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08-24-09 Why is torch lamp oil mistaken for apple juice?


Question of the Week
August 24, 2009
Why is Torch Lamp Oil mistaken for Apple Juice?
 Because of the container and the color of the liquid.
Deaths have occurred when Torch Oil was mistakenly drunk because of its close resemblance to apple juice.
Torch Lamp Oil bottles resemble apple juice containers.  In addition, this product is commonly poured into another container e.g. Styrofoam cup to make transfer to the torch much easier.
Lamp Oil is a petroleum distillate, which are crude oil by-products that range from petroleum ether to lubricating oils. These products contain varying amounts of straight chain and cyclic hydrocarbons.  Viscosity (fluid’s resistance to flow), surface tension (cohesive force generated by attraction between molecules) and volatility (tendency for a liquid to become a gas) determine the degree of toxicity of petroleum distillates.  The most dangerous are those with low surface tension and viscosity.
The majority of exposures occur in toddlers who ingest household products containing petroleum distillate. Aspiration is the primary life-threat. Surfactant inhibition causes alveolar instability, distal airway closure, ventilation/perfusion mismatch and hypoxemia. Pulmonary capillary damage causes a chemical pneumonitis and bronchopneumonia.  CNS depression may occur and vomiting occurs in about 50% of cases. Hemolysis can occur when petroleum distillates are drunk in large amounts after intentional ingestions.
Clinical management is supportive care.  GI decontamination is contraindicated in this setting as it increases the aspiration potential.  Symptomatic patients should be admitted.  CXR does not correlate with the clinical picture. (Early after exposure, the CXR is frequently “negative”; Later, it always looks worse than the patient.)
Question prepared by: Donna Seger, M.D.  Medical Toxicologist