In an earlier post I blogged about carbon monoxide (CO) poisoning. (Carbon Monoxide – Lost Wanderer) But, there are obviously many other ways you can poison yourself:
According to the CDC, poisonings killed 32,691 people in the United States in 2005. About 72% of these were unintentional (23,618), 10% undetermined (3,240), 18% suicides (5,744), and 0.3% homicides (89). To understand where the bulk of this risk is coming from it’s important to know that 95% of the unintentional poisoning related deaths were caused by drugs. The most common drugs involved, in descending order, were opioid pain medications, cocaine, and heroin. Benzodiazepines, sedatives, hypnotics, and antidepressants were also commonly involved. (Poisoning in the United States: Fact Sheet – CDC)
If we look at poisonings of children under age 6, in 2001, drugs accounted for 42% of poisonings, and non-drugs accounted for 58% of the total. 90% of these events occurred at home. (Pediatric Poisoning by John P. Lamb)
Drug poisonings in this age group involved analgesics (19%), topicals (19%), cold/cough (15%), vitamins (10%), antimicrobials (8%), GI preps (9%), hormones (7%), antihistamines (7%), minerals/Lytes (3%), and antidepressants (3%). Among analgesics the percentages were ibuprofen (40%), acetaminophen (31%), others (11%), combination (10%), aspirin (5%), and opiates (3%).
Non-drug poisonings in children under 6 involved cosmetics (26%), cleaners (22%), foreign bodies (15%), plants (13%), pens/inks (6%), pesticides (5%), hydrocarbons (4%), foods (3%), rodenticides (3%), and alcohols (3%). The pesticides involved were insecticides (51%), rodenticides (22%), repellents (14%), herbicides (10%), fungicides (2%), and fumigants (1%). Insecticide exposures in 2002 were from the following sources: Pyrethrin (37%), organophosphate (22%), others (16%), borates (8%), unknown (8%), Carbamate (6%), combinations (5%), Chlorinated HC (3%), Arsenic (1%), and Metaldehyde (0%). Herbicide exposure in 2002 was 14,021, and was from the following sources: other (43%), Glyphosate (32%), Chlorophenoxy (15%).
The effects of pesticide exposure broke down in the following way: no effect 21,844 (55%), minor effect 14,563 (37%), moderate effect 2,661 (7%), major effect 274 (0.7%), death 18 (0.05%).
The routes of exposure were oral (76%), dermal (8%), inhalation (6%), ocular (5%), bite/sting (4%), and other (1%).
The common characteristics across poisoning situations for children were availability, attractiveness, and taste. This isn’t surprising since 47% of households with children under 5 living in them had pesticides stored in an unlocked cabinet less than 4 feet high. 75% of households without children under 5 also had pesticides stored unsafely, which might not seem to be much of a problem, except for the fact that 13% of pesticide poisonings occurred in a home other than the child’s own.
Hazardous substances fall into a number of categories: Reactive ones are unstable and produce dangerous byproducts. Corrosives are acidic or alkaline, and will eat away at substances. Ignitables can catch fire. Toxic substances are by definition poisons.
In your garage or shed you might have antifreeze (which tastes sweet to dogs and cats), other automotive fluids, cleaning fluids, hand cleaner, car soaps, rust remover, lamp oil, polish and wax, fertilizer, weed killer, gasoline and kerosene, lighter fluid, lime or lye, mothballs, paint, paint thinner and stripper (paint strippers are among the most dangerous products in your home), pesticides (such as rat and other rodent poisons), insecticides (such as roach sprays and ant baits), insect repellents, turpentine, pool chemicals, charcoal lighter, windshield washer fluid, and anti-freeze .
In your kitchen you might have ammonia, bug sprays and traps, floor wax, cleansers (including floor, carpet, oven cleaner, and window), disinfectants, drain openers, medicines (both prescription and over-the-counter), glues, polish (for furniture, metals or glass), soaps and detergents. (Note: You should be very careful about mixing cleaning products. For instance, if you mix bleach with toilet bowl cleaners (or ammonia) this combination will form very deadly chlorine gas.)
