National Poisons Information Service

A service commissioned by Public Health England

 

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Members of the public

seeking specific

information on poisons

should contact:

 

In England and Wales:

NHS 111 - dial 111

 

In Scotland:

NHS 24 - dial 111

 

In N Ireland:

Contact your local GP or

pharmacist during

normal hours; click here

(www.gpoutofhours

.hscni.net/) for GP

services Out-of-Hours.

 

In Republic of Ireland:

01 809 2166

 

Healthcare

professionals seeking

poisons information

should consult:

www.toxbase.org

2,4-dinitrophenol

2,4-Dinitrophenol (DNP) is a highly toxic industrial chemical which, if ingested, can cause serious health effects including high fever, rapid heart rate, agitation, headache, diarrhoea, vomiting, convulsions, acidosis, muscular rigidity and multi-organ failure. These features are all too frequently fatal in spite of intensive medical treatment. Despite these risks associated with DNP use it is still sometimes taken as a ‘fat burner’ to promote weight reduction or for ‘body sculpting’.


The NPIS has been tracking episodes of poisoning relating to DNP since the service first reported an increase in enquiry numbers and deaths in 2013. This information has been shared on a quarterly basis with the Food Standards Agency (FSA) and PHE to support actions to protect public health. Data on DNP enquiries has also been published in our annual reports.


In last year’s annual report we described an increase in enquiries relating to DNP in late 2017 and early 2018. This had occurred in spite of earlier public health measures including warnings to the public, focussed educational activity (e.g. in gyms) and law enforcement action targeting illegal internet sales. Further details of these actions are provided in previous annual reports.

 

During 2018/19 there was some reduction in telephone enquiries and TOXBASE accesses relating to DNP since the most recent peak in the first quarter of 2018 (Figure 1). During the 2018 calendar year there were 20 cases (18 males and two females) discussed by phone with the NPIS; six of these are known to have died, emphasising the very high toxicity of DNP. There were two further non-fatal cases in the first quarter of 2019.

 

Figure 1. Quarterly numbers of NPIS cases referred by telephone and TOXBASE accesses relating to systemic DNP exposure, January 2011 - March 2019

 

In total there have been 120 cases of systemic DNP exposure discussed by phone with the NPIS since 2007. Of these, 20 (17%) are known to have died. The NPIS is aware of at least six further fatal cases that were not discussed with the service at any stage. This means that there have been at least 26 DNP-related deaths in the UK since 2007, 18 since January 2015.


In response to this recent information provided by the NPIS, PHE issued updated advice to the public via its Public Health Matters blog in August 2018 and the FSA issued a further warning in December 2018. Subsequently information and advice was provided about DNP to healthcare professionals via PHE (May 2019) and the Chief Medical Officer for Scotland (March 2019).

 

The NPIS will continue to monitor and report on enquiries relating to DNP and encourage the responsible government agencies to take the necessary actions to restrict the use of this highly toxic chemical.

 


Information from the NPIS Annual Report 2018/19.

 

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