Hair dye poisoning: Retrospective analyses of patients admitted to ICU at a rural hospital in India

Sánchez, Laura Elísabet Gómez; Handyal, Harish; Kannan, Shanmugamari; Siddalingeshwara,; Alvarez-Uria, Gerardo; Gavaldà, Laura; Corbella, Xavier

doi:10.4103/0971-5916.193301

Cited by 7 publications

(6 citation statements)

References 9 publications

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“…Hair dye poisoning was the cause of 439 deaths (2.6% of all reported deaths) during the middle decade, with 319 reported during 2004-2008 and 120 during 2009-2013. All were due to paraphenylenediamine (PPD) poisoning [77,[126][127][128][129]166], either in the generic form of stone hair dye or the branded Vasmol 33. It is unclear whether cases continued after 2013, in the absence of reports; no regulatory activities were identified to explain a reduction.…”

Section: Resultsmentioning

confidence: 99%

Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review

et al. 2021

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Background Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years. Methods We performed a systematic literature review in Medline, Embase and Google Scholar (1999–2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study. Results We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999–2003), the number of deaths declining thereafter (to n = 1714 in 2014–2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths. Conclusion Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter’s lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions.

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Section: Resultsmentioning

confidence: 99%

Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review

et al. 2021

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“…In case of repiratory system complications, tracheostomy is a life saving procedure. 16 In 4 studies including all age groups mortality rates were found as 33.30%, 11.90%, 9.50%, and 3.50%. 3,[17][18][19] These lower rates were explained with early referral to hospital and detoxification treatment given to patients.…”

Section: Discussionmentioning

confidence: 95%

Retrospective evaluation of childhood paraphenylenediamine intoxication due to black henna

Güdeloğlu¹,

Erdur

2020

Turk J Pediatr

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Background and objectives. Paraphenylenediamine (PPD) is a toxic substance in henna. Oral intake of this substance causes severe systemic toxicity. To the best of our knowledge there are no studies in the literature conducted only on children exposed to henna intoxication.Methods. Twenty-three patients aged between 1 and 17 who referred to Nyala-Sudan Turkey Training and Research Hospital between May 2015 and June 2018 were evaluated retrospectively in terms of demographic, clinic and laboratory characteristics.Results. Four (17.39%) patients were male and 19 (82.61%) were female. Average age of patients was 10.95 ± 3.2. Most of the referrals to the hospital following PPD intoxication occurred in the first 16 hours. All of the patients between 10 and 17 had taken henna for suicidal purposes. All patients had vomiting and agitation. The most common symptoms apart from these were gastrointestinal symptoms, tachycardia, tachypnea and dyspnea. Twelve (52.17%) patients had elevated liver function tests and 3 (13.04%) had developed renal failure. None of the patients had neurological complications. Two (8.70%) patients developed a need for tracheostomy. Average hospitalization period of patients was 8.5 days. Two patients died. One was in 1-5 age group and died due to renal complications, while the other was in 6-10 age group and died due to hepatic failure. Conclusion.PPD intoxication is a life-threatening situation even in low doses. For this reason, even asymptomatic cases should undergo physical examination and should be followed closely in terms of respiratory tract obstruction. Ensuring hydration and diuresis in the early period, steroid and adrenalin therapy for prophylaxis in terms of respiratory tract obstruction are important and tracheostomy should not be abstained in necessary cases. It should not be forgotten that symptomatic treatment for organ systems and dialysis will decrease mortality and morbidity.

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“…Rhabdomyolysis is the main cause of ARF. Hypovolemia and metabolites of PPD also contribute to acute kidney injury (AKI) (Sanchez et al, 2016;Senthilkumaran & Thirumalaikolundusubramania, 2015). Another study also reported marked peritubular capillary congestion in the cortex as well as medulla (Behera, Mridha, Kumar, & Millo, 2015).…”

Section: Discussionmentioning

confidence: 99%

Toxicological studies on commercial hair dye brand commonly used in Saudi Arabia: histological study of the liver, kidney, heart, and testis

Al-Shaikh¹,

Alkaseb²,

Mudawi³

et al. 2018

JoBAZ

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Background: Hair dye is commonly used in the Kingdom of Saudi Arabia (KSA). Poisoning occurs when someone swallows dye or tint used to color hair and is considered one of the most significant causes of intentional self-harm. Commercial hair dye may contain varying amounts of paraphenylenediamine and even undeclared chemical ingredients. Therefore, the aim of this study was to evaluate the organ toxicity of commercial hair dye in rats. Acute toxicity study: The commercial hair dye X was orally administered to the rats at a dose of 50 mg/kg and was observed for 24 h for mortality or behavioral changes. Sub-chronic toxicity: The commercial hair dye X was administered to rats orally for 8 days in doses of 2.5 and 5 mg/kg, then the heart, liver, kidney, and testis were dissected out of the animals and kept in formalin for histopathological examinations using H-E stain. Results: In this study, the commercial hair dye X at the dose of 50 mg/kg single dose has not shown any mortality in rats. On the other hand, the commercial hair dye X administered to rats orally for 8 days at doses of 2.5 and 5 mg/kg caused toxicological effects manifested by some histopathological changes in the heart, liver, kidney, and testis in rats compared to the control group. Conclusion: The current study showed that the commercial hair dye X at doses of 2.5 and 5 mg/kg produced toxic effects on the heart, liver, kidney, and testis in rats. Therefore, it is important to raise the public awareness about the potential toxicity of the hair dyes.

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Hair dye poisoning: Retrospective analyses of patients admitted to ICU at a rural hospital in India

Cited by 7 publications

References 9 publications

Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review

Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review

Retrospective evaluation of childhood paraphenylenediamine intoxication due to black henna

Toxicological studies on commercial hair dye brand commonly used in Saudi Arabia: histological study of the liver, kidney, heart, and testis

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