What is Bleach Toxicity?
Bleach refers to a wide variety of compounds that we commonly use to make materials lighter or whiter. Often, these substances are used for cleaning and disinfection because they can kill or control many different types of viruses, bacteria, molds, mildews, and algae. There are other uses for bleach too, such as killing weeds and preserving cut flowers. Given the many uses, bleaches are found nearly everywhere.
You can find two types of bleach. One is based on chlorine, like calcium hypochlorite, commonly known as bleaching powder, while the other is non-chlorine, using peroxidase.
These bleaches work by either oxidation, which means they add oxygen, or reduction, which means they remove oxygen. Chlorine bleaches break the chemical bond of the color-producing portion of a pigment (the chromophore) through oxidation, which makes it unable to react with light. Reduction changes double bonds into single bonds, again making these bonds unreactive to visible light.
An interesting feature of bleach is its antimicrobial, or disinfecting properties. Bleaches disinfect by changing or ‘denaturing’ bacterial proteins, meaning they lose their normal shape and clump together, rendering them useless- similar to how cooking an egg changes its properties and it cannot be uncooked.
For the purpose of this explanation, we’re referring to common household bleach which contains 3% to 8% sodium hypochlorite (NaOCl), with sodium hydroxide (NaOH) added to prevent it from breaking down. There are much stronger forms of bleach used in industrial contexts or to treat water supplies, which we are not touching on here. For potential risks and exposures, you can refer to the product’s Material Safety Data Sheet (MSDS).
Since the appearance of coronavirus, people have shown growing interest in sanitization. Bleach is quite effective for this; it can kill coronavirus within a minute of contact with a 0.1% diluted solution of hypochlorite bleach.
What Causes Bleach Toxicity?
Exposure to bleach can happen in several ways. Understanding these ways is crucial for deciding the right treatment.
Also, you need to know that bleach has many uses, and people often mix it with other chemicals to achieve their aim, such as pest control, managing plants, or cleaning areas. Sometimes, these chemical mixtures can create harmful by-products.
Ways you can be exposed to bleach include:
- Mist created by spraying (direct or indirect): can affect the lungs, eyes, and skin (to a lesser extent).
- Immersion or splashing: can affect the eyes, skin, and the digestive system.
- Ingestion: can affect the digestive system and lungs.
- Aspiration (inhaling): can affect the lungs.
Risk Factors and Frequency for Bleach Toxicity
Bleach is a versatile product we often use at home for tasks such as deep-cleaning surfaces, laundering clothes, and treating fabric. When bleach is used as directed, including taking the recommended precautions like adequate ventilation and protective gear, it is generally not harmful to humans. However, it’s essential not to become complacent since misuse or mixing bleach with other substances can be dangerous or even lethal.
A notable pediatric study in 2010 by McKenzie and his team, conducted over a 16-year period, disclosed that nearly 270,000 children under 5 years in the US suffered injuries from household cleaning products. In the report, bleach topped the list as the leading source of injuries, accounting for 37% of incidents, and ingestion was the usual method of exposure (63%). The study also found that a spray bottle was often the primary source of the bleach (40%).
Signs and Symptoms of Bleach Toxicity
Exposure to certain chemicals can cause various symptoms, including:
- Redness, irritation, and tearing in the eyes. Vision may also become blurry.
- Irritation in the mouth and throat. However, the mouth and throat are generally resistant to damage unless exposed to other harmful substances.
- Mild irritation on the skin. One should avoid spreading the chemicals on the skin.
- Rare symptoms involving the stomach or digestive tract. Generally, the digestive system is tough and can bounce back from such disturbances.
- Respiratory irritation, which can even cause bronchospasm. But this doesn’t apply if the chemical is chlorine gas. Exposure to chlorine gas can be very severe and potentially fatal.
Testing for Bleach Toxicity
The standard procedure involves asking you about your symptoms and doing a physical exam. It’s important to bring the container of the substance involved in your case, even if someone has to go back home to get it.
If the bleach was mixed with another chemical, in particular, toilet bowl cleaners or ammonia, it’s crucial to refer to the section about inhaling chlorine gas.
Treatment Options for Bleach Toxicity
In case of exposure to harmful substances, here’s what you should do at home and what will likely happen if you need to visit a hospital:
For eyes: At home, rinse your eyes with tap water. In the hospital, a doctor or nurse will numb your eye with a special drop called a topical anesthetic (such as tetracaine or proparacaine) and then wash it out with a balanced salt solution. To apply the anesthetic eye drops, they’ll put two drops near the inner corner of your eye and then gently open your eyelid (direct application is often too difficult because of an expected automatic reaction to close the eye tightly). The doctor will then use a type of dye called fluorescein to stain the eye to examine it more closely, looking for corneal ulcers or other signs of injury. This check is usually done under a specialized tool called a slit lamp, but a Wood’s lamp can also be used if needed, though it might not give as detailed a picture. After the examination, your eye will be washed out thoroughly and the pH level is checked to make sure it’s normal. During this whole process, an eye specialist or an emergency physician will probably be consulted for advice.
For skin: At home, clean the area with a mild soap and water. The approach in the hospital is the same.
For the mouth and throat: Both at home and in the hospital, drink plenty of water. Milk might feel more soothing but it’s not mandatory.
For the stomach and gastrointestinal tract: Whether at home or in the hospital, don’t attempt to make yourself vomit. This is because the harmful substance would burn your throat and mouth if brought back up just like it did when it went down. Again, drinking plenty of water can be helpful.
For the respiratory system: Use an albuterol MDI inhaler if you’re having trouble breathing. If you have asthma, you might need more intensive treatment. If you’ve inhaled chlorine gas from mixed chemicals, you might be facing more severe symptoms. In such cases, you might require a procedure called bronchoscopy, where a small tube is inserted through your nose or mouth to directly visualize the insides of your airways and lungs, and wash it as needed. There’s a chance that you might have to stay in the hospital for observation as the severity of the injury might not be immediately clear.
What else can Bleach Toxicity be?
The conditions that could be related to breathing issues may include:
- Ammonia toxicity
- Acute Respiratory Distress Syndrome (a severe lung condition)
- Smoke inhalation injury (damage to lungs due to inhalation of smoke)
- Hydrogen sulfide inhalation (poisoning due to breathing in hydrogen sulfide gas)
