Geospatial correlation between COVID-19 health misinformation and poisoning with household cleaners in the Greater Boston Area.

INTRODUCTION: Calls to poison control about exposure to household cleaners have increased during the COVID-19 pandemic. This dynamic may reflect increased exposure from public health efforts as well as health misinformation shared on social media. METHODS: We analyzed the dynamics of calls to the Regional Center for Poison Control and Prevention serving Massachusetts and Rhode Island (MARI PCC) and tweets discussing treating COVID-19 with house cleaners from January 20, 2020 to May 5, 2020. We obtained publicly available tweets discussing the use of household cleaners to "cure COVID" from the same time period with geographic co-ordinates indicating that they were emitted from the Greater Boston Area. RESULTS: Our main finding is that public health efforts were followed by a sustained increase in calls after March 15, 2020 (10 ± 2 calls per day before to 15 ± 2.5 after) while misinformation on social media was associated with intermittent spikes in calls. Overall, calls significantly increased during the study period by 34% as compared to the previous 8 years, mostly reporting unintentional ingestions with no serious effects. The daily volume of tweets and retweets was significantly correlated with daily call rates to MARI PCC for the surrounding 7-10 days. CONCLUSIONS: Health misinformation on social media about using household cleaning agents to treat COVID-19 and public health efforts lead to different dynamics in PCC calls. Public health efforts were followed by a sustained increase in calls after March 15, 2020 while misinformation on social media was followed by intermittent spikes in calls. This analysis is the first to link the geospatial dynamics of social media and public health interventions to poison center calls about exposure to household cleaners.

[Analysis of pre-hospital and in-hospital linkage in the treatment of phenol burn patients].

Objective: To analyze the pre-hospital and in-hospital linkage effect on reducing the degree and reduce the complications of phenol burn. Methods: From January 2015 to July 2016, 51 patients with phenol burns in Shanghai Chemical Industry Park Medical Center were treated by in-hospital and in-hospital treatment. Gathering the general data, clinical situation, treatment methods and treatment results were compared with the previous literature on phenol burn treatment. Results: Among the 51 cases, 50 patients with burn area <5%, 1 patient with burn area 5%~0%, 51 patients were cured, and the cure rate was 100%, during the period under observation and all treated patients out of follow-up after under observation, there were no obvious abnormalities in blood and urine routine, did not appear damage of liver and renal function. Conclusion: Phenol can damage many important organs and tissues of the whole body, and it can affect the body and develop corresponding symptoms within a few minutes and hours. Therefore, it is very important to quickly and correctly respond to the injury caused by phenol. The treatment of pre-hospital and in-hospital linkage treatment method has obvious effect on reducing phenol injury and reducing the incidence of complications.

[The specific features of the distribution of 4-metoxyhydroxybenzene in the organism of the warm-blooded animals suffering lethal intoxication]. / Osobennosti raspredeleniya 4-metoksigidroksibenzola v organizme teplokrovnykh zhivotnykh pri letal'nykh otravleniyakh.

This work was designed to study the distribution of 4-metoxyhydroxybenzene in the organism of the omnivorous warm-blooded animals (rats) after the intragastric administration of this poisonous compound at a dose three-fold greater than the LD50 value. The administered 4-metoxyhydroxybenzene was isolated from the organs and blood of the experimental animals by exposing the biological tissues to acetone with subsequent purification on a silica gel L 40/100 mcm using a hexane:dioxane:propanol-2 (20:5:1) as the mobile phase. The identification and quantitation of 4-metoxyhydroxybenzene were carried out with the use of TLC, GC-MS, and UF-spectrophotometry. It was shown that the administered 4-metoxyhydroxybenzene remained unmetabolized in the internal organs and blood of the poisoned experimental animals. The largest amounts of 4-metoxyhydroxybenzene were found in the stomach contents (2584,92±117,47), brain (59.49±6.05), contents of small intestines (28.21±3.77), and kidneys (26.13±1.64).

Parental phenols exposure and spontaneous abortion in Chinese population residing in the middle and lower reaches of the Yangtze River.

