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|Example of Acute Exposure data from MEDITEXT.|
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ACUTE EXPOSURE INFORMATION
- USES: Hydrogen peroxide is a colorless, odorless liquid at room temperature, with a bitter taste. It is found in many household products at low concentrations (3% to 5%) for medicinal applications as skin disinfectant and antiseptic, and as a clothes and hair bleach. In industry, hydrogen peroxide in higher concentrations (10% to 35%) is used as bleach for textiles and paper, as a component of rocket fuels, and for producing foam rubber and organic chemicals (up to 70% concentration).
- PHARMACOLOGY: Hydrogen peroxide is an oxidizing agent. The strength of the oxidizing reaction is determined by the concentration.
- TOXICOLOGY: The primary effect is tissue injury due to oxidation of proteins. Hydrogen peroxide can be toxic if ingested, inhaled, or contacts the skin or eyes. Occasionally, the release of oxygen may cause distension, gastric or intestinal perforation, as well as venous or arterial gas embolization. One mL of 3% hydrogen peroxide produces 10 mL of oxygen at standard temperature and pressure, while 60 mL of 35% of hydrogen peroxide solution has the potential to produce 6.1 L of oxygen.
- EPIDEMIOLOGY: Ingestions are relatively common, but serious toxicity is rare with ingestion of household products.
- WITH THERAPEUTIC USE
- Hydrogen peroxide may cause burning when applied to wounds as a disinfectant. Systemic embolization has occurred when used for irrigation of surgical wounds resulting in ECG changes and, rarely, cardiac arrest and death. Risk increases when used under high pressure, in closed tissue spaces and a highly concentrated hydrogen peroxide solution is applied.
- WITH POISONING/EXPOSURE
- MILD TO MODERATE TOXICITY: The severity of injury depends on the concentration and amount of the ingested hydrogen peroxide. Ingestion of dilute solutions of hydrogen peroxide may result in vomiting, mild gastrointestinal (GI) irritation, gastric distension, and, on rare occasions, gastrointestinal erosions or gas embolism. Inhalation and ocular exposure of household strength hydrogen peroxide (3%) can cause respiratory irritation and mild ocular irritation, respectively.
- SEVERE TOXICITY: INGESTION: Severe toxicity generally only occurs with ingestion of higher (greater than 10%) concentration products. Ingestions may cause caustic injuries to the gastrointestinal tract, leading to hemorrhagic gastritis, burns in the mouth, throat, esophagus, and stomach, ulcerating colitis, intestinal gangrene, and gas embolization. Systemic gas embolization can involve any organ, resulting in seizure, cerebral infarction, cerebral edema, spinal cord infarction, acute myocardial infarction, hypotension, cardiac arrest, and death. INHALATION: Inhalation of vapors from concentrated (greater than 10%) solutions may result in severe pulmonary irritation. Acute lung injury and respiratory arrest have also been reported following massive exposures. OCULAR: Eye exposure to high concentrations can cause corneal ulceration and perforation. DERMAL: Dermal exposure to concentrated solutions has resulted in burns and gangrene.
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