{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:35:50Z","timestamp":1792809350391,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Methanol is a widely used industrial and household alcohol that poses significant health risks upon exposure. Despite its extensive use, methanol poisoning remains a critical public health concern globally, often resulting from accidental or intentional ingestion and outbreaks linked to contaminated beverages. Methanol toxicity stems from its metabolic conversion to formaldehyde and formic acid, leading to severe metabolic acidosis and multiorgan damage, including profound CNS effects and visual impairments. Epidemiological data underscore the widespread impact of methanol poisoning, with alarming case fatality rates reported in various countries. Comprehensive prevention and effective management strategies are urgently needed to address the significant morbidity and mortality associated with methanol poisoning. The clinical manifestations of methanol toxicity vary between adult and pediatric populations and between acute and chronic exposure. Adults typically present with gastrointestinal and neurological symptoms, whereas pediatric patients often exhibit more severe outcomes due to differences in metabolism and body weight. The diagnosis of methanol poisoning involves a combination of clinical evaluation, laboratory testing, and advanced diagnostic techniques. The identification of metabolic acidosis, elevated anion and osmolal gaps, and confirmation through methanol and formate levels are critical for accurate diagnosis. Timely intervention is crucial, and the management of methanol poisoning includes securing the airway, breathing, and circulation; addressing metabolic acidosis with sodium bicarbonate; administering antidotes such as fomepizole or ethanol; and administering hemodialysis, which plays a pivotal role in eliminating methanol and its toxic metabolites, especially in severe cases. The complexity of methanol poisoning necessitates a comprehensive approach encompassing early recognition, prompt intervention, and coordinated care among healthcare providers. Increased awareness, effective prevention strategies, and timely treatment protocols are essential to mitigate severe health consequences and improve patient survival and recovery.<\/jats:p>","DOI":"10.3390\/toxics12120924","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T07:42:18Z","timestamp":1734680538000},"page":"924","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["The Perils of Methanol Exposure: Insights into Toxicity and Clinical Management"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5203-8962","authenticated-orcid":false,"given":"Mohammed","family":"Alrashed","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"Pharmaceutical Care Department, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norah S.","family":"Aldeghaither","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shatha Y.","family":"Almutairi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meshari","family":"Almutairi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8292-5212","authenticated-orcid":false,"given":"Abdulrhman","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"Department of Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada H.","family":"Almojathel","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 12371, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada A.","family":"Alnassar","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 12371, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan M.","family":"Alghadeer","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 12371, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmajeed","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"Pharmaceutical Care Department, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-5437","authenticated-orcid":false,"given":"Mohammed","family":"Alnuhait","sequence":"additional","affiliation":[{"name":"Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3792-4106","authenticated-orcid":false,"given":"Omar A.","family":"Almohammed","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 12371, Saudi Arabia"},{"name":"Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh 12371, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref_1","unstructured":"Ashurst, J.V., and Nappe, T.M. (2024, July 02). Methanol Toxicity, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482121\/."},{"key":"ref_2","unstructured":"World Health Organization (WHO) (2014). Methanol Poisoning Outbreaks, World Health Organization (WHO). Available online: https:\/\/www.methanol.org\/wp-content\/uploads\/2016\/06\/WHO-Methanol-Poisoning-Fact-Sheet.pdf."},{"key":"ref_3","first-page":"652129","article-title":"A case of methanol poisoning in a child","volume":"2014","author":"Loza","year":"2014","journal-title":"Case Rep. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"102445","DOI":"10.1016\/j.amsu.2021.102445","article-title":"Methanol poisoning as a new world challenge: A review","volume":"66","author":"Nekoukar","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Bateman, N., Jefferson, R., Thomas, S., Thompson, J., and Vale, A. (2014). Common complications of poisoning. Oxford Desk Reference: Toxicology, Oxford University Press.","DOI":"10.1093\/med\/9780199594740.001.0001"},{"key":"ref_6","first-page":"294","article-title":"Acute methanol intoxication: Physiopathology, prognosis and treatment","volume":"160","author":"Hantson","year":"2005","journal-title":"Bull. Mem. Acad. R. Med. Belg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40557-017-0197-5","article-title":"Estimations of the lethal and exposure doses for representative methanol symptoms in humans","volume":"29","author":"Moon","year":"2017","journal-title":"Ann. Occup. Environ. