A previously healthy 32-year-old man presented to the emergency department (ED) after unintentionally ingesting a mouthful of concentrated (35%) hydrogen peroxide (H2O2) from an unmarked bottle he kept in his refrigerator. Upon realizing his error, he immediately drank a liter of water, which promptly induced vomiting. In the ED, the patient complained of mild throat and chest discomfort as well as “abdominal fullness.”
His initial vital signs included a blood pressure of 140/92 mm Hg; heart rate, 93 beats/min; respiratory rate, 18 breaths/min; and temperature, 96.4°F. His O2 saturation was 98% on room air. Physical examination revealed tenderness in the epigastric region with no peritoneal findings. Oropharynx and chest examination were normal, and standard laboratory investigations were all within normal limits.
WHAT ARE THE POTENTIAL EXPOSURES TO HYDROGEN PEROXIDE?
Hydrogen peroxide is a colorless and odorless liquid. Solutions with concentrations ranging from 3% to 5% have many household applications, including use as a wound disinfectant and dentifrice; dilute solutions are also utilized for similar purposes in the hospital setting. Industrial-strength H2O2 (concentrations of 10% to 35%) is employed to bleach textiles and paper, and higher concentrations (70% to 90%) are used as an oxygen source for rocket engines.
Consumer application of concentrated H2O2 solutions has become increasingly common. Some, like this patient, clean the surfaces of fruits and vegetables with H2O2 to decrease transmission of bacteria during cutting.1 More concerning, however, is the purported medicinal benefits of ingesting “food-grade” (35%) H2O2 mixed with water—touted on many Internet sites as a treatment for illnesses such as emphysema, cancer, anemia, and HIV.2 Sometimes referred to as “hyperoxygenation therapy,” this so-called treatment has not been approved by the FDA for any such purpose.3 When diluted sufficiently, this concoction is not harmful but is unlikely to provide any health benefits.
Continue reading for the toxic effects of concentrated hydrogen peroxide...