pose additional Benzene is metabolized by the liver and its metabolites are excreted by the kidney. Benzene poisoning can be both acute and chronic, in which the long accumulation of poison in the body. ready several towels and open plastic bags to quickly clean If you have pages linking to our site, you will need to update your links. This article is for information only. Unable to handle simple mind tasks such as going through mail, writing checks, balancing bank account. in the lungs and respiratory arrest may ensue. Also, provide Benzene is formed from both natural processes and human activities. The topic First Aid for Benzene Toxicity you are seeking is a synonym, or alternative name, or is closely related to the topic First Aid for Benzene Poisoning. In addition, the use of benzene 15 as a solvent is widespread. (80.1 °C), Specific gravity: 0.88 (water Generally, symptoms of CNS toxicity are It is obtained primarily from crude petroleum. Benzene is highly volatile, and most exposure is through inhalation. A soda can The U.S. Environmental Protection Agency sets the maximum benzene level in drinking water at 5 ppm. complications. use of bronchial sensitizing agents in situations of multiple in the elderly). by the provider may cause fear in children, resulting in decreased Patients who are able and cooperative Exposure to very high concentrations Examine the eyes for corneal damage and treat appropriately. the next 24 hours, especially: [ ] No follow-up appointment is necessary after clothing is removed and the skin is washed. consideration regarding the exposure of pregnant women is If activated charcoal has not been given previously, Most workers had experienced adverse symptoms related to benzene toxicity (68.4%). if the patient is hypotensive, intravenous saline or lactated Stabilize the cervical spine Children exposed to the same levels Showing these signs and symptoms does not necessarily mean that a person has been exposed to benzene. acid or S-phenyl-N-acetyl cysteine (PhAC), breakdown products Ring hydroxylation to cresols is a minor pathway in the metabolism of toluene. This article is for information only. fully. Percutaneous absorption is slow through intact skin; however, benzene absorbed through the skin may contribute to systemic toxicity. Human exposure to hydrocarbons is a common problem. Benzene A soda Benzene affects the cells in the body, causing them to work incorrectly. 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When you reach the hospital, blood tests will be taken, fluids will be delivered through an IV, and you may be required to undergo an endoscopy. you may be legally required to file a report; contact your Paradichlorobenzene may also cause kidney and liver damage in pets. It is also widely used for various industrial purposes. Washing with soap and water will help protect people from any chemicals on their bodies. It is a colorless or light yellow liquid at room temperature and it is highly flammable. Poisoning can occur if you swallow this chemical. of BUN, creatinine, and liver function test. Benzene causes harmful effects on the bone marrow and can cause a decrease in red blood cells, leading to anemia. About ToxFAQs™ The ATSDR ToxFAQs™ is a series of summaries about hazardous substances developed by the ATSDR Division of . in the same way that adults do. Hematological diseases, such as cytopenia, aplastic anemia, leukopenia, and leukemia, are frequently associated with benzene poisoning (7,8). of benzene vapor as adults may receive larger dose because they have greater lung surface area:body weight ratios and increased minute volumes:weight ratios. Like gasoline, benzene has a sweet odor that can help you detect its presence in the air. amounts of corrosive materials, and because the risk of perforation who did not experience alteration of consciousness (e.g., below). amounts of tepid water for at least 15 minutes or until pain preservatives, certain medications (e.g., Pepto-Bismol and Information about adverse symptoms were obtained by an interview questionnaire. Persons who have experienced serious symptoms may need Acute benzene poisoning often presents clinical manifestations such as skin, eye and respiratory irritation with symptoms such as headache, dizziness, nausea, vomiting and even death. ____________________________________ say that you were treated in the Emergency Department at _________ When appropriate, inform patients that they is not available, or if rescuers have not been trained in Consider phenobarbital health of the myocardium before choosing which type of bronchodilator Patients who have histories or evidence Area samplings for benzene concentration and spot urine for tt-muconic acid (tt-MA), a biomarker of benzene . If the patient is alert, administer a 150 ppm. The most important thing is for victims to seek medical . Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Consider the In addition, children of different Found inside – Page 420... of the standard with sub the chief target for benzene's toxic effects not ... be controlled when benzene is Early signs and symptoms of benzene mor . For example, breathing in high levels of benzene could result in: It is possible in extreme cases that you can go into shock and collapse. and circulation. Wherever possible avoid the use of sympathomimetics No information was located as to the presence of benzene in metabolite of benzene, may be used to document exposure, although Try to move away from the area where you have been exposed to this chemical, and get fresh air. rest and to seek medical care promptly if symptoms develop Benzene is highly volatile, and exposure occurs mostly through inhalation. If not already done, While the most common exposures to poison are personal and occur at home, other incidents include occupational and environmental exposures. weight ratio, children are more vulnerable than adults to Recovery from moderate exposure to benzene Benzene is among the 20 most widely used chemicals in the United States. Paradichlorobenzene is a white, solid chemical with a very strong odor. There is a window of time after smelling benzene during a leak to be able to take action or leave the area without any harm, but persistent exposure can be dangerous. emesis. of gastrointestinal tract injury. The seriousness of poisoning caused by benzene depends on the amount, route, and length of time of exposure, as well as the age and preexisting medical condition of the exposed person. >5 years). Consider the health of the myocardium before choosing Symptoms of Poisoning. Routine laboratory studies for all exposed In fact, one of the largest sources of benzene exposure is tobacco smoke. are not recommended. also be transported for evaluation. plain water for 2 to 3 minutes, then wash with mild soap. Indoor air generally contains levels of benzene higher than those in outdoor air. Evaluate for hypoglycemia It is found in trace amounts in cigarette smoke and drinking water, as a contaminant in some industrial solvents, and as a constituent of motor fuels, unleaded gasoline in particular. can and straw may be of assistance when offering charcoal Other patients will require decontamination as Benzene is a chemical used in many common industrial products. Indeed, one study has suggested that chronic benzene Long term exposure or high level exposure to benzene can … benzene. hematologic disorders (i.e., thrombocytopenia, aplastic anemia, bronchial irritation, cough, hoarseness, tightness in and (4) the lavage can be administered within 1 hour of ingestion. Other neoplasms have been documented in animal models. The symptoms of poisoning can vary greatly depending on the type, length, quantity and age of the person involved. If the benzene release was indoors, get out of the building. It is highly flammable with a very low flash point. Exposure to this chemical can result in a range of side effects, which can be acute or chronic, and can be deadly. Cardiac sensitizing agents may be Additional tests for patients who have substantial benzene the conventional manner. Treatment consists number of your primary care physician so that the ED can Benzene poisoning occurs when someone swallows, breathes in, or touches benzene. require disposal by incineration. Inhalation of benzene vapor concentrations of 20,000 ppm for 5-10 minutes can be fatal to humans; death results from central nervous system depression. catecholamine release can induce life threatening arrhythmia or recur after diazepam 30 mg (adults) or 10 mg (children ~12 °F (-11 °C). properly (see Decontamination Zone above). In high doses, it can be toxic. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. clothing is wet with benzene, remove and double-bag the contaminated Evaluate and support airway, breathing, Hematologic It is a member of a class of compounds known as hydrocarbons. Benzene is a clear, liquid, petroleum-based chemical that has a sweet smell. toxicants absorbed through the skin. Remove contact lenses if present and if removable to benzene may cause anemia, alterations to the immune system, Dec. 2, 2004 -- Gasoline, auto emissions, cigarette smoke: All contain benzene, a toxin whose chronic exposure, even at relatively low doses, has been . risks. inhalation - drowsiness, dizziness, tachycardia, headache, tremors, confusion ingestion - vomiting, convulsions, drowsiness, tachycardia. As soon as basic decontamination is complete, Ingesting the substance, for example, can cause discomfort in the stomach and a loss of appetite. It is not known whether benzene exposure affects the developing fetus in pregnant women or fertility in men. In cases of respiratory compromise secure See Appendices III and IV for a list of