This section will describe clinical practice and research concerning methods for reducing toxic effects of exposure to boron. This section is intended to inform the public of existing clinical practice and the status of research concerning such methods. However, because some of the treatments discussed may be experimental and unproven, this section should not be used as a guide for treatment of exposures to boron. When specific exposures have occurred, poison control centers and medical toxiciologists should be consulted for medical advice.
Human exposure to boron may occur by inhalation, ingestion, or dermal contact (see Chapter 5). Boron in the form of boric acid or borate dust is an upper respiratory tract irritant following inhalation and may also irritate the eyes and skin. Ingestion of boron may cause gastrointestinal, neurological, hepatic, renal, and dermal effects (see Section 2.2). General recommendations for reducing absorption of boron following exposure have included removing the exposed individual from the contaminated area and removing the contaminated clothing. If the eyes and skin were exposed, they are flushed with water.
Nausea, vomiting, and diarrhea have been induced by ingestion of boron in humans. Some authors recommend reducing absorption of boron from the gastrointestinal tract by administration of emetics (e.g. syrup of ipecac) and cathartics (e.g. magnesium sulfate) (Stewart and McHugh 1990). Caution should be, however, taken not to induce further damage to the esophageal mucosa or to cause aspiration of the vomit into the lungs during emesis. There is disagreement regarding the efficiency of activated charcoal in preventing absorption of boron from the gastrointestinal tract following oral exposure (Ellenhorn and Barceloux 1988; Stewart and McHugh 1990). It has been suggested that activated charcoal be administered following gastric evacuation, but its effectiveness has not been established (Ellenhorn and Barceloux 1988). Administration of intravenous fluids may be required if severe dehydration or shock develop and local skin care may be necessary if skin desquamation occurs (Stewart and McHugh 1990). In addition, the treatment of boron poisoning may request a control for convulsions.
Elemental boron is not metabolized (see Section 2.3). Studies in human volunteers indicated that most of the administered dose is excreted in the urine within few days (Jansen et al. 1984a).
Saline diuresis has been suggested to further enhance urinary excretion of boron (Goldfrank et al. 1990). Exchange transfusions, peritoneal dialysis, or hemodialysis may be employed to lower plasma boron levels following either acute or chronic intoxication. There are indications that hemodialysis is the most effective of these procedures (Goldfrank et al. 1990; Stewart and McHugh 1990). Additional details regarding treatment of boron intoxication may be found in the cited references.
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