Many countries have decided to ban a number of pesticides, for public health, environmental, and economic reasons [1Lee Y.Y., et al. The cost-effectiveness of banning highly hazardous pesticides to prevent suicides due to pesticide self-ingestion across 14 countries: an economic modelling study Lancet Glob Health 2021 ;  9 (3) : e291-e300 [cross-ref]

Cliquez ici pour aller à la section Références, 2European Commission. Food safety. [accessed 2022 Feb 24]. Available from: farm-fork-targets-progress_fr.

Cliquez ici pour aller à la section Références]. Since the new regulation banning the use and sale of herbicides in France was introduced in 2019, many French people are turning to alternative solutions to weed their garden. These alternatives, which are promoted on gardening websites in particular, include the use of vinegar and even bleach, which are inexpensive and commonly-used products.

This is a retrospective and observational study of cases exposure to chlorine relating to weed control reported to the Angers Poison Control Centers from 1st January 2001 to 31st December 2021.

Results revealed a sharp increase in the number of cases, starting in 2019. Since 2001, there have been a total of 57 cases of chlorine exposure, more than 75% of which occurred after 2019 (n=43), with a 120% increase in cases between 2019 and 2021. These patients had mixed bleach with vinegar (n=44) or hydrochloric acid (n=15), with all 3 products mixed together in 2 of these cases. Almost all of the patients presented immediately and had mild symptoms with a cough, but there was dyspnea or bronchospasm in 46% of cases (n=26). Even though the prognosis was good for most of the patients, 42% (n=24) had to be admitted to Emergency Department: seven patients required oxygen due to hypoxia, and two patients were still followed by a pulmonologist 1 and 6 months after exposure due to a decrease in their respiratory capacity.

A number of patients had mixed some of the advised products (mainly bleach and vinegar) before spraying them. This mixture produces a chemical reaction that suddenly releases chlorine gas, causing major irritation of the airways, and can lead to pulmonary oedema, ARDS (Adult Respiratory Distress Syndrome) and respiratory sequelae such as RADS (Reactive Airway Dysfunction Syndrome) [3Zellner T., Eyer F. Choking agents and chlorine gas – history, pathophysiology, clinical effects and treatment Toxicol Lett 2020 ;  320 : 73-79 [cross-ref]

Cliquez ici pour aller à la section Références]. Although warnings about chlorine exposure are already in circulation, mainly for the cleaning and pool maintenance sectors, these new exposures have increased the number of cases of poisoning. There is an added risk of explosion should the mixture be made in a pressurized sprayer.

Given the overuse of bleach in the wake of COVID-19, public health policies should be drafted to inform the population of the risks associated with these sorts of uses.