A lethal danger in the home: turpentine poisoning

Turpentine is an oleoresin obtained from various species of pine. In turpentine poisoning, various signs and symptoms of toxicity may develop, including hematuria, renal failure, loss of vision, chest pain, vomiting, severe coughing, gastroesophageal hemorrhage, hypotension, swelling of the throat and even death. We report a case of turpentine ingestion in a 9-year-old boy. The patient was admitted to our clinic with suspected intoxication after accidentally drinking from a glass that held a turpentine oil preparation used by his father for hair care. The patient displayed no significant signs and symptoms other than bradycardia and hypotension. Laboratory investigations revealed no abnormalities. The patient was hospitalized for close monitoring and observation. During a two-and-a-half-day observation period, hypotension was corrected with administration of dopamine and intravenous fluids. In this report, we wish to draw attention to the dangerous effects of plant-derived drugs.

Why people drink shampoo? Food Imitating Products are fooling brains and endangering consumers for marketing purposes

A Food Imitating Product (FIP) is a household cleaner or a personal care product that exhibits food attributes in order to enrich consumption experience. As revealed by many cases worldwide, such a marketing strategy led to unintentional self-poisonings and deaths. FIPs therefore constitute a very serious health and public policy issue. To understand why FIPs are a threat, we first conducted a qualitative analysis on real-life cases of household cleaners and personal care products-related phone calls at a poison control center followed by a behavioral experiment. Unintentional self-poisoning in the home following the accidental ingestion of a hygiene product by a healthy adult is very likely to result from these products being packaged like foodstuffs. Our hypothesis is that FIPs are non-verbal food metaphors that could fool the brain of consumers. We therefore conducted a subsequent functional neuroimaging (fMRI) experiment that revealed how visual processing of FIPs leads to cortical taste inferences. Considered in the grounded cognition perspective, the results of our studies reveal that healthy adults can unintentionally categorize a personal care product as something edible when a food-like package is employed to market nonedible and/or dangerous products. Our methodology combining field (qualitative) and laboratory (behavioral and functional neuroimaging) findings could be of particular relevance for policy makers, as it can help screening products prior to their market release – e.g. the way they are packaged and how they can potentially confuse the mind of consumers – and therefore save lives.

Nekrotisierende toxische Kontaktdermatitis der Kopfhaut durch Wasserstoffperoxid

Skin reactions to chemicals used by hair dressers are usually reported as irritative or allergic contact dermatitis of the hands. We describe a 15-year old girl who suffered an unusually severe injury to her scalp with necrosis of the galea aponeurotica as a result of highlighting her hair. Injury resulted in a scaring alopecia, which can only be treated by plastic reconstructive surgery. The cause for this injury might have been a higher than usual concentration of hydrogen peroxide used for highlighting the hair.

Asthma and hairdressers

PURPOSE OF REVIEW

Hairdressers have an increased prevalence of respiratory diseases and are at high risk of occupational asthma. In this paper we aim to review the most recent findings in respiratory diseases related to the occupation of hairdressing to provide a background for management and prevention.

RECENT FINDINGS

Recent studies have described several cases of occupational asthma and occupational rhinitis in hairdressers. Persulphate salts are the major causal agents. Sensitization to persulphate salts seems more related to an individual hypersusceptibility than to environmental factors. An underlying immunologic mechanism is strongly suggested but not definitively demonstrated. The diagnosis of persulphate asthma is based on the specific challenge, for which standardized methods have been described. Some data show the presence of respiratory disorders in an early stage in apprentices and demonstrate that after diagnosis a proportion of hairdressers with occupational asthma remain symptomatic despite cessation of exposure.

SUMMARY

Careful medical surveillance is recommended for hairdressers and for hairdressing apprentices. Further studies are needed to evaluate the mechanism of persulphate asthma and to determine the relative role of individual risk factors compared with environmental factors in the development of the disease.

Polymer fume fever-like syndrome due to hairspray inhalation

Inhalation of fluoropolymer pyrolysis products causes a self-limited illness termed polymer fume fever; symptoms include fever, chills, myalgias and non-productive cough, and are easily mistaken for an acute viral illness. We report a 29-y-old male who developed fever and pneumonitis shortly after the inhalation of pyrolyzed hairspray. Chest x-rays showed pictures consistent with pneumonitis. The patient was treated solely with supplemental oxgen, and his symptoms resolved over 24 h. Inhalation of pyrolyzed hairspray may cause a syndrome resembling polymer fume fever.

