Poisoning In The Home Environmental Sciences Essay

Unintentional or accidental poisoning is a significant global public health problem. In 2004, an estimated 346000 people died worldwide from unintentional poisoning.[1]This appears to be an important health threat as it has crucial implications of costs and potential years of life lost. There are various categories of substances that may leads to poisoning and children are usually at greater risk due to developmental incompetencies and their dependence on adults for their care and well-being.[2]

According to the report from National Poison Centre(NPC) of Malaysia, a total of 929 cases of poison exposure inquiries were handled by NPC from the years 1996 to 2000. The age and gender distributions are shown in table 1 implicating children younger than 9 years old has the highest incidence of exposure to poisonous substances. As for gender, a male predominance was noted throughout the five year period.[3]

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Table 1: Age and gender distributions of poisoned patients from 1996 to 2000

Some common substances involved in poisoning cases are pesticides, medicines, household products, detergents and food. From the statistics, it can be concluded that pesticides is the most common substance that leads to poisoning followed by pharmaceuticals and household products.[3] Thus, care must be taken especially at home to avoid exposure to these poisonous substances.

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Table 2: Distribution of categories of substances implicated in poisonings

1996 to 2000

Throughout the years, there was an increasing trend in the number of poison exposure as shown in Figure 1. The number of poisoning cases showed an increase with an average of 611 enquiries per year. Distributions of poisoning cases are almost the same with the previous years, with the majority cases involving agrochemicals and followed by pharmaceuticals and household chemicals.[2]

Figure 1: Number of poisoning cases in Malaysia from year 2001 to 2005

Pesticides

There are a wide variety of tools available for pest control in residential environments, including the use of chemical pesticides as well as various non-chemical techniques. Broadly defined, a pesticide is any substance or mixture of substances intended to kill, repel, or control certain forms of plant or animal life that are considered to be pests. [4] Pests are living organisms that bother, injure, or cause damage to buildings, plants, humans, and animals, including pets. [4, 5] Pesticide is used in public health to kill vectors of disease, such as mosquitoes, and in agriculture, to kill pests that damage crops. [4]

There are various way to classified pesticides for instant it can be categorized by the types of pests it control, the chemical composition of the pesticides, or by hazard of the pesticides. [5, 6] The most common method of classification would be according to the chemical composition of the pesticides itself as different pesticides may be composed of different chemical compound. The chemical category of pesticides includes organochlorine, organophosphate, carbamate, synthetic pyrethroids, inorganic, organic (botanical and microbial), and lastly the miscellaneous. [6] All of these chemical compound works in different routes in controlling pest as different chemicals may have different mechanism of action.

Organochlorine (OC)

Figure 2. Chemical structure of organochlorine [7]

Organochlorine pesticides are hydrocarbon compounds containing multiple chlorine substitutions. There are four main types of OC pesticides; dichlorodiphenylethanes; cyclodienes; chlorinated benzenes; and cyclohexanes. All share a similar pair of carbon rings, one ring being heavily chlorinated. They are the synthetic organic pesticides that are earliest discovered and used. Their characteristics are broad-spectrum, long residual effect and relatively low toxicity. However, due to their stable chemical nature, they are hard to break down in the natural environment. Prolonged use in large quantities will easily lead to environmental pollution and accumulation in mammals, resulting in cumulative poisoning or damage.  Organochlorine pesticides are therefore banned under general circumstances and gradually replaced by other pesticides. [7]

Organophosphate

Figure 3. Chemical structure of organophosphate [8]

Organophosphate pesticides are synthetic in origin and are normally esters, amides, or thiol derivatives of phosphoric, phosphonic, phosphorothioic, or phosphonothioic acids. They are characterised by their multiple functions and the capacity of controlling a broad spectrum of pests. Organophosphate pesticides (as well as sarin and VX nerve agent) irreversibly inactivate acetylcholinesterase, which is essential to nerve function in insects, humans, and many other animals.  They are nerve poisons that can be used not only as stomach poison but also as contact poison and fumigant. These pesticides are also biodegradable, cause minimum environmental pollution and slow pest resistance. Temephos and F enitrothion are examples of organophosphate pesticides. [8]

Carbamate

Figure 4. Chemical structure of carbamate [9]

Carbamates are organic compounds derived from carbamic acid (NH2COOH). A carbamate group, carbamate ester, and carbamic acids are functional groups that are inter-related structurally and often are interconverted chemically. Carbamate esters are also called urethanes. Carbamate pesticides work on the same principle as organophosphate pesticides by affecting the transmission of nerve signals resulting in the death of the pest by poisoning. They can be used as stomach and contact poisons as well as fumigant. Moreover, as their molecular structures are largely similar to that of natural organic substances, they can be degraded easily in a natural manner with minimum environmental pollution. Propoxur is an example of carbamate pesticides.[9]

Synthetic pyrethroids

Figure 5. Chemical structure of synthetic pyrethroids [10]

Synthetic-pyrethroid pesticides are a pesticide synthesized by imitating the structure of natural pyrethrins, which are taken from pyrethrum, the oleoresin extract of dried chrysanthemum flowers. The insecticidal properties of pyrethrins are derived from ketoalcoholic esters of chrysanthemic acid and pyrethroic acid. They are axonic poisons and cause paralysis of an organism by keeping the sodium channels open in the neuronal membranes. The sodium channel is a membrane protein with a hydrophilic interior. This interior is a tiny hole which is shaped precisely to strip away the partially charged water molecules from a sodium ion and create a favorable way for sodium ions to pass through the membrane, enter the axon, and propagate an action potential. When the toxin keeps the channels in their open state, the nerves cannot de-excite, so the organism is paralyzed. They are comparatively more stable with longer residual effects than natural pyrethrins. Synthetic-pyrethroid pesticides are highly toxic to insects but of only slight toxicity to mammals. A llethrin and Permethrin are examples of synthetic-pyrethroid pesticides. [10]

Inorganic pesticide

Inorganic pesticide refers to compounds that include heavy metals such as arsenic, copper sulfates, lead, cadmium, and mercury. They do not degrade readily and persist long in the system. Arsenic works by coagulates proteins, form complexes with coenzymes which is then inhibits the production of ATP. Like cadmium and mercury, it can substitute for phosphorous in some biochemical processes. Mercury has a strong affinity for sulfhydryl groups (SH) in proteins, enzymes, hemoglobin and serum albumin. The Central Nervous system is affected by damage to the blood-brain barrier; transfer of metabolites such as amino acids in the brain is not properly regulated. Cadmium affects enzymes responsible for the reabsorption of proteins in kidney tubules. It also affects the functioning of enzymes such as ADH (alcohol dehydrogenase). Cadmium is substituted for zinc as both metals are similar in solution. Arsenic was commonly used as arsenic trioxide (As2O3) or arsenous acid and mercury as mercuric chloride (HgCl2). Inorganic pesticides were often used in powder, paste, or dip form. The pesticide residue stays on the object and continues to be an effective insect killer for a long time. [11]

