CHICAGO -- Some solvents for removing fake fingernails contain dangerous cyanide-releasing chemicals that have killed one child and are toxic in very low doses, doctors warned Thursday.
Writing in the Journal of the American Medical Association, two poison control specialists, Dr. E. Martin Caravati and Dr. Toby Litovitz, described cases of two young children poisoned by solutions to remove fake nails.
The children were exposed to small amounts of SuperNail Nail Off, a glue remover that contains acetonitrile. Several hours after the chemical is consumed, breathed, or absorbed through the skin, the body converts it to cyanide, a deadly poison.
The doctors said a 16-month-old boy was found dead in his crib 12 hours after swallowing the glue remover. A 2-year-old was rescued by prompt, vigorous medical efforts after he merely spilled the remover on himself.
'Clinicians and poison centers should be alerted to the possible presence in homes of this highly toxic, cyanide-generating product,' the doctors wrote. In the two cases cited, parents had purchased SuperNail Nail Off at beauty supply outlets, and the physicians stressed the products are 'readily available to non-commercial users.' The product comes in containers that can be opened by children.
Since the study, the pair have identified six additional products that contain acetonitrile: Nailene Salon Quality Glue Remover, Ardell Instant Glue Remover, Artificial Nail Tip and Glue Remover, Super Nail Wrap Off Instant Glue Dissolver, Super Nail Tip Off, and Super Nail Glue Off.
'Though advertised for use with nail products, several are also described as multipurpose glue removers that will dissolve any brand of cyanoacrylate-based glue,' they said. Such glues are commonly known as super-glues.
'Two of these products are marketed in supermarkets and drugstores, clearly intended for the general public's use rather than for professional beauty operators,' the doctors stressed, warning that a potentially lethal dose of acetonitrile is present in 'just a single container of any of the products we list.'
They said another reason the products are particularly dangerous is that they often are confused by parents and poison centers with less dangerous fingernail polish remover, or fake nail removers that do not contain the cyanide-producing chemical.
'We urge regulatory agencies to reconsider the wisdom of marketing a cosmetic that poses such an extreme health hazard,' the doctors conclude.'
A spokesman for the Food and Drug Administration said the chemical 'is not a trivial concern,' but said, 'Like other products, including cosmetics, such a thing (as fatal poisoning) could happen with almost anything that is carelessly left around where children are.'
An FDA cosmetics expert said acetonitrile is a 'borderline' but not 'highly' toxic product and said there is little the agency can do to regulate such products. He said if the products do not have poison warning labels, the manufacturers could likely be sued, but he said companies that make fake nail removers tend to be small and 'here today, gone tomorrow.'
To regulate the product, he said, it would have to be shown to be 'a hazard of public concern. You cannot do that on the basis of one death, no matter how tragic that is to the family involved.'
Caravati works at the Intermountain Regional Poison Control Center at the University of Utah in Salt Lake City. Litovitz works at the National Capital Poison Center at Georgetown University Hospital in Washington.