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INTRODUCTION

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HISTORY AND EPIDEMIOLOGY

Methanol was a component of the embalming fluid used in ancient Egypt. Robert Boyle first isolated the molecule in 1661 by distilling boxwood, calling it spirit of box.29 The molecular composition was determined in 1834 by Dumas and Peligot, who coined the term “methylene” from the Greek roots for “wood wine.”215 Industrial production began in 1923, and today most methanol is used for the synthesis of other chemicals. Methanol-containing consumer products that are commonly encountered include model airplane and model car fuel, windshield washer fluid, solid cooking fuel for camping and chafing dishes, photocopying fluid, colognes and perfumes, and gas line antifreeze (“dry gas”). Methanol is also used as a solvent by itself or as an adulterant in “denatured” alcohol.141 Most reported cases of methanol poisoning in the United States involve ingestions of one of the above products, with more than 60% involving windshield washer fluid,58 although most inhalational exposures involve carburetor cleaner.86 In a Tunisian series, ingested cologne was the most common etiology.30 In a Turkish series, cologne was also most common, accounting for almost 75% of ingestions.132 Perfume was one of several exposures in a patient with methanol poisoning in a report from Spain,183 and methanol poisoning from cologne was also reported in India.12 There are sporadic epidemics of mass methanol poisoning, most commonly involving tainted fermented beverages.23,133 These epidemics are a continuing problem in many parts of the world (Table 106–1).102,216 Abuse of hydraulic fracturing (“fracking”) fluid is another more recent source of methanol poisoning.50 Methyl acetate in non-acetone nail polish removers is hydrolyzed to methanol in acidic environments, but it is unclear to what extent this occurs in vivo.184

TABLE 106–1International Methanol Poisoning Epidemics Since 1998102

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