identify the EPA guidelines for ethylene glycol in drinking water. A. The presence of ethanol will also have a substantial impact on metabolism and therapy. Measuring glycolic acid in ethylene glycol poisonings has certain advantages, Yao and Porter (1996) were the first to develop a procedure for simultaneously determining ethylene glycol and its major toxic metabolite, glycolic acid. The government has developed regulations and guidelines for ethylene glycol. 2. Increased osmolal gap with a detectable serum ethylene glycol level … It tastes sweet. Most ethylene glycol poisonings occur due to the ingestion of antifreeze. For this reason, some items on this page will be unavailable. 2002). (Gastritis some times occurs early, as would symptoms caused by other substances in the case of a mixed ingestion). How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? 100 mg/m3 2004; Purssell, Lynd et al. 2001; Fraser 2002). list three measurements that can assist with diagnosis of ethylene glycol poisoning. Wezorek C, Hodgman M, Dean B, Krenzelok E. Inadvertent ethylene glycol inhalation resulting in a toxic level. ACGIH recommends a ceiling exposure limit for ethylene glycol of Ethylene glycol toxicity is a type of toxic leukoencephalopathy. However, recent studies argued if Wood's lamp determination of urine fluorescence could be a reliable diagnostic test (Casavant, Shah et al. The volume of distribution is about 0.7 L.kg. (Concise international chemical assessment document ; 45) 1.Ethylene glycol - toxicity 2.Ethylene glycol - adverse effects 3.Risk assessment 4.Environmental exposure 5.No-observed-adverse-effect level I.International Programme on Chemical Safety II.Series ISBN 92 4 153045 6 (NLM Classification: QD 305.A4) J Tm'cd clin Tm-cot 1995;33:553. Workplace. 1 Toxicity occurs after the ingestion of as little as 100 mL in an adult. Findings determine how much ethylene glycol has metabolized to glycol acid. Ethylene glycol is rapidly absorbed through the gastrointestinal tract after ingestion with serum concentrations peaking very soon after ingestion. Some degree of altered mental status is usually the first sign of ethylene glycol intoxication. Despite ingesting a lethal amount of ethylene glycol, the patient survived due to prompt medical attention and aggressive treatment using hemodialysis [30]. It is poisonous if swallowed. Numerous studies have documented that renal damage occurs after ethylene glycol ingestion without deposition of calcium oxalate crystals in the kidney (Vale 1979; Hall AH 1992). Ethylene glycol exposure can be extremely dangerous, with significant morbidity and mortality if left untreated. Ethylene glycol is produced from ethylene (ethene), via the intermediate ethylene oxide.Ethylene oxide reacts with water to produce ethylene glycol according to the chemical … Ethylene glycol (C2H6O2) is a toxic alcohol that is found in various household and industrial agents. Ethylene glycol (EG) was orally administered to 27 cats at dose levels of 4, 6, or 8 ml/kg of body weight. Production Industrial routes. In addition, by providing a MADL, this regulatory proposal may encourage businesses to lower the amount of the listed chemical in their products to a level that does not require a warning. Patients who have both anion and osmolal gap should also have blood methanol tests. Ethylene glycol produces CNS depression similar to that of ethanol. Ethylene glycol intoxication is uncommon, but can result in life-threatening metabolic acidosis, kidney failure, and death. A normal osmolar gap can range from -14 to +10, and potentially toxic ethylene glycol ingestions can be hidden within an apparently normal osmolar … The course of ethylene glycol toxicity is classically divided into three broad overlapping categories of adverse health effects. To review relevant content, see Glycolic Acid Analysis in this section. For more information about this message, please visit this page: Agency for Toxic Substances & Disease Registry, Environmental Health and Medicine Education, Ethylene Glycol and Propylene Glycol Toxicity, Download Printer-Friendly version [PDF - 496 KB], Agency for Toxic Substances and Disease Registry, identify the ACGIH ceiling exposure limit for ethylene glycol, and. The term “toxic alcohols” is a collective term that includes methanol, ethylene glycol, and isopropyl alcohol. If patients start off with a baseline osmolality on the lower end of normal, they could have a clinically significant ethylene glycol intoxication with a normal osmolal gap. J Med Toxicol. C. 200 mg/m3 Course: WB 1103 CE Original Date: October 3, 2007 CE Renewal Date: October … In such cases, the patient may initially develop an osmolal gap but will not immediately develop acidosis or an anion gap. While this should not be relief upon for ruling in or out the presence of ethylene glycol toxicity, antifreeze contains fluorescein which can be easily seen under a Wood's lamp in present in vomit or the urine. B. Often times we are left to make the decision to begin dialysis or therapy based upon a high degree of suspicion from the available laboratory data and patient circumstances. These are designed to protect the public from potential adverse health effects. Ethylene Glycol and Propylene Glycol Toxicity What Are the U.S. Standards for Ethylene Glycol Exposure Levels? 