Organic pesticide

Organic pesticides are carbon-based compounds that include pesticides such as Naphthalene and Paradichlorobenzene (PDB), two chemicals commonly known as mothballs. Naphthalene and PDB are applied as a solid (in mothball and flake form) and sublimate, acting as a fumigant. The fumes from these materials kill insects and work best in tightly closed spaces. The pesticide residue is expected to evaporate over time. Old collections often smell of these pesticides and it is not clearly understood how long it takes for the chemicals to completely sublimate in the museum environment. [12]

Miscellaneous

There are wide variety of commercial product of miscellaneous pesticides including 4-Aminipyridine, calcium cyanamide, creosote, endothall, metakdehyde, and sodium chlorate. 4-aminopyridine is a highly toxic white powder used as a bird repellent. It works by making one or two birds acutely ill, thus warning off the remaining birds by cries of dostress.it is toxic to vertebrates. Calcium cynamide incorporated into soil to serve as fertilizer, fungicide, and herbicides. Creosote is extensively used as a wood preservatives, usually by high-pressure impregnation of lumber.it has also been used as an animal dip and disinfectant. Endothall can act as the free acid or as sodium, potassium, or amine salts. It is used as a contact herbicide, defoliant, aquatic herbicide, and algaecide. Methaldehyde is a four-unit cyclic polymer of acetaldehyde which has long been used to kill slug and snails, which attracted to it without the use of bait. Sodium chlorate is used in agriculture as a defoliant, nonselective contact herbicide, and semi-permanent soil sterilant. [13]

Pesticides Classified by Chemical Category

Category

Examples

Organochlorines*

Aldrin, chlordane, DDT

Organophosphates

chlorpyrifos (Dursban), diazinon, acephate (Orthene), malathion

Carbamates

carbaryl (Sevin), propoxur (Baygon)

Synthetic pyrethroids

permethrin, resmethrin, cypermethrin, cyfluthrin

Inorganic

boric acid, chlorates, cryolite, diatomaceous earth, silica aerogel, chromated copper arsenate (CCA)

Organic (botanical)

garlic, limonene, neem, nicotine, pyrethrum, rotenone, ryania, sabadilla

Miscellaneous

Horticultural oils, insect growth regulators, insecticidal soaps, insect pheromones

Table 3. Major chemical classes of pesticides

Type of Pesticide

Activity

Algaecides

Control algae in bodies of water, including swimming pools.

Antimicrobials

Kill microorganisms that produce disease

Attractants

Attract specific pests using natural insect chemicals called pheromones that confuse the mating behavior of insects.

Avicides

Control pest birds.

Biopesticides

Naturally occurring substances with pesticidal properties.

Defoliants

Cause foliage to drop from a plant, typically to aid in the harvesting process.

Desiccants

Aid in the drying process of plants or insects, usually for laboratory purposes.

Fumigants

Produce vapors or gases to control air- or soilborne insects and diseases.

Fungicides

Destroy fungi that infect plants, animals, or people.

Herbicides

Control noxious weeds and other vegetation that are growing or competing with a desired species.

Insect Growth Regulators (IGRs)

Accelerate or retard the rate of growth of insects.

Insecticides

Control or eliminate insects that affect plants, animals, or people.

Miticides (Acaricides)

Kill mites that live on plants, livestock, and people.

Molluscicides

Kill snails and slugs.

Nematicides

Kill nematodes, which are microscopic wormlike organisms that live in the soil and cause damage to food crops.

Ovicides

Control insect eggs through the application of low-sulfur petroleum oils to plants and animals.

Piscicides

Control pest fish.

Plant Growth Regulators (PGRs)

Accelerate or retard the rate of growth of a plant.

Predacides

Control vertebrate pests.

Repellents

Repel pests such as mosquitoes, flies, ticks, and fleas.

Rodenticides

Control mice, rats, and other rodents.

Table 4. Types of pesticides

Pesticide Poisoning

Pesticide poisoning occurs after exposure to pesticides. It may occur shortly after a single exposure (acute poisoning) or gradually after repeated exposures over a period of time (chronic poisoning).[17]

Acute poisoning presents symptoms like headache, dizziness, nausea and vomiting, stomach cramps, diarrhea, blurred vision, excessive eye watering, sweating and excessive saliva. More severe case of acute poisoning may also lead to changes in heart rate, chest tightness, muscle weakness and twitching, difficulty breathing and walking, constricted pupils and incontinence. In very severe case of acute poisoning, seizures and unconsciousness may occur.[17]

Chronic poisoning presents symptoms like muscle weakness, fatigue, difficulty concentrating and remember things, and generally feeling unwell.[17]

The type of symptoms, how long they last and how severe they are may vary depending on factors such as the type and concentration of the pesticide used, the type and concentration of the pesticide used, the degree of exposure and the health and age of the person exposed. Many of the potential symptoms are not specific to pesticide poisoning. They may be due to other conditions, such as illness or allergy.[17]

Most common pesticide poisoning: Mechanism of action/toxicity and signs and symptoms

Table 5 shows most common pesticide poisoning. It is classified according to the class of chemical ingredient contained in pesticide. It also shows mechanism of action or toxicity, sign and symptoms treatment of pesticide poisoning of each class.

Class

Mechanism of

action/toxicity

Signs and symptoms

Organophosphates

Acephate (Orthene)

Chlorphoxim (Baythion-C)

Chlorpyrifos (Dursban, Lorsban)

Diazinon

Dimethoate (Cygon, DeFend)

Ethoprop (Mocap)

Fenitrothion (Sumithion)

Fenthion (Baytex)

Malathion (Cythion)

Naled (Dibrome)

Terbufos (Counter)

Inhibit cholinesterase leading to excess acetylcholine

CNS-anxiety, seizures, skeletal nerve-muscle junctions, autonomic ganglia-twitching, tachycardia, muscle weakness (nicotinic effects); peripheral cholinergic neuroeffector junctions- “all faucets on”- sweating, salivation, diarrhea, tearing (muscarinic effects); miosis (pinpoint pupils) most commonly, but 15 percent have mydriasis secondary to epinephrine release from adrenals due to nicotinic receptor stimulation.

