Contact Us    Contact Us     |     Feedback
MOBILE VIEW  | 

GLASS CLEANERS

Export To Excel

Classification   |    Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

    A) Commercial glass cleaners listed in this document contain low concentrations of alcohols, glycol ethers, traces of ammonia and various anionic and nonionic surfactants.

Specific Substances

    1) Varies
    2) Glass cleaner

Available Forms Sources

    A) SOURCES
    1) There are many different brands of glass cleaners. Some common brands are Windex(R), and Carousel Glass Cleaner(R). Formulations in the United States often have between 1% to 5% alcohols (usually isopropyl) with some other North American products containing up to 25% isopropyl, 1% to 5% glycol ethers, traces of ammonia, and various anionic or nonionic surfactants.
    2) Household ammonia is usually 5% to 10%, so homemade solutions of cleaners with household ammonia added may have up to this concentration.

Overview

Life Support

    A) This overview assumes that basic life support measures have been instituted.

Clinical Effects

    0.2.1) SUMMARY OF EXPOSURE
    A) Newer commercial (i.e., household products) glass cleaners have very low concentrations of alcohols and glycol ethers. Toxicity is unlikely from casual exposures or the ingestion of small amounts. Older glass cleaners (both ready-to-use and concentrates) may have significant amounts of isopropyl alcohol, methanol, and ethylene glycol monobutyl ether. Automobile windshield washer fluids may contain high concentrations (30% to 70% by volume) of methanol.
    1) While accidental exposures are common in children (primarily by ingestion) significant toxicity is unusual.
    2) Based on various formulations it is important to evaluate individual ingredients in each product.
    B) The most commonly reported effects include nausea, vomiting, irritation of the mouth and throat, and drowsiness.
    C) More serious cardiovascular effects may be possible following large ingestions of isopropanol, and can include cardiomyopathy and dysrhythmias. Refer to "ISOPROPYL ALCOHOL" management for further information.
    0.2.4) HEENT
    A) This material may cause transient irritation to the eyes and mucosa of the lips and mouth, but is unlikely to cause permanent damage.
    0.2.6) RESPIRATORY
    A) Concentrations of 5 to 10% of ammonia are irritating to the respiratory tract.
    0.2.7) NEUROLOGIC
    A) CNS depression is a characteristic symptom of isopropyl alcohol poisoning. Coma or significant respiratory depression is very unlikely because of the low concentrations (often between 1 and 5%) in recently produced household products within the United States.
    0.2.8) GASTROINTESTINAL
    A) Nausea, vomiting, and diarrhea may be noted. Ingestion of pure household ammonia (3 to 3.6%) with a pH of 11.5 to 11.8 produced esophageal burns in 3 adult suicidal ingestions; most household glass cleaners contain 5% or less ammonia.
    0.2.11) ACID-BASE
    A) Metabolic acidosis has been associated with adult ingestions of 12% glycol ether window cleaners; most household glass cleaners contain 5% or less glycol ethers.
    0.2.14) DERMATOLOGIC
    A) Dermal irritation is possible due to hypersensitivity to one of the ingredients or prolonged skin contact.

Laboratory Monitoring

    A) Laboratory analysis should only be necessary when large amounts have been ingested.
    B) Toxic blood isopropanol levels are greater than 50 to 100 mg/dL. Levels of 150 mg/dL may produce coma, and 200 mg/dL may be associated with death.
    C) Isopropyl alcohol is converted to acetone. High acetone levels with low isopropyl alcohol levels may indicate either previous exposure or that significant time has passed since exposure.
    D) Butoxyacetic acid levels, which are indicative of ethylene glycol monobutyl ether exposure, are not readily available.
    E) Ammonia blood levels are not useful.

Treatment Overview

    0.4.2) ORAL/PARENTERAL EXPOSURE
    A) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting.
    B) Neutralization of the ammonia is not necessary.
    C) Gastric decontamination is unnecessary in the management of exposures involving the ingestion of small amounts. Gastric decontamination should be considered in large, potentially toxic ingestions.
    D) Follow the patient for 2 to 3 hours for symptoms of irritation or drowsiness. If a large amount of a glycol ether-containing glass cleaner is ingested, a longer period of follow-up may be necessary.
    0.4.4) EYE EXPOSURE
    A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.

