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close this bookManagement of Poisoning - A Handbook for Health Care Workers (ILO, WHO; 1997; 267 pages)
View the documentPreface
View the documentAcknowledgements
open this folder and view contentsIntroduction
open this folder and view contentsPart 1 - General Information on Poison and Poisoning
close this folderPart 2 - Information on specific poisons
open this folder and view contentsIntroduction
open this folder and view contentsPesticides
close this folderChemicals and chemical products used in the home and the workplace
View the documentAerosol sprays
View the documentAir-fresheners, deodorant blocks and moth-balls
View the documentBenzene, tetrachloroethylene, toluene, trichloroethane, trichloroethylene and xylene
View the documentBorax, boric acid, and sodium perborate
View the documentButton batteries
View the documentCarbon monoxide
View the documentCarbon tetrachloride
View the documentCaustic and corrosive chemicals
View the documentCosmetics and toiletries
View the documentCyanides
View the documentDisinfectants and antiseptics
View the documentEthanol and isopropanol
View the documentEthylene glycol and methanol
View the documentGlue
View the documentLead
View the documentPetroleum distillates
View the documentPhosgene
View the documentSoap and detergents
View the documentTobacco products
View the documentVolatile oils
View the documentProducts that are not usually harmful
open this folder and view contentsMedicines
open this folder and view contentsPlants, animals and natural toxins
View the documentWord list
 

Soap and detergents

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.

Uses

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.


Cationic detergents:

- burns in the mouth, throat and gullet,
- vomiting and diarrhoea,
- muscle weakness,
- the patient cannot breathe,
- unconsciousness,
- fits,
- 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.

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