Editing RDX (section)

==Toxicity==
The substance's toxicity has been studied for many years.<ref>[http://www.epa.gov/ncea/iris/pdfs/Litsearch_RDX.pdf Annotated Reference Outline for the Toxicological Review of hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX)]. U.S. Environmental Protection Agency (November 23, 2010)</ref> RDX has caused convulsions (seizures) in military field personnel ingesting it, and in [[munition]] workers inhaling its dust during manufacture. At least one fatality was attributed to RDX toxicity in a European munitions manufacturing plant.<ref name="Schneider1977">{{cite journal |doi=10.1016/0041-008X(77)90144-2 |pmid=854927 |title=Toxicology of cyclotrimethylenetrinitramine: Distribution and metabolism in the rat and the miniature swine |journal=Toxicology and Applied Pharmacology |volume=39 |issue=3 |pages=531–41 |date=March 1977 |last1=Schneider |first1=N. R. |last2=Bradley |first2=S. L. |last3=Andersen |first3=M. E. |bibcode=1977ToxAP..39..531S }}</ref>

During the [[Vietnam War]], at least 40 American soldiers were hospitalized with [[C-4 (explosive)|composition C-4]] (which is 91% RDX) intoxication from December 1968 to December 1969. C-4 was frequently used by soldiers as a fuel to heat food, and the food was generally mixed by the same knife that was used to cut C-4 into small pieces prior to burning. Soldiers were exposed to C-4 either due to inhaling the fumes, or due to ingestion, made possible by many small particles adhering to the knife having been deposited into the cooked food. The symptom complex involved nausea, vomiting, generalized seizures, and prolonged [[postictal state|postictal confusion]] and amnesia; which indicated [[toxic encephalopathy]].<ref>{{cite journal |last1=Ketel |first1=W. B. |last2=Hughes |first2=J. R. |title=Toxic encephalopathy with seizures secondary to ingestion of composition C-4: A clinical and electroencephalographic study |journal=Neurology |date=1 August 1972 |volume=22 |issue=8 |pages=871–6 |doi=10.1212/WNL.22.8.870 |pmid=4673417 |s2cid=38403787}}</ref>

Oral toxicity of RDX depends on its physical form; in rats, the LD50 was found to be 100&nbsp;mg/kg for finely powdered RDX, and 300&nbsp;mg/kg for coarse, granular RDX.<ref name="Schneider1977" /> A case has been reported of a human child hospitalized in [[status epilepticus]] following the ingestion of 84.82&nbsp;mg/kg dose of RDX (or 1.23 g for the patient's body weight of 14.5&nbsp;kg) in the "plastic explosive" form.<ref>{{cite journal |last1=Woody |first1=R.C. |last2=Kearns |first2=G.L. |last3=Brewster |first3=M.A. |last4=Turley |first4=C.P. |last5=Sharp |first5=G.B. |last6=Lake |first6=R.S. |title=The Neurotoxicity of Cyclotrimethylenetrinitramine (RDX) in a Child: A Clinical and Pharmacokinetic Evaluation |journal=Journal of Toxicology: Clinical Toxicology |date=1986 |volume=24 |issue=4 |pages=305–319 |doi=10.3109/15563658608992595 |pmid=3746987}}</ref>

The substance has low to moderate toxicity with a [[possible human carcinogen]] classification.<ref>Faust, Rosmarie A. (December 1994) [https://web.archive.org/web/20050411005431/http://cira.ornl.gov/documents/RDX.pdf Toxicity summary for hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX)]. [[Oak Ridge National Laboratory]]</ref><ref>{{cite journal |doi=10.1016/j.chemosphere.2006.12.005 |pmid=17275885 |title=Age dependent acute oral toxicity of hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) and two anaerobic ''N''-nitroso metabolites in deer mice (''Peromyscus maniculatus'') |journal=Chemosphere |volume=67 |issue=11 |pages=2267–73 |year=2007 |last1=Smith |first1=Jordan N. |last2=Liu |first2=Jun |last3=Espino |first3=Marina A. |last4=Cobb |first4=George P. |bibcode=2007Chmsp..67.2267S }}</ref><ref>{{cite journal |doi=10.1016/j.mrgentox.2007.01.006 |pmid=17360228 |title=Examination of the mutagenicity of RDX and its ''N''-nitroso metabolites using the ''Salmonella'' reverse mutation assay |journal=Mutation Research/Genetic Toxicology and Environmental Mutagenesis |volume=629 |issue=1 |pages=64–9 |year=2007 |last1=Pan |first1=Xiaoping |last2=San Francisco |first2=Michael J. |last3=Lee |first3=Crystal |last4=Ochoa |first4=Kelly M. |last5=Xu |first5=Xiaozheng |last6=Liu |first6=Jun |last7=Zhang |first7=Baohong |last8=Cox |first8=Stephen B. |last9=Cobb |first9=George P. |bibcode=2007MRGTE.629...64P }}</ref> Further research is ongoing, however, and this classification may be revised by the [[United States Environmental Protection Agency]] (EPA).<ref>Muhly, Robert L. (December 2001) [https://web.archive.org/web/20091112035039/http://www.mass.gov/dep/cleanup/compliance/rdxwhite.pdf Update on the Reevaluation of the Carcinogenic Potential of RDX]. [[U.S. Army Center for Health Promotion and Preventive Medicine]] (CHPPM) "white paper"</ref><ref>{{cite web |title=Hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) (CASRN 121-82-4)|url=http://www.epa.gov/iris/subst/0313.htm|publisher=epa.gov|access-date=January 1, 2014}}</ref> Remediating RDX-contaminated water supplies has proven to be successful.<ref>Newell, Charles (August 2008). [https://web.archive.org/web/20140116190908/http://www.serdp.org/content/download/4725/68763/file/ER-0426-FR.pdf Treatment of RDX & HMX Plumes Using Mulch Biowalls]. GSI Environmental, Inc.</ref> It is known to be a kidney toxin in humans and highly toxic to earthworms and plants, thus army testing ranges where RDX was used heavily may need to undergo environmental remediation.<ref>{{cite book|last1=Klapötke|first1=Thomas M.|title=Chemistry of high-energy materials|date=2012|publisher=De Gruyter|location=Berlin [u.a.]|isbn=978-311027358-8|edition=Second}}</ref> Concerns have been raised by research published in late 2017 indicating that the issue has not been addressed correctly by U.S. officials.<ref>Lustgarten, Abrahm, ''[https://www.propublica.org/article/canadian-research-adds-to-worry-over-an-environmental-threat-the-pentagon-has-downplayed-for-decades Canadian Research Adds to Worry Over an Environmental Threat the Pentagon Has Downplayed for Decades, a study released late last year gives environmental experts a way to quantify how much RDX, a chemical used in military explosives, is spreading into surrounding communities]'', Propublica, January 9, 2018</ref>