From profound hypokalemia to life-threatening hyperkalemia: a case of barium sulfide poisoning

We describe a 25-year-old man who was brought to the emergency department with skeletal muscle weakness, respiratory arrest, and rhabdomyolysis, as well as life-threatening hyperkalemia, after ingesting a depilatory containing barium sulfide (Magic Shave; Carson Products Co, Savannah, Ga). The findings of his physical examination were significant for hyporeflexia with marked weakness. He was in respiratory distress and required intubation and ventilatory support owing to progressive weakness of the respiratory muscles. His serum potassium level was 1.5 mmol/L. He was treated with intravenous and oral potassium. His serum potassium level peaked at 8.3 mmol/L and his serum creatine kinase level at 8286 IU/L. His acute respiratory weakness resolved with correction of the potassium concentration; his rhabdomyolysis responded well to hydration; and his renal function returned to normal. We also discuss the various pathophysiological findings in this case and compare our patient with another who, despite ingesting a similar amount of the same hair remover, did not develop any of the above complications.

Sudden death due to intravenous infusion of hair conditioner

A case of sudden death in a 14-year-old girl due to self administration of hair conditioner through an intravenous infusion pump is described. This report demonstrates difficulties that may occur in determining the manner of death in such cases and outlines a specific danger that may occur when adolescents have unsupervised access to intravenous infusion equipment.

Toxic mechanism of bromate poisoning in a dog: a case study

Efforts to link the observed signs in a canine poisoning event with 1 or more possible permanent wave solution chemicals ingested are described. A scenario is presented describing the mechanisms by which the most likely of those compounds, ammonium thioglycolate and sodium or potassium bromate, could have acted to cause both the immediate and delayed signs of acute vestibular dysfunction.

Fatality associated with inhalation of a pyrethrin shampoo

A fatality associated with the inhalational exposure to a pyrethrin insecticide is described. Death was attributed to sudden irreversible bronchospasm. While less severe allergic reactions have been reported, this is the first death associated with pyrethrin inhalation.

Two children with bromate intoxication due to ingestion of the second preparation for permanent hair waving

We report two children who suffered from sodium bromate intoxication due to ingestion of the second preparation for permanent hair waving (the second permanent preparation). One child suffered from gastrointestinal symptoms only. The other exhibited slight acute renal insufficiency. Results of the histological examination of the kidney in the sick child with acute renal insufficiency showed sporadic epithelial separation of the proximal tubuli under light microscopy. In addition, we could demonstrate more clearly epithelial separation and unbroken tubular basement membranes under electron microscopy (EM). To our knowledge, this is the first report of EM findings in this disease. The mechanism of epithelial injuries by bromate is not clear.

Fatal ethanol intoxication from household products not intended for ingestion

Fatal acute ethanol intoxication is frequently encountered in medicolegal practice. Although the vast majority of acute ethanol toxicity deaths follow the ingestion of conventional alcoholic beverages, ethanol can be obtained from a variety of commercial products, which often contain high levels of ethyl alcohol but are not manufactured or designed for consumption. Such products may be easily purchased in locales where statutory limitations restrict liquor availability on Sundays or during the early morning hours. Several acute ethanol fatalities have been encountered in New Mexico that were directly related to consumption of non-beverage ethanol-containing products, all of them occurring during times when alcoholic beverage sales were restricted. Despite the fact that manufacturers deliberately include compounds in these products that discourage ingestion, this policy apparently does little to deter individuals who are searching for a source of ethanol when no conventional beverages are available. The products that were consumed in these fatalities also contained other compounds which would be toxic at much greater concentrations, but which were inconsequential in their effects in comparison with the direct toxic effect of ethanol. Investigation of the scene and awareness that alcohol-containing products can be fatally abused are essential to detecting these unconventional ethanol sources.

Toxicity and carcinogenicity of potassium bromate--a new renal carcinogen

Potassium bromate (KBrO3) is an oxidizing agent that has been used as a food additive, mainly in the bread-making process. Although adverse effects are not evident in animals fed bread-based diets made from flour treated with KBrO3, the agent is carcinogenic in rats and nephrotoxic in both man and experimental animals when given orally. It has been demonstrated that KBrO3 induces renal cell tumors, mesotheliomas of the peritoneum, and follicular cell tumors of the thyroid. In addition, experiments aimed at elucidating the mode of carcinogenic action have revealed that KBrO3 is a complete carcinogen, possessing both initiating and promoting activities for rat renal tumorigenesis. However, the potential seems to be weak in mice and hamsters. In contrast to its weak mutagenic activity in microbial assays, KBrO3 showed relatively strong potential inducing chromosome aberrations both in vitro and in vivo. Glutathione and cysteine degrade KBrO3 in vitro; in turn, the KBrO3 has inhibitory effects on inducing lipid peroxidation in the rat kidney. Active oxygen radicals generated from KBrO3 were implicated in its toxic and carcinogenic effects, especially because KBrO3 produced 8-hydroxydeoxyguanosine in the rat kidney. A wide range of data from applications of various analytical methods are now available for risk assessment purposes.

Mortality of hematopoietic disorders and hair dye use among barbers

A total of 8,316 barbers were followed up from 1976 to 1987 to examine the relations between hair dye use and deaths from hematopoietic disorders. The follow-up rate was about 95%. Three leukemia deaths and two malignant lymphoma deaths were observed in this cohort. The observed deaths were less than the expected number calculated from age- and sex-specific mortality of the general population in Japan (3.8 and 3.0, respectively). No deaths from aplastic anemia or the other hematopoietic disorders were observed.