Carbamates

Carbaryl (Sevin)

Pirimicarb (Aphox, Rapid)

Propoxur (Baygon)

Timethacarb (Landrin)

Other carbamates

Reversible cholinesterase inhibition (carbamoyl- acetylcholinesterase [AChE] complex dissociates much more easily and quickly than OP-AChE complex)

Cholinergic crisis with “all faucets on”; CNS depression with coma, seizures, hypotonicity in serious toxic exposures

Organochlorines

Chlorobenzilate

Dicofol (Kelthane)

Dienochlor (Pentac)

Endosulfan

Lindane (Kwell)

Induction of hyperexcitable state in central and peripheral nervous system by disruption of normal flow of sodium and potassium across the axon membrane; may antagonize GABA- mediated inhibition in CNS.

Seizures, headache, dizziness, nausea, vomiting, paresthesias, incoordination, tremor/twitching following topical treatment for lice/scabies or accidental or intentional ingestion of liquid pesticide.

Pyrethrins/pyrethroids

Allethrin

Cyfluthrin (Baythroid)

Cypermethrin (Barricade, Cymbush, Cynoff, Demon)

Deltamethrin

Dimethrin

Fenothrin

Fenvalerate

Permethrin (Ambush, Dragnet, Nix, Pounce)

Remethrin

Pyrethrins are derived from chrysanthemums; pyrethroids are synthetic compounds with longer half-lives; both can produce toxic effects on the nervous system but are not well absorbed and are effectively and quickly detoxified by mammalian liver enzyme systems.

The most severe symptoms are seizures, though highly uncommon unless highly exposed (usually through ingestion of large quantities); tremor, incoordination, salivation, vomiting; topical exposure can produce short-term paresthesias, especially of the hands and face; a small portion of the population (1 to 3 percent) is allergic to pyrethrins/pyrethroids-resulting in symptoms ranging from nasal stuffiness to asthma.

Bacillus thuringiensis

Variety aizawai (Agree, Mattch)

Variety israelensis (Aquabac, Skeetal)

Variety kurstaki (Bactur, Dipel)

Wide range of products derived from several varieties of this organism; highly limited effects on mammalian systems.

Mild irritative pulmonary symptoms in some involved in manufacturing process, not in mixers or appliers; theoretical risk of respiratory infection in immunocompromised individuals; single corneal ulceration reported, successfully treated with standard antibiotics; mild gastroenteritis with heavy ingestion.

Repellants

Diethyltoluamide- DEET (Muskol, Off!, Skeeter Beater, Skeeter Cheater, Skintastic for Kids, others)

Mechanism of toxicity unknown.

CNS depression followed by seizures; rare unless applied excessively under occlusion; mild skin irritating effects with repeated use; corneal and mucosal irritation; nausea and vomiting with ingestion and, rarely, hypotension, tachycardia with heavy dermal exposure。

Table 5: Most common pesticide poisoning: Mechanism of action/toxicity and signs and symptoms [18]

Possible harm of pesticide to the environment

On objects, plants or animals:

Pesticides can move away from the release site when they are on or in objects or organisms that move (or are moved) offsite. Pesticides may stick to shoes or clothing, to animal fur, or to blowing dust and be transferred to other surfaces. When pesticide handlers bring home or wear home contaminated personal protective equipment, work clothing, or other items, residues can rub off on carpeting, furniture, and laundry items and onto pets and people. [19]

Harmful effect on nontarget plants and animals:

Nontarget organisms may be harmed by pesticides in two ways. The pesticide may cause injury by contacting the nontarget organism directly. Another way is the pesticide may leave a residue that causes later injuries. [19]

Harmful effect from direct contact:

Pesticides may harm nontarget organisms that are present during a pesticide application. Poorly timed applications can kill bees and other pollinators that are active in or near the target site. Pesticides may harm other wildlife, too. Read the warnings and directions on the pesticide labeling carefully to avoid harming nontarget organisms during a pesticide application.

Drift from the target site may injure wildlife, livestock, pets, sensitive plants, and people. For example, drift of herbicides can damage sensitive nearby plants, including crops, forests, or ornamental plantings. Drift also can kill beneficial parasites and predators that are near the target site.[19]

Harmful effects from residues:

A residue is the part of a pesticide that remains in the environment for a period of time following application or a spill. Pesticides usually break down into harmless components after they are released into an environment. The breakdown time ranges from less than a day to several years. The rate of pesticide breakdown depends mostly on the chemical structure of the pesticide active ingredient.

Persistent pesticides leave residues that stay in the environment without breaking down for long periods of time. These pesticides are sometimes desirable, because they provide long-term pest control and may reduce the need for repeated applications. However, some persistent pesticides that are applied to or spilled on soil, plants, lumber, and other surfaces or into water can later cause harm to sensitive plants or animals, including humans, that contact them.

While using persistent pesticides, consider whether their continued presence in the environment is likely to harm plants and animals. Sometimes animals can be harmed when they feed on plants or animals that have pesticide residues on or in them. [19]

Harmful effects on surfaces

Sometimes surfaces are harmed by pesticides or pesticide residues. Some surfaces may become discolored by contact with certain pesticides. Other surfaces may be pitted or marked by contact with some pesticides. Some pesticides can corrode or obstruct electronic systems or metal. Sometimes a pesticide will leave a visible deposit on the treated surface.[19]

Safety Measures of the Use of Pesticide

Many types of pesticides are obtainable to eliminate a particular pest and a variety of pesticide formulations are available to the consumers. Thus, it is crucial to choose the correct pesticide in order to control the pest(s) in the house, garden or lawn. To select the more appropriate pesticide for the targeted pest(s), consumer should:[20]

Identify the insect, weed, disease, rodent or other pest that one is attempted to control.

Consider utilizing alternative nonchemical control procedures if applicable.

Purchase the least toxic pesticide product which will eliminate the pest. The pesticide should be purchased in a quantity for immediate use only.

Before purchasing and using the pesticide products, consumers should read the label of the product.[20]

Pesticides Labels

Pesticides should be packed and labeled according to World Health Organization (WHO) specifications. The label should be in English and in local language. It is a legal document which should indicate the contents, safety instructions and possible measures in the events of swallowing or contamination. Table 6 below has incorporated the information provided in the pesticide label.[21]

Trade, brand, or product names

The trade name is each company’s unique market name for the product.

Ingredient statement

This statement identifies every active ingredient, the percentage by weight for each active ingredient and the percentage by weight for all inert ingredients.

