Chapter 37: Domestic Poisons

37.1: Domestic/Household Poisons

Hydrocarbons

Aliphatic Hydrocarbons

• These are %%petroleum distillates%% which are common constituents of several industrial and household products and are involved in accidental poisoning, especially among children.

  1. Low molecular weight:

     1. Gaseous Forms — Methane, ethane, propane, and butane.

     2. Liquid Forms —  Petroleum distillates, are break-down products remaining after processing crude oil.

     3. Kerosene, diesel oil, gasoline, and furniture polishes.

  2. High molecular weight:

     1. Hydrocarbons of petroleum distillate origin:

     2. Petroleum jelly and paraffin wax.

     3. Hydrocarbons of non-petroleum distillate origin:

     4. Turpentine and carbon tetrachloride.

Sign and Symptoms

Acute Poisoning

• A characteristic odor specific to hydrocarbon ingested is appreciated in the vicinity of the patient.
• Peculiar odor is usually evident in breath and vomitus. Cyanosis can occur due to pulmonary complications such as bronchopneumonia.
• Depression resulting in vertigo, giddiness, drowsiness, headache, tremors, convulsions, etc. Toluene sniffing may present with a drunken appearance. Pupils are usually constricted initially but later on dilated when coma supervenes.
• Ingestion of the poison results in pain, burning pain in throat, nausea, vomiting, colicky abdomen, diarrhea, etc.
• Cardiomyopathy, arrhythmias, etc.
• In fatal cases:
  • Drowsiness merges into coma and death due to respiratory failure.
  • There may be intense excitement, hallucinations and convulsions, cyanosis, unconsciousness, profound coma, and death.

Chronic Poisoning

• Chronic eczematoid dermatitis, with redness, itching, and inflammation. Cutaneous exposure to gasoline and other hydrocarbons can cause second-degree burns.
• Dizziness, weakness, weight loss, anemia, nervousness, pain in limbs, peripheral numbness, paraesthesias’s, etc.

Treatment

• Wash the contaminated skin with a copious amount of water and soap.
• Give liquid paraffin orally — dose 250 ml. It dissolves kerosene and reduces its absorption.
• Activated charcoal in large doses is recommended, though petroleum distillers are not adsorbed.
• Saline purgatives may also be useful.
• Avoid gastric lavage for the fear of aspiration.
• Avoid intravenous fluid overload, as it may precipitate pulmonary edema.
• Rest of the treatment includes symptomatic measures.
• Chronic case of poisoning — isolate and prevent further absorption of poison.

Aromatic Hydrocarbons

• Most of the aromatic hydrocarbons are widely used in industry. Some of the examples are benzene, toluene, xylene, styrene, etc.
• Most of the aromatic hydrocarbons have characteristic odors and they are %%absorbed through inhalation, ingestion and direct skin contact%%.
• Both benzene and toluene are highly toxic, while xylene is relatively nontoxic.

Common Domestic Poisons

• Babies and Children
  • Baby powder — Boric acid
  • Crayons (chalk) —- Colored by copper, arsenic, lead components
  • Crayon (wax) — Paranitroaniline, azo dyes
  • Fireworks — Arsenic, antimony, lead, thiocyanate, phosphorus
  • Toys (paints) — Lead, chromium, copper, etc.
• Cosmetics
  • Cuticle remover — Potassium hydroxide, trisodium phosphate
  • Depilatories — Barium sulfide
  • Nailpolish removers — Acetone, ethylacetate
  • Sun tan lotions — Denatured alcohol, methyl salicylate
• Kitchen
  • Baking powder — Tartaric acid (mild irritant)
  • Baking soda — Sodium bicarbonate (causes alkalosis in doses over 5 gm/kg)
  • Dishwashing compounds (machine) — Sodium polyphosphates, sodium carbonate
  • Domestic fuel — Kerosene
  • Domestic gas — LPG (accumulated gas explodes with air when flame/spark is provided)
  • Fire extinguishing fluids — Carbon tetrachloride, methyl bromide
  • Matches — Antimony, phosphorus sesquisulfide, potassium chlorate
• Rat poisons
  • Rat paste — Phosphorus, zinc/aluminum phosphide
  • Rodine (brown bran paste) — Barium carbonate, thallium acetate
  • Warfarin — Yellow phosphorus, it is a 4-hydroxy coumarin
• Sanitary
  • Deodorants — Formaldehyde, naphthalene
  • Drain cleaners — Sodium hydroxid
  • Lysol — Phenol
• Miscellaneous
  • Anti-rust products — Ammonium sulfide, naptha, oxalic acid
  • Cleaning solvents (inflammable) — Petroleum hydrocarbons
  • Cleaning solvents (noninflammable) — Carbon tetrachloride, trichloroethylene
  • Dentifrices, mouthwashes — Hydrogen peroxide
  • Furniture polish — Ordinary denatured spirit, resins, sodium hypochlorite (5%), oxalic acid
  • Insecticide (spray) — Organochloro, organophosphorus and carbamate insecticides
  • Lavatory cleaners — Mineral acids
  • Marking ink — Aniline
  • Mothballs — Naphthalene
  • Paint removers — Sodium hydroxide, acetone
  • Shoe polish — Aniline, nitrobenzene
  • Straw hat cleaner — Oxalic acid

Medical Household Poisons

• Antiseptics — lodine, benzoin, phenol
• Cough remedies — Codeine
• Headache remedies — Asprin, phenacetin, analgin
• Pep tablets — Benzedrine
• Sleeping preparations — Barbiturates
• Throat tablets — Potassium chlorate
• Tonic syrup — Easton’s syrup (strychnine)
• Others — Antidepressants, tranquilizers, antibiotics, analgesics, etc.

Garden Poisons

• Fungicides — Lead arsenate, copper compounds, organic mercurials, lime, sulfur

• Insecticides pesticides — Nicotine, tar oils, organochloro and  organophosphorus compound carbamates, cyanides, etc.

• Weed killers — Sodium chlorate, arsenious oxide (herbicides) and arsenites, dinitrocresol, paraquat

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