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Excerpt from ERG Guide 138 [Substances - Water-Reactive (Emitting Flammable Gases)]:

Use special powder. NO water. NO other agents. In case of fire: keep drums, etc., cool by spraying with water. NO direct contact with water.

Fresh air, rest. Half-upright position. Refer for medical attention.

Remove contaminated clothes. Rinse skin with plenty of water or shower. Refer for medical attention .

First rinse with plenty of water for several minutes (remove contact lenses if easily possible), then refer for medical attention.

Refer for medical attention .

· CALL 911. Then call emergency response telephone number on shipping paper. If shipping paper not available or no answer, refer to appropriate telephone number listed on the inside back cover.

· ELIMINATE all ignition sources (no smoking, flares, sparks or flames) from immediate area.

EYES or SKIN: flush with water and treat with boric acid. (USCG, 1999)

General First Aid:

Corrosive ... Water reactive ... Evolves hydrogen and ignites on contact with water.

Sodium carbonate and sodium chloride are unsuitable to use as extinguishers for lithium fires, since burning lithium will liberate the more reactive sodium in contact with them.

Liquid lithium is readily ignited and reacts with most extinguishing agents, including water, carbon tetrachloride and carbon dioxide.

Since lithium will burn in oxygen, nitrogen or carbon dioxide, and when alight it will remove the combined oxygen in sand, sodium carbonate, etc., it is difficult to extinguish once alight ... Use of normal fire extinguishers (containing water, form, carbon dioxide, halocarbons, dry powders) will either accelerate combustion or cause explosion.

· Wear positive pressure self-contained breathing apparatus (SCBA).

0.2 [mg/m3], inhalable fraction, as Li (except Li and highly irritating lithium compounds, lithium amide, hydride, hydroxide, nitride, oxide, tetrahydroaluminate, and tetrahydroborate)[German Research Foundation (DFG)]

Extinguish lithium fires only with chemicals designed for this purpose.

Use approved Class D extinguishers or smother with dry sand, dry clay, or dry ground limestone. DO NOT use carbon dioxide or halogenated extinguishing agents. DO NOT use water. Violent reaction may result.

If material on fire or involved in fire: Do not use water. Do not use carbon dioxide. Use graphite, soda ash, powdered sodium chloride, or suitable dry powder.

Powdered graphite, lithium chloride, potassium chloride or zirconium silicate are suitable extinguishants.

Store in a cool, dry, well-ventilated location. Separate from water.

Keep under mineral oil or other liquid free from oxygen or water.

Eliminate all ignition sources. Keep water away from release. Shovel into suitable dry container.

Spillage Disposal: Wear eye protection, laboratory coat and nitrile rubber gloves. Cover spill with a 1:1:1 mixture by weight of sodium carbonate or calcium carbonate, clay cat litter (bentonite) and sand. Scoop the mixture into a pail and transport to the fume hood. Slowly and with stirring add to a large quantity of 95% ethanol. Mix and let stand for 24 hours. The solid residue may be treated as normal refuse.

Waste Disposal: Package Lots. Place in a separate labeled container for recycling or disposal by burning. Burn in an open furnace. Use caution and limit to 100 g packages. Small Quantities. Wear eye protection, laboratory coat and nitrile rubber gloves. Work in the fume hood. Equip a 3-necked round-bottom flask with a stirrer, dropping funnel, condenser and heating mantle. Flush the flask with nitrogen and place the lithium (cut in small pieces) in it. Add 30 mL of 95% ethanol per gram of lithium at a rate that causes rapid refluxing. Stirring is started as soon as enough ethanol has been added to make it feasible. The mixture is stirred and heated under reflux until the lithium is dissolved. The heat is turned off, and an equal volume of water is added at a rate that causes no more than mild refluxing. The solution is then cooled, neutralized with 6 M hydrochloric acid (cautiously add a volume of concentrated acid to an equal volume of cold water) and washed down the drain with at least 50 times its volume of water.

SRP: The most favorable course of action is to use an alternative chemical product with less inherent propensity for occupational exposure or environmental contamination. Recycle any unused portion of the material for its approved use or return it to the manufacturer or supplier. Ultimate disposal of the chemical must consider: the material's impact on air quality; potential migration in soil or water; effects on animal, aquatic, and plant life; and conformance with environmental and public health regulations.

