2,4-dinitrophenol (DNP) is an industrial chemical with a legitimate use in biomedical research and in the manufacture of other chemicals. Although not licensed as a medicine, DNP is sometimes taken orally by body builders to promote ‘fat burning’ and may also be used more generally as a weight-reducing agent. This is of great concern because DNP is highly toxic, causing fever which can be severe and lead to multi-organ failure and death in spite of optimum medical treatment.
Because of its severe toxicity, the NPIS has been monitoring enquiries relating to DNP in recent years. Steep increases in the numbers of NPIS telephone enquiries and TOXBASE accesses in late 2012 and early 2013 were reported in our annual report for 2012/13. These prompted warnings to the public from the FSA and actions by the police and local authorities to restrict the illegal sales of DNP. Educational work was also carried out in places where DNP might be promoted, such as gyms. Emergency departments and general practitioners were briefed by a letter from the Chief Medical Officer sent in August 2013.
Following this activity, enquiry numbers about DNP fell during 2014, as reported in our annual report last year. The NPIS has continued to keep cases of DNP exposure under surveillance and increasing numbers of telephone enquiries and TOXBASE accesses were observed in the second quarter of 2015 (Figure 1). This prompted a letter from the Medical Director of Public Health England to health professionals, while information and data were also published on the Public Health Matters blog1.
|Figure 1. Telephone enquiries and TOXBASE accesses relating to DNP (2008-2016)|
The FSA’s National Food Crime Unit also launched an operation during 2015 to tackle online sales of DNP and closed down several websites. Following that peak in activity in 2015, it is encouraging that the numbers of telephone calls and TOXBASE accesses have again fallen, suggesting that the actions taken have had some impact. The situation needs to be kept under close review because of the severity of toxicity associated with DNP. Of 77 cases discussed in telephone enquiries with NPIS since 2008, 11 (14%, 7 male, 4 female) are known to have died, including six reported to NPIS during 2015.
Information from the NPIS Annual Report 2015/16.
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