Widespread use of phenols has led to ubiquitous exposure to phenols. In experimental animals, phenols increased resorptions, reduced live litter size and fetal body weights. However, there are limited epidemiological evidences of the relationships between exposure to phenols and pregnancy outcomes. We evaluated the associations between parental urinary levels of various phenols and spontaneous abortion in a Chinese population residing in the middle and lower reaches of the Yangtze River. A case-control study was conducted that included 70 case couples with medically unexplained spontaneous abortion and 180 control couples who did not have a history of spontaneous abortion and had at least one living child. Both parental urinary phenols were measured by ultra-high performance liquid chromatography-tandem mass spectrometry including bisphenol A (BPA), benzophenone-3 (BP-3), 2,3,4-trichlorophenol (2,3,4-TCP), pentachlorophenol (PCP), 4-n-octylphenol (4-n-OP) and 4-n-nonylphenol (4-n-NP). Compared with the low exposure group, there was an increased risk of spontaneous abortion with high paternal urinary PCP concentration [odds ratio (OR)=2.09, 95% Confidence Interval (CI), 1.05-4.14], and maternal exposure to 4-n-OP and alkylphenol(s) also significantly increased the risk of spontaneous abortion (OR=2.21, 95% CI, 1.02-4.80; OR=2.81, 95% CI, 1.39-5.65, respectively). Our study firstly provides the evidence that paternal PCP exposure, maternal 4-n-OP and alkylphenol(s) exposure are associated with spontaneous abortion in humans.

Renal excretion of phenol from physicians after nail matrix phenolization: an observational prospective study.

BACKGROUND: Animal studies have shown that many signs of acute poisoning result from phenol entry into the systemic circulation by absorption or ingestion. While no evidence of systemic complications in patients who have undergone phenol nail matrixectomies have been reported, the safety of phenol vapour inhalation by physicians performing this treatment has yet to be investigated. OBJECTIVE: The goal of this study was to determine whether the levels of phenol to which physicians are exposed to during a phenol-based matrixectomy procedure are within the limits of safe exposure. METHODS: A continuous prospective study was carried out to measure the urinary phenol concentrations from physicians after performing chemical matrixectomy for ingrown toenails. RESULTS: The highest concentration of urinary phenol was measured at almost 10 mg/L within the first 2 h after exposure, and subsequently decreased approximately 1 mg/L every 2 h for the first 10 h post exposure. The levels dropped to 3 mg/L at 72 h post exposure. CONCLUSIONS: The risk associated with phenol exposure while performing chemical phenol matrixectomy was well below the current safety limits when the physician is exposed to 90% phenol vapour for approximately 20 min. Thus, no further specific safety recommendations are required for physicians performing this procedure.

[Management of phenol burn cases combined with poisoning].

OBJECTIVE: To explore the therapeutic processing and nursing for phenol burn patients combined with poisoning. METHODS: The clinical data of 42 phenol burn cases admitted in our hospital from 1998 to 2010 were reviewed retrospectively. The general clinical manifestations, treatment and nursing methods, and the treatment results of these cases were analysed. RESULTS: Out of 42 phenol burns patients, the total burn surface area (TBSA) of 22 cases were ≤ 5%, 10 cases' TBSA were 6% ∼ 10%, and 5 cases' > 20%. 36 patients showed systemic poisoning symptoms 1 ∼ 2 hours after injury, the severity and enduring period of which correlated with TBSA. Patients whose TBSA > 10% appeared obviously dysfunction of the liver and kidney. The therapeutic methods included wound management, compensation of fluid, diuresis, alkalized urine, large dose of vitamin C and glucocorticoid, early surgery, blood purification, etc. 39 of 42 cases were successful cured, while the other 3 cases died. CONCLUSIONS: Phenol burn often complicates systemic poisoning. In the treatment of patients with this special chemical burn, it is key scheme to block phenol absorption and promote elimination of already absorbed poison as early as possible. The comprehensive management and nursing should be necessary for supporting functions of important organs.

[Biogenic amines during intoxication with phenol and correction with the liquid oxygen in the experiment].

Among many toxic substances present in the nature, phenol represents one of those, which may be considered as the endocrinological deregulator. We were conducting experiment on 40 male rats every day influencing by inhalation of the vapor of the phenol, as they laid on the thigh, at the second stage after the inhalation we were making injections of the liquid oxygen under the skin to each rats for the purpose of treatment. After we produced the decapitation of the animals under general narcoses, we took the hypothalamus and investigated concentrations of biogenic amines - dopamine, noradrenalin and serotonin. It was shown that in response to the inhalation of the phenol concentration of the biogenic amines has been abolished in comparison with the norm. The liquid oxygen gave the therapeutic effect.