In your bedroom you might have cosmetics, perfumes, colognes, cough medicine, prescription drugs, and sleeping aids.
In your bathroom you might have aftershave lotion, baby oil, toothpaste, alcohol, hydrogen peroxide, bath oil, cleansers (including floor, window, toilet bowl, and tub/tile cleaners), disinfectants, deodorizers and sanitizers, products used to kill mold or mildew, drain openers, hair removers, hair colors and perm solutions, nail products, personal hygiene products, mouthwash, ointments, flea and tick shampoos, powders and dips for pets, and shampoo.
In your laundry room you might have laundry detergents, softeners, bleach, cleaning fluids, soaps, stain removers, and spray starch.
One special case is that of your art supplies. Lead glazes can cause lead poisoning. Rubber cements can cause nerve damage. Acrylic paints can contain formaldehyde. Oil paints, or anything that requires solvents, can be toxic. Darkroom chemicals can be hazardous. Dust from sanding can trigger allergic reactions. Copper salt dust can be toxic. Turpentine can strip oil off skin, making it vulnerable. “Zinc shakes” and “bronze fever” have occurred.
Often the dose does make the poison, so be aware of the extent of your exposure and try to space it out. Temperature can also make a difference, since in warm temperatures liquids evaporate more quickly. (Using Art Materials Safely) (Art and Hobby Materials) (Health Hazards Manual for Artists by Michael McCann)
For children you should make sure everything is labeled non-toxic. Safe materials for children include crayons, colored pencils, water colors, finger paints, many modeling materials, some inks, and some glues. (ACTS : Arts, Crafts & Theatre Safety) (Kids Art)
Other hazards you might have in your home are alcoholic beverages, vitamins, supplements, diet pills, hair sprays, colognes, nail polish and remover, furniture polish, cigarettes, nicotine patches, folk remedies and herbal preparations, ammunition, and batteries (including button cell batteries like those in watches).
One basic way of minimizing the danger from hazardous substances, etc. is by limiting your use of them and educating yourself about safer alternatives. Most household cleaners can be replaced by five things: plain soap, borax, baking soda, vinegar, and ammonia. Instead of cough medicine you can mix honey and lemon juice with hot water. Instead of iodine you can use soap and water. (Home Safe Home by Deborah Lynn Dadd, Nontoxic, Natural & Earthwise by Deborah Lynn Dadd, and Green Seal) The general rule is to use the least powerful chemical necessary to do the job. The warnings run from “DANGER, DANGER – POISON,” to “WARNING,” to “CAUTION.” Get the product designed to address your specific problem, and, unless you are an expert, only buy pesticides labeled for general use.
For the dangerous things that you do decide to keep in your house (the following advice includes medicines) store all hazardous substances separately in a locked and high cabinet protected from heat and cold. Return a container to the cabinet immediately after removing the amount needed. (You need to consider how best to secure your cosmetics, given the number of poisonings they cause.) For a second layer of defense put child safety caps on all of the containers you can. But don’t rely on packaging to protect your kids, since child-resistant packaging does not mean childproof packaging. Keep children and pets away from a work area, and remove toys. Obviously, a woman who is pregnant should stay away when hazardous chemicals are being used.
Always keep dangerous substances in their original containers, since their labels provide valuable information in the event of an accident, and substituting other containers invites deadly confusion. (You should apply transparent tape over the labels to keep them legible.) You should read these labels (and any relevant safety data sheets that are available) and know the details about what you have. (1) Follow their advice regarding the recommended safety precautions and product restrictions, and contact the manufacturer if you have any questions. For example, use neoprene gloves, eye goggles, long sleeves, long pants, socks, shoes, proper cross-ventilation, and masks if the label says to.
