Metal cleaner poisoning: MedlinePlus Medical Encyclopedia

P Metal cleaners are very strong chemical products that contain acids. This article discusses poisoning from swallowing or breathing in such products.
P This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

T Poisonous Ingredient
P Metal cleaners contain organic compounds called hydrocarbons, including:
- 1,2-butylene oxide
- Boric acid
- Cocoyl sarcosine
- Dicarboxylic fatty acid
- Dimethoxymethane
- Dodecanedioic acid
- N-propyl bromide
- Sodium hydroxide
- T-butanol

T Where Found
P Various metal cleaners contain these compounds.

T Symptoms
P Below are symptoms of metal cleaner poisoning in different parts of the body.
P AIRWAYS AND LUNGS
- Breathing difficulty (from breathing in the chemical)
- Throat swelling (may also cause breathing difficulty)
P EYES, EARS, NOSE, AND THROAT
- Severe pain in the throat
- Severe pain or burning in the nose, eyes, ears, lips, or tongue
- Vision loss
P HEART AND BLOOD
- Collapse
- Low blood pressure
P STOMACH AND INTESTINES
- Abdominal pain -- severe
- Blood in the stool
- Burns of the food pipe (esophagus)
- Diarrhea
- Nausea and vomiting (possibly with blood)
P NERVOUS SYSTEM
- Convulsions
- Depression
- Dizziness
- Drowsiness
- Feeling of being drunk (euphoria)
- Headache
- Loss of alertness (unconsciousness)
- Seizures
- Staggering
- Weakness
P SKIN
- Burns
- Irritation
- Necrosis (holes) in the skin or underlying tissues

T Home Care
P Get medical help right away. DO NOT make a person throw up unless told to do so by poison control or a health care provider.
P If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
P If the person swallowed the metal cleaner, give them water or milk right away, unless a provider tells you not to. DO NOT give anything to drink if the person has symptoms that make it hard to swallow. These include vomiting, convulsions, or a decreased level of alertness.
P If the person breathed in the poison, move them to fresh air right away.

T Before Calling Emergency
P Have this information ready:
- Person's age, weight, and condition
- Name of the product (ingredients, if known)
- Time it was swallowed
- Amount swallowed

T Poison Control
P Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions.
P 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.

T What to Exect at the Emergency Room
P Take the container with you to the hospital, if possible.
P The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may receive:
- Breathing support, including a tube through the mouth into the lungs, and a breathing machine (ventilator).
- Bronchoscopy. Camera placed down the throat to see burns in the airways and lungs.
- Chest x-ray
- EKG (heart tracing)
- Endoscopy. The placement of a camera down the throat to see the extent of burns to the esophagus and the stomach.
- Fluids through a vein (IV)
- Surgery to remove burned skin
- Tube through the mouth into the stomach to wash out the stomach (gastric lavage).
- Washing of the skin (irrigation). Perhaps every few hours for several days.

T Outlook (Prognosis)
P How well a person does depends on the amount of poison swallowed and how quickly treatment was received. Swallowing this type of poison can have severe effects on many parts of the body. The faster a person gets medical help, the better the chance for recovery.
P Damage can continue to occur for several weeks after the poison was swallowed. Death may occur as long as a month after the poison was swallowed.

T References
P Lee DC. Hydrocarbons. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 158.
P Mirkin DB. Benzene and related aromatic hydrocarbons. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 94.

T Review Date 11/4/2015
P Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services / Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

