Day Rachael, Eddleston Michael, Thomas Simon H L, Thompson John P, Bradberry Sally M, Vale J Allister
a NPIS (Birmingham Unit) , City Hospital , Birmingham , UK.
b NPIS (Edinburgh Unit) , Royal Infirmary , Edinburgh , UK.
Clin Toxicol (Phila). 2017 Mar;55(3):221-226. doi: 10.1080/15563650.2016.1271130. Epub 2017 Jan 13.
Automotive screenwashes commonly contain ethylene glycol, methanol, and/or isopropanol; ethanol is also included in many formulations. The concentrations and combinations of each constituent vary considerably between the products. This study was undertaken to investigate the toxicity of automotive screenwashes as reported by telephone to the United Kingdom National Poisons Information Service (NPIS).
Enquiries to the NPIS relating to automotive screenwashes were analyzed retrospectively for the period January 2012 to December 2015.
There were 295 enquiries involving 255 individual exposures. The majority (n = 241, 94.5%) of exposures involved ingestion and 14 of these also involved other routes. Six cases were due to skin contact alone, three to inhalation alone, three to eye contact alone, one to ear exposure alone and another occurred from inhalation and skin contact. Children below 5 years of age accounted for 26% of all ingestions. The identity (and therefore composition) of the screenwash was known with certainty in 124 of 241 ingestions and included methanol in 106 formulations, isopropanol in 72, ethylene glycol in 38, and ethanol in 104. The World Health Organisation/International Programme on Chemical Safety/European Commission/European Association of Poison Centres and Clinical Toxicologists Poisoning Severity Score was known in 235 of 241 cases of ingestion: most patients were asymptomatic (n = 169, 71.9%), but 59 (25.1%) developed minor (PSS 1), six (2.6%) moderate (PSS 2), and one patient severe (PSS 3) features; this patient later died. Nausea (n = 10), vomiting (n = 11), abdominal pain (n = 10), metabolic acidosis (n = 8) and raised anion gap (n = 8) were reported most commonly after ingestion.
Most patients (71.9%) ingesting automotive screenwash did not develop features. The implication is that the amount of screenwash ingested was very small. Skin and eye exposure produced either no features or only minor toxicity.
汽车挡风玻璃清洗液通常含有乙二醇、甲醇和/或异丙醇;许多配方中还含有乙醇。每种成分的浓度和组合在不同产品之间差异很大。本研究旨在调查通过电话向英国国家毒物信息服务中心(NPIS)报告的汽车挡风玻璃清洗液的毒性。
对2012年1月至2015年12月期间向NPIS咨询的与汽车挡风玻璃清洗液有关的问题进行回顾性分析。
共收到295次咨询,涉及255次个体暴露。大多数(n = 241,94.5%)暴露是由于摄入,其中14次还涉及其他途径。6例仅因皮肤接触,3例仅因吸入,3例仅因眼睛接触,1例仅因耳部暴露,另1例因吸入和皮肤接触。5岁以下儿童占所有摄入病例的26%。在241例摄入病例中,有124例能够确定挡风玻璃清洗液的成分(从而确定其配方),其中106种配方含有甲醇,72种含有异丙醇,38种含有乙二醇,104种含有乙醇。在241例摄入病例中,有235例知道世界卫生组织/国际化学品安全规划署/欧盟委员会/欧洲毒物中心和临床毒理学家协会中毒严重程度评分:大多数患者无症状(n = 169,71.9%),但59例(25.1%)出现轻微症状(PSS 1),6例(2.6%)出现中度症状(PSS 2),1例患者出现严重症状(PSS 3);该患者后来死亡。摄入后最常报告的症状有恶心(n = 10)、呕吐(n = 11)、腹痛(n = 10)、代谢性酸中毒(n = 8)和阴离子间隙升高(n = 8)。
大多数摄入汽车挡风玻璃清洗液的患者(71.9%)没有出现症状。这意味着摄入的清洗液量非常少。皮肤和眼睛接触要么没有症状,要么仅产生轻微毒性。