Hydrogen Peroxide Poisoning

Abstract

Hydrogen peroxide is an oxidising agent that is used in a number of household products, including general-purpose disinfectants, chlorine-free bleaches, fabric stain removers, contact lens disinfectants and hair dyes, and it is a component of some tooth whitening products. In industry, the principal use of hydrogen peroxide is as a bleaching agent in the manufacture of paper and pulp. Hydrogen peroxide has been employed medicinally for wound irrigation and for the sterilisation of ophthalmic and endoscopic instruments. Hydrogen peroxide causes toxicity via three main mechanisms: corrosive damage, oxygen gas formation and lipid peroxidation. Concentrated hydrogen peroxide is caustic and exposure may result in local tissue damage. Ingestion of concentrated (>35%) hydrogen peroxide can also result in the generation of substantial volumes of oxygen. Where the amount of oxygen evolved exceeds its maximum solubility in blood, venous or arterial gas embolism may occur. The mechanism of CNS damage is thought to be arterial gas embolisation with subsequent brain infarction. Rapid generation of oxygen in closed body cavities can also cause mechanical distension and there is potential for the rupture of the hollow viscus secondary to oxygen liberation. In addition, intravascular foaming following absorption can seriously impede right ventricular output and produce complete loss of cardiac output. Hydrogen peroxide can also exert a direct cytotoxic effect via lipid peroxidation. Ingestion of hydrogen peroxide may cause irritation of the gastrointestinal tract with nausea, vomiting, haematemesis and foaming at the mouth; the foam may obstruct the respiratory tract or result in pulmonary aspiration. Painful gastric distension and belching may be caused by the liberation of large volumes of oxygen in the stomach. Blistering of the mucosae and oropharyngeal burns are common following ingestion of concentrated solutions, and laryngospasm and haemorrhagic gastritis have been reported. Sinus tachycardia, lethargy, confusion, coma, convulsions, stridor, sub-epiglottic narrowing, apnoea, cyanosis and cardiorespiratory arrest may ensue within minutes of ingestion. Oxygen gas embolism may produce multiple cerebral infarctions. Although most inhalational exposures cause little more than coughing and transient dyspnoea, inhalation of highly concentrated solutions of hydrogen peroxide can cause severe irritation and inflammation of mucous membranes, with coughing and dyspnoea. Shock, coma and convulsions may ensue and pulmonary oedema may occur up to 24-72 hours post exposure. Severe toxicity has resulted from the use of hydrogen peroxide solutions to irrigate wounds within closed body cavities or under pressure as oxygen gas embolism has resulted. Inflammation, blistering and severe skin damage may follow dermal contact. Ocular exposure to 3% solutions may cause immediate stinging, irritation, lacrimation and blurred vision, but severe injury is unlikely. Exposure to more concentrated hydrogen peroxide solutions (>10%) may result in ulce...

Anaesthetic properties of ketamine in chicks stressed with hydrogen peroxide

“…Several previous studies have used the powerful oxidant agent H 2 O 2 for induction of OS in laboratory animals such as rabbits, rats and chicks (Wohaieb et al 1994;Mohammad et al 1999; Mousa and Mohammad 2012a); further, it is known that OS modulates the pharmacological response to centrally acting sedatives and analgesics in chicks (Mousa and Mohammad 2012a). H 2 O 2 induces OS through its ability to elevate the reactive oxygen species and free radical formation in the body tissue especially in the CNS (Pastore et al 2003;Watt et al 2004;Sayre et al 2008) as well as facilitating oxidative damage that affects the blood-brain barrier (Lochhead et al 2010) which increase the permeability of materials and drugs. The goal of this study was to induce OS in chicks with H 2 O 2 and to examine its impact on the anaesthetic properties of ketamine, i.e., its hypnotic and analgesic efficacy in chicks.…”

“…The hypnotic and analgesic efficacy as well as the lethal effects of ketamine were shown to be augmented in the stressed chicks in comparison to those receiving only tap water which is reported here for the first time by measuring the hypnotic and analgesic ED 50s and acute LD 50 values of ketamine in chicks. These changes can be attributed to the ability of H 2 O 2 to elevate reactive oxygen species and free radical formation especially in the CNS (Pastore et al 2003;Watt et al 2004;Sayre et al 2008) as well as oxidative damage that affects the blood-brain barrier (Lochhead et al 2010). This can increase the permeability of centrally acting drugs such as ketamine, leading to increased ketamine concentrations in the CNS, in turn leading to higher effects on its target receptor.…”

Minimally Invasive Sensing

“…The biosensors employed in these devices used glucose oxidase enzyme that was distributed throughout the gel (Tierney et al, 2001). Considering that the product of the glucose-glucose oxidase reaction is hydrogen peroxide, a known irritant (Watt et al, 2004), it is clear that irritation is a risk with prolonged use of these types of embedded sensors. The use of mediated enzyme electrodes for analyte detection, where the detection enzyme is bonded to the electrode alongside a mediator (Liu & Okuma, 1998;Sato et al, 2006), or where the components are dispersed in the ink of a printed electrode (Saby et al, 1995), has removed this particular limitation.…”

Hydrogen Peroxide for Insect and Algae Control in a Lettuce Hydroponic Environment

“…The objective of this work was to evaluate the efficiency of hydrogen peroxide (H 2 O 2 ) as a sanitizing agent (for algae control) and insecticide (for fly control) in a hydroponic commercial system. H 2 O 2 has a recognized potential for causing oxidative stress in living organisms (Vännin & Koskula, 1998;Qin et al, 2011;Wojtyla et al, 2016) and is widely used as a disinfectant and sterilant (Watt et al, 2004). The evaluation of entomopathogenic fungi to replace synthetic insecticides, in the control of fungus gnats and shore fly, was also explored as a more sustainable form of fly control (Stanghellini & El-Hamalawi, 2005) and other vector insects (Tiago et al, 2014), in a hydroponic system.…”