Hydrogen peroxide

CAS RN: 7722-84-1

Health Effects

0.2.1 SUMMARY OF EXPOSURE
  • 0.2.1.1 ACUTE EXPOSURE
    • A) USES: Hydrogen peroxide is a colorless, odorless liquid at room temperature, with a bitter taste. It is found in many household products at low concentrations (3% to 5%) for medicinal applications as skin disinfectant and antiseptic, and as a clothes and hair bleach. In industry, hydrogen peroxide in higher concentrations (10% to 35%) is used as bleach for textiles and paper, as a component of rocket fuels, and for producing foam rubber and organic chemicals (up to 70% concentration).
    • B) PHARMACOLOGY: Hydrogen peroxide is an oxidizing agent. The strength of the oxidizing reaction is determined by the concentration.
    • C) TOXICOLOGY: The primary effect is tissue injury due to oxidation of proteins. Hydrogen peroxide can be toxic if ingested, inhaled, or contacts the skin or eyes. Occasionally, the release of oxygen may cause distension, gastric or intestinal perforation, as well as venous or arterial gas embolization. One mL of 3% hydrogen peroxide produces 10 mL of oxygen at standard temperature and pressure, while 60 mL of 35% of hydrogen peroxide solution has the potential to produce 6.1 L of oxygen.
    • D) EPIDEMIOLOGY: Ingestions are relatively common, but serious toxicity is rare with ingestion of household products.
    • E) WITH THERAPEUTIC USE
      • 1) Hydrogen peroxide may cause burning when applied to wounds as a disinfectant. Systemic embolization has occurred when used for irrigation of surgical wounds resulting in ECG changes and, rarely, cardiac arrest and death. Risk increases when used under high pressure, in closed tissue spaces and a highly concentrated hydrogen peroxide solution is applied.
    • F) WITH POISONING/EXPOSURE
      • 1) MILD TO MODERATE TOXICITY: The severity of injury depends on the concentration and amount of the ingested hydrogen peroxide. Ingestion of dilute solutions of hydrogen peroxide may result in vomiting, mild gastrointestinal (GI) irritation, gastric distension, and, on rare occasions, gastrointestinal erosions or gas embolism. Inhalation and ocular exposure of household strength hydrogen peroxide (3%) can cause respiratory irritation and mild ocular irritation, respectively.
      • 2) SEVERE TOXICITY: INGESTION: Severe toxicity generally only occurs with ingestion of higher (greater than 10%) concentration products. Ingestions may cause caustic injuries to the gastrointestinal tract, leading to hemorrhagic gastritis, burns in the mouth, throat, esophagus, and stomach, ulcerating colitis, intestinal gangrene, and gas embolization. Systemic gas embolization can involve any organ, resulting in seizure, cerebral infarction, cerebral edema, spinal cord infarction, acute myocardial infarction, hypotension, cardiac arrest, and death. INHALATION: Inhalation of vapors from concentrated (greater than 10%) solutions may result in severe pulmonary irritation. Acute lung injury and respiratory arrest have also been reported following massive exposures. OCULAR: Eye exposure to high concentrations can cause corneal ulceration and perforation. DERMAL: Dermal exposure to concentrated solutions has resulted in burns and gangrene.
0.2.3 VITAL SIGNS
  • 0.2.3.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Hypotension and apnea have been reported with severe poisonings.
0.2.20 REPRODUCTIVE HAZARDS
  • A) At the time of this review, no reproductive studies were found for hydrogen peroxide in humans. Hydrogen peroxide was not embryotoxic or teratogenic in a single animal study (when tested in hair dyes). It was weakly embryotoxic and teratogenic to chick embryos exposed in an air chamber. The implications of the latter study for human occupational exposure are unclear.
0.2.21 CARCINOGENICITY
  • 0.2.21.1 IARC CATEGORY
    • A) IARC Carcinogenicity Ratings for CAS7722-84-1 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) IARC Classification
        • a) Listed as: Hydrogen peroxide
        • b) Carcinogen Rating: 3
      • 1) The agent (mixture or exposure circumstance) is not classifiable as to its carcinogenicity to humans. This category is used most commonly for agents, mixtures and exposure circumstances for which the evidence of carcinogenicity is inadequate in humans and inadequate or limited in experimental animals. Exceptionally, agents (mixtures) for which the evidence of carcinogenicity is inadequate in humans but sufficient in experimental animals may be placed in this category when there is strong evidence that the mechanism of carcinogenicity in experimental animals does not operate in humans. Agents, mixtures and exposure circumstances that do not fall into any other group are also placed in this category.
  • 0.2.21.2 HUMAN OVERVIEW
    • A) A study of hairdressers found an increased incidence of leukemias, but this conclusion was based on a fairly small number, has not been independently confirmed, and the increased prevalence of leukemia could not be attributed to hydrogen peroxide because of chronic exposures to multiple substances with carcinogenic potential.
    • B) There is lack of strong evidence to support that hydrogen peroxide containing tooth whitening products have a tumor-promotion risk.
  • 0.2.21.3 ANIMAL OVERVIEW
    • A) Hydrogen peroxide 30% and 90% were found to induce gastrointestinal tumors and were given a rating of Carcinogenic by RTECS criteria in mouse studies.
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