Use classification statement

The Environmental Protection Agency (EPA) classifies every pesticide product either as Restricted Use or Unclassified/General Use. The restricted use pesticides must include a special statement. Under law, only those persons who have been certified and receive specialized training can use these types of pesticides. Generally, most pesticide products used in and around the home setting are Unclassified/General Use pesticides.

Name and address of manufacturer

Emergency telephone number

Registration number

The EPA registration number indicates that the pesticide product has been registered and that’s its label has been approved by the EPA.

Signal words and symbols

These words and symbols provide the user with an indication of the relative acute toxicity of the product to humans and animals. The statement keep out of reach of children must also be printed on the front panel of the label.

Signal words

Indication On the Products

Caution

Slightly toxic either orally, dermally, or through inhalation or cause slight eye and skin irritation.

Warning

Moderately toxic either orally, dermally, or through inhalation or cause moderate eye and skin irritation.

Danger

Cause severe eye damage or skin irritation.

Danger (with poison and the skull crossbones symbol)

Highly toxic by any route of entry.

Precautionary statements

Statements to help applicators decide what precautions to take to protect other persons or animals who may be exposed.

Statement of practical treatment

First aid treatments recommended in case of a poisoning. In addition, instructions for physicians and medical personnel may be included.

Environmental hazards

Usually only for the restricted-use pesticides.Statements can indicate that a product is especially hazardous to wildlife and include common sense procedures to avoid contamination of the environment.

Physical or chemical hazards

Describes any special fire, explosion, or chemical hazards the product may pose.

Restricted entry level (REI)

Provides information on the duration of time must pass between the last application of a pesticide and when people can reenter a treated area.

Storage and disposal

General instruction for the appriopriate storage and disposal of the pesticide and its container.

Directions for use

Provides instructions concerning the method employed to use the product, the type of pest to be treated, the application sites and any application equipment to be usedTable 6. Pesticide Label Information [20]

In Malaysia, in order to facilitate the consumers to understand the level of toxicity of the pesticide products to human beings, there is a colour band indicating the toxicity class at the bottom of the label. The Malaysian Pesticide Board has classified all the registered pesticide into four classes (colors) according to their level of toxicity to human beings.

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Figure 6: Classification of Pesticide Products by the Malaysian Pesticide Board.

The indication of each class ( colour bands) are as follow:

Class

Colour Band

Toxic Level

Class 1

Black band for Class 1a

Red band for Class 1b

( Both with a skull and crossbones symbol)

Highly poisonous.

Only used by trained personnels.

Class 2

Yellow band.

Poisonous

Class 3

Blue band.

Harmful

Class 4

White band

Least toxic group

Table 7: Indication of the toxicity of each classes of pesticide product with their respective colour bands.[19]

Protective Clothing During Pesticide Application

The type of protective clothing and equipment needed depends on the pesticide being used and the extent of the pest elimination plan (size of the garden or lawn). Users should refer to the personal protection equipment (PPE) on the label for selection of protective clothing and equipment.At a minimum, consumers should have the following protective items while handling pesticide:[20]

Personal Protection Equipment (PPE)

Proper ways of using PPE

Clean clothing

Long-sleeved shirt, long trousers or coveralls made of tightly woven fabric or a water-repellant material. Cotton t-shirts or tank tops, shorts and sandals are unsuitable as they do not provide adequate protection during pesticide application.

Rubber gloves

Unlined and without a fabric wristband.

Shirtsleeves should be worn over the gloves to prevent the spills from running down inside of the glove.

Waterproof boots

Pants legs should be worn over the boots and not tucked inside.

Waterproof hat

If required.

Eye protection

Safety goggles should be worn if needed.

Dusts mask or cartridge respirator

If required.

Table 8: Proper ways of using personal protection equipmentUser

Image: An appriopriately clothed pesticide user. (Image taken from: http://web.extension.illinois.edu )

Safety Measures While Handling Pesticides

Generally, during pesticide application, the product might possibly enter the body via oral route, inhalation or dermal exposure. For oral exposure, user may ingest the pesticide through the mouth. For inhalation exposure, user may breathe in pesticide vapours, dust or spray particles. On the other hand, pesticide may also be absorbed into skin via dermal exposure to the product. Thus, it is essential to practice safety measures while handling the products in order to lower the risk of exposure to the pesticide.[20]

Mixing

During mixing, fill the spray tank about half full of water before adding in the chemical. Then, measure the recommended amount of chemical accurately according to the label instructions. Finish filling the spray tank with the correct amount of water, being careful not to spill or splash the mixture.

All measuring utensils such as cups and spoons, containers and application equipment should be specifically marked and kept at the same place where pesticide are stored. After each use, the utensils should be washed thoroughly.[20]

Use safe practices. Do not splash. Pour with care; illustration (37 Kb PDF file)

Image: Proper technique in mixing pesticides (Image taken from: www.stewardshipcommunity.com )

Application of pesticides

Upon using, the discharge from the sprayer should be directed away from the body. Leaking of equipment should be repaired. Organophosphorus and carbamate compounds should not be applied for more than 5-6 hours a day and the hands should be washed after every pump charge.

Users should guard against the drifts of pesticide sprays or dusts by performing the application when there is no wind as some chemicals may drift in considerable distances if the right conditions exist. Users should not eat, drink or smoke while applying pesticides.[20]

Spillage of Pesticide

Upon spillage, users should clean up the spill immediately by using absorbent material such as sawdust, soil in order to soak up any spillage.

The spillage and contaminated waste should then be collected and put into a bag or container and to be disposed accordingly.[21]

Storage and disposal of pesticides

Storage of pesticides in quantity by certified applicators, wholesalers, dealers and retailers must comply with the following:

All pesticides stored in quantity must be stored in securely locked well ventilated rooms, well away from all food or feed items. The pesticides should be stored in such manner as to prevent fumes from contaminating food or feed.

Pesticides should be separated during storage, preferably in bins, depending upon the type of pesticide. Each type of pesticide, i.e., herbicides, insecticides, fungicides, etc., must be stored separately from each other.

Herbicides must not be stored in a bin on top of, or located above, any other type of pesticide, to preclude accidental contamination of other pesticides by leakage or spillage.

Any pesticide container which is leaking or otherwise damaged must be immediately removed to an area where its contents will be fully contained in the event that its condition deteriorates further..[20]

Disposal of pesticide

For proper disposal of pesticide:

Rinse each container at least three times, add the rinse to your spray tank, and apply the mix to a labeled site.

