> PLEASE LET ME CNOW About serious and documented injury caused to people

An agricultural accident in Iceland [where] undiluted formic acid [was] splashed over the lower extremities of a 15-year-old girl. Her clothes were removed immediately and irrigation with water started. According to the girl there was a peculiar cooling sensation in the burned areas, but then increasing pain which required analgesic treatment. She was hospitalized at the University Hospital in Reykjavik 4 h later and appeared to be in good condition. During the transport and after arrival she complained of nausea and she vomited a couple of times.

After the initial period the girl’s main complaints were nausea and diffuse abdominal pain which disappeared after a few days. The burned skin had a peculiar greenish hue. On the second and third days gross edema formed on both lower extremities with moderate blister formation. No antibiotics were given and only minor infection occurred. On the 16th day after the accident the burned areas were surgically revised under general anesthesia. The burn turned out to be mainly full thickness. Over the next 2 weeks the burned areas were gradually revised and grafted with good take of the grafts. There was heavy scarring in the burned areas, as is common in chemical burns, and later 2 secondary revisions and graftings were required. 

DISCUSSION  

A case of formic acid bum is reported. It seems a fortunate coincidence that the common agricultural and industrial use of this acid has not resulted in more serious accidents. Formic acid is dangerous both to the skin and to the eyes and its ingestion is life-threatening. Formic acid burn can be more serious than it may appear in the beginning.

The first aid after formic acid burn is the same as for other chemical burns, i.e. unclothing and vigorous irrigation with water. Then the patient should be hospitalized. In addition to ordinary burn treatment, the patient must be observed carefully with respect to systemic effects. It appears that formic acid is absorbed from the burned areas. Thus it can result in the same symptoms and signs as seen after oral ingestion, i.e. metabolic acidosis, intravascular hemolysis, hemoglobinuria and renal failure.   

Fig. 3. Heavy scarring three years after a formic acid burn.

Formic acid burn-local and systemic effects: report of a case. Sigurdsson, et al.

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