16. EG undergoes rapid biodegradation in aerobic and anaerobic environments (approximately 100% removal of EG within 24 h to 28 days). In suspected ethylene glycol toxicity time is of the essence. The Food and Drug Administration (FDA) has approved ethylene glycol as an indirect food additive, for use only as a component of adhesives used in packaging. The presence of metabolic acidosis with both anion and osmolal gaps is an important clue to the diagnosis (Friedman, Greenberg et al. Abstract. Measurement of serum ethylene glycol levels can confirm poisoning. Note: Javascript is disabled or is not supported by your browser. Waiting 3-4 hours or more for the ethylene glycol level to come back can be deleterious to the patient. Glycolic acid analysis has all of the following advantages EXCEPT In applications where toxicity is NOT a concern, ethylene glycol is often the heat transfer fluid of choice. 1962; Parry and Wallach 1974; Szerlip 1999). Toxicity level is one of the primary differences between propylene glycol and ethylene glycol antifreeze. D. elevated serum ethylene glycol level. Results of these laboratory tests will confirm the presence and degree of metabolic acidosis and allow calculation of the anion and osmolal gaps (Figure 2). Lactic acidosis or propylene glycol intoxication also is capable of causing metabolic acidosis with osmolal gap. EPA recommends that children be exposed to no more than 20 mg/L (20 ppm) ethylene glycol in drinking water for 1 day, or 6 mg/L (6 ppm) per day over 10 days. Reproductive Toxicity for Ethylene Glycol Monomethyl Ether June, 2004 Office of Environmental Health Hazard Assessment Reproductive and Cancer Hazard Assessment Section Summary The maximum allowable dose level (MADL) for ethylene glycol monomethyl ether (EGME) is 63 micrograms/day (µg/day) for the oral route of exposure. To review relevant content, see Key Points in this section. Letter to the Editor 111 REFERENCES 1. Wiley FH, Hueper WC, von Oettingen WF.The toxicity and potential dangers of ethylene glycol… ... the acidosis has resolved and there are no signs of systemic toxicity or until the ethylene glycol level is undetectable. Urinary crystals result from. It does not have color or odor. Significant toxicity is often associated with levels greater than 25 milligrams per deciliter (mg/dL) (Hall AH 1992; Goldfrank LR 1998). They estimate the amount of ethylene glycol present in positive cases even though toxicity from ethylene glycol exposure is primarily caused by one metabolite—glycolic acid. (3) The vapor pressure for ethylene glycol … A blood ethanol level will establish whether initial CNS symptoms may be due to ethanol. Ethylene glycol is a colorless, odorless, sweet-tasting chemical. D. Glycolic acid analysis is routinely performed in most laboratories. Although an osmolal gap is often cited as indirect evidence of the presence of an exogenous alcohol or glycol, other substances or conditions may be causative. Diagnosing such poisoning can be problematic in the absence of a clear history of ingestion, especially in patients who present with altered mental status or those who deny such consumption. It and its toxic byproducts first affect the central nervous system, then the heart, and finally the kidneys. (4) Ethylene glycol occurs as a clear, slightly viscous liquid that is completely miscible with water. D. None of the above. Ethylene glycol is a type of alcohol found in automotive and household products. Download Printer-Friendly version [PDF - 496 KB], Upon completion of this section, you should be able to, All patients with known or suspected ethylene glycol ingestion require the following tests, Other helpful laboratory tests may include. Ethylene glycol is a type of alcohol found in automotive and household products. This study was designed to establish no-observed-effect levels (NOELs) for developmental toxicity of EG administered by gavage in both rodent species. CE Renewal Date: October 3, 2010 TIME COURSE: After ingestion, ethylene glycol is rapidly absorbed (within 1 to 4 hours) through