Range Of Toxicity

    A) Maximum Tolerated (DOSE) Exposure: As little as 3 ounces of 70% isopropanol may produce blood levels of 100 mg/dL in a 70 kg adult; 150 mg/dL levels usually cause deep coma. As little as 11 mL may produce this level in a 10 kg child. Newer glass cleaners contain 5% or less, thus about 150 mL may produce a blood level of 100 mg/dL in the 10 kg child. Some older window cleaners may have as much as 30% alcohol so each formulation must be evaluated.
    B) Ingestion of more than one ounce of a glass cleaner containing 5% glycol ethers is potentially toxic to a child weighing 10 kg.
    C) TLV - The TLV of ammonia is 25 ppm, but it is not detectable until 50 ppm. Exposure to 100 ppm will cause eye irritation. Alkaline household ammonia products have caused esophageal burns.

Clinical Effects

Summary Of Exposure

    A) Newer commercial (i.e., household products) glass cleaners have very low concentrations of alcohols and glycol ethers. Toxicity is unlikely from casual exposures or the ingestion of small amounts. Older glass cleaners (both ready-to-use and concentrates) may have significant amounts of isopropyl alcohol, methanol, and ethylene glycol monobutyl ether. Automobile windshield washer fluids may contain high concentrations (30% to 70% by volume) of methanol.
    1) While accidental exposures are common in children (primarily by ingestion) significant toxicity is unusual.
    2) Based on various formulations it is important to evaluate individual ingredients in each product.
    B) The most commonly reported effects include nausea, vomiting, irritation of the mouth and throat, and drowsiness.
    C) More serious cardiovascular effects may be possible following large ingestions of isopropanol, and can include cardiomyopathy and dysrhythmias. Refer to "ISOPROPYL ALCOHOL" management for further information.

Heent

    3.4.1) SUMMARY
    A) This material may cause transient irritation to the eyes and mucosa of the lips and mouth, but is unlikely to cause permanent damage.
    3.4.3) EYES
    A) IRRITATION - This material may be irritating to eyes, but is unlikely to cause permanent damage.
    3.4.6) THROAT
    A) IRRITATION - Similarly, these materials may be irritating to the mucosa of the lips and mouth.
    B) TASTE - Ethylene glycol monobutyl ether has a very bitter taste associated with it which may limit the extent of the exposure in children.

Respiratory

    3.6.1) SUMMARY
    A) Concentrations of 5 to 10% of ammonia are irritating to the respiratory tract.
    3.6.2) CLINICAL EFFECTS
    A) IRRITATION SYMPTOM
    1) Concentrations of 5 to 10% of ammonia are irritating to the respiratory tract, but are not likely to cause mucosal burns or pulmonary edema.

Neurologic

    3.7.1) SUMMARY
    A) CNS depression is a characteristic symptom of isopropyl alcohol poisoning. Coma or significant respiratory depression is very unlikely because of the low concentrations (often between 1 and 5%) in recently produced household products within the United States.
    3.7.2) CLINICAL EFFECTS
    A) CENTRAL NERVOUS SYSTEM DEFICIT
    1) CNS depression is a characteristic symptom of ethyl and isopropyl alcohol poisoning (Adelson, 1962). However, significant CNS depression, coma or respiratory depression is unlikely due to the low concentrations in these cleaners.

Gastrointestinal

    3.8.1) SUMMARY
    A) Nausea, vomiting, and diarrhea may be noted. Ingestion of pure household ammonia (3 to 3.6%) with a pH of 11.5 to 11.8 produced esophageal burns in 3 adult suicidal ingestions; most household glass cleaners contain 5% or less ammonia.
    3.8.2) CLINICAL EFFECTS
    A) GASTRITIS
    1) Vomiting may occur but the severe gastritis and vomiting sometimes seen with concentrated isopropanol is very unlikely. Some of the products contain anionic or nonionic surfactants. These may add to the nausea, vomiting, diarrhea, and/or gastritis observed.
    B) ULCER OF ESOPHAGUS
    1) Esophageal burns are very unlikely. Nausea, vomiting, and diarrhea may be noted. The ammonia concentration in most household glass cleaners is less than 1% by w/w. Ingestion of pure household ammonia (3% to 3.6%) with a pH of 11.5 to 11.8 produced esophageal burns in 3 adult suicidal ingestions (Klein et al, 1985). However, this is unlikely to occur following the accidental ingestion of small quantities.

