Chemicals covered in this section
This section covers:
* dinitro-o-cresol (DNOC), dinitrophenol and dinoseb (2-sec-butyl 4,6-dinitrophenol);
* pentachlorophenol, also called chlorophen, PCP, and pentachlorphenol;
* sodium pentachlorophenate, also called pentachlorphenate sodium, pentachlorophenoxy sodium, sodium PCP, sodium pentachlorphenate, sodium pentachlorophenolate, and sodium pentachlorophenoxide.
They are used to kill weeds, insects and fungi, and to preserve wood from rot and decay.
How they cause harm
They speed up chemical processes in the body so that the body overheats, causing heat stroke or heat exhaustion. They also damage the liver and kidney and the nervous system. Liquid products may contain petroleum distillates or methanol.
How poisonous they are
Spray, dust and fumes are poisonous if breathed in or swallowed, or if they come into contact with the skin. Poisoning is worse if the patient is hot.
People may be poisoned by breathing in fumes or spray if pentachlorophenol is used inside buildings where there is too little fresh air. It is dangerous to use these chemicals without wearing protective clothing to cover the body and prevent skin absorption.
Signs and symptoms
* If swallowed
Within a few hours:
- yellow skin, especially on the palms of the hands, and yellow hair, but the whites of the eyes do not turn yellow (dinitro-o- cresol and dinoseb only),
- sweating and thirst,
- nausea and vomiting,
- high fever,
- anxiety, restlessness, headache and confusion,
- fast deep breathing,
- fast pulse,
- bright yellow urine (dinitro-o-cresol and dinoseb only),
- the patient passes very little urine, as a result of kidney damage,
- lung oedema.
* On the skin:
- same effects as when swallowed.
* In the eyes:
- severe irritation, redness and watering.
* If breathed in:
- irritation of the nose and throat,
- shortness of breath and chest pain,
- same effects as when swallowed.
What to do
If there are poisonous sprays, dusts, gases or fumes, move the patient into fresh air. Wear breathing equipment to protect yourself from being poisoned.
Give first aid. If the patient stops breathing open the airway, wash chemical off the patient's lips, then give mouth-to-mouth or mouth-to-nose respiration. If the patient is unconscious or drowsy, lay him or her on one side in the recovery position. Check breathing every 10 minutes.
If the patient has a fit, treat as recommended in chapter five.
If the patient is awake, give water to drink, to replace the water lost by sweating.
If the patient has a fever, wash the body with cool water. Do not give aspirin to treat the fever.
Keep the patient lying down and resting.
In the eyes
Dab the face very gently with a cloth or paper to soak up chemical. Wash the eyes for at least 15-20 minutes with water. Check that there are no solid bits of chemical on the lashes or eyebrows, or in the folds of skin round the eyes.
On the skin
Immediately remove contaminated clothes, shoes, socks and jewellery. Wash the skin, nails and hair thoroughly with soap and cold or lukewarm water for at least 15 minutes, if possible using running water. If a large area is affected use a shower or a hand-held hose but protect the patient's eyes. Do not try to remove all the yellow colour - it is in the skin and will not wash off.
Take the patient to hospital at once. Do not let the patient walk, as it will quickly exhaust him or her and make the poisoning worse.
What to do if there is a delay in getting to hospital
Keep the patient lying down in a cool place.
If the chemical was swallowed: if it happened less than 4 hours ago, and if the patient is fully awake, breathing normally, and has not had muscle twitching or fits:
* Give activated charcoal and water to drink.
* Give 2 cupfuls of water every hour for the first 24 hours.
Do not make the patient vomit. The patient may choke on the vomit if he or she becomes unconscious or has a fit.
If the patient has lung oedema, treat as recommended in chapter nine. If the patient has signs of liver damage, treat as recommended in chapter nine. If the patient has signs of kidney damage, treat as recommended in chapter nine.
Information for doctors outside hospital
As well as the effects listed above, there may be metabolic acidosis. Monitor breathing, pulse, blood pressure, rectal temperature, blood glucose, and liver and kidney function. Supportive care, including oxygen and ventilation, should be given as needed:
* Intravenous glucose or frequent meals to make sure the patient has a good supply of energy.
* Fluid and electrolyte balance and acid-base balance should be corrected.
* For repeated fits diazepam should be given by intravenous injection.
Dose: Adults: 10-20 mg at a rate of 0.5 ml (2.5 mg) per 30 seconds, repeated if necessary after 30-60 minutes; this may be followed by intravenous infusion to a maximum of 3 mg/kg of body weight over 24 hours.
Children: 200-300 µg/kg of body weight.