title: Toxicity from automotive screenwashes reported to the United Kingdom National Poisons Information Service (NPIS) from 2012 to 2015.
abstract: BACKGROUND
  Automotive screenwashes commonly contain ethylene glycol, methanol, and/or isopropanol; ethanol is also included in many formulations. The concentrations and combinations of each constituent vary considerably between the products. This study was undertaken to investigate the toxicity of automotive screenwashes as reported by telephone to the United Kingdom National Poisons Information Service (NPIS).
  
  
  METHODS
  Enquiries to the NPIS relating to automotive screenwashes were analyzed retrospectively for the period January 2012 to December 2015.
  
  
  RESULTS
  There were 295 enquiries involving 255 individual exposures. The majority (n = 241, 94.5%) of exposures involved ingestion and 14 of these also involved other routes. Six cases were due to skin contact alone, three to inhalation alone, three to eye contact alone, one to ear exposure alone and another occurred from inhalation and skin contact. Children below 5 years of age accounted for 26% of all ingestions. The identity (and therefore composition) of the screenwash was known with certainty in 124 of 241 ingestions and included methanol in 106 formulations, isopropanol in 72, ethylene glycol in 38, and ethanol in 104. The World Health Organisation/International Programme on Chemical Safety/European Commission/European Association of Poison Centres and Clinical Toxicologists Poisoning Severity Score was known in 235 of 241 cases of ingestion: most patients were asymptomatic (n = 169, 71.9%), but 59 (25.1%) developed minor (PSS 1), six (2.6%) moderate (PSS 2), and one patient severe (PSS 3) features; this patient later died. Nausea (n = 10), vomiting (n = 11), abdominal pain (n = 10), metabolic acidosis (n = 8) and raised anion gap (n = 8) were reported most commonly after ingestion.
  
  
  CONCLUSIONS
  Most patients (71.9%) ingesting automotive screenwash did not develop features. The implication is that the amount of screenwash ingested was very small. Skin and eye exposure produced either no features or only minor toxicity.
authors.affiliation: a NPIS (Birmingham Unit) , City Hospital , Birmingham , UK.
authors.forename: Rachael
authors.initials: R
authors.lastname: Day
authors.affiliation: b NPIS (Edinburgh Unit) , Royal Infirmary , Edinburgh , UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Eddleston
authors.affiliation: c NPIS (Newcastle Unit) , Regional Drug and Therapeutics Centre , Newcastle , UK.
authors.forename: Simon H L
authors.initials: SH
authors.lastname: Thomas
authors.affiliation: d NPIS (Cardiff Unit) , University Hospital Llandough , Cardiff , UK.
authors.forename: John P
authors.initials: JP
authors.lastname: Thompson
authors.affiliation: a NPIS (Birmingham Unit) , City Hospital , Birmingham , UK.
authors.forename: Sally M
authors.initials: SM
authors.lastname: Bradberry
authors.affiliation: a NPIS (Birmingham Unit) , City Hospital , Birmingham , UK.
authors.forename: J Allister
authors.initials: JA
authors.lastname: Vale
mesh_terms: D019840:2-Propanol / Q000737:chemistry / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000737:chemistry / Q000506:poisoning*; D019855:Ethylene Glycol / Q000737:chemistry / Q000506:poisoning*; D006801:Humans; D000432:Methanol / Q000737:chemistry / Q000506:poisoning*; D008875:Middle Aged; D011039:Poison Control Centers; D011041:Poisoning / Q000453:epidemiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000431:Ethanol; D019855:Ethylene Glycol; D019840:2-Propanol; D000432:Methanol
keywords: Ethylene glycol; isopropanol; methanol; screenwash; windscreen wash; windshield wash