Toluene and xylene poisoning
Definition
Toluene and xylene are strong compounds that are used in many household and industrial products. Toluene and xylene poisoning can occur when someone swallows these substances, breathes in their fumes, or when these substances touch the skin.
This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Alternative Names
Xylene poisoning
Poisonous Ingredient
The harmful substances in these products are:
- Toluene (methylbenzene, phenylmethane)
- Xylene (ortho-xylene, meta-xylene, para-xylene)
Where Found
Toluene and xylene are used in:
- Fingernail polish
- Glues and adhesives
- Lacquers
- Octane booster in gasoline
- Paints
- Paint thinners
- Printing and leather tanning processes
- Rubber and plastic cements
- Wood stains
Other products may also contain toluene and xylene.
Symptoms
Below are symptoms of toluene and xylene poisoning in different parts of the body.
EYES, EARS, NOSE, AND THROAT
- Blurred vision
- Burning pain
- Hearing loss
STOMACH AND INTESTINES
- Bloody stools
- Abdominal pain (severe)
- Loss of appetite
- Nausea
- Vomiting (may be bloody)
HEART AND BLOOD VESSELS
KIDNEYS
- Kidney damage
LUNGS AND AIRWAYS
- Breathing difficulty
- Chest pain
- Cough
- Rapid, shallow breathing
NERVOUS SYSTEM
- Convulsions (seizures)
- Dizziness
- Drowsiness
- Extreme feeling of well-being (euphoria)
- Headache
- Memory loss
- Nervousness
- Staggering
- Tremors
- Unconsciousness (lack of responsiveness)
SKIN
- Dry, cracked skin
- Pale skin
Home Care
Get medical help right away. Do not make the person throw up unless poison control or a health care provider tells you to. If the substance is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
If the person swallowed the substance, give them water or milk right away if poison control or a provider tells you to do so. Do not give anything to drink if the person has symptoms that make it hard to swallow. These include vomiting, convulsions, or a decreased level of alertness.
If the person breathed in fumes, move them to fresh air right away.
Before Calling Emergency
Have this information ready:
- Person's age, weight, and condition
- Name of the product (and ingredients, if known)
- Time it was swallowed
- Amount swallowed
Poison Control
Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
Take the container to the hospital with you, if possible.
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.
Tests that may be done include:
- Blood and urine tests
- Bronchoscopy -- camera down the throat to look for burns in the airways and lungs
- Chest x-ray
- Electrocardiogram (ECG)
- Endoscopy -- camera down the throat to check for burns in the esophagus and the stomach
Treatment may include:
- Fluids through a vein (by IV)
- Washing of the skin (irrigation), perhaps every few hours for several days
- Tube through the mouth into the stomach to wash out the stomach (gastric lavage)
- Surgery to remove burned skin
- Breathing support, including tube through the mouth into the lungs and breathing machine (ventilator)
Outlook (Prognosis)
How well someone does depends on how severe the poisoning is and how quickly treatment is received. The faster medical help is given, the better the chance for recovery.
Inhaling these substances for long periods of time can cause permanent brain damage. This type of damage is seen in people who sniff these substances on purpose to get high.
Swallowing such poisons can have severe effects on many parts of the body. Burns in the airway or gastrointestinal tract can lead to tissue necrosis, resulting in infection, shock, and death, even several months after the substance was first swallowed. Scars may form in these tissues leading to long-term difficulties with breathing, swallowing, and digestion.
References
Aronson JK. Organic solvents. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:385-389.
Wang GS, Buchanan JA. Hydrocarbons. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 147.
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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