Intoxication by bleach ingestion

Acute accidental inhalation of Chlorine gas: A mini review

The Authors report an accidental gas exposure of Chlorine gas in a worker. This accident is very uncommon and can lead to important life-threatening conditions, such as Reactive Airway Disfunction Syndrome (RADS) and Acute Respiratory Distress Syndrome (ARDS) with important pulmonary disfunctions and even death. This syndrome results are reversible when a quick and appropriate intensive treatment is performed.

Determination of 3-chloro-l-tyrosine as a novel indicator of chlorine poisoning utilizing gas chromatography-mass spectrometric analysis

Chlorine gas exposure occurs in chemical warfare, industrial and household accidents. In forensic science, the generation of chlorine gas by mixing sodium hypochlorite detergent and strong acid detergent cannot be overlooked because of the possibility of suicide method (NaClO + 2HCl → NaCl + H₂O + Cl₂). Though typical autopsy findings are obtained in chlorine exposure, such as pulmonary edema, useful biomarkers don't exist. In this research, we developed an analytical method of 3-chloro-l-tyrosine (Cl-Tyr) in blood as a novel marker of chlorine poisoning utilizing gas chromatography-mass spectrometry (GC-MS). Cl-Tyr was purified using protein precipitation and cation-exchange solid phase extraction, derivatized by the silylation agent and subjected to GC-MS. The quantification range was 10-200 ng/mL and good reproducibility was obtained. We applied the developed method to analyze Cl-Tyr in autopsy sample, which is suspected of chlorine poisoning, and detected 59.7 ng/mL Cl-Tyr in left heart blood. To our knowledge, this is the first report of determination of the chlorinated biomolecule in the human autopsy sample from chlorine poisoning.

Consequences of chemical impact of disinfectants: safe preventive measures against COVID-19

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has created a significant threat to global health. It originated in Wuhan, China and caused a total of 83,483 confirmed cases and 4634 deaths until June 2020. This novel virus spread primarily through respiratory droplets and close contact. The person-to-person transmission by direct transmittance through cough, sneeze, droplet inhalation, and contact spreading from dry surfaces contaminated with secretions of nose, mouth, and eyes of an infected person has been proven about SARS-CoV-2 transmission. As disease progressed, a series of complications tends to develop, especially in critically ill and immunocompromised patients. Pathological studies showed representative features of acute respiratory distress syndrome (ARDS) and implications on multiple organs as well. However, no specific antiviral drugs or vaccines are immediately available for the treatment of this lethal disease. The efficacy of some promising antivirals needs to be investigated by ongoing clinical trials. In current circumstances, supportive care, precautions, and social distancing are the only preventive options to ameliorate COVID-19. To disinfect the environment, mainly chemical disinfectants are being used robustly. However, due to panic state, fright, and unawareness, people are using it violently, which can have an adverse effect on human health and environment. This review discusses about the potential harmful effect of disinfectants, if used inappropriately. Here, we will also discuss safe preventive options as an alternative to robust use of disinfection methods to fight against COVID-19.

Difficulties in interpretation when assessing prolonged and subacute exposure to the toxic effects of chlorine

The purpose of this study was a toxicological interpretation of exposure to chlorine with unusual course. Medical, clinical and court records, as well as reviews of the literature, served as the basis for this interpretation. The first case of poisoning concerns a 52-year-old man who for a short time (probably several hours), during the industrial cleaning of facilities with sodium hypochlorite, was exposed to chlorine in a presumed high concentration. The man was obese and suffered from hypertension and moderate atherosclerosis, and therefore could be more susceptible to the toxic effects of chlorine. After exposure no pulmonary edema or symptoms typical for acute respiratory distress syndrome were present. The second case concerns the chronic poisoning of a 56-year-old man who worked for eight years, 8 h a day, 5 days a week, in a room which was next to a chlorination room. In this chamber technical sodium hypochlorite was stored and dosed. In both cases, determining a cause and effect relationship between exposure to toxic and allergic agents in the form of active chlorine, and the onset of symptoms may be difficult. The findings described above in the first and second case are particularly important in cases of compensation claims and may have a completely different etiology than previously described in medical literature.

Chemical Burn Induced by Cutaneous Exposure to a Concentrated Sodium Hypochlorite and Alkyl Sulfate Solution

BACKGROUND

Acute irritant contact dermatitis induced by cutaneous exposure to chemicals is a common dermatologic problem in the workplace. In severe cases, irritant contact responses can result in a caustic burn. Chemical burn induced by concentrated sodium hypochlorite (the active ingredient in bleach) has been reported infrequently in the literature, with no previously reported cases of chemical burn due to an alkyl sulfate (a common surfactant in cleaning fluids). Here we describe a chemical burn in a 16-year-old girl resulting from exposure to a solution of concentrated sodium hypochlorite and alkyl sulfate applied as a sanitizer to the interior of roller skates worn at work.

OBSERVATIONS

The diagnosis was made on the basis of the patient's exposure history, clinical appearance, and laboratory results. On physical examination, the erythematous plaque, located at the site of chemical exposure, had intact skin lines, surrounding edema, and decreased sensitivity to touch. The peripheral white blood cell count was within normal limits and bacterial and fungal cultures from the lesion were negative.

CONCLUSIONS

The irritant effect of exposure to chemicals, including those that usually are not major irritants, and the possible additive effect of simultaneous exposure to different chemicals, should be considered in the differential diagnosis of acute dermatitis of unknown etiology. Moreover, increased reporting of cases of chemical-induced acute irritant contact dermatitis will help lead to crucial early and appropriate treatment.

Storage and utilization patterns of cleaning products in the home: toxicity implications

BACKGROUND AND AIMS

Cleaning products are used to achieve cleaner homes. However, they have been responsible for a considerable number of poisoning cases. The aims of this study were to investigate the storage and utilization patterns of cleaning products in the home, as well as the risk of adverse and toxic effects produced by them.

METHODS

This study has been performed using a questionnaire that was developed by the Poison Control and Drug Information Center (PCDIC). The questionnaire was distributed randomly in northern Palestine. The questionnaire included questions regarding storage, utilization habits, and the adverse effects experienced by respondents upon handling the cleaning products.

RESULTS

All respondents utilized and stored cleaning products in their homes. Chlorine bleach and acidic cleaning products were the most common. Respondents stored cleaning products at different places in their homes, but most of those storage places were suboptimal and were within the reach of children. The daily utilization rate of cleaning products was 1.6+/-0.8 with chlorine bleach being the most commonly used. Of the respondents, 27% reported experiencing a wide range of acute adverse and toxic effects resulting from cleaning product use and that exposure occurred mainly via inhalation. Caustic substances, bleach, and kerosene were the agents mainly involved in producing these adverse and toxic effects. About half of those who experienced adverse and toxic effects sought medical help, and 22% of them were children younger than 6 years of age. Finally, most respondents reported mixing and discarding cleaning product leftovers and their containers improperly.

CONCLUSION AND RECOMMENDATIONS

Correct utilization and safer storage of cleaning products is encouraged. Several preventive strategies should be implemented in order to decrease the incidence of accidental harmful exposure that is due to cleaning agents. The role of the PCDIC is very important in the education, prevention, and management of cleaning product-induced adverse effects.