Make sure your equipment is in good working condition. Open containers carefully with a rag around the cap. Proper ventilation requires by definition a large turnover of air. Turn on a fan (unless a substance is highly flammable) and open several windows when using chemical products such as household cleaners. Don’t use power tools with flammable materials. Mix insect sprays outdoors away from areas used by people and pets, and stay upwind. Basements can allow fumes to collect near the floor. Don’t spray when it’s windy. Follow the waiting times before allowing anyone into the area treated. You should never keep gasoline in your home, but if you do use a specifically designed container for gasoline. Some paint strippers will produce toxic gas if used in direct sunlight. Only use the amount of product recommended for the application, clean up any spills as soon as they happen, and wash off thoroughly after any contact with a hazardous substance. Don’t apply a pesticide more often than recommended. Be sure you know how close to harvest you can apply a product. If you are working with poisons don’t wear leather belts or shoes. Don’t smoke, drink, or eat when handling these materials. Re-close containers if interrupted (e.g. phone call or doorbell) during an application or dosing. Remember that most poisonings happen when a product is in use. Often something is going on which distracts people, such as someone is sick, there has been a death in the family, or it is mealtime.
Wash all sprayed fruits and vegetables. One method is to put them in vinegar and water for a few minutes, and rinse again with water. You should wash your clothes three times separately after exposure to strong pesticides. Triple rinse tools, equipment, or empty containers. Puncture empty containers so they can’t be reused, and dispose of them according to directions.
Only buy and mix what you need, then use it up. In other words, don’t buy in bulk. If you store hazardous substances for long periods of time they can react with their containers, which can then leak. Another problem is that their labels can become worn.
You should properly dispose of expired materials. Do not burn them. Also, don’t burn or reuse their containers. Don’t burn plywood or lumber that has been treated with preservatives, the resulting fumes can be thick with heavy metals.
Your local public health or hazardous-waste organization is often the best place to find information about how to dispose of a product. Some things such are motor oil, or batteries, can be recycled. Hazardous waste often needs to be put into special landfills.
You need to know the names of your medications and supplements, both prescription and over-the-counter. When you take or give medicine put your glasses on, turn on the lights, and read the label every time. Always check for the proper dose, and be sure you are giving the right medication to the right person. Never take another person’s medicine. Take medicine at the correct time of day, and keep track of when you took it by writing it down if necessary. Know and don’t confuse the abbreviations for tablespoon (Tbsp) and teaspoon (tsp). Avoid making conversions. If the label says two teaspoons, and you’re using a dosing cup with ounces only, get another measuring device. If the medicine came with a measuring device use only that device. Know how much medication you have, so you can tell if any is missing by regularly doing a count, and keeping a line marked on bottles.
Never guess on the amount of medicine that should be given to someone. For example, kids aren’t just small adults; half an adult amount may be more than your child needs, or not enough to help. Always follow the age limit recommendations. Twice the dose obviously isn’t appropriate just because your child seems twice as sick as last time.
It can be confusing when there are multiple caregivers giving medications to someone. Be sure to communicate to each other every dose you give, and also write down each dose given in a log.
Medications can interact with each other. If someone is already taking one medicine, check with your doctor before adding any other meds to be sure they are compatible. If multiple doctors are prescribing a variety of medications, be sure to communicate with each doctor and your pharmacist so they can check for drug interactions. Some medicines will interact with certain foods, some need to be taken with food, some without.
Never leave vitamin bottles, aspirin bottles, or other medications on kitchen tables, countertops, bedside tables, or dresser tops. Children will imitate you, so ideally take your medicines where children can’t watch, and never call medicine candy. Teach children to ask before eating or drinking anything. Talk about prescription drugs, and stress that they are only safe for the person who receives the prescription from the doctor. (For advice on how to talk to your child/teen go to www.drugfree.org) Something as seemingly harmless as pain-relieving skin creams will often contain benzocaine, dibucaine or lidocaine. A child who swallows just a small amount of these can have seizures and might even die.
Throw away expired medications in the garbage. Don’t put them down the sink or toilet because they can contaminate the water supply. For privacy sake remove the labels. Keep children and pets away from the garbage. Crush old pills and mix them with sand, coffee grounds, or kitty litter. Place them inside a container such as an empty yogurt or margarine tub and tape it shut. Your health department might know of a place to take old medicines. (Poison Prevention Tips)
At Christmas time don’t put presents like perfumes and after-shaves under the tree, but put them out of the reach of children. Clean up immediately after parties, so alcohol or cigarettes won’t be a temptation for children.
