Pine oil poisoning

Pine oil (terpenes) is the poisonous ingredient.

Pine oil is found in:

• Various cleaning products
• Some porcelain cleaners

Pine oil poisoning can affect many parts of the body.

EYES, EARS, NOSE, AND THROAT

• Difficulty swallowing
• Throat burning
• Eye burning

LUNGS

• Breathing trouble

GASTROINTESTINAL TRACT

• Abdominal pain
• Diarrhea
• Nausea
• Vomiting

HEART AND BLOOD CIRCULATION

• Rapid heartbeat

NERVOUS SYSTEM

• Coma
• Confusion
• Depression
• Dizziness
• Headache
• Irritability
• Lightheadedness
• Nervousness
• Stupor (decreased level of consciousness)
• Unconsciousness

Seek immediate medical help. DO NOT make a person throw up unless you are told to do so by a health care provider or poison control.

Determine the following information:

• The person's age, weight, and condition
• Name of product (as well as the ingredients and strengths, if known)
• The time it was swallowed
• The amount swallowed

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood and urine tests will be done. The person may receive:

• Airway and breathing support, including oxygen. In extreme cases, a tube may be passed through the mouth into the lungs to prevent aspiration. A breathing machine (ventilator) would then be needed.
• Chest x-ray.
• ECG (electrocardiogram, or heart tracing).
• Endoscopy -- a camera down the throat to see burns in the esophagus and stomach.
• Fluids through a vein (by IV).
• Laxatives to move the poison quickly through the body.
• Medicines to treat symptoms.
• Surgical removal of burned skin (skin debridement).
• Tube through the mouth into the stomach (rare) to wash out the stomach (gastric lavage).
• Washing of the skin (irrigation), perhaps every few hours for several days.

How well a person does depends on the amount of poison swallowed and how quickly treatment was received. Swallowing pine oil can have severe effects on many parts of the body. In most cases, the biggest problem is that pine oil is swallowed (aspirated) into the lungs instead of the stomach, causing breathing problems.

The faster a person gets medical help, the better the chance for recovery.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Wang GS, Buchanan JA. Hydrocarbons. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 147.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.