Hydrogen peroxide nebulisation: Is it safe?

Indian actress Samantha Ruth Prabhu’s viral infection remedy using hygrogen peroxide nebulisation has caused a stir. After she suggested using hydrogen peroxide through a nebuliser to get relief from viral infections, the internet has been buzzing about whether this is safe to use or not. Read on to know whether inhaling hydrogen peroxide is safe for your health or not.

What is hydrogen peroxide?

Hydrogen peroxide is an antiseptic, which is often used as an oxidising and disinfecting agent in various applications. This chemical compound is used in bleaches, dyes, antiseptics and disinfectants. Composed of two hydrogen atoms and two oxygen atoms, this colourless liquid has a slightly sharp odour. This bleaching agent is also used for medical and cosmetic purposes in concentration. However, higher concentrations of hydrogen peroxide can cause respiratory irritation, vomiting and severe pulmonary conditions, according to the Agency of Toxic Substances and Disease Registry.

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What are the potential health risks of hydrogen peroxide nebulisation?

While many believe that it is an alternative option for treating respiratory conditions and viral infections, inhaling hydrogen peroxide may cause lung tissue damage and oxidative stress. Some potential health risks of inhaling hydrogen peroxide are:

1. Mucosal irritation

Mucosal irritation refers to inflammation or discomfort in the mucous membranes. These membranes produce mucus that protects and lubricates the tissues. Inhaling hydrogen peroxide can lead to mucosal irritation, which can cause swelling, pain, burning, dryness and difficulty in swallowing. The US Centers for Disease Control and Prevention states that even 3 per cent of the solution can irritate the mucosal tissue and asphyxiation.

2. Cytotoxicity

Chemical agents like hydrogen peroxide can be cytotoxic to epithelial cells. Cytotoxicity refers to the quality of being toxic to cells according to the journal, Thermo Fisher Scientific. It can occur through several mechanisms like membrane drainage, DNA damage, oxidative stress and interference with cellular processes. Hydrogen peroxide can lead to cell death and tissue damage.

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3. Risk of pulmonary edema

Inhaling hydrogen peroxide increases the risk of pulmonary edema. It is a condition where fluid accumulates in the lungs. This condition can cause severe respiratory distress, decrease oxygen levels in the blood and cause life-threatening complications. A study published in the Journal of Applied Physiology, Respiratory, Environmental and Exercise Physiology states that hydrogen peroxide can impair pulmonary vasoreactivity and cause edema.

4. Chemical pneumonitis

High concentration or prolonged exposure to hydrogen peroxide can result in chemical pneumonitis. It is an inflammation of the lung tissue caused by the inhalation of irritants. Its symptoms include chest pain, difficulty breathing and persistent coughing. A study published in the journal, Cureus states that inhaling hydrogen peroxide can cause acute pneumonitis.

5. Risk of infections

Hydrogen peroxide can cause respiratory infections by irritating and damaging the mucous membranes. This damage can disrupt the natural barriers, which protect against pathogens, making it easier for bacteria, viruses and other microbes to invade and infect the respiratory system. It can also cause oxidative stress, which can weaken the immune response, increasing the risks of infections.

Mechanism of damage by hydrogen peroxide

Hydrogen peroxide is known for its antiseptic and oxidising properties. But it can also damage cells when exposed for extended periods. Internal medicine physician Dr Manish Itolikar says that it can lead to corrosive damage, oxygen gas formation and lipid peroxidation.

1. Corrosive damage

Hydrogen peroxide can lead to corrosive damage. It can cause oxidative effects, tissue destruction and an acidic environment. This chemical compound decomposes when applied to tissues to release oxygen and reactive oxygen species, which can initiate oxidative reactions. It can cause degradation of proteins, lipids and DNA in cells and tissues. The oxidative stress induced by hydrogen peroxide can disrupt the cellular membrane, which can lead to cell lysis and necrosis. Direct contact with this compound can cause chemical burns, inflammation, pain and tissue necrosis.

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2. Lipid peroxidation

The ROS (reactive oxygen species), which is generated from hydrogen peroxide can lead to lipid peroxidation. It is a chain reaction, which can damage cell membranes, disrupt membrane integrity, lead to leakage of cellular contents and increase oxidative damage. A study published in the journal, Oxidative Medicine and Cellular Longevity states that lipid peroxidation can cause heart failure, cancer and other immunological disorders.

3. Oxygen gas formation

Hydrogen peroxide decomposes into water and oxygen gas and this process can be accelerated by catalysts like transition metal ions or enzymes present in biological systems. This leads to toxicity, which can cause significant air emboli, and lead to abdominal pain, vomiting and nausea, according to a study published in StatPearls.

What are the alternatives to hydrogen peroxide for nebulisation?

Using saline solution nebulization is one of the best alternatives to hydrogen peroxide nebulisation. It helps moisturise and clear the airways. According to the Cambridge University Hospitals, saline nebulisers help to thin down the secretion, which makes it easier to cough up and swallow. It can mitigate the functional signs of threatening pulmonary obstruction and treat mild respiratory problems, according to a study published in the journal, Physiological Research. Besides this, it is recommended to use prescribed medications from your healthcare provider and use steam inhalation and humidifiers to add moisture to the air.

So, check with your doctor before using hydrogen peroxide or any other inhalation process to avoid health risks.