A toxic dose requiring medical treatment varies but is considered more than 0.1 mL per kg body weight (mL/kg) of pure substance. Hemodialysis is used to enhance the removal of unmetabolized ethylene glycol, as well as its metabolites from the body. et al. ", In Canada, Environment Canada reports that "in recent years, management practices at Canada’s major airports have improved with the installation of new ethylene glycol application and mitigation facilities or improvements to existing ones.  Toxicity and death may occur after drinking even a small amount. Similar to ethanol, it causes intoxication, followed by drowsiness or coma. It is important to recognize the signs that accompany ethylene glycol poisoning with your dog or cat. While five of the hospital visits involved kidney problems, doctors never thought to suspect ethylene glycol poisoning, prosecutors said. In this situation stabilization of the person including airway management with intubation should be performed in preference to gastrointestinal decontamination. It has been shown to be highly effective in the removal of ethylene glycol and its metabolites from the blood. In turn, the sailors demanded “proof” by pouring a sample on gunpowder. , Treatment for antifreeze poisoning needs to be started as soon after ingestion as possible to be effective; the earlier treatment is started, the greater the chance of survival. Juenke  Further, "Anaerobic biodegradation may also release relatively toxic byproducts such as acetaldehyde, ethanol, acetate, and methane (p. Ethylene glycol in biological fluids can be determined by gas chromatography. The person' serum osmolality is measured by freezing point depression and then compared with the predicted osmolality based on the person's measured sodium, glucose, blood urea nitrogen, and any ethanol that may have been ingested. " Since 1994, federal airports must comply with the Glycol Guidelines of the Canadian Environmental Protection Act, monitoring and reporting on concentrations of glycols in surface water. Ishwarlal Jialal, MD, PhD, FRCPath, DABCC, Sridevi Devaraj, PhD, DABCC, Laboratory Diagnosis of Ethylene Glycol Poisoning: The Cup Is Half Full?, American Journal of Clinical Pathology, Volume 136, Issue 2, August 2011, Pages 165–166, https://doi.org/10.1309/AJCPTZO0HRPKVPWM.  It may be drunk accidentally or intentionally in a suicide attempt. Following ingestion of antifreeze products containing ethylene glycol and fluorescein, a Wood's lamp may reveal fluorescence of a person's mouth area, clothing, vomitus, or urine which can help to diagnose poisoning. TP If the lighted gunpowder sparked or Online Course: Ethylene Glycol and Propylene Glycol Toxicity; Emergency Response Card: Information for First Responders Agent-specific identification, medical symptoms, prevention & personal protective equipment, fire fighting, sampling & analytical methods, decontamination, spillage disposal, packaging & labeling information. et al. 12). Search for other works by this author on: National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: recommendations for the use of laboratory tests to support poisoned patients who present to the emergency department, Toxic alcohol ingestions: clinical features, diagnosis, and management, Ethylene glycol intoxication: evaluation of kinetics and crystalluria, Rapid and specific quantification of ethylene glycol: adaptation of a commercial enzymatic assay to automated chemistry analyzers, Blood alcohol testing: comparison of the performance obtained with the different methods used in the Belgian External Quality Assessment schemes, Enzymatic method for measuring ethylene glycol with a centrifugal analyzer, A rapid screen for ethylene glycol: evaluation of the CATACHEM ethylene glycol enzymatic assay performed with the Olympus AU400e analyzer [abstract], Fomepizole for ethylene glycol and methanol poisoning, 1999 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System, © American Society for Clinical Pathology, Multisite Quality Improvement Study of a Patient-Pathologist Consultation Program.  The central nervous system is affected early in the course of poisoning as the result of a direct action of ethylene glycol. ethylene glycol, but propylene glycol products are becoming more common. Ishwarlal Jialal, MD, PhD, FRCPath, DABCC, Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA. , Generally, if the person is treated and survives then a full recovery is expected.  Once kidney failure develops, the prognosis is poor. Ethylene glycol poisoning is poisoning caused by drinking ethylene glycol. Oxalic acid binds with calcium to form calcium oxalate crystals which may deposit and cause damage to many areas of the body including the brain, heart, kidneys, and lungs. People therefore must be monitored in an intensive care unit. J.J. Mackenzie, "Prevent Antifreeze Poisoning", in Laurie Halse Anderson, elevated blood concentration of potassium, EU classification of dangerous substances, "College of Veterinary Medicine: Pet Health Topics: Antifreeze Poisoning", "Ethylene glycol: an estimate of tolerable levels of exposure based on a review of animal and human data", "Antifreeze Poisoning in Dogs & Cats (Ethylene Glycol Poisoning)", "Severe ethylene glycol intoxication with multisystem failure", "Government of Canada: Environment Canada: Ethylene Glycol (Final Content)", "Cerebral computed tomography of ethylene glycol intoxication", "Ethylene glycol poisoning: toxicokinetic and analytical factors affecting laboratory diagnosis", "Fomepizole in the treatment of ethylene glycol poisoning", "Oklahoma Veterinary Medical Association: ASPCA answers questions about antifreeze poisoning", "Ethylene glycol ingestion treated only with fomepizole", "[Fatal chronic oxalosis after sublethal ethylene glycol poisoning]", "Experiences of the Czech toxicological information centre with ethylene glycol poisoning", "Ethylene glycol toxicosis in a free-ranging raccoon (Procyon lotor) from Prince Edward Island", "The Merck Veterinary Manual: Overview of Ethylene Glycol Toxicity", "General properties, irritant and toxic actions of ethylene glycol", "Concise International Chemical Assessment Document 22: Ethylene Glycol: Environmental Aspects", "Preliminary Data Summary: Airport Deicing Operations (Revised)", "Glycol Mitigation Strategies: The Canadian Approach".  A report prepared for the World Health Organization in 2000 stated that laboratory tests exposing aquatic organisms to stream water receiving runoff from airports have shown toxic effects and death (p.  Other sources of ethylene glycol include windshield deicing agents, brake fluid, motor oil, developing solutions for hobby photographers, wood stains, solvents, and paints. Cases of permanent kidney damage, often requiring chronic dialysis or kidney transplantation, have been reported after severe poisoning. Webb Urine Fluorescence Using a Wood's Lamp to Detect the Antifreeze Additive Sodium Fluorescein: A Qualitative Adjunctive Test in Suspected Ethylene Glycol Ingestions. Hardy Differential Diagnosis of Alcohol Poisoning.  Accumulation of glycolic acid in the body is mainly responsible for toxicity.  Airports that discharge the collected aircraft deicing fluid directly to waters of the U.S. must also meet numeric discharge requirements for chemical oxygen demand. 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