Identification and quantification of ethylene glycol and diethylene glycol presented in pediatric cough and cold syrups in Iraqi local market
Year 2026,
Volume: 30 Issue: 1, 186 - 197, 11.01.2026
Noor Waheed
,
Amal Fakhrulddin
Abstract
Ethylene glycol (EG) is a cheap available solvent used mainly as antifreeze and in resin industry while diethylene glycol (DEG) is usually used in natural gas industry. In the past few years there was increasing reports about EG and DEG intoxication especially in Indonesia, Uzbekistan, Panama, India, Gambia and some African countries. The intoxication was due to using some pediatric cough syrups that are contaminated with these harmful solvents which lead to acute renal failure and death in some cases. World Health Organization declares that any limit of EG or DEG more than 0.1% considered a safety issue in the pharmaceutical products. In 2023, random pharmaceutical samples from Iraqi local market were tested by independent US laboratory (Valisure LLC) and there was an EG contaminated cough syrup with approximately 21 times more than the accepted limits. The above report encourage the conduction of this research to investigate the presences and the amount of EG and DEG in cold and cough syrups available in the Iraqi markets.
In this study, 12 samples of cold and cough pediatric syrups of different origin were collected from the local market in Iraq and the levels of EG and DEG were measured by using gas chromatography with flame ionization detection (GC-FID) to estimate the presence and concentration of these compounds in the selected drugs. The results showed that only one sample was containing 0.65% DEG , while other samples were containing less than 0.1% or undetectable levels of either EG or DEG.
Ethical Statement
our research do not require ethical statement
References
-
[1] Ibrahim RK, Hayyan M, AlSaadi MA, Ibrahim S, Hayyan A, Hashim MA. Physical properties of ethylene glycol-based deep eutectic solvents. J Mol Liq. 2019;276:794–800. https://doi.org/10.1016/j.molliq.2018.12.032.
-
[2] Mastrogianni O. Fatal Ethylene Glycol Intoxication. J Forensic Sci Crim Investig. 2017;2(3):2–4. http://doi.org/10.19080/JFSCI.2017.02.555589
-
[3] Schep LJ, Slaughter RJ, Temple WA, Beasley DMG. Diethylene glycol poisoning. Clin Toxicol. 2009;47(6):525–35. http://doi.org/10.1080/15563650903086444
-
[4] Ghannoum M, Gosselin S, Hoffman RS, Lavergne V, Mégarbane B, Hassanian-Moghaddam H, Rif M, Kallab S, Bird S, Wood DM, Roberts DM; EXTRIP Workgroup. Extracorporeal treatment for ethylene glycol poisoning: systematic review and recommendations from the EXTRIP workgroup. Crit Care. 2023;27(1):56. https://doi.org/10.1186/s13054-022-04227-2
-
[5] Thiagarajan K. WHO investigates cough syrups after deaths of 66 children in Gambia. BMJ. 2022;379:o2472. https://doi.org/10.1136/bmj.o2472
-
[6] Jamison Courtney N, Cuevas-Ocampo Areli K, Flowers Ashley B, Nam Hyung W, Dayton Robert D, McKinney Mary P, Mitchell Hannah G, Fitzgerald Joseph S, Steib Mattie E, Toups Colton R, McMartin Kenneth E. Histopathological evidence that diethylene glycol produces kidney and nervous system damage in rats. Neurotoxicology. 2022;91:200-210. https://doi.org/10.1016/j.neuro.2022.05.015
-
[7] WHO C. Medical Product Alert N ° 6 / 2022 Substandard ( contaminated ) paediatric medicines identified in WHO region of Africa. 2022;(October):5–6. https://www.who.int/news/item/05-10-2022-medical-product-alert-n-6-2022-substandard-(contaminated)-paediatric-medicines
-
[8] Aulya RN. PhD Thesis. Consumer protection against the use of syrup drugs containing ethylene glycol and diethylene glycol exceeding the safe threshold. Faculty of Law, Universitas Islam Indonesia, Yogakarta, Indonesia, 2023.
-
[9] U.S FAD. Information Related to a WHO Risk Alert Regarding Children’s Cough and Cold Syrup. U.S.A; 2022. https://content.govdelivery.com/accounts/USFDA/bulletins/3359763
-
[10] Kurdistan 24 [Internet]. 2023. Indian-made cold syrup tainted with toxic chemicals: Bloomberg.Available from: https://www.kurdistan24.net/en/story/392080/Indian-made-cold-syrup-tainted-with-toxic-chemicals:-Bloomberg. (accessed on 23 November 2024).
-
[11] R-Mider Z. Bloomberg. 2023. indian made cold syrup sent to iraq contains poison, test shows. Available from: https://www.bloomberg.com/news/articles/2023-07-28/indian-made-cold-syrup-sent-to-iraq-contains-poison-test-shows. (accessed on 23 November 2024).
-
[12] Fowles J, Banton M, Klapacz J, Shen H. A toxicological review of the ethylene glycol series: Commonalities and differences in toxicity and modes of action. Toxicol Lett. 2017;278(May):66–83. https://doi.org/10.1016/j.toxlet.2017.06.009
-
[13] Soegiantoro DH. Community Response to Acute Kidney Injury Due to Children’s Syrup Preparations. Int J Public Heal Excell. 2023;2(2):565–573. https://doi.org/10.55299/ijphe.v2i2.335
-
[14] Jamison CN, Dayton RD, Latimer B, McKinney MP, Mitchell HG, McMartin KE. Neurotoxic effects of nephrotoxic compound diethylene glycol. Clin Toxicol. 2021;59(9):810–821. https://doi.org/10.1080/15563650.2021.1874403
-
[15] Jamison CN, Dayton RD, Latimer B, McKinney MP, Mitchell HG, McMartin KE. Diethylene glycol produces nephrotoxic and neurotoxic effects in female rats. Clin Toxicol. 2022;60(3):324–331. https://doi.org/10.1080/15563650.2021.1953049
-
[16] Ibrahim NN, Al-Mashhadane FA, ALtaaye SKAI. Protective effects of vitamin C against oxidative stress induced by diethylene glycol in liver and kidney. Int J Health Sci (Qassim). 2022;6(June):7077–7087. https://doi.org/10.53730/ijhs.v6nS5.11594
-
[17] Tokunaga H, Osako T, Sato K. Determination of ethylene glycol and diethylene glycol as the adulterant in concentrated glycerin, glycerin and propylene glycol. Japanese Cosmet Sci Soc. 2012;36(4):269–275. https://doi.org/10.11469/koshohin.36.269
-
[18] World Health Organisation. Tests for diethylene glycol and ethylene glycol in liquid preparations for oral use. In: Tests for diethylene glycol and ethylene glycol in liquid preparations for oral use. 2023. p. 1–13. https://cdn.who.int/media/docs/default-source/medicines/pharmacopoeia/2023-11-16-deg-eg-inliquidoraldosageforms-qas22-922rev3.pdf
-
[19] Schier JG, Rubin CS, Miller D, Barr D, McGeehin MA. Medication-associated diethylene glycol mass poisoning: A review and discussion on the origin of contamination. J Public Health Policy. 2009;30(2):127–143. https://doi.org/10.1057/jphp.2009.2
-
[20] Oil E, Mathai J, Damale S, Makhamale R, Raju K. Application News Determination of Trace Amount of Ethylene Glycol in Used. :1–3. https://www.shimadzu.com/an/sites/shimadzu.com.an/files/pim/pim_document_file/applications/application_note/14209/an_07-gc-21008-en.pdf