Hydrogen Peroxide Poisoning [Toxicity] –Ingestion-Inhalations-[Case Study]
Pure hydrogen peroxide is found in the form of crystalline solid below 12 F and above 12F it exists in the form of colorless liquid having a bitter test. Hydrogen Peroxide (H2O2) is commonly always used as a diluted aqueous solution, which is available in different concentrations form (3% to 10%) for household use purpose and in higher concentrated form (greater than 30%) for industrial application. Hydrogen peroxide is unstable and decomposing rapidly into oxygen and water with the liberation of heat. Commercial peroxide products added a stabilizer (usually acetanilide) to bring slow down the rate of spontaneous decomposition in the presence of light and heat.
Hydrogen peroxide is non-flammable in nature, however, it is a powerful oxidizing agent that can result in spontaneous combustion when it makes contact with organic material.
Hydrogen Peroxide Poisoning
Inhalation of hydrogen peroxide in the form of vapors, aerosols, or mists from high concentrated solutions can cause major morbidity. H2O2 vapor is heavier than atmospheric air and can cause asphyxiation in sheltered, inadequately ventilated, or low-lying fields. The presence of hydrogen peroxide is not detectable by a person because it is nearly odorless almost non-irritating except its high concentration.
Children may be more vulnerable to the corrosiveness of hydrogen peroxide as compared to adults because of the lesser diameter of their airways. When Children are exposed to the same levels of hydrogen peroxide vapor as adults they may receive larger doses because their small height of stature as the hydrogen peroxide is heavier than the air and found in higher concentration near to the ground
hydrogen peroxide may also cause problems if it is ingested, low concentrated solution hydrogen peroxide up to concentrations of 9% are usually nontoxic; but, even a 3% solution is mildly irritating to the mucosal tissue and can cause vomiting and diarrhea. Ingestion of high-strength solutions (10% or higher) can cause systemic toxicity and sometimes turned evidence of fatalities
Hydrogen peroxide (H2O2) is scantily absorbed throughout the intact skin. When it is consumed for household disinfectant purposes with diluted concentration (3% to 5%), it can mildly irritating to the skin and mucous membranes. At a concentration of 10% H2O2, which is used in several hair-bleaching solutions, it can cause strong irritation and may be corrosive to skin
What happens within body On Ingestion of High Concentration?
Ingestion of concentrated hydrogen peroxide can produce large volumes of oxygen gas. When oxygen levels crossed their maximum solubility limits in blood, venous or arterial gas emboli formation may be happening. The speedy generation of oxygen in closed body cavities can result in mechanical distension with prospective significant risk for hollow viscus rupture due to oxygen liberation. The liberation of large volumes of oxygen in the stomach can cause painful gastric distension and belching.
Household use of concentrated hydrogen peroxide may increase the chances of accidental ingestion of concentrated solution of H2O2. Futher its odourless, colorless, and properties, H2O2 can be easily misguided as water when not stored in a proper manner. As an oxidizing agent, it is corrosive to the surrounding tissues while ingested and can cause oxygen emboli formation, which are captured on CT as systemic venous and/or portal gas. Hyperbaric oxygen therapy is a useful and effective treatment. More than to hyperbaric oxygen therapy, the patients have to follow-up the CT abdomen and pelvis area of the body.
How Hydrogen Peroxide become a hazard to health
While ingestion of diluted solution (3%) of H2O2 is generally asymptomatic or with minimal symptoms, exposure to higher concentration (>35%) is corrosive and to be expected to cause tissue damage requiring medical treatment. so we should always aware of hydrogen peroxide poisoning effect
Case Study of Hydrogen Peroxide Poisoning
Hydrogen Peroxide Poisoning: Case study-1.
A case of accidental of a highly concentrated (35%) solution of H2O2 ingestion accidental case study:
A man of 52-years old admitted to the emergency department with severe nausea and vomiting symptoms, which is further reported as an accidental case of the ingestion of H2O2. [1] Accidental ingestion of high concentration H2O2 solution has become a cause of extensive injury to surrounding tissues. The case study reveals that this injury spreads via three major mechanisms such as (i) corrosive damage, (ii) oxygen gas formation, and (iii) lipid peroxidation.
35% of hydrogen peroxide may be lethal upon ingestion and have need of to be handle with caution and appropriately and systematic storage. Public awareness and regulation of the use and safety hazardous of this hydrogen peroxide is essential.
Hydrogen Peroxide Poisoning: Case study-2.
An healthy man of 39-year-old has reported to accidental ingestion of 1/2 of a half litter container of 35% hydrogen peroxide solution. The hydrogen peroxide was in an unlabelled container in a friend’s refrigerator and was taken as considering water. Without delay after ingesting the hydrogen peroxide, he felt that it was caustic stuff and he drank a glass of water to induce vomiting. A miniature amount of hematemesis was observed . He suffered from mild epigastric pain with no oropharyngitis. or shortness of breath[3]
Hydrogen Peroxide Poisoning: Case study-3.
A Seventy-three-year-old woman reported with mild epigastric pain and hematemesis. She had suffered from depression and Alzheimer’s dementia without any identified GI disorder. She admitted to the hospital that she had taken bleaching stuff with suicidal intent before arrival, which has 3% hydrogen peroxide (H2O2), Basic and essential laboratory tests were found normal. were normal. intrahepatic portal venous gas is reported by CT gas, and hemorrhagic gastritis is reported by EGD After a few days of middle-of-the-road treatment with a proton pump inhibitor, she was discharged from the hospital without any sequelae.[2]
How the strength of H2O2is represented
When 1 volume of 10-volume hydrogen peroxide is decomposed, it generates 10 volumes of oxygen; the 3% solution of hydrogen peroxide is equivalent to 10-volume concentration. For laboratory application, 30% solutions are generally used and commercial grades hydrogen peroxide from 70% to 98% are also available,
References
1.Eslam W Youssef,Victor S Chukwueke, Lina Elsamaloty, Sherif Moawad, Haitham Elsamaloty;Radiology Case. 2018 Aug; 12(8):12-16
2.S Pritchett, D Green, P Rossos. Accidental ingestion of 35% hydrogen peroxide. Can J Gastroenterol 2007;21(10):665-667.
3.http://dx.doi.org/10.1016/j.gie.2013.11.039
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