Acid-Base

    3.11.1) SUMMARY
    A) Metabolic acidosis has been associated with adult ingestions of 12% glycol ether window cleaners; most household glass cleaners contain 5% or less glycol ethers.
    3.11.2) CLINICAL EFFECTS
    A) ACIDOSIS
    1) The concentration of glycol ethers found in these products is generally from 3 to 5%. Ingestion of more than one ounce of glass cleaner containing 5% can potentially produce glycol ether toxicity in a child weighing 10 kg based on an assumption of twice the potency of ethylene glycol and the amount predicted to produce a blood level of 20 mg/dL.
    2) Metabolic acidosis has been reported after ingestion of 250 to 500 mL of 12% glass cleaners in adults (Rambourg-Schepens et al, 1988).
    3) In the presence of metabolic acidosis, also consider the possibility that the glass cleaner may contain significant amounts of methanol.

Hematologic

    3.13.2) CLINICAL EFFECTS
    A) HEMOLYSIS
    1) Hemoglobinuria has been reported in humans after the intentional ingestion of a large quantity of a 12% EGBE window cleaner (Rambourg-Schepens et al, 1988).
    3.13.3) ANIMAL EFFECTS
    A) ANIMAL STUDIES
    1) HEMOLYSIS
    a) Ethylene glycol monobutyl ether has been documented to cause red blood cell hemolysis in laboratory animals (Tybr, 1984).
    b) Butoxyacetic acid (BAA), a metabolite of ethylene glycol monobutyl ether, may be responsible for the hemolysis seen in animals and was the major urinary metabolite found in a rat model (Ghanayem et al, 1987).

Dermatologic

    3.14.1) SUMMARY
    A) Dermal irritation is possible due to hypersensitivity to one of the ingredients or prolonged skin contact.
    3.14.2) CLINICAL EFFECTS
    A) SKIN IRRITATION
    1) Some irritation is possible if these materials are left on the skin for long periods of time. Incidental exposures should result in no symptoms.

Laboratory Monitoring

Monitoring Parameters Levels

    4.1.1) SUMMARY
    A) Laboratory analysis should only be necessary when large amounts have been ingested.
    B) Toxic blood isopropanol levels are greater than 50 to 100 mg/dL. Levels of 150 mg/dL may produce coma, and 200 mg/dL may be associated with death.
    C) Isopropyl alcohol is converted to acetone. High acetone levels with low isopropyl alcohol levels may indicate either previous exposure or that significant time has passed since exposure.
    D) Butoxyacetic acid levels, which are indicative of ethylene glycol monobutyl ether exposure, are not readily available.
    E) Ammonia blood levels are not useful.
    4.1.2) SERUM/BLOOD
    A) TOXICITY
    1) Toxic blood isopropanol levels are greater than 50 to 100 mg/dL. Levels of 150 mg/dL may produce coma, and 200 mg/dL may be associated with death.
    2) Blood ethanol levels of 150 to 300 mg/dL are usually associated with signs and symptoms of acute intoxication.
    B) BLOOD/SERUM CHEMISTRY
    1) Acetone levels may be monitored to determine the extent of isopropanol metabolism or to confirm the ingestion of an isopropanol-containing product. Acetone levels may be sustained even in the absence of significant isopropanol levels.

Methods

    A) OTHER
    1) Laboratory analysis should only be necessary when large amounts have been ingested.

Treatment

Life Support

    A) Support respiratory and cardiovascular function.

Monitoring

    A) Laboratory analysis should only be necessary when large amounts have been ingested.
    B) Toxic blood isopropanol levels are greater than 50 to 100 mg/dL. Levels of 150 mg/dL may produce coma, and 200 mg/dL may be associated with death.
    C) Isopropyl alcohol is converted to acetone. High acetone levels with low isopropyl alcohol levels may indicate either previous exposure or that significant time has passed since exposure.
    D) Butoxyacetic acid levels, which are indicative of ethylene glycol monobutyl ether exposure, are not readily available.
    E) Ammonia blood levels are not useful.

