Boric acid poisoning

Poisonous Ingredient

Boric acid

Where Found

• Antiseptics and astringents
• Enamels and glazes
• Glass fiber manufacturing
• Medicated powders
• Skin lotions
• Some paints
• Some rodent and ant pesticides
• Photography chemicals
• Powders to kill roaches
• Some eye wash products

Note: This list may not be all inclusive.

Symptoms

The main symptoms of boric acid poisoning are blue-green vomit, diarrhea, and a bright red rash on the skin. Other symptoms may include:

• Blisters
• Collapse
• Coma
• Convulsions
• Drowsiness
• Fever
• Lack of desire to do anything
• Low blood pressure
• Significantly decreased urine output (or none)
• Sloughing of skin
• Twitching of facial muscles, arms, hands, legs, and feet

Home Care

If the chemical is on the skin, remove by washing the area thoroughly.

If the chemical was swallowed, seek medical treatment immediately.

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

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.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

What to Expect at the Emergency Room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Treatment depends on the individual symptoms. The patient may receive:

• Camera down the throat to see burns in the esophagus and the stomach (endoscopy)
• Dialysis
• Fluids by mouth or IV
• Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Note: Activated charcoal does not effectively treat (absorb) boric acid.

Outlook (Prognosis)

The infant death rate from boric acid poisonings is high. However, boric acid poisoning is considerably rarer than in the past because the substance is no longer used as a disinfectant in nurseries. It is also no longer commonly used in medical preparations. Boric acid is an ingredient in some vaginal suppositories used for yeast infections, although this is NOT a standard treatment.

Alternative Names

Borax poisoning

References

Goldfrank LR. Ed. Goldfrank’s Toxicologic Emergencies. 8th ed. New York, NY: McGraw-Hill; 2006.

Cain WS. Sensory and associated reactions to mineral dusts: sodium borate, calcium oxide, and calcium sulfate. J Occup Environ Hyg. April 2004; 1(4): 222-36.

Matsuda K Toxicological analyses over the past five years at a single institution. Rinsho Byori.Oct. 2004; 52(10): 819-23.

Update Date: 1/4/2012

Reviewed by: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network (2/2/2011).