Punch holes in metal, plastic or cardboard containers, crush them, wrap them in newspaper and put them in the household trash (if not prohibited by the label directions).[21]

Education for Household Pesticide User

Poisoning due to pesticides is usually acute and resulted from extensive skin contact or ingestion. Signs and symptoms vary with the type of pesticide and can sometimes be confused with those of other illnesses.

Thus, upon suspected pesticide poisoning, first aid treatment must be given immediately to eradicate the pesticide from the body. Users should be well aware of some of the symptoms of pesticide poisoning and also a few fundamental first aid techniques.[20]

Immediate Action

If the pesticide has been spilled on the skin or clothing.

Strip off all clothing and thoroughly wash the affected skin with soap and water

If pesticide has been inhaled

Get the victim to fresh air. Have the victim lie down and loosen all clothing. To seek medical attention is preferable.

If pesticide has been swallowed

Never induce vomiting if the victim has swallowed petroleum products (kerosene,gasoline, oil, lighter fluid), unless directed by the label or by a physician. Petroleum products drawn into the lungs can cause serious respiratory disorders.

Never induce vomiting if the victim has swallowed a corrosive poison, a strong acid or alkali (base). The victim may experience severe pain and have extensive mouth and throat burns.

Victim should seek for medical attention immediately.

If acidic pesticide has been ingested

Victim should take the milk of magnesia (1 tablespoon to 1 cup of water) or baking soda in water.

If alkaline pesticide has been ingested

Victim should take lemon juice or vinegar.

Table 8: Immediate actions taken at different conditions

In short, home pesticide products are safe if handled properly according to the instructions on the product label. Users should educate themselves about the product and the proper ways to use it. Besides, users should also be well educated of the first aids if pesticides were to spilled, ingested or swallowed.[20]

Furnishing, Medications and Food

Furnishing

Our dwellings are full with chemicals which found in furniture, lamps, plastics and so on that infiltrate our bodies. Some are clearly toxic whereas others are suspected of being harmful. The only things we can do are know where they are found and the way to avoid expose to those toxics. Indeed, the type and severity of symptoms varies depending on the amount of chemical involved and the nature of the exposure. [22]

Firstly, furniture polish contains a kind of chemicals can lead to poisoning when someone swallows or breathes in or inhales or sprayed into the eyes. This chemical is hydrocarbons or naphtha which causes damage to the organs and gastrointestinal lining for weeks after the ingestion and severe cases can result in death.[22]

Formaldehyde releases from furniture, combustion of gasoline, particle board and pressed-wood products. For instances, when burn materials such as natural gas, gasoline or tobacco, formaldehyde gas is released. Formaldehyde has a strong pickle-like odour which classified as a volatile organic compound (VOC’s). VOC’s are chemicals that become gas into the air and this is called off-gassing. If high concentration of this chemical breathed in, it could cause health problems. Human eyes are especially sensitive to formaldehyde, thus eye irritation is common complaint of getting formaldehyde poisoning. However, we can prevent this by ensure the combustion sources are properly maintained and ventilated or before bringing any formaldehyde containing products into home, allow them to off-gas outside the home or leave it unsealed in the warehouse for a few days. Since formaldehyde is water soluble and reacts to temperature changes, by keeping the temperature and humidity low, the amount of formaldehyde off-gassing into air is decrease. [23]

Mold or mildew is a type of fungus grows on surfaces in the form of downy or powdery substances. Mold likely grows in a situation where there is occurrence of leak and in moisture environment. Mold spores containing volatile organic compounds (VOC’s) which cause person to become ill, this is known as black mold poisoning. VOCs are extremely dangerous to humans as they affect the nervous system and respiratory system of human. Some of the main symptoms like memory loss, lethargy, asthma and infertility when it is in severe case. It can prevent by buy moisture control products and placed around the house to control the moisture level in the air or fix any leakage to avoid water seep down into the walls. [24,25]

Cleaners use to clean sofa like simple green concentrated all-purpose cleaner and febreze, they both contains chemical which bring harm to bodies. Simple green concentrated all-purpose cleaner contains 2-butoxyethanol, a solvent soaks through the skin and damages red blood cells. On the other hand, febreze contains quaternary ammonium compounds or ethanolamine which can cause or trigger asthma. To solve this, can create own potent germ-killing cleaner by combining 9 parts of water and one part of white vinegar in a spray bottle. For extra hard jobs, can spray hydrogen peroxide followed by the vinegar solution. [26]

Apart from that, we might get poisoning from the paint in the house accidentally. There are two different types of paint which are lead and oil-based paint. Lead is very common to be used in gasoline, house paint before 1978, toys and furniture painted before1976. Children get lead in their bodies when they get lead poison on their fingers from touching dusty or peeling lead objects, then putting their fingers in mouth. Normally, more common cases for lead poisoning is build up over time due to repeated exposure. Actually, lead is more harmful to children than adults as it affects the children’s developing nerves and brain. The younger the child, the more harmful the lead can be. In very high level of lead can cause muscle weakness, seizures or coma. In terms of oil-based paint poisoning, it is due to the toxic chemical – hydrocarbon. It is primary poisonous ingredient in oil paints. Poisoning occur when oil-based paint gets into the stomach or lungs. It may also occur if the poison gets into eyes or touches the skin. It might causes rapid heartbeat, damage in nervous system and form blisters on the skin. In order to prevent this, recommend everyone wash hands before eat and keep home as dust-free as possible.[27,28]

On the other hand, curtain in house also contains high amount of chemicals. For instances, shower curtain and bedroom curtains made of natural or organic materials. The distinctive smell in shower curtains when take out from the packaging, this odour is plastic softener. These kind of plastic shower curtains contain high amounts of phthalates and vinyl chloride. Phthalates is a chemical which has been scientifically linked to birth defects while vinyl chloride is a well-known carcinogen that shown to cause liver cancer in humans. For bedroom curtains, the most common are cotton, ramie, polyester, nylon, polyurethane and wrinkle-free materials. It will release toxic gases when exposed to heat, this is especially true of polyurethane, which always used as an insulating backing on curtains. Flax or linen is a healthier option for bedroom drapes. It is a little bit heavier but has a contemporary natural look but it does wrinkle easily. Always look for the labels and avoid those printed PVC or vinyl. [29]