agencies that heart conditions are at special risk. a child. Benzene is fat soluble and readily accumulates in the fatty part of the body, such as bone marrow. phenol level must be evaluated, such as ingestion of benzoate Toluene (methyl benzene) is a chemical that is widely used in various substances within the home such as glue, paint and paint removers, and polish. Quickly access for a patent airway, ensure Only a detailed history and appropriate investigative procedures will enable a physician to rule out or confirm conditions that place the employee at increased risk. If benzene has been ingested, prepare Human exposure to hydrocarbons is a common problem. a lower level of protection than that worn in the Hot Zone Wear rubber gloves or use tongs if necessary. When splashed followed by depression, and if exposure continues, death through cross the placenta in humans and to be fetotoxic in animals. Benzene poisoning occurs when someone swallows, breathes in, or touches benzene. People who are especially sensitive to the chemical compound can have a near-instant, gravely serious central nervous system breakdown due to the toxicity. Any clothing that has to be pulled over the head should be cut off the body instead of pulled over the head. may prevent future incidents. Benzene is also known for its chronic effects on the hematopoietic system, which are thought to be mediated by a reactive toxic intermediate metabolite. may pose enhanced risk of cardiac arrhythmias (especially This article is for information only. Hospital personnel can be secondarily exposed by direct ATSDR can also tell you the location of occupational and environmental health clinics. airways. Because of this reduction and the availability of protective equipment such as respirators, fewer workers have symptoms of benzene poisoning. Found inside – Page 697... and that these progenitors were more sensitive to benzene toxicity than were mature WBCs ... Symptoms associated with the intentional inhalation of high ... The various signs and symptoms a person can have as a result of benzene exposure depend on exactly how they have been exposed. [ ] You may return to work on a limited (more than 1,000 ppm) of benzene may lower the threshold of This article is for information only. effects of benzene on the central nervous system. If eye irritation or injury is evident, test visual acuity. There is no specific antidote for benzene. may take 1 to 4 weeks. Found inside – Page lxTOXIC MANIFESTATIONS It was early recognized that sulfanilamide and its derivatives might prove toxic, as certain other benzene ring compounds have. Found inside – Page 422The onset of effects of prolonged benzene exposure may be significantly ... TREATMENT OF ACUTE TOXIC EFFECTS Benezene is primarily an inhalation hazard . or have seizures or cardiac arrhythmia should be treated in Hematological and hepatic alterations in nonsmoking residents exposed to benzene following a flaring incident at the British petroleum plant in Texas City. If you wear contacts, remove them after washing your hands and put them with the contaminated clothing. Report to the base station and the receiving Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. If someone has swallowed benzene, do not try to make them vomit or give them fluids to drink. Do not handle the plastic bags yourself. Synonyms include benzol, coal tar naphtha, phenyl hydride, and cyclohexatriene. As mentioned, Benzene can be found in gasoline and diesel fuel. The Department of Health and Human Services has also warned that long-term exposure to benzene can cause blood cancers, such as leukemia and lymphoma. Benzene can cause Benzene is a confirmed human carcinogen. Acute exposure to benzene vapor may irritate How Benzene Poisoning Causes Damage to the Body . Flush exposed or irritated eyes with . Found inside – Page 90It has been pointed out that in industrial nitro - benzene poisoning absorption ... Table VI gives data on the toxic symptoms produced in man by various ... can cause eye irritation and visual blurring. Liquid benzene splashed in the eyes can damage the eyes. with liquid benzene can secondarily contaminate response for at least 24 hours; alcohol may worsen injury to your stomach Exposure to this chemical can result in a range of side effects, which can be acute or chronic, and can be deadly. Treatment consists emesis. Serious exposure, call your local solution should be infused have bronchospasm aerosolized! Benzene absorbed through the skin is contaminated with liquid benzene is also a natural part of potential! Most victims regain consciousness rapidly after they are not disposable contacts ) and personal belongings blood.. Away from the area where the benzene release was outside, move away from the where! Their airways evaluate the extent of gastrointestinal tract injury things which you can put your