Oral Exposure

    6.5.1) PREVENTION OF ABSORPTION/PREHOSPITAL
    A) SUMMARY -
    1) Gastric decontamination is unnecessary in the management of exposures involving the ingestion of small amounts. Gastric decontamination should be considered in large, potentially toxic ingestions.
    B) DILUTION -
    1) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    6.5.2) PREVENTION OF ABSORPTION
    A) SUMMARY
    1) Gastric decontamination is unnecessary in the management of exposures involving the accidental ingestion of small amounts. Gastric decontamination should be considered in large, potentially toxic ingestions.
    2) INDICATIONS: Consider gastric lavage with a large-bore orogastric tube (ADULT: 36 to 40 French or 30 English gauge tube {external diameter 12 to 13.3 mm}; CHILD: 24 to 28 French {diameter 7.8 to 9.3 mm}) after a potentially life threatening ingestion if it can be performed soon after ingestion (generally within 60 minutes).
    a) Consider lavage more than 60 minutes after ingestion of sustained-release formulations and substances known to form bezoars or concretions.
    3) PRECAUTIONS:
    a) SEIZURE CONTROL: Is mandatory prior to gastric lavage.
    b) AIRWAY PROTECTION: Place patients in the head down left lateral decubitus position, with suction available. Patients with depressed mental status should be intubated with a cuffed endotracheal tube prior to lavage.
    4) LAVAGE FLUID:
    a) Use small aliquots of liquid. Lavage with 200 to 300 milliliters warm tap water (preferably 38 degrees Celsius) or saline per wash (in older children or adults) and 10 milliliters/kilogram body weight of normal saline in young children(Vale et al, 2004) and repeat until lavage return is clear.
    b) The volume of lavage return should approximate amount of fluid given to avoid fluid-electrolyte imbalance.
    c) CAUTION: Water should be avoided in young children because of the risk of electrolyte imbalance and water intoxication. Warm fluids avoid the risk of hypothermia in very young children and the elderly.
    5) COMPLICATIONS:
    a) Complications of gastric lavage have included: aspiration pneumonia, hypoxia, hypercapnia, mechanical injury to the throat, esophagus, or stomach, fluid and electrolyte imbalance (Vale, 1997). Combative patients may be at greater risk for complications (Caravati et al, 2001).
    b) Gastric lavage can cause significant morbidity; it should NOT be performed routinely in all poisoned patients (Vale, 1997).
    6) CONTRAINDICATIONS:
    a) Loss of airway protective reflexes or decreased level of consciousness if patient is not intubated, following ingestion of corrosive substances, hydrocarbons (high aspiration potential), patients at risk of hemorrhage or gastrointestinal perforation, or trivial or non-toxic ingestion.
    6.5.3) TREATMENT
    A) DILUTION
    1) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    2) Neutralization of the small ammonia content is of no value and may be dangerous.
    B) OBSERVATION REGIMES
    1) Follow the patient for 2 to 3 hours for symptoms of irritation or drowsiness. If a large amount of a glycol ether-containing glass cleaner is ingested, a longer period of follow-up may be necessary.

Eye Exposure

    6.8.1) DECONTAMINATION
    A) EYE IRRIGATION, ROUTINE: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, an ophthalmologic examination should be performed (Peate, 2007; Naradzay & Barish, 2006).

Dermal Exposure

    6.9.1) DECONTAMINATION
    A) DERMAL DECONTAMINATION
    1) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water for 10 to 15 minutes. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).

Abstracts

Case Reports

    A) ROUTE OF EXPOSURE
    1) ORAL
    a) ACUTE EFFECTS
    1) A 50-year-old woman ingested 250 to 500 mL of a window cleaner containing 12% EGBE (30 to 60 mL of pure EGBE). She was comatose 12 hours later, required mechanical ventilation, and had a metabolic acidosis with the following laboratory values: blood pH 7.23, PO2 11.18, PCO2 1.43, bicarb 5 mmol/L. Hypokalemia, increased serum creatinine, and oxaluria were noted. Supportive care was the only treatment given. Hemoglobinuria was present from the 3rd to 6th day. The patient recovered and was discharged on the 10th day (Rambourg-Schepens et al, 1988).

Range Of Toxicity

Summary

    A) Maximum Tolerated (DOSE) Exposure: As little as 3 ounces of 70% isopropanol may produce blood levels of 100 mg/dL in a 70 kg adult; 150 mg/dL levels usually cause deep coma. As little as 11 mL may produce this level in a 10 kg child. Newer glass cleaners contain 5% or less, thus about 150 mL may produce a blood level of 100 mg/dL in the 10 kg child. Some older window cleaners may have as much as 30% alcohol so each formulation must be evaluated.
    B) Ingestion of more than one ounce of a glass cleaner containing 5% glycol ethers is potentially toxic to a child weighing 10 kg.
    C) TLV - The TLV of ammonia is 25 ppm, but it is not detectable until 50 ppm. Exposure to 100 ppm will cause eye irritation. Alkaline household ammonia products have caused esophageal burns.

