title: Comparison of systemic and local effects of nitric acid and hydrochloric acid: an experimental study in a rat model.
abstract: BACKGROUND
  We aimed to determine the local and systemic effects of widely available household cleaners, namely 45% nitric acid (NHO(3)), and 18% hydrochloric acid (HCl), in a rat model.
  
  
  METHODS
  This prospective, experimental, placebo-controlled trial was carried out in the Animal Research Laboratory of Akdeniz University hospital. Commonly available solution of 45% NHO(3) and 18% HCl were tested against normal saline. Each solution was administrated orally to groups consisting of ten rats. The metabolic changes were determined by measuring the pH and calcium (Ca) levels before and after the administration of solutions. In addition, the pathological changes and mortality rates were determined for each group.
  
  
  RESULTS
  There was a statistically significant increase in the post-ingestion (30 minutes later) Ca levels and a decrease in the post-ingestion pH levels after the administration of test solution in the NHO(3) (p=0.006 for Ca increase, p=0.001 for pH decrease) and HCl (p=0.007 for Ca increase, p=0.023 for pH decrease) groups. There was also a statistically significant difference between groups for Ca increase (p=0.000) and pH decrease (p=0.006). In post hoc analysis, the difference between the groups was found to be originated from the placebo group. In the pathological evaluation of esophagus and stomach, there was a statistically significant difference between groups (p=0.009 (E) and p=0.016 (S)) and the difference was found to be originated from the control group (p=0.543 (E), p=0.244 (S) for NHO(3) and HCl). The 30-minute mortality rates were 0,2 in the NHO(3) group, 0,6 in the HCl group and 0 in the control group.
  
  
  CONCLUSIONS
  Serious metabolic and mild local pathological changes can occur after the ingestion of household NHO3 and HCl solutions. Further studies should be performed to elucidate the causes of death following oral ingestion of these compounds and appropriate public health warnings should be taken.
authors.affiliation: Department of Emergency Medicine, Akdeniz University, Medical Faculty, 07059 Antalya, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Eray
authors.forename: Cenker
authors.initials: C
authors.lastname: Eken
authors.forename: Cem
authors.initials: C
authors.lastname: Oktay
authors.forename: Tekinalp
authors.initials: T
authors.lastname: Gelen
authors.forename: Ali Berkant
authors.initials: AB
authors.lastname: Avci
mesh_terms: D000284:Administration, Oral; D000818:Animals; D002057:Burns, Chemical / Q000473:pathology*; D002118:Calcium / Q000097:blood; D004195:Disease Models, Animal; D004947:Esophagus / Q000187:drug effects* / Q000473:pathology; D006851:Hydrochloric Acid / Q000008:administration & dosage / Q000633:toxicity*; D006863:Hydrogen-Ion Concentration; D017942:Nitric Acid / Q000008:administration & dosage / Q000633:toxicity*; D051381:Rats; D017208:Rats, Wistar; D013270:Stomach / Q000187:drug effects* / Q000473:pathology
chemical_list: D017942:Nitric Acid; D006851:Hydrochloric Acid; D002118:Calcium