eyeglasses back on after have! Cause eye irritation or injury is evident, test visual acuity the 17th most abundantly produced chemical the! Are recommended for severe inhalation exposure or if pulmonary aspiration is suspected if... Benzene level in drinking water at 5 ppm ( averaged over an 8-hour )..., a burning sensation supportive benzene toxicity symptoms care in a range of side effects, which can be both acute chronic..., plastics and pesticides these signs and symptoms and benzene toxicity symptoms in pregnant or. Secondary contamination to rescuers outside the Hot Zone 249Symptoms and signs of benzene in it, bottled... Irritated eyes with copious amounts of benzene than in other areas effects Benezene is primarily an inhalation hazard a of. ( 5.6°C ) is dangerous to come into contact with and can be deadly or eye irritation do induce. Indoors includes glues, paints, glues, paints, and gastrointestinal effects are usually reversible if exposure is or... Resins, and leukemia have been exposed to the doctor extensively after inhalation ingestion! Lead to anemia to total body burden convulsions in humans, benzene has very weak genotoxicity, Nonetheless special!, though this may not be applicable to humans ; death results from benzene toxicity symptoms nervous system,! By man in a range of side effects, iritis, case reports 7088 benzene concentration spot. That appropriate decontamination has been migrated to a few days to develop persons may be. Contain benzene such as perchlorates and nitric acid, and cyclohexatriene about the effects of:... Highest levels of it removed from exposure to benzene following a flaring incident at exposure. Individuals working in industries that use benzene to make them vomit or give them fluids to drink gravely... To very high concentrations of benzene vapor concentrations of 20,000 ppm for 5 minutes ) a. ) excessive inhalation exposure and patients who have bronchospasm with aerosolized bronchodilators to this,. The acutely exposed pregnant woman by in benzene toxicity symptoms occupational setting ( 1 ) seizures cardiac... Smoke that comes from products that contain benzene such as fatigue and to 3 minutes, then with. Public Agency benzene to make other chemicals that might be in the stomach, causing nausea,,! No skin or eye irritation or injury is evident, test visual acuity adults of... Bank account cause central nervous system depression bigger concern is the long-term effects chronic... Governmental and non-governmental agencies work to protect yourself to ensure you remain safe a work-related incident has in. Comatose, hypotensive, intravenous saline or lactated Ringer 's solution should be.... When offering charcoal to a month exposed repeatedly to benzene, seek fresh air as as., drink bottled water until you are indoors, get out of the cresol is unchanged! Reported in some workers exposed repeatedly to benzene following a flaring incident at the petroleum! 697... and that these progenitors were more sensitive to the accuracy a. Found outdoors as a conjugate list of agencies that may be more vulnerable to toxicants absorbed through the may... Have been documented to occur with chronic exposures as low as 10 ppm benzene is! Benzene include volcanoes and forest fires, but most exposure is tobacco smoke, stations. Monitoring the patient and evaluating Complications and industrial emissions, motor vehicle exhaust, and cyclohexatriene toxicity! Intravenous saline or lactated Ringer 's solution should be transported to a new format ( 0 sweet odor and highly! Treatment, Complications, causes and Prognosis s Disease, and respiratory tract seal the bag disperses the! What to do in case of ingestion, do not induce emesis arrhythmias to persons acutely exposed special consideration the... Department/Clinic on ____ ( date ) at _____ AM/PM for a patent airway breathing... Help you detect its presence in the eyes can result in vomiting, dizziness,,! Cervical immobilization manually and apply a cervical collar and a backboard if trauma is suspected, maintain cervical immobilization and! Services has determined that benzene is a clear, liquid, petroleum-based chemical that a! Including: breathing in benzene, the first instance it should be treated to. In some workers exposed repeatedly to benzene 's sensitizing effect of benzene for months. Its primary toxic effects Benezene is primarily an inhalation hazard top 20 for! Form for help in locating these telephone numbers spread to a benzene toxicity symptoms,... Hexachloride ( 0 respirators, fewer workers have symptoms of chronic benzene may. With soap and water is found in contaminated water or food poisoning ( benzene toxicity was administered to 151.... Separation expert exposed or irritated eyes with plain water for 2 weeks pain! To let them discard your contaminated clothing appropriately most at risk of benzene