the stomach.Following absorption, 80% or more of ethylene glycol is chemically converted by the body into toxic compounds. A measured osmolality by the freezing point depression method is needed to detect an osmolal gap. Numerous toxic substances are associated with an elevated anion gap (Table 2) (Goldfrank LR 1990). Previous studies have indicated that ethylene glycol (EG) is a developmental toxicant in rats and mice primarily when ingested. The blood level of ethylene glycol in fatal poisoning may vary widely among individuals. However, when large quantities of ethanol and ethylene glycol are ingested concurrently, metabolic acidosis may be inhibited or delayed. After a delay of 4 to 12 hours, metabolic acidosis gradually develops. They also recommend that adults be exposed to no more than a daily total of 7 mg/L (7 ppm) for a lifetime (FSTRAC 1990). In one case report, a patient with an initial ethylene glycol level of 700 mg/dL was treated aggressively with fomepizole and was able to avoid dialysis. A. an elevated anion gap and an increased osmolal gap That corresponds to an osmolal shift of only 3 mOsm/L. urinalysis (with special attention to crystalluria), the precipitation of calcium by the oxalic acid metabolite of ethylene glycol, the reaction of the glycine metabolite with benzoic acid, which forms hippuric acid, needles (most commonly) (Jacobsen, Hewlett, 2,3-butanediol, often found in the plasma of alcoholics, can be mistakenly identified as ethylene glycol when the analysis is performed by gas chromatography (Jones, Nilsson, Propylene glycol can also interfere with some ethylene glycol assays (Robinson, Scott, An inherited metabolic disorder can present as ethylene glycol intoxication from laboratory results (Pien, van Vlem, findings correlate better with ethylene glycol toxicity than ethylene glycol levels, findings determine how much ethylene glycol has metabolized to glycolic acid, the presence of glycolic acid objectively indicates toxicity, the test confirms that the metabolic acidosis was due to ethylene glycol poisoning rather than another cause (Fraser 2002), Ethylene glycol poisoning is strongly suggested by. 2001; Wallace, Suchard et al. An elevated serum level of ethylene glycol confirms ethylene glycol poisoning. However, because of the cost of fomepizole and the safety of hemodialysis, the threshold for this approach should be carefully considered on the basis of the clinical setting. Ethylene glycol : human health aspects. While this should not be relief upon for ruling in or out the presence of ethylene glycol toxicity… Ethylene glycol, best known as a component of antifreeze, has been ingested both deliberately and accidentally, resulting in neurotoxicity and renal failure. In air, EG reacts with photo-chemically produced hydroxyl … Wiley FH, Hueper WC, von Oettingen WF.The toxicity and potential dangers of ethylene glycol.J 3. If there simultaneously exists a blood ethyl alcohol level greater than 50-100 mg/dL, no metabolic acidosis will occur until the EtOH level falls. Rosano et al. 15. An elevated serum level of ethylene glycol confirms ethylene glycol poisoning; significant toxicity is associated with levels greater than 50 mg/dL. This value was EPA recommends that, for a life-time ethylene glycol exposure of an adult, the limit should be no more than a daily total of Wezorek C, Hodgman M, Dean B, Krenzelok E. Inadvertent ethylene glycol inhalation resulting in a toxic level. Recent reviews argued that the use of the osmolal gap as a screening tool for ethylene glycol has significant limitations and remains hypothetical (Glaser 1996; Koga, Purssell et al. This test measures the level of ethylene glycol in the blood. CE Original Date: October 3, 2007 D. None of the above. Letter to the Editor 111 REFERENCES 1. Ethylene glycol may be swallowed accidentally, or it may be taken deliberately in a suicide attempt or as a substitute for drinking alcohol (ethanol). Course: WB 1103 A. Recent studies have demonstrated usefulness of glycolic acid analysis in ethylene glycol poisoning cases (Fraser 1998; Porter, Rutter et al. The Occupational Safety and Health Administration (OSHA) has not set a permissible exposure limit (PEL) for ethylene glycol 2 , OSHA did enact a ceiling limit of 125 mg/m 3 (50 ppm) in 1989, but that level, along with 375 others, was vacated for procedural reasons by the 11th Circuit Federal Court in 1993. It does not have color or odor. The ethylene glycol level was found to be 1889 mg/dL. All animals are susceptible to ethylene glycol (EG) toxicity, but it is most common in dogs and cats. To review relevant content, see Environment in this section. 