2,4-dinitrophenol (DNP) is a yellow substance which is being incorporated into weight loss pills. It is easily available to purchase online and is marketed as a ‘safe weight loss agent’. It was apparent as early as 1885 that nitrated naphthols, such as DNP, were able to speed up lipid metabolism, causing fat burning effects without the need for calorie control. It also causes excess energy to be released as heat, resulting in hyperthermia. This is particularly concerning as there is no bedside antidote for DNP poisoning, and most cases result in death.
DNP has been circulated throughout Wales and England, causing 23 deaths between 2012 and 2018. A Public Health Link by the Chief Medical Officer for Wales stated that the number of DNP poisoning cases and documented fatalities has significantly increased since 2012. Up until the end of March 2019 there had been 120 cases of systemic DNP exposure, with 98% of these cases occurring since 2012. But issues with DNP are not new, and DNP has been a problem in Wales since the late 1800s.
What is now Pembrey Country Park on the Carmarthenshire Coast was once 771 acres of hidden tunnels and bunkers, known as Pembrey Munitions Factory. This location was seen as an ideal place for a munitions factory as sand dunes would offer protection in the event of an explosion. The factory was first built in 1882 by the Stowmark Explosive Company, however a decade later most of the factory had been burnt down. With the outbreak of the First World War, Alfred Nobel’s Explosive Company built a new site with two factories, a TNT factory, and a shell filling factory.
At its peak, Pembrey Munitions Factory had 6,000 employees, the majority of them women. The women working in the factory were nicknamed the ‘canary girls’ as the chemicals they were working with would turn their skin and hair yellow, much like the skin of French munition workers during World War I. The common denominator here is that both the Welsh and French munition workers were exposed to DNP.
During World War I, DNP was used in combination with picric acid (in a mixture better known as Shellite) to fill armour piercing shells. DNP was toxic to the munition workers handling it, resulting in rapid weight loss, and even death. The women working at Pembrey Munitions Factory would often suffer seizures and sight loss, which are both symptoms of systemic DNP poisoning. As the workers were manufacturing TNT and handling Shellite, it is likely that both contributed to the DNP poisoning-like symptoms.
Many of us think of war heroes as the hundreds of thousands of men who lost their lives on the front line. However, many are unaware of the bravery and sacrifices made by those who worked in munitions factories, such as that in Pembrey. An extract from a diary written by Gabriella West, a sergeant at Pembrey Munitions Factory during World War I, reads ‘the girls here are very rough, but so are the conditions’. The girls Gabriella is referring to are some of the unsung heroes of the war.
After the First World War, many workers were laid off and Pembrey Munitions Factory was sold in 1926. A new government-owned factory was built in 1938 at the start of World War II, known as The Royal Ordnance Factory Pembrey. However, by 1963 this too had been shut down. Almost two decades later and the site was reopened as what is known today as one of the top tourist attractions in Wales, Pembrey Country Park.
Fast forward to the 2000s and DNP poisoning is again a growing problem in Wales, with 3 deaths occurring in the Swansea area alone since 2015. Despite warnings by the Welsh Health Minister and the Royal Pharmaceutical Society’s numerous attempts to raise awareness via social media, DNP poisoning cases, whether accidental or deliberate, continue to grow.
Now there is increasing focus on DNP poisoning, and steps are being taken to try and tackle the issues surrounding it. In January 2021, the Home Office announced that they would decide in the coming months whether DNP would be added to the list of regulated poisons under the Poisons Act 1972. Ongoing work at Swansea University is also aiming to develop novel antidote therapies for DNP toxicity.
Despite this, the fact remains that DNP is still being sold illegally online, mainly to those within the slimming and body building community. Social media has created concerns over body image and weight, and DNP is seen as a solution for those desiring the perfect body. More recent cases of DNP exposure have involved young adults, males more often than females, and it is likely that these sufferers were unaware of dangers of ingesting DNP.
The Royal Pharmaceutical Society’s chief scientist Gino Martini said:
“We welcome the Government’s recognition of the threat of inappropriate supply via online marketplaces and hope that given their acceptance of the ACMD’s (Advisory Council on the Misuse of Drugs) recommendations, they take immediate steps to delist DNP products rather than wait for legislative change”.
For more than a century, DNP has been causing deaths. It is likely that these deaths were due accidental toxicity, deliberate overdose, or accidental occupational toxicity, as many of those working in Pembrey Munitions Factory would have suffered. There is still no antidote for DNP poisoning, therefore it is an unmet clinical need that must be addressed, not only in Wales but all over the UK. Hopefully, the Home Office’s decision to label DNP as a regulated poison, and continued research into DNP toxicity, will be a big step towards tackling the issue of DNP poisoning.
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