Acetone Poisoning

Acetone poisoning occurs when the amount of acetone in the body is more than what the liver is able to break down. Acetone is a clear liquid that smells like nail polish remover. When exposed to the air, it quickly evaporates and remains highly flammable, making acetone dangerous to use around an open flame. Hundreds of household products contain acetone, including furniture polish, rubbing alcohol, and nail polish. Despite its presence in hundreds of common products, the incidence of acetone poisoning is very low. The body is able to handle up to 200ml without serious consequences. This is because the liver is able to take acetone and break it down into chemicals usable by the body. The source of the acetone is not always external. Your body produces acetone when it breaks down fat, so you will have more acetone in your body when you are on a low-fat diet. Acetone poisoning can be caused by metabolic diseases, starvation, or chemical overexposure. The symptoms of acetone poisoning include headaches, dizziness, and, in rare cases, death. If acetone has been swallowed, stomach pumping may be used as a treatment. In other cases, oral breathing treatment will clear the acetone from the blood through the lungs.

Acetone poisoning is rare. The body is capable of breaking down large amounts of acetone naturally. Therefore, for overexposure to occur, very large amounts must be produced, ingested, or inhaled. Mild acetone poisoning symptoms include:

• headache
• slurred speech
• lethargic state

Severe symptoms are very rare and include:

• coma
• deep stupor
• death

Every day, the body breaks down fats into organic molecules called ketones. Ketones contain acetone and travel through the bloodstream until they are broken down in the liver. Acetone poisoning can occur when an abnormally high amount of ketones is present. This is a condition known as ketoacidosis. Metabolic diseases, such as diabetes mellitus (types 1 and 2), can cause ketoacidosis. In cases of extreme starvation, the body’s carbohydrate stores are depleted and the body begins to break down its stored fats into ketones. The liver cannot compensate for so many ketones, and blood ketone levels grow dangerously high. Acetone poisoning can have other causes, including:

• ingestion of rubbing alcohol for intoxication
• overexposure to specific paints in closed spaces
• ingestion of nail polish remover

Acetone poisoning has an unusual symptom that aids in diagnosis: the breath of the patient will have a fruity odor from all the ketones in his or her blood. Laboratory tests are difficult to run for acetone because of the amount naturally present in the body. Physicians look for high levels of acetone and ketones and physical symptoms to make a diagnosis. Tests to aid in diagnosing acetone poisoning include:

• urine test to look for ketones (under normal circumstances, there are no ketones in urine)
• blood test to check blood level of ketones
• toxicology screening to determine what toxic chemicals are present in the body

Patients with acetone poisoning often have fruity breath because breathing is one way your body gets rid of acetone. One way to treat those with acetone poisoning is by giving oxygen. The concentration ratio of acetone in the blood to acetone in the alveoli (sacs) of the lungs is 330. This means that 330 liters of air must be breathed out and replaced with clean air to clear the acetone from one liter of blood (Ramu et al., 1978 ). (The average adult body contains five to six liters of blood) This is an effective way to remove acetone from blood. However, clearing acetone through the lungs can bring recovery in days or weeks.

If large amounts of acetone have been ingested, do not induce vomiting. Acetone is harmful to the skin in your mouth and the lining of the esophagus. The common treatment is to pump the stomach. Doctors pump the stomach by putting a tube down the throat into the stomach. Small amounts of water or saline are pumped into the stomach and sucked back out.

This is done until no more acetone is present. The stomach pumping procedure raises the risk of accidental aspiration pneumonia, a condition in which the water is accidentally pumped into the lungs instead of the stomach. The patient can drown from the liquid filling his or her lungs.

If you have a metabolic disorder, such as diabetes, be sure to follow your doctor’s instructions regarding diet, medication, and lifestyle. If you notice changes in your symptoms, contact your doctor to discuss adjustments to your regimen. This will keep internal sources of acetone under control.

Acetone from external sources can enter the body four different ways:

• breathing: inhaling acetone from products such as nail polish or paint thinner
• eye contact: acetone splashes into the eye
• touching: spilling acetone on your skin
• drinking: accidentally or purposefully ingesting acetone

Preventing acetone exposure is a matter of following simple precautions, which include:

• keeping spaces well-ventilated when using products with acetone
• wearing a face mask if ventilation is poor
• wearing safety glasses to prevent eye contact with acetone
• keeping children away from bottles of liquid containing acetone
• keeping acetone away from flames

Small amounts of acetone will not hurt you. However, breathing larger amounts for a short time can irritate your nose, throat, lungs, and eyes. It can cause headaches, dizziness, confusion, rapid pulse, nausea, vomiting, unconsciousness, and possible coma. Swallowing large amounts can damage the skin in your mouth and may cause unconsciousness. Long-term exposure in animals has been shown to cause damage to kidneys, liver, and nerves. It is not known if these same effects occur in humans. It is not yet known if acetone can cause cancer.