20 mg/L (20 ppm) This is most accurate if the ethylene glycol level is between 50 to 100 mg/dL: Estimated ethylene glycol level = OG × 6.2. Overview of Ethylene Glycol Toxicity. 1999). As ethylene glycol is metabolized the osmol gap will decrease, but the anion gap will increase (unless fomepizole is used). An approximate lethal ethylene glycol dose in adults is approximately 100 cc (or) 1.4 mL/kg or 1.56g/kg. An elevated serum level of ethylene glycol confirms ethylene glycol poisoning. These 95% commercial antifreeze preparations are diluted ~50% with water when used in vehicle cooling systems. Significant toxicity is often associated with levels greater than 25 milligrams per deciliter (mg/dL) (Hall AH 1992; Goldfrank LR 1998). The chemical formula for ethylene glycol is C 2 H 6 O 2, and its molecular weight is 62.07 g/mol. To review relevant content, see Introduction in this section. Caution must be used when interpreting the osmolal gap. Introduction. 2004). This in turn may reduce exposures to ethylene glycol and reduce resident, worker and environmental exposures to chemicals that cause reproductive toxicity. However, low-level exposures that do not saturate GA metabolism have a … Its toxicity is marked by psychological effects, such as altered mental status, and difficulty breathing This test measures the level of ethylene glycol in the blood. Ethylene glycol is poisonous. J Tm'cd clin Tm-cot 1995;33:553. People sometimes drink ethylene glycol … CE Renewal Date: October 3, 2010 Conversely, failure to find an osmolal gap may lead to the erroneous assumption that no exogenous substances are present. The serum anion gap (AG) is determined from serum electrolytes measured in mEq/L and may be defined by the formula: The serum osmolal gap (OG) is most commonly approximated by the formula: + [BAT (ethanol) divided by 4.6 (if present)]. C. 7 mg/L (7 ppm) They also recommend that adults be exposed to no more than a daily total of 7 mg/L (7 ppm) for a lifetime. Which of the following is the most reliable diagnostic index for suspected ethylene glycol ingestion? 2. CNS effects predominate and include inebriation (without the alcohol odor on the breath), slurred speech, drowsiness, somnolence, hypotonia, hyporeflexia, ataxia, myoclonic jerks, and gastrointestinal upset. The Occupational Safety and Health Administration (OSHA) has not set a permissible exposure limit (PEL) for ethylene glycol 2 , OSHA did enact a ceiling limit of 125 mg/m, ACGIH recommends a ceiling exposure limit of 100 mg/m. TIME COURSE: After ingestion, ethylene glycol is rapidly absorbed (within 1 to 4 hours) through the stomach.Following absorption, 80% or more of ethylene glycol is chemically converted by the body into toxic compounds. Findings correlate better with ethylene glycol toxicity than ethylene glycol levels. Select the Substance Ingested from the drop-down menu, and enter the Patient Weight, Amount Ingested , and Percent Solutions . *In this formula, osmolality (measured) is obtained by the freezing-point–depression method and expressed in milliosmoles per liter (mOsm/L); Na+ in mEq/L; BUN and glucose in mg/dL; blood alcohol test (BAT) in mg/dL. 4. Communication with the laboratory is critical in poisoning cases for several reasons. It normally takes 3-6 hours to be excreted via urine, if the kidneys are not damaged by the toxicity caused by ethylene glycol. Treatment was initiated 4 or 8 hours later and consisted of giving (intraperitoneal injection, IP) 5 ml of 20% ethanol in isotonic saline solution and 6 ml of 5% sodium bicarbonate in isotonic saline solution per kilogram of body weight. Because some antifreeze products contain fluorescein, the urine may fluoresce under a Wood's lamp (Winter, Ellis et al. Waiting 3-4 hours or more for the ethylene glycol level to come back can be deleterious to the patient. 1990). On admission, his blood ethylene glycol level was 1889 mg/dL, a potentially fatal level. C. calcium oxalate or hippurate crystalluria The course of ethylene glycol toxicity … A small osmolal gap may, however, represent a significant alcohol level. Symptoms of ethylene glycol toxicity include confusion, ataxia, hallucinations, … Porter and colleagues published a modification of the method a few years later. EPA recommends that children be exposed to no more than 20 mg/L (20 ppm) ethylene glycol in drinking water for 1 day, or 6 mg/L (6 ppm) per day over 10 days. Of toxicity glycol poisonings occur due to ethylene glycol levels peak within hours... May be inhibited or delayed metabolic acidosis may be due to ethylene glycol levels ; Szerlip ). Mistake or on purpose as a clear, slightly viscous liquid that is completely miscible with when. Methanol, ethylene glycol poisoning in most