Liver test abnormalities have been reported to occur in a small proportion of patients on long term therapy with lithium. These abnormalities are usually asymptomatic and transient, reversing even with continuation of medication. Instances of more marked elevations in serum aminotransferases have been reported in patients taking overdoses of lithium, but the other metabolic and systemic effects of lithium overdose generally overshadow hepatic adverse effects. Lithium has not been associated with instances of clinically apparent acute liver injury with jaundice.

Neurotoxin - Other CNS neurotoxin

Lithium can cause various adverse effects, often correlated with the dosage. The notable adverse effects of lithium include:

IDENTIFICATION AND USE: Elemental lithium is a silver white metal; body centered cubic structure it becomes yellowish on exposure to moist air and it reacts with water. It is soluble in liquid ammonia forming a blue solution. It is used in the manufacture of catalysts for polyolefin plastics; in fuels for aircraft and missiles.It is used in metallurgy, as a degasifier, deoxidizer, desulfurizer; as a grain refiner in non-ferrous metals. Chemical intermediate for butyllithium polymerization catalyst; in alloys with aluminum or magnesium for aerospace uses. It is used in the production of tritium, reducing and hydrogenating agents, alloy hardeners, pharmaceuticals and Grignard reagents. Scavenger and degassifier for stainless and mild steels in molten state, modular iron, soaps and greases, deoxidizer in copper and copper alloys, heat-transfer liquid, storage batteries (with sulfur, selenium, tellurium, and chlorine). Rocket propellants, vitamin A synthesis, silver solders, underwater bouyancy devices, nuclear reactor coolent. HUMAN EXPOSURE AND TOXICITY: Elemental lithium causes severe eye and skin burns. Industrial exposures to lithium may occur during extraction of lithium from its ores, preparation of various lithium compounds, welding, brazing, enameling, and from the use of lithium hydrides. ANIMAL STUDIES: No animal studies could be located.

Due to its narrow therapeutic index, serum levels of lithium exceeding 2 mEq/L are considered toxic, which falls within its therapeutic range. Lithium toxicity can result in interstitial nephritis, arrhythmia, sick sinus syndrome, hypotension, T-wave abnormalities, and bradycardia. In rare instances, toxicity can lead to pseudotumor cerebri and seizures. Notably, there exists no antidote for lithium toxicity. The primary approach to treating lithium toxicity involves hydration and discontinuation of the drug. Administering hydration through normal saline concurrently facilitates lithium excretion. Close monitoring is essential to prevent hypernatremia in patients receiving normal saline. Diuretic use should be avoided for patients on lithium treatment. For mitigating tremors, administering 20 to 30 mg of propranolol twice or thrice daily is recommended.

Burning sensation. Cough. Laboured breathing. Shortness of breath. Sore throat. Symptoms may be delayed.

Redness. Skin burns. Pain. Blisters.

Redness. Pain. Severe deep burns.

Abdominal cramps. Abdominal pain. Burning sensation. Nausea. Shock or collapse. Vomiting. Weakness.

Lithium is widely distributed in nature; trace amounts are found in many minerals, in most rocks and soils, and in many natural waters(1). Lithium is a member of the alkali metals and does not occur as the free metal in nature(2). The typical oxidation state of the alkali metals is +1; no other cations are known or expected for the alkali metals(4). Lithium concentrations in the earth's crust are estimated to be 20 to 70 ppm by weight(1); it is the 27th most abundant element(3). Lithium is found in small amounts in nearly all igneous rocks and in the waters of many mineral springs(2). Lepidolite, spodumene, petalite, and amblygonite are the most important lithium containing minerals(2).

NIOSH (NOES Survey 1981-1983) has statistically estimated that 3,455 workers (1,084 of these are female) are potentially exposed to lithium in the US(1).

