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.

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

  2. High molecular weight:

     1. Hydrocarbons of petroleum distillate origin:

        1. Petroleum jelly and paraffin wax.

     2. Hydrocarbons of non-petroleum distillate origin:

        1. 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