Bromate intoxication: hairdressers' anuria

A 17-year-old hairdresser developed sodium bromate poisoning after drinking a cup of hair neutralizer in a suicide attempt. She presented 1 week later with anuria, required hemodialysis for 5 days, and subsequently recovered. Sensorineural hearing loss, often a characteristic finding, was absent. Early diagnosis of bromate intoxication requires an appreciation that it commonly occurs in hairdressers, may be accompanied by deafness, and may present with insidious anuria.

Acute bromate poisoning associated with renal failure and deafness presenting as hemolytic uremic syndrome

A case of bromate-induced acute renal failure (ARF) in an infant associated with hemolysis, thrombocytopenia and deafness is presented. The initial clinical and laboratory features suggested the diagnosis of hemolytic uremic syndrome (HUS). The serum bromide level was in the nontoxic range (1.2 mg/dl). However, further investigation of the ingested material revealed the toxic agent to be bromate rather than bromide. The spectrum of bromate (BrO3-) toxicity is different from bromide (Br-) and includes the induction of ARF and deafness. This combined with clinical evidence of behavioral regression and speech loss led to detection of deafness in this patient and confirmed the diagnosis of bromate toxicity.

Paraphenylenediamine induced acute tubular necrosis following hair dye ingestion

A case is reported of paraphenylenediamine toxicity following hair dye ingestion. Renal biopsy showed histology typical of acute tubular necrosis.

Lead poisoning from hair spray ingestion

A 37-year-old alcoholic woman was poisoned by lead from drinking hair spray mixed with water. Laboratory and pathologic findings showed changes due to lead poisoning. Further analysis by Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray Analysis (EDXA) confirmed the presence of lead in both the tissues and the hair spray. The significance of these findings is discussed.

Severe acute poisoning from the ingestion of a permanent wave solution of mercuric chloride

1 A woman developed severe mercury intoxication from ingestion of about 2.5 g of mercuric chloride. 2 Antidotal treatment with a dithiol (BAL i.m.) and a monothiol (tiopronin i.v.) was started promptly. 3 Dialysis treatment thereafter markedly increased the elimination of mercury, thus hastening recovery. 4 It is suggested that chelating agents associated with dialysis are an effective treatment for mercury poisoning.

Hearing loss following potassium bromate: two case reports

Bromate has not been regarded as an ototoxic drug. Potassium bromate, marketed as a neutralizer in home permanent cold wave hair kits, has caused several cases of accidental poisoning in children, resulting from the ingestion of this solution. Two cases of hearing loss following ingestion of this solution for the purpose of suicide have been reported here and in the literature review.

Relationship of hair dye use, benign breast disease, and breast cancer

An epidemiologic case-control study of 118 breast cancer patients and 233 controls was conducted to test the hypothesis that hair dyes are related to breast cancer. Matched controls were selected by "random digit dialing," and all epidemiologic data were collected by telephone interviews. No overall association was detected. On a prospective basis, the interaction between hair dye exposure and six variables known to be risk factors for breast cancer then were examined: previous benign breast disease (BBD), "ever" versus "never" pregnant, age at first pregnancy, menopause induced by operation, age at menarche, and education. A statistically significant increased risk of breast cancer was found for women with a history of BBD and exposure to hair dyes as compared to women with BBD but no hair dye exposure: The relative risk (RR) was 4.5, and the 95% confidence intervals (C) were 1.20 and 15.78. A total of 24 women (19 patients and 5 controls) reported a history of BBD and hair dye use. Further analysis revealed a significant association between hair dye use and breast cancer among women 40-49 years of age (RR = 3.33; 95% CI: 1.1 and 10.85) and a highly significant (P = 0.0008) dose-response relationship among women who used hair dyes for changing their natural color as opposed to covering gray hair. The numbers of patients and controls included in this study were small and several hypotheses were tested. Additional epidemiologic studies are needed before firm conclusions can be reached concerning the nature of these associations.

Case-control study of hair dye use by patients with breast cancer and endometrial cancer

A case-control study was undertaken of use of permanent and semipermanent hair dyes by women with cancers of several sites, including breast and endometrium. In London, Ontario, 50 cases of of breast cancer and in Toronto 35 cases of breast cancer and 36 cases of endometrial cancer were identified in cancer treatment centers. In London, controls were selected from hospitalized women with diseases other than cancer; in Toronto, controls were selected from women living in the same neighborhood as the patients with cancer. The results did not suggest an increased risk of either breast or endometrial cancer in users of permanent or permanent and semipermanent dyes combined. Although the numbers of cases and controls were small, the consistency of the results for both sites, in both study centers, and the absence of any clear positive relationship between various measures of intensity of use and risk of cancer provided evidence that a large increase in risk was not missed.