Association Belge des Syndicats Médicaux

L’exposition humaine aux substances caustiques et/ou corrosives (acides et bases)

Avis n° 9108 (disponible uniquement en anglais)

This advisory report was drawn up in response to a series of burn incidents that were reported to the Belgian Poison Centre (BPC) and that were caused by the use of a cleaning agentcontaining detergents and potassium hydroxide. The Minister subsequently requested the Superior Health Council (SHC) to issue an advisory report on the health hazards posed by acids and bases. The questions put to the SHC were the following:

- Which bases and acids or mixtures thereof entail an unacceptable public health risk when they are sold to the general public, given the incidents that are or could be reported to the
- Apart from the manner in which these substances or mixtures are currently marketed (in accordance with existing legislation), what additional measures and conditions for selling them to the general public do you recommend to reduce the risks posed by these acids
and bases to an acceptable level? The SHC was also requested to take into account their known dangerous properties, the risks they entail depending on the concentration, the intended use and manner in which they are applied.
The Council decided to extend the report to caustic substances. Caustic products (such as acids and bases) are frequently used by the consumer for a whole range of applications. Some are biocides belonging to the group of disinfectants (Product Types (PT) 1-4), and are used for human hygiene, as disinfectants and algaecides, for veterinary hygiene and for food/feed area treatments. Besides a lot of other caustic products are available for the general public.
A survey of the other in Belgium authorised products for consumer use containing caustics is given. The products can be defined according to their use as swimming pool agents,cleaners/polishers, drain cleaners, degreasing agents/stove glass cleaners/wheel and truck cleaners, removers (lime scale removers/descaling agents, paint strippers, rust removers and etching agents), cosmetic/personnel hygiene products (hair straighteners, hydrogen peroxide and nail primers), bleach/disinfectants (products containing hypochlorite salts, quaternary ammonium compounds, hydrogen peroxide, glutaraldehyde and formaldehyde), agents used in batteries, commonly available chemicals, and products derived from cement and lime.
Products containing caustic agents can be hazardous because of their dermal, ocular, gastrointestinal, respiratory health effects, and their impact on the nervous system after dermal exposure, ingestion or inhalation. They can be classified as corrosive or irritant according to their potential for irritancy/corrosivity dependent on their concentration of acid or base.
Several factors play a role in the risk of exposure to caustic products, e.g. the quantity, the formulation type, the application frequency and the use of personal protective equipment (PPE), such as clothes, gloves, goggles, etc. Data on the epidemiology of caustic exposures and caustic burns are only very fragmentary. During the first 6 months of 2014 an exploratory study was performed by the BPC. Additionally, a small survey was done in the 6 Belgian burn centres.
It can be concluded that in 2014 about 1250 consultations for caustic exposures were registered at the BPC, although this is probably an underestimate. No cases with life threatening or deadly symptoms were registered, but this might be due to a bias in the calls to the BPC as the data from the burn centres suggest. About 20 % of the cases of the BPC analysed involved child exposure; 75 % of the cases were consumer accidents. Bases were clearly more frequently involved than acids. Adults were more frequently exposed through the skin and the eyes.
Children were most frequently orally exposed. The data obtained from the BPC and the burn centres lead to the conclusion that caustic burns are a real public health problem, both because
of their frequency, and because of their severity.
Protection measures include recommendations formulated at the different stages of the formulation – regulation – marketing – application – post-application - monitoring chain, such as good labelling practices, better risk information for the user, improving the application
techniques, preventing misuses, and stimulating the awareness of the consumer.



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Date de publication: 03/12/2015