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TitleHydrogen Peroxide (PIM 946)
TagsHydrogen Peroxide Bleach Medical Specialties Clinical Medicine Chemistry
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and mucous membranes and pain may be signs of exposure.

2.4 First aid measures and management principles

Ingestion: Gastric decontamination is not worthwhile
for ingestion of hydrogen peroxide due to its rapid
dissociation. Asymptomatic patients who have ingested only a
small quantity of low concentrated solutions (3 to 6%)
probably do not require treatment. Any patient with
haematemesis, abdominal discomfort, persistent vomiting,
central nervous system (CNS) or respiratory effects must be
admitted.

Treatment is supportive. If gastric distension is severe a
fine bore gastric tube may be passed to aid the release of
gas. Endoscopy should be considered in patients with
haematemesis or persistent vomiting or if the solution was
&gt10%.

Patients with severe clinical effects require abdominal and
chest X-rays. The Trendelenburg positioning (head down,
elevated foot of bed) should be avoided since this may trap
air in the apex of the right ventricle and cause obstruction
of the blood flow. Monitor the ECG in severe cases.
Ventilation may be required in patient with severe
respiratory effects.


Hyperbaric oxygen therapy has been suggested for patients
with evidence of cerebral embolism due to hydrogen
peroxide.

Inhalation: remove from exposure; supportive care should be
given.

Dermal: irrigate thoroughly with saline or water and treat
symptomatically.

Ocular: irrigate thoroughly with running water or saline
for 15 minutes. Refer to an ophthalmologist.

Intravenous: monitor ECG and check renal function. Perform
X-rays.

Rectal: give supportive care; parenteral (then oral)
steroids may be of benefit. Sigmoidoscopy is recommended to
determine the extent of the injury.

3. PHYSICO-CHEMICAL PROPERTIES

3.1 Origin of the substance

3.2 Chemical structure

Chemical formula: H2O2
Molecular mass: 34

3.3 Physical properties

3.3.1 Colour

Colourless

3.3.2 State/Form

Liquid

3.3.3 Description

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Hydrogen peroxide is an odourless liquid with a
bitter taste; it is an oxidising agent which in the
presence of organic matter or if permitted to become
alkaline vigorously decomposes to oxygen and water.
The strength of a solution may be described as a
percentage or volume, where 1% hydrogen peroxide
releases 3.3 volumes of oxygen during decomposition.
Thus, a 3% solution is equivalent to 10 volume and a
6% solution to 20 volume, etc.


Boiling point: 115 to 157°C
Melting point: &lt50°C
Relative density (water = 1): 1.3
Solubility in water: Miscible
Vapour pressure, kPa at 30°C: 0.7
Relative vapour density (air = 1): 1.2
Relative density of the vapour/air-mixture at 20°C
(air = 1): 1.06

3.4 Hazardous characteristics

Hydrogen peroxide decomposes on warming producing oxygen
which increases fire hazard. The substance is a strong
oxidant and reacts violently with combustible and reducing
materials causing fire and explosion hazard particularly in
the presence of metals. Hydrogen peroxide attacks many
organic substances, e.g. textile and paper.

4. USES

4.1 Uses

4.1.1 Uses

4.1.2 Description

Hydrogen peroxide is used as a 6% solution for
bleaching hair and some disinfectant solutions for
contact lenses contain 3% hydrogen peroxide. Chlorine
free bleaches contain 6% hydrogen peroxide. Some newer
fabric stain removers/bleaches contain 5 to 15%
hydrogen peroxide. Industrial strengths of hydrogen
peroxide are manufactured up to 90%. They are used
mainly as bleaching and oxidising agents. Solutions
of 90% are used as rocket fuel.

Hydrogen peroxide (35%) is also sold as a health aid
for so-called 'hyperoxygenation therapy' for
everything from arthritis to AIDS and cancer. It is
kept refrigerated, diluted for use, and taken
regularly (Leikin et al., 1993).

4.2 High risk circumstance of poisoning

4.3 Occupationally exposed populations

5. ROUTES OF EXPOSURE

5.1 Oral

Common route of exposure.

5.2 Inhalation

Hydrogen peroxide can be inhaled.

5.3 Dermal

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Leikin J, Sing K and Woods K (1993) Fatality from intravenous use
of hydrogen peroxide for home 'superoxygenation therapyœ
(abstract). Vet Hum Toxicol 35 (4):342

Litovitz Tl, Bailey Km, Schmitz BF, Holm KC & Klein-Schwartz W
(1991) 1990 Annual report of the AAPCC National Data Collection
System. Am J Emerg Med 9(5):461-509

Litovitz TL, Felberg L, Soloway RA, Ford M, Geller R. (1995) 1994
Annual Report of the AAPCC toxic exposure surveillence system. Am
J Emerg Med 13 (5):551-597

Litovitz TL, Smilkstein M, Felberg L, Klein-Schwartz W, Berlin R
and Morgan JL. (1997) 1996 Annual Report of the AAPCC toxic
exposure surveillence system. Am J Emerg Med 15 (5):447-500

Lubec B, Hayn M, Denk W and Bauer G (1996) Brain lipid
peroxidation and hydroxyradical attack following the intravenous
infusion of hydrogen peroxide in an infant. Free Rad Biol Med 21
(2):219-223

Luu TA, Kelley MT, Strauch JA & Avradopoulos K (1992) Portal vein
embolism from hydrogen peroxide ingestion. Ann Emerg med 21(11):
1391-1393

Rackoff Wr & Merton DF (1990) Gas embolism after ingestion of
hydrogen peroxide. Pediatrics 85(4): 593-594

Sherman SJ, Boyer LV and Sibley WA (1994) Cerebral infarction
immediately after ingestion of hydrogen peroxide. Stroke
25:1065-1067

14. AUTHOR(S), REVIEWER(S), DATE(S) (INCLUDING UPDATES), COMPLETE
ADDRESS(ES)

Author: Medical Toxicology Unit,
Guyœs and St Thomasœ Trust
Avonley Road, London SE14 5ER, UK

Date: December, 1997

Review: As for author. 1997

Peer review: INTOX meeting, March 1998, London, UK
(Members of group: Drs G. Allridge, L.
Lubomovir, R. Turk, C. Alonso, S. de Ben, K.
Hartigan-Go, N. Bates)

Editor: Dr M.Ruse (September, 1998)


See Also:
Toxicological Abbreviations
Hydrogen peroxide (FAO Nutrition Meetings Report Series 40abc)
Hydrogen peroxide (WHO Food Additives Series 5)
HYDROGEN PEROXIDE (JECFA Evaluation)
Hydrogen Peroxide (IARC Summary & Evaluation, Volume 71, 1999)

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