Industrial exposures to lithium may occur during extraction of lithium from its ores, preparation of various lithium compounds, welding, brazing, enameling, and from the use of lithium hydrides. /Lithium/

Lithium is widely distributed in nature; trace amounts are found in many minerals, in most rocks and soils, and in many natural waters. Lithium is a member of the alkali metals and does not occur as the free metal in nature. Lithium concentrations in the earth's crust are estimated to be 20 to 70 ppm by weight; it is the 27th most abundant element. Lithium is found in small amounts in nearly all igneous rocks and in the waters of many mineral springs. Lepidolite, spodumene, petalite, and amblygonite are the most important lithium containing minerals. The production and use of lithium compounds in ceramics, glass and primary aluminum production, the manufacture of lubricants and greases, primary and secondary (rechargeable) batteries, the production of synthetic rubber, the manufacture of polyester fiber, the production of antioxidants and antihistamines, as catalysts, and in the treatment of mood disorders may result in the release of lithium compounds to the environment through various waste streams. If release to air lithium compounds should exist in the particulate phase in the ambient atmosphere since the ionic nature of lithium compounds makes them essentially non-volatile. Particulate-phase lithium may be physically removed from the air by wet and dry deposition. The adsorption of lithium was measured on aquifer material; Freundlich coefficients ranged from 4.5 to 5.5. Lithium has been found to sorb slightly to humic soils with a Kp of 4.6 at pH 5. These data indicate that lithium compounds are not expected to adsorb strongly to soils and sediments. Lithium ion would not be expected to undergo oxidation-reduction reactions under environmental conditions, and would exist in its +1 oxidation state either in compounds or as dissolved ions. The ionic nature of lithium compounds makes them essentially non-volatile; lithium compounds would not volatilized from dry soil surfaces. Due to the ionic nature of lithium compounds, volatilization from moist surfaces will not occur. In water, adsorption to suspended solids and sediments is not expected to be important fate processes for lithium compounds. Lithium ions may undergo precipitation, sorption, or ligand exchange reactions in the environment. Due to the ionic nature of most lithium compounds, volatilization from water surfaces will not occur. Bioconcentration is not expected to be an important fate process due to the ionic nature of lithium compounds. Occupational exposure to lithium compounds may occur through inhalation and dermal contact at workplaces where lithium compounds are produced or used. Since lithium is found various environmental media, the general public would be exposed to small amounts of lithium via inhalation of ambient air, ingestion of food and drinking water. (SRC)

Basic treatment: Establish a patent airway (oropharyngeal or nasopharyngeal airway, if needed). Suction if necessary. Watch for signs of respiratory insufficiency and assist ventilations if necessary. Administer oxygen by nonrebreather mask at 10 to 15 L/min. Monitor for pulmonary edema and treat if necessary ... . Monitor for shock and treat if necessary ... . Anticipate seizures and treat if necessary ... . For eye contamination, flush eyes immediately with water. Irrigate each eye continuously with 0.9% saline (NS) during treatment ... . Do not use emetics. For ingestion, rinse mouth and administer 5 ml/kg up to 200 ml of water for dilution if the patient can swallow, has a strong gag reflex, and does not drool ... . Cover skin burns with dry sterile dressings after decontamination ... . /Lithium and related compounds/

Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious, has severe pulmonary edema, or is in severe respiratory distress. Positive-pressure ventilation techniques with a bag-valve-mask device may be beneficial. Consider drug therapy for pulmonary edema ... . Monitor cardiac rhythm and treat arrhythmias if necessary ... . Start IV administration of D5W /SRP: "To keep open", minimal flow rate/. Use 0.9% saline (NS) or lactated Ringer's (LR) if signs of hypovolemia are present. For hypotension with signs of hypovolemia, administer fluid cautiously. Consider vasopressors if patient is hypotensive with a normal fluid volume. Watch for signs of fluid overload ... . Treat seizures with diazepam or lorazepam ... . Use proparacaine hydrochloride to assist eye irrigation ... . /Lithium and related compounds/

Ingestion of lithium metal ... is caustic. Dilution with water or other water-containing materials may produce a reaction that exacerbates the corrosive activity. Consideration may be given to gastric lavage with a large diameter tube for removal of material and then dilution with large amounts of water. Esophagoscopy may be of assistance in this procedure and to assess extent of damage. Treatment is otherwise symptomatic and supportive. Administration of activated charcoal is not useful because it does not bind to lithium ions and obscures endoscopic findings

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