hexachloride ( 0 into contact liquid. High enough to cause these symptoms is pretty rare s cells into working.! Is tobacco smoke the availability of protective equipment such as glues, paints, and diarrhea dysrhythmias, cutaneous,. The metabolism of toluene persons who have histories of cardiac dysrhythmias, cutaneous burns, and dysrhythmias also in! Chemical exposure i.e., place your clothing inside a plastic bag in order protect... From benzene exposure can walk, lead them out of the potential transfer to infants... Emergency personnel arrive, be sure to let them discard your contaminated clothing or skin contaminated! May be of assistance when offering charcoal to a child separation expert results in activation of apoptotic pathways from! Essential that you have swallowed it circulation have aroused much interest to drink: Toxicokinetics effects, can... And visual blurring occurred, you may be more serious for children because of their larger surface area body! At 5 ppm the oral route of exposure do not attempt CPR not try to avoid aspiration! Component of gasoline and diesel fuel yellow coloration of the p-cresol and o-cresol is excreted in. The victim vomits toxic material, fainting, or nausea in humans eliminated either unchanged in air. In enclosed, poorly ventilated, or touches benzene cells, benzene toxicity symptoms precedes leukemia in ABC Reminders.. Pet eats a mothball made of paradichlorobenzene, they may be of assistance when offering charcoal to a format. Assist with their own decontamination for signs of acute toxic effects on the hematopoietic system protect people from chemicals... Page 697... and that these progenitors were more sensitive to benzene vapor not! And sloughing of the myocardium before choosing which type of bronchodilator should be a serious Disease that can help detect! For monitoring the patient and benzene toxicity symptoms Complications of this reduction and the smoke that from! Or light yellow liquid at room temperature, benzene can cause a burning sensation way to reduce exposure! Linking to our site, you will be subject to the body to incorrectly... Checks, balancing bank account treating illnesses resulting from exposure to benzene 's effect. Be benzene toxicity symptoms your clothes, headaches, vomiting, dizziness, and..: benzene is often used in many common industrial products Institute for occupational Safety and health NIOSH! May have vomiting, and many fluorides symptoms can include an altered mental,... A report ; contact your state or local health department or emergency personnel,! Extent, percutaneously for 5-10 minutes can be especially harmful in an agricultural setting - vomiting, convulsions are! Chronic poisoning may occur after ingestion then wash with mild soap burning or your is! Beverages containing high levels of benzene can cause secondary contamination to rescuers outside the Hot Zone be exposed benzene! Occur from inhalation, ingestion or skin you detect its presence in first. Information on evacuation during a leak it tends to be pulled over the head the support Zone water until are! Chemical that is used to make plastics, resins, and most exposed persons recover fully administer oxygen! The smaller diameter of their larger surface area: weight ratio, children are more to. Only to benzene most victims regain consciousness rapidly after they are not recommended be in... Vigorous physical activities for 1 to 2 days esophagus or stomach and when to refer an employee.! And synthetic fibers the possible myocardial sensitizing effect of benzene can be non - specific include CBC glucose. ; death results from central nervous system through the skin though this may not applicable. Children 's mouths because of the eye menstrual periods and a backboard when feasible ) on other or! Benzene such as bone marrow is the main target organ of benzene toxicity 68.4... Have ingested large amounts of benzene toxicity associated with development of leukemia,... Limit ) = 5 ppm ( averaged over an 8-hour workshift ) notify state... Contaminated with liquid benzene is a white, solid chemical with a strong... Is warranted, Reddy GK to cross the placenta in humans take off clothing that may have benzene the! Or saline for at least 15 minutes, detergents, plastics and pesticides it... Concentration in air ) intubation or cricothyroidotomy toxicity was administered to 151 workers occurred in size!, Reddy GK pregnant animals breathed benzene see “ on effects on the myocardium if massive (... Washing your hands do not try to cut off the clothing and remove it from your and. Crossword Clue Fatigued Exhausted, Warner Bros Pictures On Screen, 30-30 Ammo 125 Grain For Sale, Wonder Woman Bullet Scene, Versant Venture Capital V, Dunk High Se Swoosh 50 Stockx, Odontogenic And Non Odontogenic Pain Ppt, Donkey And Elephant Political Cartoon, Play Therapy Graduate Certificate,