Surprisingly, lamp in the house can also lead to poisoning. Poisoning can be due to two different types of lamp, one is seldom use nowadays which is kerosene whereas the other is compact fluorescent light bulb (CFL) which contains mercury. Kerosene is oil used as fuel for lamps, heating and cooking, however, it is seldom being used nowadays when the technology is getting advance. If a person who accidentally swallows or breath in kerosene, it can cause breathing difficulty, convulsion, vision loss or bloody stool due to the hydrocarbon inside the kerosene. Besides this, not only mercury poisoning, but also dangerous to the earth when mercury leakage from a break compact fluorescent light bulb (CFL) as mercury can leak into air as well as storm water. To prevent further damage to human and the environment, broken gas should handle properly by put on gloves and should proper recycling of CFL bulbs. [30]

Last but not least, gas poisoning becomes common nowadays as we can see there are vehicles everywhere and even there are household appliances in home. There are several types of poisoning due to toxic gases, methane gas poisoning and carbon monoxide poisoning are two examples of gas poisoning in home. Odourless methane gas may produce from rotting food in the kitchen or potting soil in a plastic bag. It is also a primary gas used in the mixture for heating purposes. When a person exposed to methane gas, he o she might experiences headache, heart palpitations, flu like symptoms or decrease in motor coordination. Same as methane gas, carbon monoxide has no smell or taste and if a person get the poisoning from carbon monoxide, he or she will also experiences the symptoms like the one who get methane gas poisoning. Leakage of carbon monoxide may come from cookers and heater. Thus, it is necessary to maintain house ventilated to prevent the formation of methane gas and carbon monoxide at home. Perhaps, install a carbon monoxide detector to detect carbon monoxide level in home is a good choice to prevent poisoning after leakage has been occurred. [31,32]

All in all, behaviour of a person is important to decrease the chances of get poisoning from the furniture and household appliances.

Medicine

Poisoning due to medications has been a major problem in children as well as adults. For children, some common medications involved are vitamins and iron supplementation, analgesics, antipyretics and hypnotics. [2]

As for adults, prescription painkillers such as methadone, hydrocodone and oxycodone are often involved, followed by cocaine and heroin. [33] Studies by Centers for Disease Control and Prevention(CDC) show that there were 14800 prescription painkiller deaths in United States in 2008. Some other commonly abused medications also include opiods, benzodiazepines and amphetamine-like drugs.[34]

Various factors can be involved in medication poisoning in home. A common cause of this is due to overdosage. [2] Medicines are helpful in therapeutic dose but can be poisonous when taken in excess. Examples includes vitamins A and D which have a relatively low tolerable upper limit of toxicity and may leads to liver problem and death when taken in excessive amount. One very common drug that is often being used in house is paracetamol. It is considered one of the safest drugs but can be toxic to liver when taken in large amount. [35] Thus, adults should pay extra care about the maximum dose of medications to avoid unintentional poisoning.

Drug interactions can be fatal too and is especially common in those elderly who are on polypharmacy. Interactions with alcohol can also leads to certain unwanted toxicities. Drug allergy is another causative factor to pharmaceutical poisoning in the home. Individuals with hypersensitivity to certain drugs often suffered from toxidromes associated with drug allergy. Glucose-6-phosphate dehydrogenase deficiency is an example of drug allergy which is due to genetic defects. In some cases, it can leads to severe hemolysis in the presence of substances such as naphthalene and sulphonamide drugs.[2] Improper storage of medications often contributes to the increased risk of exposure of children to poisonous substances.

Prevention is an extremely important measure in reducing risk of accidental exposure. Studies have shown that storage of medications in child proof containers was observed in only 10.5 percent of accidental poisoning cases in children[2] This data proves that child proof containers is useful in preventing children medication poisoning. Other precaution steps include disposal of old medicines, keeping pills and liquids in their original containers, storing all medications in a locked cabinet and never prepare or give medication to a child in the dark. [36]

On the other hand, there are also several ways of preventing adults’ medication poisoning. They should only take prescription medications as prescribed by the healthcare professional. Misuse and abuse of prescription and over-the-counter medications should be avoided. Adults should follow directions on the label and read all warning labels while give or take medications. Prescription drugs should not be share or sell to others as this may lead to drug misuse. Besides, they should never take larger or more frequent doses of medications to achieve faster or more powerful effects. [37]

Food

Food poisoning is an acute syndrome with nausea, abdominal cramping, vomiting and diarrhea, which appear suddenly and within 48 hours after ingestion of food contaminated with pathogenic bacteria, viruses or toxins produced by bacteria. Foodborne disease can also be caused by large variety of toxins that affect the environment, such as pesticides and medicines in food, and naturally toxic substances such as poisonous reef fish.[38]

One of the major risks involves the consumption of raw or undercooked food that may be naturally contaminated by food borne pathogens. V. cholera are known for causing cholera, usually found on seafood and require the salt environment of sea water for growth. These Vibrio bacteria are very sensitive to cold and heat. [39] Food poisoning caused by this bacterium is a result of insufficient cooking. In addition, food poisoning arises from improper handling and preparation of food as well as poor sanitation. Food can be infected with bacteria such as Salmonella if food stored at wrong temperature. [40]

Food or beverage also can become contaminated with bacteria if it is handled by an infected person with unwashed hands or if it comes in contact with contaminated food or feces. Moreover, contamination of cooked foods occurs when contact with surfaces or utensils that were not properly washed after use with raw products. Proper storage of the perishable seafood below 40oF and subsequent cooking and holding above 150oF, can destroy all the bacteria on food. The ingestion of contaminated foods leads, within hours, to vomiting, fatigue and diarrhea. [41]

Food poisoning can prevent with good manufacturing and handlings practices Attention should also be paid to the personal hygiene. It is essential to cook food thoroughly before consumption. For example, high-risk food such as oysters shall be cooked in boiling water for not less than 5 minutes. Moreover, raw materials such as red meat and seafood shall be properly wrapped or covered before storage. A specific portion of a refrigerator or a designated refrigerator shall reserve for storage of seafood to be eaten raw, such as sashimi and oysters.

Tetrodotoxin is a potent marine neurotoxin, named after the order Tetraodontiforms with which it is commonly associated. Puffer fish and porcupine fish are common example of fish that containing a large amount of tetrodotoxin. The distribution of tetrodotoxin is mainly in the liver, ovary and skin of puffer fish. The flesh of many puffer fish may not usually be dangerously toxic. Puffer fish is prepared by chefs specially trained and certified by government to remove the viscera to reduce the danger of poisoning.

