Chemicals covered in this section
Soap is a natural product made from animal or vegetable fats or oils. Deter-gents are synthetic chemicals. They are more effective cleaning agents than soap and do not cause scum in hard water. There are three groups: nonionic, anionic and cationic. It is important to be able to distinguish the cationic detergents from other kinds, because they are more harmful.
The most common cationic detergents are benzalkonium, cetrimide, cetylpyridinium and dequalinium. They are sometimes called quaternary ammonium compounds.
Detergent products usually also contain other chemicals such as phosphates, carbonates and silicates to improve the cleaning action, bleaches, perfumes, chemicals to kill bacteria, and stain removers.
Anionic detergents are used in most household products for washing dishes, clothes, or hair or for general household cleaning. Nonionic detergents are used in low-lather laundry products.
Cationic detergents are used as antiseptics and disinfectants in the home, in the food and dairy industries, in health centres and in hospitals.
Soap is usually sold in solid blocks or bars, liquids or flakes for washing the skin or washing fabrics.
How they cause harm
Most household products containing anionic or nonionic detergents are mild irritants. Detergents for use in automatic dishwashers are corrosive, and so are many products used in hospitals, agriculture or industry. Cationic detergents may burn the inside of the mouth and throat and are also poisonous when swallowed, affecting the muscles.
Some shampoos for killing lice or other insects contain insecticides. If the shampoo is not used in the right way, people may be poisoned by the insecticide.
How poisonous they are
Household detergents do not usually cause harm if swallowed in small amounts, except for automatic dishwasher detergents which can cause burns. Cationic detergents may cause serious poisoning that may result in death.
Signs and symptoms
* If swallowed
Soap, nonionic and anionic detergents:
- soreness in the mouth,
- swelling of lips and tongue if a block of soap is sucked,
- vomiting and diarrhoea.
- burns in the mouth, throat and gullet,
- vomiting and diarrhoea,
- muscle weakness,
- the patient cannot breathe,
- low blood pressure,
- lung oedema.
* On the skin
Repeated contact may make skin dry and cracked.
* In the eyes
Cationic detergents may cause serious burns.
What to do
Give first aid. If breathing stops, open the airway and give mouth-to-mouth respiration. If the patient is unconscious or drowsy, lay him or her on one side in the recovery position. Check breathing every 10 minutes and keep the patient warm.
If the patient has a fit, treat as recommended in chapter five.
Take the patient to hospital at once in any of the following circumstances:
* The patient has swallowed a product containing cationic detergent.
* The patient vomits for a long time or has other signs or symptoms of poisoning.
* The patient has burns in the mouth.
If the patient does not need to go to hospital, give milk to drink.
In the eyes
Gently brush or dab away any liquid or powder from the face then 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. Take the patient to hospital if pain or irritation continues.
On the skin
Remove contaminated clothing, shoes, socks and jewellery. Wash the skin well with cold water, if possible using running water.
What to do if there is a delay in getting to hospital
If the chemical was swallowed: if the patient is awake, give a cup of water to drink. Do not try to make the patient vomit, because the vomit may burn the throat.
If there are signs of lung oedema, treat as recommended in chapter nine.
Information for doctors outside hospital
Monitor breathing, pulse, blood pressure, and fluid and electrolyte balance. Supportive care, including oxygen and ventilation, should be given as needed. 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.