Cleaning Products
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þ Bleach:
  - Household concentrations (~5%) don't cause burns of esophagus, just
    irritation [Vet Hum Toxicol 1988; 30:349-350.]
  - stronger concentrations (commercial bleaches) may cause severe burns

þ Ammonia:
  - Household ammonia is 1-10%.  Ingestion of small amounts not a medical
    emergency:  just dilute [Krenzelok EP.  Household Cleaning Products. Clin
    Tox Forum 3(5).]
  - Commercial strength (27-30%) may cause burns.

þ Toilet Bowl Cleaners:
  - unlike ammonia or bleach, may cause serious burns or inhalation injury.
    Often contain HCl at about 10% or 70% sodium bisulfate granules (pH<1).
    Usually only a major problem if ingested with suicidal intent.
  - Cleaners that are released slowly into the water from the reservoir:
    ingestion of small amounts causes no problems.

þ Mixing cleaning products:
  - bleach + acid (e.g., toilet bowl cleaner):  liberates chlorine gas
  - bleach + ammonia:  liberates chloramine gas
  - both are irritating, but irritation goes away in about an hour and no
    specific treatment.

þ Disinfectants:
  - pine oil can cause CNS depression and GI irritation, and is aspiration
    hazard.
  - many other components:  identify ingredients and call poison control
    center.

þ Dishwashing products:
  - Hand Dishwashing agents:  seldom cause more than diarrhea, stomach ache,
    and vomiting, even in large amounts; dilute.
  - Automatic Dishwasher agents:  may produce significant GI or oral
    irritation, but household products unlikely to produce significant burns.
    Liquid dishwasher detergent ingestion, in small amounts, causes no serious
    problems [Ann Emerg Med 1989; 18:60-63.]  Granular products may stay in
    mouth or esophagus for a long time and dilution and cleansing is
    important.

þ Laundry detergents:  contain many ingredients, these days:  contact poison
  control.

þ Scouring Powder (Comet etc.):  small amounts can be treated with dilution at
  home.  However, metal cleaners and some others may be corrosive or contain
  oxalic acid; contact poison control.

þ Glass Cleaners (Windex etc.):  contain butyl cellosolve (ehtylene glycol
  monobutyl ether).  This is _not_ metabolized to ethylene glycol and
  ingestion of 5-10 cc of glass cleaners containing it does _not_ cause
  toxicity [Vet Hum Toxicol 1991; 33:362.].  Large ingestions may cause oxalic
  acid production like ethylene glycol toxicity [Nitter-Huage S. Poisoning
  with ethylene glycol monomethyl ether.  Acta Med Scand 1970; 188:277-280.]
  [Rambourg-Schepens MO, et al. Severe ethylene glycol butyl ether poisoning:
  Kinetics and metabolic pattern.  Human Toxicol 19988; 7:187-189.].  Though
  can't get butyl cellosolve levels, most of these cleaners contain
  isopropanol and can get isopropanol levels to estimate ingestion amount.