Mothballs should be hung in containers. If they are used in closets or chests, they should be put out of children’s reach. Bait traps should be tamper-resistant. Store bottles of alcohol in a locked cabinet far from kids’ reach, and remember that food extracts, such as vanilla and almond, may contain alcohol that can be harmful to kids.
When you have party guests designate a locked room where relatives and guests can place their coats and purses that may contain medications. Ingesting as few as six cigarette butts can send a child to the hospital, so you should empty ash trays often. Remove and empty partially filled glasses of alcoholic beverages. Be aware of any legal or illegal drugs that guests may bring into your home. Do not let guests leave drugs where children can find them, for example, in a pillbox, purse, backpack, or coat pocket. Be aware of all medications in your home (and in the homes of your relatives if your kids spend time there).
If relatives come to stay through the holidays, be sure their medications are put away. Lock medicines in a suitcase or, if in a purse, place it out of reach. Buy plastic plants with fake berries, not the real ones.
You should have the national poison hotline by each phone, the number is 1-800-222-1222. They will want to know the condition, weight, and age of the person. Have they been sick, and if so, what medications have they been on? Do they have any allergies? Also, have a poison first-aid chart at hand. (Poison First Aid) (Poison First Aid) (Emergency First-Aid Chart)
Here is some general advice for specific situations: Has the person collapsed or stopped breathing? Call 911 or your local emergency number right away. Do you have poison in the eyes? Then rinse your eyes with warm running water for 15 to 20 minutes. What about poison on your skin? You should take off any clothing that the poison touched, and rinse your skin with running water for 15 to 20 minutes. Have you Inhaled poison? You should get to fresh air right away. Did you swallow the wrong medicine or too much medicine? Then don’t take anything by mouth. Have you swallowed something that’s not food or medicine? You should then drink a small amount of milk or water. You should also keep a supply of ipecac syrup on hand (to induce vomiting if necessary).
Identify all the plants in your home and yard by taking them into a nursery, greenhouse, or florist. Label the pots, and make a map of the yard. Don’t assume a plant is safe because birds or wildlife eat it. Remember that even a safe plant can be a choking hazard. You can try to remove material from a child’s mouth with a damp washcloth wrapped around your finger. Store seeds, bulbs, and plant food out of the reach of children. Seeds and bulbs might be coated with fungicides and insecticides. (Poisoncenter Brochure)
Teach children to not eat wild plants or mushrooms. It’s easy to confuse safe and unsafe ones. Unless you are an expert, you cannot tell poisonous mushrooms from safe mushrooms. Mushrooms that are called “death caps” (Amanita phalloides, Amanita verna) grow easily in yards and parks. Eating even a few bites can cause fatal liver damage. Mushrooms will often sprout up after a rain. Inspect your yard and remove them. If you do decide to go mushroom hunting get a good guide and read up. (Mushrooms Demystified by David Arora, The Mushroom Hunter’s Field Guide by Alexander Smith, and Mushrooms of North America by Orson K. Miller) You should note the environment, shape, color, odor, terrain, whether it is growing in a cluster or alone. Since many mushrooms are very similar, all of the characteristics must match for you to know what you have. Check for a fetid odor, signs of decomposition, or worm infestation. Try only a few at first, and set a few aside in case you are poisoned.
Dividing plants into safe and unsafe ones is a crude method of categorizing them. So, the list below is only a very rough guide, and, of course, it is far from complete. Ideally you should identify each plant you are likely to be exposed to by its scientific name, and know the degree and nature of its toxicity.
