Sodium hypochlorite poisoning

Definition

Sodium hypochlorite is a chemical commonly found in bleach, water purifiers, and cleaning products.

Swallowing sodium hypochlorite can lead to poisoning. Breathing sodium hypochlorite fumes may also cause poisoning, especially if the product is mixed with ammonia.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Alternative Names

Bleach; Clorox; Carrel-Dakin solution

Poisonous Ingredient

Sodium hypochlorite

Where Found

• Chemical used to add chlorine to swimming pools
• Disinfectants
• Some bleaching solutions
• Water purifiers

Symptoms

Watered-down (diluted) sodium hypochlorite generally causes only mild stomach irritation. Swallowing larger amounts can cause more serious symptoms.

NEVER mix ammonia with sodium hypochlorite (bleach or bleach-containing products). This common household error produces a toxic gas that can cause choking and serious breathing problems.

Symptoms of sodium hypochlorite poisoning may include:

• Airways and lungs
  • Coughing (from the fumes)
• Eyes, ears, nose, mouth, and throat
  • Burning, red eyes
  • Gagging sensation
  • Pain in the mouth
  • Pain in the throat
  • Possible burns on esophagus
• Heart and blood vessels
  • Chest pain
  • Low blood pressure
  • Slow heartbeat
  • Shock
• Nervous system
  • Delirium
  • Coma
• Skin
  • Irritation of the exposed area
  • Burns
  • Blistering
• Stomach and intestines
  • Stomach or abdominal pain
  • Vomiting

Home Treatment

Seek immediate medical help. DO NOT make a person throw up unless told to do so by Poison Control or a health care professional.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

If the chemical was swallowed, immediately give the person water or milk, unless instructed otherwise by a health care provider. DO NOT give water or milk if the patient is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow.

If the person breathed in the poison, immediately move him or her to fresh air.

Before Calling Emergency

Determine the following information:

• The patient's age, weight, and condition
• The name of the product (ingredients and strengths if known)
• The time it was swallowed
• The amount swallowed

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to expect at the emergency room

The person will be admitted to a hospital. The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.

Specific treatment depends on how the poisoning occured.

For swallowed poison:

• A tube thru the nose into the stomach to empty the stomach (gastric lavage)
• Endoscopy -- camera down the throat to see burns in the esophagus and the stomach
• Fluids by IV
• Medicine (antidote) to reverse the effect of the poison

For inhaled poison, treatment may include:

• Breathing tube
• Bronchoscopy -- camera down the throat to see burns in the airways and lungs
• Oxygen

For skin exposure, treatment may include:

• Irrigation (washing of the skin), perhaps every few hours for several days
• Skin debridement (surgical removal of burned skin)
• Transfer to a hospital that specializes in burn care

Expectations (prognosis)

Swallowing , smelling, or touching household bleach will likely not cause any significant problems. However, more severe problems can occur with industrial strength bleach, or mixing bleach with ammonia.

How well a patient does depends on how rapidly the sodium hypochlorite was diluted and neutralized. There is a good chance of recovery if proper treatment is given soon after the poison was swallowed. Without prompt treatment, extensive damage to the mouth, throat, eyes, lungs, esophagus, nose, and stomach are possible, depending on how exposure occurred.

References

Ford MD, Clinical Toxicology. 1st ed. Philadelphia, Pa: WB Saunders; 2001:753.

Agabiti N, Ancona C, Forastiere F, et al. Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident. Occup Environ Med. 2001 Jun;58(6):399-404.

Lambert H, Manel J, Gabrion I. Poisoning by household products. Rev Prat. 2000 Feb 15;50(4):365-71.