2022年12月21日 星期三

硼砂Na2B4O5(OH)4·8H2O中毒; 硼酸 H3BO3中毒

 Substance

-       Na2B4O5(OH)4·8H2O

-       A hydrated borate of sodium

-       Alkaline after soluble in water

 

Common name/ Trade name

-       Borax

-       Boric acid, H3BO3, prepared from borax. [1]

 

Involving system [2]

-       Respiratory system: acute poisoning via inhalation exposure

-       GI system: acute poisoning after oral exposure

-       Skin: could be affected by oral or dermal exposure

-       CV system and CNS system: could be affected under chronic exposure

 

Presentation

-       Respiratory system: nose and throat irritation, causing coughing or dyspnea

-       GI system: diarrhea or vomiting, frequently confused with acute gastroenteritis [1]

-       Skin: eye irritation, skin lesions, hair loss, exfoliation, desquamation of the skin ("boiled lobster" rash) [1, 3, 4]

-       CV system: Arrhythmia

-       CNS system: Seizure, delirium, coma [1, 5]

-       a Large amount of borax ingestion may cause death [2]

 

Antidote/Treatment

-       No specific antidote

-       NG irrigation and usage of activated charcoal or laxatives are  NOT recommended due to poor adsorptive capacity [1]

-       Exchange transfusion, Dialysis may be a possible method for preventing deterioration [1]

 

Disposition

-       Alkaline ingestion should be treated according to the Zargar grading of esophagogastroduodenoscopy

-       Lethal dose is 2-3 grams for infants, 5-6 grams for children, and 15-20 grams for adults

 

References

[1]   Goldfrank’s Toxicologic Emergencies 11th ed. Ch.101: 1375.

[2]  Hadrup N, Frederiksen M, Sharma AK. Toxicity of boric acid, borax and other boron containing compounds: A review. Regul Toxicol Pharmacol. 2021 Apr;121:104873. doi: 10.1016/j.yrtph.2021.104873. Epub 2021 Jan 22. PMID: 33485927

[3]  Hubbard SA. Comparative toxicology of borates. Biol Trace Elem Res. 1998 Winter;66(1-3):343-57. doi: 10.1007/BF02783147. PMID: 10050929.

[4]  Beckett WS, Oskvig R, Gaynor ME, Goldgeier MH. Association of reversible alopecia with occupational topical exposure to common borax-containing solutions. J Am Acad Dermatol. 2001 Apr;44(4):599-602. doi: 10.1067/mjd.2001.112223. PMID: 11260532.

[5]  Gordon AS, Prichard JS, Freedman MH. Seizure disorders and anemia associated with chronic borax intoxication. Can Med Assoc J. 1973 Mar 17;108(6):719-21 passim. PMID: 4691106; PMCID: PMC1941259.

 

- edited by Chun Chen and Yu-Jang Su  Dec 21, 2022.