Houseplants: African Violet, Air Fern, Aluminum Plant, Asparagus Fern, Baby Tears, Beauty Bush, Begonia, Common Blood leaf, Boston Fern, Bridal Veil, Bromeliad, Christmas Cactus, Coleus Blumei, False Aralia, Gloxinia, Hoya, Hibiscus, Inch Plant, Jade, Kalanchoe, Lipstick Plant, Norfolk Pine, Palm – Big Leaf, Peperomia, Piggyback Plant, Poinsettias are not that harmful, Prayer Plant, Snake Plant, Spider Plant, Spider Aralia, Swedish Ivy, Umbrella Plant, Wandering Jew, Yucca, Zebra Plant, and Zinnia. Garden: Aster, Baby’s Breath, Coral Bell, Crocus - Spring, Dahlia, Fuschia, Golden Sedum, Impatiens, Lily (Easter, Tiger), Nasturtium, Petunia, and Snapdragon. Field Plants: Dandelion. Trees: Mountain Ash and Mulberry. Ornamentals: Autumn Olive, Forsythia, Lilac, and Pussywillow. Miscellaneous: Christmas tree preservatives are usually not toxic, but check the label, and Nandia berries.
Unsafe Plants (It’s probably best to simply not have these in the house.):
Houseplants: Amaryllis, Bird of Paradise, Burro Tail, Caladium, Crown of Thorns, Dumbcane, Elephant’s Ear, Gardenia, Jerusalem Cherry, Mother In Law’s Tongue, Philodendron, Pothos, and Purple Passion. Garden Plants: Aconite, Bleeding Heart, Bloodroot, Christmas Rose, Crocus - Autumn, Daffodil, Daisy, Delphinium, Dutchman’s Breeches, Eucalyptus, Four O’clock, Foxglove, Gladiola, Heather, Hellebore, Hyacinth, Iris, Jimsonweed, Jonquil, Larkspur, Lily of the Valley, Lobelia, Lupine, Monk’s Hood, Morning glory, Narcissus, Nicotiana, Star of Bethlehem, Sweet Pea, and Wolfsbane. Field Plants: Angel’s Trumpet, Baneberry, Bittersweet, Buttercup, Dogbane, Goldenrod, Nightshade, English Ivy, Poison Ivy, Poison Oak, Poison Sumac, Pokeweed, Queen Anne’s Lace, Snow on the Mountain, Spurge, and Virginia Creeper. Trees: Black Locust, Buckeye, Chinaberry Tree, Elderberry, Dogwood, Jatropha, Oak, and Wild Black Cherry. Ornamentals: Atropa Belladonna, Azalea, Carolina Jessamine, Cotoneaster, Daphne, Golden Chain, Heath Family, Holly, Hydrangea, Jessamine, Juniper, Lantana, Mistletoe, Mountain Laurel, Oleander, Privet, Rhododendron, Wisteria, and Yew. Woods: Baneberry, Death Camas, Jack in the Pulpit, and May Apple. Swamps: Cowbane, False Parsley, Hemlock, and Skunk Cabbage. Miscellaneous: Boxwood, Castor Bean, Java Bean, Jequirity Bean, Potato (green parts), Rosary Pea, and Rhubarb (leaf blades). (Know Your Plants – Connecticut Poison Control Center)
(1) Having said this, you can’t fully trust the instructions, since researchers have found they can be wrong. They have also found that local poison control centers will often be wrong, so the advice is to call the regional and national ones.
(Poison Prevention Tips)(Poison Prevention Brochures)(Poison Prevention Checklist)(Pesticide Poison Prevention Checklist) (HOUSEHOLD GUIDE TO POISON CONTROL) (Household Safety: Preventing Poisoning) (Preventing Poisoning: 10 Things You Need to Know)(Tips to Prevent Poisonings - CDC) (Poisoning in the United States: Fact Sheet) (Holiday Safety Tips) (Preventing Poisoning) (Preventing Poisoning: Safety Tips for You, Your Family, and Friends) (Poison Prevention.org) (Poison Prevention.org) (Home Safety Council Index) (Home Safety Council – Bathroom Poison Safety) (Kitchen Poison Safety- Home Safety Council) (Poison Prevention Tips – Home Safety Council) (Outdoor Poisonings and Chemicals – Home Safety Council) (Pediatric Poisoning by John P. Lamb) (Poisoning in the United States: Fact Sheet - CDC)