Poisoning from tetrodotoxin is major public health concern. This is because many Japanese know that puffer fish, especially their livers (“kimo”), are very toxic. Nevertheless, there are more than a few “kimo” fans who dare to ingest the liver, believing that the toxin can be eliminated by their own special or traditional detoxification methods. Poisonings also can cause by the improper way to preparing puffer fish. Most of poisoning cases usually occur after eating fish caught and prepared by uncertified handler. In human, the lethal dose of tetradotoxin is around 1 to 2m g and the minimum dose necessary to cause symptoms has been estimated to be 0.2mg. [42] Tetrodotoxin inhibits nerve and muscle conduction by selectively block sodium channel, resulting in respiratory paralysis that causes death. [43]

There is currently no effective antidote to tetrodotoxin poisoning. This poisoning can be avoided by understanding the way to clean the puffer fish. First, cut around the mouth and eyes of the puffer fish using the knife, and pull the skin off. Secondly, wash the puffer fish under cold running water to remove the gel that coats the fish. Remove the eyes and organs of the blowfish with the knife. Be extra careful in this particularly with the liver and ovaries as they contain the highest concentration of the poison, and if they burst or accidentally cut, the toxin will seep into fish. After that, cut through the flesh of the puffer fish, carefully removing it from the bones and followed by cut off the head and chop it into two or three pieces.[44]

Apart than that, there are other toxins to be concerned about such as pesticides sprayed on fruits and vegetables. Food poisoning if do not thoroughly wash the fruits and vegetables. One study from California showed that outbreak of illness caused by watermelon-borne pesticide toxicity. A total of 1,376 illness results from consumption of watermelons containing residues of aldicarb, anticholinesterase inhibitor. There were 47 reports of illness involving pregnant women, two of whom reported having subsequent stillbirths. Therefore, it is essential the wash the vegetables and fruits thoroughly before eating as well as peeling the skin of fruits off. [45]

Governments and regulators lack the resources to conduct surveillance of health and safety practices in pesticides application, and to monitor the incidence of residues.

Melamine bowl and food packaging

Melamine is an organic base commercially synthesized from urea with an intermediate step producing cyanic acid. It is a nitrogen-rich heterocyclic triazine which consists of six atoms of nitrogen in a molecule, constituting 66% of molecular weight. The structure of melamine is as shown below. [46]

Figure 1.

Figure 7: Structure of Melamine [46]

Melamine can be used to increase the apparent level of protein in certain foods, especially in diary and wheat products because it is rich in nitrogen. It is combined with formaldehyde by industry to produce melamine resin, a very durable thermosetting plastic, and melamine foam, polymeric cleanser. Other commercial products containing melamine include fabric, glues, housewares, and flame retardants. [46]

The toxicity of melamine came to people’s attention because of outbreak of urinary stones in children who consumed melamine-tainted milk in China in 2008. This incident resulted in 6 deaths and approximately 50,000 hospitalizations. Even after the incident in 2008, melamine exposure remains common. [46] In the latest study, published in JAMA Internal Medicine, researchers from Taiwan studied on total melamine excretion in urine after volunteers consumed hot noodle soup from melamine bowls. [47]

In their small experiment, the researchers requested 6 healthy volunteers to consume 500ml of hot noodle soup (initial temperature, 900C) from melamine bowl and another 6 from ceramic bowl. All participants provided spot urine samples before their meal and at two-hour intervals after eating the soup, for up to 12 hours. Following a three-week ‘wash-out’ period, the two groups reversed, and those who ate from melamine bowls ate soup from ceramic bowls and vice versa. The researchers reported that the total melamine excretion in urine was 8.35mcg for those using melamine bowl and 1.31mcg for those eating from ceramic bowls. [48]

This showed that melamine tableware may release large amounts of melamine when used to serve high-temperature food. However, amount of melamine released from melamine tableware varies by brand, so the results of this study of one brand may not generalize to other brands. [48]

According to WHO, melamine is not metabolized and is rapidly eliminated in the urine with a half-life in plasma of around 3 hours. The compound has a low acute toxicity. There is no human data found on the oral toxicity of melamine. Data are available from animal feeding studies carried out in rats, mice and dogs. [49]

Besides of melamine bowl, materials that used for packaging food which include glass, metal cans and plastics can cause poisoning as well. Glass packaging is a combination of different materials: a glass container, made of silica glass, and a closure, made of glass, metal, cork, or plastic. According to Pedersen et al. 2008, plasticizers like phthalates have been found to migrate from glass container closures containing PVC gaskets. [50]

For metal cans, it may either consist of tin plate or of aluminium and steel coated with a lacquer. Tin plate has reducing abilities preventing colour and flavour loss and prevent oxidation. However, it can dissolve into the product. Lacquers may also migrate into the food. [50]

Symbol

Types

Examples of applications

Adverse Effects

File 5110

Polyethylene

Terephthalate

Fizzy drink and water bottles

-Suspected human carcinogen

File 5111

High Density

Polyethylene

Milk bottles and most

shampoo bottles.

File 5112

Polyvinyl

Chloride

Pipes

-Can cause cancer, birth defects, genetic changes, chronic bronchitis, ulcers, skin diseases, deafness, vision failure, indigestion, and liver dysfunction

File 5113

Low Density

Polyethylene

Carrier bags, bin liners and packaging films.

File 5114

Polypropylene

microwaveable meal trays

File 5115

Polystyrene

Yoghurt pots, foam hamburger boxes and egg cartons, and plastic cutlery

-Migrates into food and stores in body fat

-Elevated rates of lymphatic and hematopoietic cancers for workers.

File 5116

Other

Polycarbonate, with Bisphenol A

Baby and water bottles

-Scientists  have linked very low doses of bisphenol A exposure to cancers, impaired  immune function, early onset of puberty, obesity, and diabetes

Table 9: Categories of Plastics [51]

According to the U.S. Food and Drug administration, chemical components can indeed migrate from plastics into food at microwaving temperatures. However, FDA has assessed migration levels of substances added to regulated plastics and has found the levels to be well within the margin of safety. [52]

Diethylhexyl adipate (DEHA) is a plasticizer that added to some plastics to make them flexible. DEHA exposure may occur when eating certain foods wrapped in plastics, especially fatty foods such as meat and cheese. However, the levels are low. The level of plasticizer that might be consumed is well below the levels showing no toxic effect in animal studies. [52]

  Whenever possible consumer should find alternatives to plastic in food or drink preparation. It is advisable to cook and store food in glass, stainless steel, and porcelain. The most important is to avoid heating food in plastic containers, or storing fatty foods in plastic containers or plastic wrap. Consumers should stop buying or using bottled water. Also, it is recommended to buy food in metal containers. Leftovers food should be covered in bowls with a plate. Besides that, instead of using Teflon pans, it is better to use stainless steel pans and avoid canned food. Lastly, consumers should be educated that only plastic containers or packaging labelled ‘microwave safe’ should be used in microwave ovens. [53]

