Sodium hydroxide (NaOH), commonly known as lye or caustic soda, is a corrosive base found in many household and industrial products, including drain cleaners and oven cleaners. Inhalation of sodium hydroxide dust, mist, or aerosols is dangerous because it causes immediate chemical burns upon contact with the delicate tissues of the respiratory tract. The corrosive action of this chemical, which works by hydrolysis of proteins, can quickly lead to severe inflammation, swelling, and damage to the nose, throat, and lungs. A rapid and informed response to inhalation is paramount.
Immediate First Aid Response
The most important first step after inhaling sodium hydroxide is to immediately move the exposed person to an area with fresh air, away from the source of the chemical mist or dust. This action stops further exposure to the corrosive agent and is the initial priority for safety. Once the person is in a safe location, emergency medical services, such as 911 or Poison Control, must be called to ensure professional help is on the way.
If the exposure involved a mist or dust that settled on the body, quickly remove any contaminated clothing to prevent secondary chemical burns. The immediate focus for inhalation exposure remains on maintaining an open airway. It is important to keep the person calm and still, as agitation can increase oxygen demand and worsen breathing difficulties.
Do not attempt to neutralize the chemical by giving the person anything to drink or by trying to induce vomiting, as this can cause further injury to the already damaged tissues. Treatment for sodium hydroxide exposure is supportive. If the person is not breathing, trained personnel should begin artificial respiration or cardiopulmonary resuscitation (CPR).
Recognizing Signs of Exposure
Exposure to inhaled sodium hydroxide produces noticeable physical symptoms indicating damage to the respiratory systems. Initial signs include persistent coughing, often accompanied by a sore throat and sneezing as the caustic substance irritates the mucous membranes. The chemical burn can cause immediate swelling or spasms of the larynx, which may manifest as a high-pitched, harsh sound when breathing, known as stridor.
Difficulty breathing, or dyspnea, is a serious sign that the airway is becoming obstructed or that the lungs are inflamed. In severe cases, the victim may develop non-cardiogenic pulmonary edema, which is an accumulation of fluid in the lungs that can occur hours after the initial exposure. Visible signs of severe respiratory distress include chest tightness and a blue or gray discoloration of the skin, lips, or nail beds (cyanosis). These symptoms signal a medical emergency requiring immediate hospitalization.
Professional Medical Intervention
Upon arrival at a medical facility, the immediate focus of professional care is securing and maintaining the patient’s airway. If laryngeal edema is severe and threatens to close the airway, intubation may be necessary, where a tube is inserted into the trachea to allow mechanical ventilation. Patients who are struggling to breathe will receive supportive care, which includes humidified supplemental oxygen to help with respiratory function.
Diagnostic procedures are used to assess the full extent of the internal damage caused by the inhaled caustic mist. A bronchoscopy, which involves inserting a camera down the throat into the airways, allows physicians to visualize the severity of the burns to the larynx, trachea, and bronchi. Chest X-rays may also be used to check for signs of lung inflammation or fluid accumulation, such as pulmonary edema. Treatment is primarily supportive, aimed at managing the chemical burn injuries and preventing secondary complications like infection, with intravenous fluids and pain medication.
Preventing Future Incidents
Avoiding sodium hydroxide inhalation requires adherence to safety protocols. When working with substances like drain or oven cleaners, always ensure the area has adequate ventilation to disperse any dust or mist. Working outdoors or opening windows and using exhaust fans can reduce the concentration of the chemical in the breathing zone.
For powdered or highly concentrated liquid sodium hydroxide, appropriate Personal Protective Equipment (PPE) is mandatory. This includes wearing chemical safety goggles or a full-face shield, and using a respirator with a high-efficiency particulate filter to prevent the inhalation of mists or aerosols. Household products should always be stored in their original containers, tightly sealed, and locked away out of the reach of children.