Phenol intoxication in a child.

Phenol preparations are used in dermatology and plastic surgery for the treatment of acne and during chemical face peeling. At this institution, phenol peeling is used in addition to mechanical dermabrasion for the elimination of subclinical premalignant lesions of patients having xeroderma pigmentosum. As the phenol peel is performed, most surgeons concentrate on skin results, ignoring systemic complications. Local histological changes and systemic toxicity have been seen during applications. Cardiac arrhythmias and even sudden death have been reported. The high incidence of cardiac arrhythmias after topical application of phenol preparations is demonstrated. The case of an 11-year-old boy with a diagnosis of xeroderma pigmentosum who underwent mechanical dermabrasion and chemical peeling with phenol and then developed severe cardiac arrhythmias is reported. A serious systemic toxic effect on cardiac rhythm from cutaneously applied phenol occurred in this case.

Determination of phenol and o-cresol by GC/MS in a fatal poisoning case.

A fatality due to the ingestion of solution containing phenol and o-cresol is described. The pathological findings were typical of acute substantial poisoning. Blood, urine and stomach content were obtained during post mortem examinations. Phenol and o-cresol were identified using GC/MS. The extractions from autopsy materials were obtained as follows: by gel permeation with cyclohexane/dichloromethane from stomach content, by solid phase extraction (SPE) from urine and by deproteinization with acetonitrile from blood. The phenol and o-cresol concentrations in the samples were found, respectively, as follows: 115.0 and 5.0 microg/g in the stomach contents, 58.3 and 1.9 microg/ml in the blood, 3.3 and 20.5 microg/ml in the urine. Distributions of phenol in fatal poisonings have been reported, but, usually, colorimetry was used as the analytical method and it cannot exclude the interference of other phenolic compounds.

[Acute phenol poisoning]. / Akutna trovanja fenolom.

INTRODUCTION: Phenol (carbolic acid) is one of the oldest antiseptic agents. Currently it is used as a disinfectant, chemical intermediate and nail cauterizer. Phenol is a general protoplasmic poison (denatured protein) with corrosive local effects. Phenol derivates are less toxic than pure phenol. The lethal dose is between 3 to 30 g, but may be as little as 1 g. Phenol is well absorbed by inhalation, dermal application, and ingestion. MANIFESTATIONS OF ACUTE POISONING: Local manifestations. Dermal exposure produces lesions which are initially painless white patches and later turn erythematous and finally brown. Phenol produces mucosal burns and coagulum. They cause eye irritation and corneal damage. When ingested, it causes extensive local corrosions, pain, nausea, vomiting, sweating, and diarrhea. Severe gastrointestinal burns are uncommon and strictures are rare. Inhalation produces respiratory tract irritation and pneumonia. Systemic manifestations develop after 5 to 30 minutes postingestion or post dermal application, and may produce nausea, vomiting, lethargy or coma, hypotension, tachycardia or bradycardia, dysrhythmias, seizures, acidosis, hemolysis, methemoglobinemia, and shock. MANAGEMENT: Phenol poisoning requires immediate medical evaluation, in cases of significant phenol ingestion (more than 1 g for adults or 50 mg for infants) or symptomatic intoxication. It is necessary to establish and maintain vital functions and establish vascular access. Treatment includes the following: shock (fluids and dopamine), arrhythmias (lidocaine) and convulsions (diazepam). Health personnel should use gowns and rubber gloves. Inhalation of 100% oxygen is recommended. Intubate and assisted ventilation might be necessary. Metabolic acidosis should be managed by 1 to 2 mEq/kg of sodium bicarbonate. Methemoglobinemia should be treated if greater than 30%, or in cases of respiratory distress, with methylene blue 1 to 2 mg/kg of 1% solution, slowly i.v. If phenol is ingested, avoid emesis, alcohol and oral mineral oil and dilution, because they may increase absorption. Gastric lavage is usually not recommended. Immediate administration of olive oil and activated charcoal by small bore nasogastric tube is necessary. CONCLUSION: Apart from the abovementioned, immediately decontaminate the skin with copious amounts of water followed by undiluted polyethylene glycol. Wash the area thoroughly with soap and water after treatment. Immediately decontaminate the eyes with copious amounts of tepid water for at least 15 minutes. Follow up examination using fluorescein stain of eyes for corneal abrasion is recommended

Phenol poisoning in three dogs.

