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Boric Acid Poisoning: Toxicity, Symptoms, Treatment, and Prevention

Toxicity Profile

Boric acid (H₃BO₃) and borates are low-to-moderate toxicity. Acute lethal dose (human): ~5–20 g (≈1–4 tsp) in adults; lower in children. Chronic exposure causes cumulative toxicity.

Routes

  • Ingestion (roach powder, laundry additives, eye washes).
  • Dermal (large surface area, damaged skin).
  • Inhalation (dust).

Clinical Manifestations

  • GI: Nausea, vomiting, diarrhea, abdominal pain (blue-green vomit/stool characteristic).
  • CNS: Headache, lethargy, confusion, seizures, coma.
  • Skin: Erythematous rash → desquamation ("boiled lobster" appearance).
  • Renal: Acute tubular necrosis, oliguria.
  • Hemodynamic: Hypotension, tachycardia.

Management

  • No specific antidote.
  • Decontamination: Activated charcoal (if recent ingestion, no contraindications). Gastric lavage rarely indicated.
  • Supportive: IV fluids, electrolyte correction, seizure control (benzodiazepines), hemodialysis for severe renal failure/large ingestions (boric acid is dialyzable).

Prevention

  • Store products locked, out of reach of children/pets.
  • Use tamper-resistant bait stations for pesticides.
  • Follow label directions precisely.

Call Poison Control (1-800-222-1222 US) immediately for any suspected significant exposure.

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