What Is Benzalkonium Chloride?
Benzalkonium chloride (BACs) is a type of quaternary ammonium compound that is widely used as a disinfectant and preservative in a variety of household and personal care products. This substance presents itself in the form of a powder that is either white or yellowish and is soluble in water and ethanol. Benzalkonium chloride is commonly found in products such as hand sanitizers, soaps, disinfectant sprays, and medical equipment cleaners. Gerhard Domagk first reported benzalkonium chloride in 1935, and they entered the market under the trade name Zephiran.
What Are the Uses of Benzalkonium Chloride?
The common uses of Benzalkonium chloride include the following:
- Hand Sanitizers: Benzalkonium chloride is commonly used as an active ingredient to kill germs on hands. It effectively kills a wide range of microorganisms, including MRSA (Methicillin-resistant Staphylococcus aureus) and Escherichia coli (E. coli).
- Disinfectant Solutions: Benzalkonium chloride is used in disinfectant solutions for surfaces, medical equipment, and instruments. It eliminates bacteria, viruses, and fungi that can cause infections in patients.
- Antiseptics: Benzalkonium chloride is used as an antiseptic to clean and disinfect the skin before medical procedures like surgery. Additionally, it has applications in cleansing and disinfecting wounds, as well as in preventing infections.
- Eye Drops and Nasal Sprays: Benzalkonium chloride is used as a preservative in eye drops and nasal sprays to prevent contamination and extend their shelf life.
- Lozenges: Benzalkonium chloride is utilized in tablets as an active pharmaceutical ingredient for treating surface-level infections in the throat and mouth.
- Creams and Gels: Benzalkonium chloride is frequently employed in gels and creams for addressing herpes and cold sore infections or as an ingredient in pain-relieving gum gels. Herpes is a contagious viral infection where blister-like sores may appear on any part of the body, with certain areas, such as the lips, being more frequently affected than others. A cold sore is a cluster of fluid-containing blisters that are present around the face, nose, and mouth.
- Antiseptic Mouth Sprays: Benzalkonium chloride is often present in antiseptic mouth sprays.
What Is Benzalkonium Chloride Poisoning?
Benzalkonium chloride poisoning is a condition that occurs when an individual is exposed to high levels of benzalkonium chloride. Benzalkonium chloride poisoning can occur through ingestion, inhalation, or skin contact. The toxic level of benzalkonium chloride can vary depending on the exposure duration and route. The generally accepted lethal dose for humans is estimated to be between 50 to 500 mg/kg (milligram per kilogram), depending on the concentration of benzalkonium chloride in the product and the route of exposure.
In terms of skin exposure, benzalkonium chloride can cause irritation or allergic reactions at concentrations as low as 0.1 percent. Eye exposure to benzalkonium chloride can cause severe irritation or damage, and concentrations as low as 0.005 percent can be toxic to the eye. Poisoning through inhalation occurs due to prolonged exposure to this compound, leading to respiratory distress and other complications. Even repeated exposure to low levels of BAC can also have toxic effects, particularly on the respiratory system. This is a concern for healthcare workers, who may be exposed to low levels of BAC on a regular basis.
What Are the Causes of Benzalkonium Chloride Poisoning?
Common causes of benzalkonium chloride poisoning include:
- Accidental ingestion of these products can occur, particularly in children who may mistake the product for food or drink.
- Inhalation of benzalkonium chloride can occur when using aerosolized products, such as disinfectant sprays or nasal sprays, or when working in an environment with high levels of benzalkonium chloride in the air.
- Occupational exposure is found among workers in industries that use this chemical, such as healthcare, cleaning, and agriculture. This type of exposure may happen either through skin contact or inhalation.
- Some individuals may be allergic to benzalkonium chloride and may experience symptoms of poisoning with even small amounts of exposure.
What Are the Symptoms of Benzalkonium Chloride Poisoning?
The symptoms of benzalkonium chloride poisoning include the following:
- Ingesting benzalkonium chloride can cause symptoms such as nausea, vomiting, and abdominal pain.
- Respiratory problems, including coughing, wheezing, and shortness of breath. Prolonged exposure can lead to lung damage, chronic respiratory problems, and rarely respiratory failure.
- Skin irritation, redness, and blistering. Prolonged or repeated exposure can lead to skin sensitization and allergic reactions.
- Eye irritation, redness, and discomfort in case of eye exposure.
- Allergic reactions such as itching, hives (reddish, itchy bumps), swelling, and difficulty breathing.
- Seizures, tremors, and loss of consciousness in severe cases.
How Can Benzalkonium Chloride Poisoning Be Diagnosed?
Benzalkonium chloride poisoning is diagnosed with the help of history taking, physical examination, and other tests. In order to evaluate symptoms and signs of poisoning, a healthcare professional will conduct a thorough physical examination and obtain a detailed medical history. The tests done for diagnosis include:
- Blood Tests: Blood tests may be suggested to assess electrolyte levels, kidney function, liver function, and other parameters that may be affected by benzalkonium chloride poisoning.
- Urine Tests: Urine tests may be ordered to assess kidney function and to detect the presence of benzalkonium chloride in the body.
- Imaging Tests: Imaging tests such as X-rays, CT (computed tomography) scans, or MRI (magnetic resonance imaging) may be ordered to assess damage to the respiratory system or other organs.
- Skin Patch Testing: Skin patch testing may be used to assess allergic reactions to benzalkonium chloride.
- Chemical Analysis: Chemical analysis of products suspected to contain benzalkonium chloride can help confirm exposure.
What Is the Treatment for Benzalkonium Chloride Poisoning?
The treatment for benzalkonium chloride poisoning will depend on both the severity of a patient’s condition and the exposure route. The following are the common treatments for benzalkonium chloride poisoning:
- Decontamination: If benzalkonium chloride has been ingested, inhaled, or come into direct contact with the eyes or skin surface, decontamination may be necessary. This may include washing the affected area with water, flushing the eyes with saline solution, or inducing vomiting if the substance was ingested.
- Supportive Care: Supportive care may be necessary to manage symptoms such as nausea, vomiting, and respiratory distress. This may include oxygen therapy, IV (intravenous) fluids, and electrolyte replacement.
- Antidotes: Currently, there is no specific antidote for benzalkonium chloride poisoning. However, medications may be given to manage symptoms and support organ function.
- Monitoring: Patients with benzalkonium chloride poisoning may require monitoring of vital signs, kidney function, and other parameters to ensure that their condition is stable and improving.
- Allergy Treatment: Antihistamines and steroids may be required for managing allergic patients.
What Are the Ways to Prevent Benzalkonium Chloride Poisoning?
Preventing benzalkonium chloride poisoning involves taking precautions to minimize exposure to the chemical. Some ways to prevent benzalkonium chloride poisoning include:
- Check the labels of products to ensure that they do not contain benzalkonium chloride if the patient is allergic to this chemical. If the chemical is present, follow the instructions for use carefully.
- Wear protective equipment, such as goggles, gloves, and masks, while handling benzalkonium chloride products.
- Products containing benzalkonium chloride should be kept in a safe place inaccessible to children and pets.
- Keep products away from food.
Conclusion:
Benzalkonium chloride is a beneficial and effective disinfectant and preservative that is widely used in a variety of products available. Even though benzalkonium chloride poisoning is uncommon, it can occur if the chemical is ingested, inhaled, or comes into contact with the skin or eyes in high concentrations. Proper use and storage of these products can help to minimize the risk of poisoning. If benzalkonium chloride poisoning is suspected, seek medical attention immediately.