Consumers can recycle disposable food packaging material. Almost all packaging materials (glass, metal, and thermoplastic) are recyclable. Besides recycling, they can be disposed by combustion which is the controlled burning of waste in a designated facility. It is an alternative for waste that cannot be recycled. Another method is landfilling. Landfills provide environmental-friendly disposal of residues of recycling and combustion operations. The location and operation of landfills are governed by federal and state regulations, and landfills are carefully designed structure in which waste is isolated from the surrounding environment. [54]

Detergents

Apart from those poisoning that has been mentioned above, household cleaning products are also one of the hidden dangers in the house that can lead to health problems. Based on a research article from Brazil, the route of exposure in unintentional poisoning according to age, ingestion accounted for 90.4% which is the highest of all exposures, followed by inhalation (4.3%), skin contact (2.4%) and eye contact (2%) where children under the age of five were exposed by almost all routes. [46] In adults, inhalation was the second most common route of poisoning (Table 10). Among the products involved in unintentional poisoning, bleach was the most reported across all ages. In all major categories of products involved in poisoning, children under the age of 5 accounted for more than 70% of the reported incidents (Table 11). As a reference of the article from Brazil, we can also conclude that ingestion, inhalation and dermal contact are the most common that lead to intoxication. [55] Besides that, storage of a product in a container that was different to the original became the second most frequent risk factor for intoxication. This appeared to be associated to poisoning in both children and adults. Children tend to be at a higher risk for accidental poisoning from soap or cleaning products because they are more likely to drink or eat these products without realizing that they are toxic, whereas poisoning can occur if users do not follow the instructions for proper product use during cleaning.[55]

Table 10: Route of exposure in unintentional poisoning caused by household cleaning products, disinfectants and pesticides according to age, Rio de Janeiro, Brazil, 2000-2002.

*Available from “A profile of unintentional poisoning caused by household cleaning products, disinfectants and pesticides” by Presgrave RDF, Camacho LAB, Villas Boas MHS.1

Table 11: Distribution of toxic agents by age in unintentional poisoning caused by household cleaning products, disinfectants and pesticides, Rio de Janeiro, Brazil, 2000-2002.

*Available from “A profile of unintentional poisoning caused by household cleaning products, disinfectants and pesticides” by Presgrave RDF, Camacho LAB, Villas Boas MHS.

There were 2 case reports on the detergent poisoning reported by Centers for Disease Control and Prevention (CDC). [56] The first case report happened in Charlotte, North Carolina that two critically ill young children who had been exposed to laundry detergent from pod were sent to the Carolinas Poison Center. Both patients were aged 20 months and 15 months respectively. Both of them showed the symptoms of vomiting and subsequently developed respiratory distress, became unresponsive, and developed seizure-like activity. There was another girl aged 10 months was brought to a local health-care facility with vomiting, difficulty breathing, and drooling after biting into a laundry detergent pod and was admitted to the intensive care unit. [56]

Laundry detergent, fabric softener, carpet cleaner and bleach can be found commonly in the laundry room and thought to be highly toxic. Detergent generally defined as cleaning products normally contain surfactants that help water to wet surfaces in order to maximise cleaning and washing performance with additional ingredients that enhance the cleaning efficacy of the surfactants. [57] The surfactants and builders contained in these products are the major contributors to product toxicity. Detergent surfactants are divided into four categories corresponding to the electrical charge on the polar portion of the molecule: (a) non-ionic, (b) anionic, (c) cationic, and (d) amphoteric (show in Table 11). Laundry detergent toxicity is generally more common among those detergents toxicity in the house which usually contain non-ionic or anionic surfactants, or a combination of the two. The additional ingredients such as alkaline builders that can be found in laundry detergents are complex phosphates, sodium carbonate, sodium silicate, and sodium metasilicate. Ingestion of laundry detergent is associated with nausea, vomiting, and diarrhea where aspiration of the products will lead to respiratory irritation or chemical pneumonitis with associated coughing or dyspnea. Ocular exposure to laundry detergent typically results in irritation, stinging, and erythema of the conjunctiva. Prolonged dermal exposure would manifest as dryness, pruritus, or erythema. [57]

Anionic

Alkyl sodium sulfates

Alkyl sodium sulfonates

Dioctyl sodium sulfosuccinate

Linear alkyl benzene sulfonate (Na+)

Sodium lauryl sulfate

Tetrapropylene benzene sulfonate (Na+)

Nonionic

Alkyl ethoxylate

Alkyl phenoxy polyethoxy ethanols

Polyethylene glycol stearate

Cationic

Quartenary ammonium compounds

Benzalkonium chloride

Benzethonium chloride

Pyridinium compounds

Cetylpyridinium chloride

Quinolinium compounds

Dequalinium chloride

Amphoteric

Imidazolines

Betaines

Table 12: Surfactants Used in Synthetic Household Detergents. [57]

Fabric softeners that contain cationic surfactants are used to reduce static cling and inter-fiber friction. [58] Cationic surfactants are rapidly absorbed from gastrointestinal tract, ingestion can lead to systemic effects, for example hypotension, restlessness, confusion, central nervous system depression and coma. Ocular tissues are more sensitive to cationic surfactants, with even 1 drop of a 2% solution having the potential to cause corrosive injury and severe corneal damage. Dermal exposure to concentrated cationic surfactants can cause dermal necrosis. Other than that, fabric softener may also contain ethyl acetate, a narcotic irritates the eye and respiratory tract; and chloroform, a neurotoxin, anesthetic, and carcinogen cause irritation of respiratory tract and loss of consciousness through inhalation which are on the Environmental Protection Agency’s (EPA) hazardous waste list. [59]

The possible toxic ingredients that can be found in carpet cleaner are perchlorethylene, a carcinogen that damages liver, kidney and nervous system damage; and ammonium hydroxide which is corrosive and lead to skin and respiratory tract irritation through direct dermal contact and inhalation. [60]

Sodium hypochlorite found from the bleach causes the toxicity due to its corrosive property that able to irritate or burn skin, eyes and respiratory tract. [50] It may also cause pulmonary edema or vomiting and coma if ingested but the most dangerous is when it contacts with other chemicals, it may produce chlorine fumes which is more toxic to the human body. [59]

Soap, shampoo and toot