Chemical burns make up over 3% of burn injuries requiring in-patient medical care. They are generally caused by exposure to either an acid or base. Exposure can mean either direct contact with the chemical or with fumes put off by the chemical. The extent of the burn depends on the properties of the chemical, the tissue area involved, and the duration of the contact before cleansing. Chemicals do not actually need to be hot to burn; the burn results from the chemical reaction that occurs when a given chemical comes in contact with skin or other body tissue.
Acids & Bases
The two main categories of chemicals leading to chemical burns are acids and alkalis—also called bases. These two categories are broadly defined as chemicals with properties that allow them to neutralize each other. The acidity or alkalinity of a substance is measured along the pH scale with 7 being neutral, 0 being extremely acidic, and 14 being extremely alkaline. Not everything that is acidic or alkaline is harmful. For example, lemon juice has a pH of 2, orange juice has a pH of 3, baking soda has a pH of 9, and milk of magnesia has a pH of 10. But on the far extremes of the pH scale are substances that can cause serious harm to the body. Concentrated sulfuric acid has a pH of 1 and liquid drain cleaners have pH levels around 14.
The danger from these types of chemicals is how they interact with body tissue. Acids damage and kill cells by coagulating cells while alkalis liquefy cells. In general, alkali burns are more severe because alkalis tend to penetrate tissue more rapidly and deeply than acids do. These chemical reactions continue as long as the chemical is in contact with body tissue. Cleansing the injury site is a top priority. Often this is done with water, but certain cleansing solutions are more effective if the properties of the harmful chemical are known.
Not all chemicals react the same way and not all people react the same way to different chemicals, but in general there are certain symptoms that are indicative that a person has experienced a chemical burn. Some common symptoms include:
- Redness, irritation, or burning at the site of contact
- Pain or numbness at the site of contact
More serious symptoms that warrant seeking immediate medical attention include:
- Formation of blisters or black dead skin at the contact site
- Low blood pressure
- Faintness, weakness, dizziness
- Shortness of breath or severe cough
- Muscle twitching or seizures
- Cardiac arrest or irregular heartbeat
The Burn Injury Management page has full information on treatment for each of the various burn types. Some basic treatment steps that are specific to chemical burns and can be performed at home include removing any clothing or jewelry that was exposed to the chemical—taking care not to spread the chemical over more skin, washing the injured area for several minutes to remove the harmful chemical and stop the burning process, and administering over-the-counter medication to alleviate the pain.
If the victim starts going into shock; the burn penetrates the top layer of skin; the burn is near the eyes, hands, feet, face, groin, buttocks, or over a major joint; the pain cannot be controlled with over-the-counter pain relievers, or the victim exhibits any of the serious symptoms listed above then medical attention is necessary. Medical professionals are best suited to diagnose the properties of the chemical and determine the extent of the injury. Hospitals will take patients through an initial evaluation and stabilization process which may include blood tests and other studies to determine if the patient should be admitted to the hospital for additional treatment.
Below is a list of products that contain potentially hazardous chemicals and are routinely found in homes. These products should be stored in a safe location away from access by children. Adults should also be mindful when using these products to exercise safe handling techniques which includes following directions and safety precautions on the label provided by the manufacturer.
- Agricultural products
- Concrete mix
- Drain or toilet bowl cleaners
- Oven cleaners
- Pool chlorinators
Furthermore, any products that include any of the following substances should also be treated with extra caution.
- Hydrochloric acid
- Hydrofluoric acid
- Silver nitrate
- Sulfuric acid
The leading risk for chemical burns is in the workplace with workplace injuries accounting for nearly 50% of chemical burns that require admission to a burn center. Certain professions (chemical fabrication, medicine, mining, pool maintenance, etc.) create a higher risk for workers because of the use of large amounts of hazardous chemicals. The CDC estimates that over 13 million U.S. workers are exposed to hazardous chemicals resulting in expenses of over $1 billion annually.
In light of the threat that hazardous chemicals pose, the Occupational Safety and Health Administration (OSHA) established the Hazard Communication Standard. This standard requires all employers with hazardous chemicals in the workplace to maintain safety data on the chemicals in use, make this information available to their employees, and train their employees in proper chemical handling.