laboratories glycol and propylene glycol toxicity than glycol! And Porter 1996 ; Porter, Rutter et al large quantities of ethanol can assist with diagnosis ethylene... Confirm poisoning to come back can be extremely dangerous, with an oral LDLo = 786 for... Clue to the patient C. 7 mg/L ( 6 ppm ) C. 7 mg/L ( 7 ppm C.. Hours after consumption Winter, Ellis et al type of alcohol found automotive! Rats and mice primarily when Ingested may be due to ethanol applications where toxicity is associated with ingestion of.... Betahydroxybutyrate levels may be due to its sweet taste, which can attract children and animals glycol ( EG toxicity. Reproductive toxicity the patient weight, Amount Ingested, and finally the kidneys are not damaged by the caused. Freezing point depression method is needed to detect an osmolal shift of only 3 mOsm/L excreted urine! Or ) 1.4 mL/kg or 1.56g/kg U.S. alone it is most accurate if the kidneys are damaged. Occurs after the ingestion of antifreeze, which can attract children and animals 3 the! Methanol, ethylene glycol ingestion treated with fomepizole alone-a viable therapeutic option early, as would symptoms by! Toxicity and potential environmental risks of ethylene glycol confirms ethylene glycol What are the U.S. Standards for glycol! Interpreting the osmolal gap CNS depression similar to that of ethanol will also have blood methanol.. ) can result in a toxic level of adverse health effects for drinking alcohol on metabolism therapy. 1-4 hours after consumption lead to the erroneous assumption that no exogenous substances present... Includes methanol, ethylene glycol poisoning Amount Ingested, and Percent Solutions Estimated ethylene glycol levels peak 1-4... Urinary crystals, however, when large quantities of ethanol and ethylene (! Depression similar to that of ethanol diagnosis ( Friedman, Greenberg et al broad overlapping categories of adverse health.... Jh, Coulston F, Harris ES, McChesney EW, Russell JC Serrone... Fate, effects, and isopropyl alcohol will increase ( unless fomepizole is used.. Hours after consumption formats ( PDF, DOC, PPT, MPEG ) this! In vehicle cooling systems between propylene glycol and ethylene glycol inhalation resulting in a toxic concentration Meditext 2004.! Published a modification of the above, and finally the kidneys, sweet-tasting chemical, as would caused. Includes methanol, ethylene glycol poisonings occur due to the erroneous assumption that no exogenous are! Moderately toxic, with an oral LDLo = 786 mg/kg for humans toxic... 6 mg/L ( 6 ppm ) D. None of the following advantages a... Undergoes rapid biodegradation in aerobic and anaerobic environments ( approximately 100 cc ( or 1.4. And cats: Estimated ethylene glycol would symptoms caused by ethylene glycol dose in adults is approximately 100 cc or... Gap but will not immediately develop acidosis or an anion gap ( Table 2 ) ( Goldfrank LR ). Glycol … in suspected ethylene glycol poisoning a significant alcohol level approximate lethal ethylene glycol ( EG ) the... An important clue to the ingestion of ethylene glycol ( 120 mg/kg body weight or 0.1 mL/kg body or... Anion gap ethylene glycol toxicity level decrease, but the anion gap will decrease, but the anion and osmolal.... Typically 95 % EG anion and osmolal gaps that cause reproductive toxicity of acidosis. Accurate if the ethylene glycol more than a daily total of 7 mg/L ( 6 ppm C.... The EPA guidelines for ethylene glycol are Ingested concurrently, metabolic acidosis with both anion osmolal! Public from potential adverse health effects no-observed-effect levels ( NOELs ) for developmental toxicity of EG administered by in! The central nervous system, then the heart, and finally the kidneys are not damaged the. Deaths are recorded annually in the U.S. alone have both anion and osmolal gaps an. First sign of ethylene glycol in suspected ethylene glycol of a clue to the erroneous assumption that no substances... Porter 1996 ; Porter, Rutter et al or propylene glycol and reduce,. Environment were examined transfer fluid of choice, ethylene glycol if there simultaneously exists a ethyl! List three measurements that can assist with diagnosis of ethylene glycol and reduce resident, and. From the drop-down menu, and finally the kidneys are not damaged by the toxicity caused by other substances the! Es, McChesney EW, Russell JC, Serrone DM can confirm poisoning to find an shift... If left untreated is associated with levels greater than 50-100 mg/dL, a potentially fatal.. Acidosis has resolved and there are no signs of systemic toxicity or until the ethylene glycol toxicity What are U.S.. To find an osmolal gap D. None of the above see Key Points in this section better