Three adult dogs were evaluated following oral administration of phenol by the owner. All three dogs experienced severe oral and gastric ulceration. Hematological abnormalities included neutropenia with the presence of toxic neutrophils, thrombocytopenia, and increased muscle enzymes. Endoscopic examination was performed, and biopsies yielded a diagnosis of gastric mucosal necrosis in two of the dogs. Following supportive care, the dogs recovered completely. Phenol is a caustic, highly poisonous derivative of coal tar. The dogs of this report were poisoned inadvertently by their owner who received misinformation concerning the use of this chemical via the Internet.

Rabbit syndrome following phenol ingestion.

CASE REPORT: An elderly Japanese woman ingested a massive quantity of phenol in a suicide attempt. She was admitted to the Emergency Department in respiratory arrest and deep coma. Duodenogastritis was evident endoscopically. With the return of spontaneous respiration and consciousness, fine, rapid rhythmic perioral movements developed together with Parkinsonian findings. The abnormal movements were aggravated by administration of a neuroleptic and ameliorated by discontinuing the drug; they disappeared completely by hospital day 15. In addition to neuroleptic drugs, phenol intoxication may cause the rabbit syndrome by inducing cholinergic dominance with relative dopamine hypofunction in the central nervous system.

Accidental intranasal administration of phenol.

A 79-y-old man developed erythema and superficial sloughing of the turbinate following accidental intranasal administration of 89.2% phenol solution. Previous documented reports of phenol exposure include exposures via dermal and oral routes, but no reports of nasal phenol administration were found.

Prolonged elimination half-life of phenol after dermal exposure.

BACKGROUND: Phenol is a general protoplastic poison which has been in use in medicine and industry for decades. It is readily absorbed through the skin causing both local and systemic toxicity. CASE REPORT: A 47-year-old male had 90% phenol spilled over his left foot and shoe (3% of body surface area). After a 4 1/2-hour exposure, manifestations included confusion, vertigo, faintness, hypotension, ventricular premature beats, atrial fibrillation, dark-green urine, and tense swelling, blue-black discoloration, hypalgesia, and hypoesthesia of the affected area. Treatment consisted of irrigation with copious amounts of water, incisions, and supportive measures. RESULTS: Peak serum phenol was 21.6 micrograms/mL, considered in the fatal range. Peak urine phenol plus urine-conjugated phenol was 13,416 mg/g creatinine, indicating a major absorption. Elimination half-life was 13.86 hours, considerably longer than previously reported. CONCLUSIONS: Prolonged skin contact with concentrated phenol in an occlusive environment may result in a major absorption and a long elimination half-life even if the area involved is small. Prolonged elimination may be explained by extensive tissue distribution or by "slow-release reservoir" properties of the skin. Such exposure may be associated with severe systemic and local toxicities. Immediate removal from exposure and aggressive decontamination of the skin are essential to reduce these risks.

Distribution of phenol in a fatal poisoning case determined by gas chromatography/mass spectrometry.

A victim who was presumed to have ingested waste fluid containing phenol of DNA extraction was found dead in his laboratory. The skin was partially chemically burned, with blisters as maps. No mechanical injuries were observed. The pathological findings of the liver and kidney were typical of those of acute substantial poisoning. Phenol concentrations in the blood, urine, stomach contents and organs were determined by gas chromatography/mass spectrometry. Phenol was distributed throughout the body. The concentration of free phenol in the blood was found to be 60 micrograms/mL, and in the urine it was 208 micrograms/mL. The phenol concentrations in the organs were found as follows: 106 micrograms/g in the brain; 116 micrograms/g in the lungs; 166 micrograms/g in the liver, and 874 micrograms/g in the kidney, respectively. Significantly high concentrations were observed in the kidney, urine, and liver. To the best of our knowledge, such an intoxication through this kind of ingestion has never been reported before. Distributions of phenol in fatal poisonings have been reported, but colorimetry was used as the analytical method and it cannot exclude the interference of other phenolic compounds.