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1152\/physrev.00034.2014","article-title":"Metabolic methanol: Molecular pathways and physiological roles","volume":"95","author":"Dorokhov","year":"2015","journal-title":"Physiol. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Teschke, R. (2018). Alcoholic Liver Disease: Alcohol Metabolism, Cascade of Molecular Mechanisms, Cellular Targets, and Clinical Aspects. Biomedicines, 6.","DOI":"10.3390\/biomedicines6040106"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/cssc.201200809","article-title":"Formaldehyde: Catalytic Oxidation as a Promising Soft Way of Elimination","volume":"6","author":"Royer","year":"2013","journal-title":"ChemSusChem"},{"key":"ref_11","first-page":"57","article-title":"Methanol poisoning and formate oxidation in nitrous oxide-treated rats","volume":"217","author":"Eells","year":"1981","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1001\/archopht.1977.04450100161023","article-title":"Methyl alcohol poisoning. IV. Alterations of the morphological findings of the retina and optic nerve","volume":"95","author":"Baumbach","year":"1977","journal-title":"Arch. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.molmet.2019.05.012","article-title":"Formate metabolism in health and disease","volume":"33","author":"Pietzke","year":"2020","journal-title":"Mol. Metab."},{"key":"ref_14","first-page":"418","article-title":"Methanol and formate kinetics in late diagnosed methanol intoxication","volume":"3","author":"Jacobsen","year":"1988","journal-title":"Med. Toxicol. Adverse. Drug Exp."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1080\/713857189","article-title":"Toxicological and metabolic consequences of methanol poisoning","volume":"13","author":"Skrzydlewska","year":"2003","journal-title":"Toxicol. Mech. Methods"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.cld.2012.08.002","article-title":"Alcohol metabolism","volume":"16","author":"Cederbaum","year":"2012","journal-title":"Clin. Liver Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s002040000107","article-title":"Invasion and distribution of methanol","volume":"74","author":"Graw","year":"2000","journal-title":"Arch. Toxicol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/BF02340834","article-title":"The elimination kinetics of methanol and the influence of ethanol","volume":"105","author":"Haffner","year":"1992","journal-title":"Int. J. Legal Med."},{"key":"ref_19","unstructured":"Centers for Disease Control and Prevention (CDC) (2024, January 27). Methanol: Systemic Agent, Available online: https:\/\/www.cdc.gov\/niosh\/ershdb\/emergencyresponsecard_29750029.html."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1097\/00005792-195312000-00002","article-title":"Acute methyl alcohol poisoning: A review based on experiences in an outbreak of 323 cases","volume":"32","author":"Bennett","year":"1953","journal-title":"Medicine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s40942-017-0089-4","article-title":"Optical coherence tomography findings in methanol toxicity","volume":"3","author":"Klein","year":"2017","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s00204-021-03202-0","article-title":"Methanol-induced optic neuropathy: A still-present problem","volume":"96","author":"Liberski","year":"2022","journal-title":"Arch. Toxicol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/096032719401300212","article-title":"Osmolal and anion gaps in patients admitted to an emergency medical department","volume":"13","author":"Aabakken","year":"1994","journal-title":"Hum. Exp. Toxicol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Lynd, L.D., Richardson, K.J., Purssell, R.A., Abu-Laban, R.B., Brubacher, J.R., Lepik, K.J., and Sivilotti, M.L. (2008). An evaluation of the osmole gap as a screening test for toxic alcohol poisoning. BMC Emerg. Med., 8.","DOI":"10.1186\/1471-227X-8-5"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/BF03161229","article-title":"Medical toxicology and public health--update on research and activities at the Centers for Disease Control and Prevention, and the Agency for Toxic Substances and Disease Registry inhalational methanol toxicity","volume":"5","author":"Kleiman","year":"2009","journal-title":"J. Med. Toxicol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1081\/CLT-120006745","article-title":"American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning","volume":"40","author":"Barceloux","year":"2002","journal-title":"J. Toxicol. Clin. Toxicol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.xkme.2020.06.012","article-title":"Acute Hemodialysis for Treatment of Severe Ethanol Intoxication","volume":"2","author":"Driscoll","year":"2020","journal-title":"Kidney Med."},{"key":"ref_28","first-page":"e28","article-title":"The Diagnosis and Management of Toxic Alcohol Poisoning in the Emergency Department: A Review Article","volume":"3","author":"Gallagher","year":"2019","journal-title":"Adv. J. Emerg. Med."},{"key":"ref_29","first-page":"67","article-title":"Treatment of patients with ethylene glycol or methanol poisoning: Focus on fomepizole","volume":"2","year":"2010","journal-title":"Open Access Emerg. Med."},{"key":"ref_30","unstructured":"Shannon, M.W., Borron, S.W., and Burns, M.J. (2007). Emergency Management of Poisoning. Haddad and Winchester\u2019s Clinical Management of Poisoning and Drug Overdose, Elsevier. [4th ed.]."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"638057","DOI":"10.1155\/2013\/638057","article-title":"A Systematic Review of Ethanol and Fomepizole Use in Toxic Alcohol Ingestions","volume":"2013","author":"Beatty","year":"2013","journal-title":"Emerg. Med. 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