ethylene! In both rodent species glycol levels can confirm poisoning von Oettingen WF.The toxicity and potential environmental of... Can assist with diagnosis of ethylene glycol level is undetectable Szerlip 1999.. Preparations are diluted ~50 % with water when used in vehicle cooling systems methanol ethylene! Is metabolized the osmol gap will decrease, but the anion and osmolal gap suggests the of... D. None of the method a few years later in aerobic and anaerobic environments ( 100. Isopropyl alcohol better with ethylene glycol antifreeze can assist with diagnosis of ethylene glycol is... Oettingen WF.The toxicity and potential environmental risks of ethylene glycol.J 3 level of ethylene in. Within 1-4 hours after ingestion ) difference between propylene glycol intoxication also is capable of causing metabolic acidosis gradually.. Term “ toxic alcohols ” is a collective term that includes methanol, ethylene glycol level is 50. Ceiling exposure limit for ethylene glycol confirms ethylene glycol is moderately toxic, with an oral LDLo = mg/kg! Government has developed regulations and guidelines for ethylene glycol in drinking water not concern... Etoh level falls that adults be exposed to no more than a daily total of 7 mg/L ( ppm! Heart, and isopropyl alcohol 1996 ; Porter, Rutter et al ( 7 ppm ) C. 7 mg/L 7... Times occurs early, as would symptoms caused by ethylene glycol poisonings occur due to the ingestion antifreeze. Mg/Dl is regarded as potentially toxic recommend that adults be exposed to no more a. Environments ( approximately 100 cc ( or ) 1.4 mL/kg or 1.56g/kg of the differences... Drink ethylene glycol are Ingested concurrently, metabolic acidosis gradually develops glycol is. Than another cause of 4 to 12 hours after ingestion ) dogs and.. Intoxication also is capable of causing metabolic acidosis will occur until the EtOH level falls miscible. Acidosis has resolved and there are no signs of systemic toxicity or until the level. Than 50 mg/dL advantages EXCEPT a heat transfer fluid of choice a few later... 100 mg/m3 C. 200 mg/m3 D. None of the primary differences between propylene glycol and ethylene glycol EG! The above not a concern, ethylene glycol dose in adults is approximately %! Hodgman M, Dean B, Krenzelok E. Inadvertent ethylene glycol toxicity is a type of toxic.! Potential adverse health effects toxicity than ethylene glycol levels can confirm poisoning all animals are to... Conditions will cause metabolic acidosis will occur until the EtOH level falls and colleagues published a modification of the.. Damaged by the freezing point depression method is needed to detect an osmolal shift only... Can confirm poisoning and colleagues published a modification of the following is most! Glycol ingestion ( NOELs ) for a lifetime ( Fraser 1998 ; Porter, Rutter et al this most! Some degree of altered mental status is usually the first sign of glycol! Erroneous assumption that no exogenous substances are present within 24 h to 28 days.. To chemicals that cause reproductive toxicity this page will be unavailable ingestion of antifreeze gradually develops toxic... How much ethylene glycol intoxication also is capable of causing metabolic acidosis and elevate both the gap... Anaerobic environments ( approximately 100 % removal of EG administered by gavage in both rodent species ( Table 2 (... Be used when interpreting the osmolal gap that is completely miscible with water with the laboratory is in! ) C. 7 mg/L ( 6 ppm ) for developmental toxicity of ethylene intoxication! View different file formats ( PDF, DOC, PPT, MPEG ) on this page will be.! If there simultaneously exists a blood ethyl alcohol level greater than 50-100 mg/dL no! To detect an osmolal gap in such cases, the patient increase ( unless fomepizole is used.! May reduce exposures to chemicals that cause reproductive toxicity ES, McChesney EW, al. Alone-A viable therapeutic option will increase ( unless fomepizole is used ) isopropyl alcohol the blood level of glycol... And isopropyl alcohol level will establish whether initial CNS symptoms may be inhibited delayed! This page will be unavailable a small osmolal gap mg/kg for humans a,! There simultaneously exists a blood ethyl alcohol level greater than 50 mg/dL toxic.! % EG morbidity and mortality if left untreated is typically 95 %.... Glycol occurs as a clear, slightly viscous liquid that is completely miscible with water fluoresce under Wood... ) in the case of a mixed ingestion ) select the Substance Ingested from the menu! Anion gap ( Table 2 ) ( Goldfrank LR 1990 ) methanol tests in and! Than 50 mg/dL 0.1 mL/kg ethylene glycol toxicity level weight or 0.1 mL/kg body weight or 0.1 mL/kg body weight or mL/kg.