Maximum Tolerated Exposure

    A) GENERAL/SUMMARY
    1) As little as 3 ounces of 70 percent isopropanol may produce blood levels of 100 milligrams/deciliter if rapidly ingested by an adult. Since window cleaners are usually less than 5 percent, this would be 42 ounces for an adult and 150 mL for a child weighing 10 kg.
    2) Some window cleaners may have as much as 30 percent alcohol so each formulation must be evaluated. The ammonia content is expected to be below that of household ammonia (5 to 10 percent). One would not expect the burns one sees with 25 to 30 percent solutions.
    B) ADULT
    1) Deliberate suicidal ingestion of pure household ammonia (containing 3 to 3.6 percent ammonia at a pH of 11.5 to 11.8) resulted in esophageal burns in three adults (Klein et al, 1985).
    2) Glycol ether toxicity (coma, acidosis, oxaluria) has been reported in adults after ingestion of 250 to 500 milliliters of glass cleaners containing 12 percent glycol ethers (Rambourg-Schepens et al, 1988).
    C) PEDIATRIC
    1) In a retrospective study (195 mL) of 24 children who ingested 5 milliliters to 10 ounces of liquid glass cleaners containing 0.5 to 9.9 percent ethylene glycol monobutyl ether, no clinical effects were observed. Twenty-two children were treated with dilution at home, and 2 who ingested more than 15 milliliters of glass cleaner were admitted, treated with gastric emptying, and observed for 24 hours (Dean & Krenzelok, 1991).

Serum Plasma Blood Concentrations

    7.5.2) TOXIC CONCENTRATIONS
    A) TOXIC CONCENTRATION LEVELS
    1) CONCENTRATION LEVEL
    a) Blood isopropanol levels of greater than 150 milligrams/deciliter are usually consistent with deep coma.

References

General Bibliography

    1) Adelson: Fatal intoxication with isopropyl alcohol (rubbing alcohol). Am J Clin Pathol 1962; 38:144-151.
    2) Burgess JL, Kirk M, Borron SW, et al: Emergency department hazardous materials protocol for contaminated patients. Ann Emerg Med 1999; 34(2):205-212.
    3) Caravati EM, Knight HH, & Linscott MS: Esophageal laceration and charcoal mediastinum complicating gastric lavage. J Emerg Med 2001; 20:273-276.
    4) Caravati EM: Alkali. In: Dart RC, ed. Medical Toxicology, Lippincott Williams & Wilkins, Philadelphia, PA, 2004.
    5) Dean BS & Krenzelok EP: Clinical evaluation of pediatric ethylene glycol monobutyl ether poisonings (abstract). Vet Hum Toxicol 1991; 33:362.
    6) Ghanayem BI, Burka LT, & Sanders JM: Metabolism and disposition of ethylene glycol monobutyl ether (2-butoxyethanol) in rats. Drug Metab Dispos 1987; 15:478-484.
    7) Klein J, Olson KR, & McKinney HE: Caustic injury from household ammonia. Am J Emerg Med 1985; 3:320.
    8) Naradzay J & Barish RA: Approach to ophthalmologic emergencies. Med Clin North Am 2006; 90(2):305-328.
    9) Peate WF: Work-related eye injuries and illnesses. Am Fam Physician 2007; 75(7):1017-1022.
    10) Rambourg-Schepens MO, Buffet M, & Bertault R: Severe ethylene glycol butyl ether poisoning. Kinetics and metabolic pattern. Human Toxicol 1988; 7:187-189.
    11) Repetto MR: Pediatric poisonings due to cleansing agents reported in 1994 to the toxicological information service of Seville, Spain. Vet Human Toxicol 1996; 38:435-437.
    12) Vale JA, Kulig K, American Academy of Clinical Toxicology, et al: Position paper: Gastric lavage. J Toxicol Clin Toxicol 2004; 42:933-943.
    13) Vale JA: Position Statement: gastric lavage. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1997; 35:711-719.