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Petroleum products, cleaning products, and glues contain hydrocarbons (substances composed largely of hydrogen and carbon). Many children younger than age 5 are poisoned by swallowing petroleum products, such as gasoline, kerosene, and paint thinners, but most recover. At greater risk are adolescents who intentionally breathe the fumes of glues, paint, solvents, cleaning sprays, gasoline, or fluorocarbons used as refrigerants or propellants in aerosols to become intoxicated, a type of drug abuse called huffing, bagging, sniffing, glue sniffing, or volatile substance abuse (see Drug Use and Abuse: Solvent Inhalants). Such inhalation may cause fatal irregular heartbeats or cardiac arrest, especially after exertion or stress. Repeated inhalation of toluene (a component of some of these products) can damage parts of the brain.
Swallowed hydrocarbons can enter and irritate the lungs, a serious condition in itself (chemical pneumonitis), and can lead to severe pneumonia. Lung involvement is a particular problem with thin, easy-flowing hydrocarbons such as mineral seal oil, which is used in furniture polish, and others, including gasoline. Severe poisoning also can affect the brain, heart, bone marrow, and kidneys. Thick, less-runny hydrocarbons such as lamp oil and motor oil are less likely to enter the lungs but can cause severe and persistent irritation if they do.
Symptoms
A person usually coughs and chokes after swallowing or inhaling hydrocarbons. A burning sensation can develop in the stomach, and the person may vomit. If the lungs are affected, the person continues to cough intensely. Breathing becomes rapid, and the skin may become bluish (cyanosis) because of low levels of oxygen in the blood. Young children may have cyanosis, hold their breath, and cough persistently. Sometimes difficulty breathing does not develop until many hours after the hydrocarbons enter the lungs.
Hydrocarbon ingestion also causes neurologic symptoms, including drowsiness, poor coordination, stupor or coma, and seizures.
Diagnosis and Treatment
Hydrocarbon poisoning is diagnosed based on a description of the events and the characteristic odor of petroleum on the person's breath or clothing or if a container is found near the person. Paint residue on the hands or around the mouth may suggest recent paint sniffing. Pneumonia and chemical pneumonitis are diagnosed with a chest x-ray and by measuring the level of oxygen in the blood (see Diagnosis of Lung Disorders: Arterial Blood Gas (ABG) Analysis). If doctors suspect brain damage, magnetic resonance imaging (MRI) is done.
To treat poisoning, contaminated clothing should be removed, and the skin should be washed. If the person has stopped coughing and choking, particularly if the ingestion was small and accidental, treatment at home is possible. Home treatment should be discussed with someone at a poison center. People with breathing problems are hospitalized. If pneumonia or chemical pneumonitis develops, hospital treatment can include oxygen and, if severe, a ventilator. Antibiotics help if pneumonia develops. Recovery from pneumonia typically takes about a week but may take much longer if thick, syrup-like hydrocarbons such as lamp oil or motor oil have entered the lungs.
Last full review/revision February 2013 by Gerald F. O'Malley, DO; Rika O'Malley, MD
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