Clinical profile and mortality determinants in hair dye poisoning

Introduction: India has a high suicide rate, and a large proportion of these suicides occur through poisoning. Poisoning by hair dye has been increasing, and in some regions, constitutes a large proportion of the poisoning cases. Aims: To determine the clinical and biochemical features of hair dye poisoning, and to identify factors affecting mortality among these cases of hair dye poisoning. Subjects and Methods: A cross-sectional study conducted from April to December 2010 in Thoothukudi, Tamil Nadu, among 125 cases of hair dye poisoning. Cases with the prior history of cardiac/respiratory illness, seizure disorder, and those consuming a mixture of poisons were excluded from the study. A standardized questionnaire was administered. Biochemical and other investigations were carried out; and patient outcomes were documented. Statistical Analysis Used: The results were compiled and analyzed using Statistical Package for the Social Sciences (version 20) software. Chi-square test, Mann-Whitney U-test, and Kruskal-Wallis test at 5% level of significance was used to analyze the data. Results: Among the 125 cases, 68.8% were females, and the overall median age was 24 (20-30.5) years. The median time of presentation was 155 min (40-275), and the average amount of hair dye consumed was about 50.0 mls (25-55 mls). Almost 68.8% of the cases developed oropharyngeal edema, and among them, 57 (66.28%) had an emergency tracheostomy performed. About 27.2% of the patients died. Conclusions: The time of presentation to the hospital is an important risk factor for developing oropharyngeal edema, which in turn determines the risk of mortality. Females, especially those in the younger age groups should be targeted for supportive and preventive strategies, so as to reduce the incidence of hair dye poisoning.