Phenol Toxicity - Symptoms, Diagnosis, Management, and Prevention

Introduction

Phenol is a toxic organic compound that can cause severe health hazards in humans, primarily through ingestion. The chemical is used in hospitals, industries, and household products. Phenol toxicity causes severe irritation to the skin, gastrointestinal tract, and mucous membrane and also produces different health effects and symptoms that can be fatal. Intentional exposure to phenol is rare, but unintentional phenol toxicity can be caused in a person due to severe exposure at the workplace and home. Therefore, people exposed to phenol must take proper measures to minimize the health risk of phenol toxicity, as it can be dangerous.

What Are the Symptoms of Phenol Toxicity?

The symptoms of phenol toxicity are as follows:

• Severe irritation in the eyes.

• Blindness or permanent damage.

• Gastrointestinal swelling, burns, irritation, Internal bleeding, diarrhea, and vomiting.

• Respiratory irritation, shortness of breath, and sore throat.

• Severe headaches, seizures, and depressed mental status.

• Skin numbness, tingling sensation, blisters, burns, and skin damage.

• Muscle weakness, loss of coordination, and tremors.

• Convulsions, sudden collapse, shock.

• Organ failure, coma, and death.

What Are the Chronic Health Effects of Phenol Toxicity?

The chronic health effects caused by phenol toxicity are as follows:

• Progressive weight loss, vertigo, dark-colored urine, diarrhea, anorexia, salivation.

• Enlarged liver, muscle weakness, and gastrointestinal irritation.

• Cardiac arrhythmias and hypotension.

• Central nervous system depression or excitation leads to coma or death.

• Acute respiratory distress syndrome (ARDS) and hypoxia.

• Skin necrosis, inflammation, blue-black discoloration, and hyperpigmentation.

What Are the Medical Uses of Phenol?

The medical uses of phenol include:

• Phenol is used in healthcare as a vaccine preservative to prevent certain vaccines' contamination for thyroid fever, polio, smallpox, meningitis, and pneumonia.

• Phenol injections are also used to treat muscle spasticity (lack of communication of the brain with nerves and spinal cord) in conditions like cerebral palsy, brain trauma, and Parkinson’s disease.

• Phenol is used for severe ingrown toenail surgeries and to prevent nail regrowth.

• Phenol is a chemical peel to remove damaged skin by penetrating the skin layers.

• Cosmetic and food industries used small amounts of phenol derivatives (butylated hydroxytoluene) as preservatives.

• The doctor can also treat irritation in the mouth or sore throat conditions in people with phenol throat spray to relieve symptoms.

• Phenol-based soaps are used as antiseptic agents during surgeries and are called carbolic soaps.

• Molecular biology procedures also use phenol with chloroform and trichloromethane to separate proteins, DNA (deoxyribonucleic acid), and RNA (ribonucleic acid) and preserve them in pure form.

What Are the Sources of Exposure to Phenol Toxicity?

• People can get exposed to phenol while working in manufacturing industries or at the workplace.

• Phenol-based medicinal products are also a source of phenol toxicity. These products include analgesic rubs, toothache drops, mouthwashes, antiseptic lotions, and throat lozenges.

How Can We Diagnose Phenol toxicity?

• Urine or serum phenol levels are checked with laboratory assessment.

• The doctor does regular monitoring of mental status and vital signs.

• An electrocardiogram is also used in the diagnostic process for cardiac monitoring.

• Laboratory evaluations identify hepatitis, acute kidney injury, and metabolic acidosis symptoms.

• Respiratory complaints due to ingestion or inhalation of phenol require chest X-rays.

How Is Phenol Toxicity Treated?

Treatment of phenol toxicity includes the following:

• Initial management and treatment of phenol toxicity include supportive measures to ensure airway and ventilation support, hemodynamic support, and oxygen therapy. Respiratory depression is also secured with endotracheal intubation to remove airway obstruction.

• Activated charcoal therapy for gastrointestinal decontamination is usually not recommended in cases of phenol ingestion as it can interfere with gastrointestinal endoscopy findings.

• Complications of phenol toxicity are also managed with hemodialysis procedures in some cases.

• A regional or local burn center usually treats severe surface phenol burns.

• People with systemic signs and symptoms of phenol toxicity are admitted to the hospital for 24-hour monitoring.

What Is the Differential Diagnosis for Phenol Toxicity?

• Dermal symptoms such as hypopigmentation due to phenol toxicity can also be related to hydrofluoric acid skin exposure.

• Also, skin exposure to phenol can be similar to alkali or acid exposure.

• Cardiovascular collapse and seizures are not very specific symptoms of phenol toxicity and can be related to many fatal toxic exposures.

• Blue-green urine discoloration is a significant feature caused by the therapeutic use of phenol-derived pharmaceuticals such as propofol.

How Can We Prevent Phenol Toxicity or Exposure?

Phenol has many health benefits in daily life, but the chemical is very toxic and can cause long-term health effects in a person. Therefore, people must follow the preventing measure to avoid toxic phenol exposure:

• Phenol can cause severe skin damage and lead to burns and blisters. Therefore, people should prevent direct skin contact with phenol.

• Drinking water contaminated with phenol should be avoided as it causes difficulty walking and muscle spasms, and excess amounts can also be fatal.

• People working in factories can have frequent phenol exposure leading to cardiac diseases. Therefore, factory workers should wear proper protective equipment to avoid unnecessary exposure.

• Eating food contaminated with phenol should be avoided as it can cause gastrointestinal irritation and fatal consequences.

What Are the Complications Associated With Phenol Toxicity?

• Respiratory failure and airway obstruction can occur due to seizures and mental status depression.

• Necrotic soft tissue damage and severe chemical burns are caused if skin exposure to phenol is not treated timely.

• People with acute respiratory distress syndrome (ARDS) may require mechanical ventilation.

• Hemoglobinuria (appearance of hemoglobin in the urine) or rhabdomyolysis (muscle breakdown leading to myoglobin release into the bloodstream) may result in a need for hemodialysis for acute kidney injury.

• Cardiovascular collapse or ventricular arrhythmia can also occur in people.

Conclusion

Phenol toxicity can be life-threatening for a person because the chemical has systemic manifestations associated with it. Unfortunately, there is no specific antidote for phenol toxicity, and the h can use only supportive and preventive measures by healthcare providers. Therefore, a person with phenol exposure must be handled with proper preventative measures, decontaminated safely, and admitted to the hospital for medical intervention. In addition, phenol is toxic for humans, so careful handling of the chemical should be the priority of people working in its exposure.