Poisoning

In what ways can poisoning occur?
Why children are at risk of accidental poisoning
How childhood poisoning can be prevented
What is a poison?
Signs of poisoning in children
First aid treatment
Where to find more information

In what ways can poisoning occur?

Poisoning occurs when a substance that can produce TOXIC effect enters the body in any of the following ways...

1. Through the mouth by swallowing (ingestion)

Poisons can enter the digestive tract through ingestion (drinking or eating). Most poisoning occurs this way. Small children often swallow poisons accidentally. When we think of childhood poisoning we think of a child ingesting a toxic substance, such as chemicals, cleaning products, pesticides or solvents; however more commonly childhood poisoning occurs when a child ingests vitamins and medicines.

2. Through the lungs by breathing (inhalation)

Poisonous gases, vapors, dust, fumes, smoke, fine spray droplets particles can enter the respiratory tract through inhalation. Pesticides, fuel oil and gasoline (petrol) give off hazardous vapors. Oil or gas heaters, cookers and fires give off poisonous fumes which can reach a toxic level if the room does not have a good supply of fresh air. Carbon monoxide from car exhaust is a common cause of gas poisoning, because it is odorless and tasteless it gives no warning of its presence.

3. Through the skin (absorption)

Some chemicals, pesticides and herbicides can be highly toxic and harmful when they come in contact with the skin. Some poisonous substances will burn or scald the skin before entering the body; other poisons can be absorbed through unbroken skin.

4. By injection through the skin

Poisons can be injected though the skin by a syringe or needle, or by a bite or sting. Poisonous animals, spiders, snakes and sea creatures can contain deadly venom which is toxic to humans. Poisons that enter the blood vessels act very quickly, whereas poisons under the skin or into muscles acts more slowly.

Separate from the toxic effects of these poisons; many people experience an allergic reaction to bites and stings. For most an allergic reaction is confined to localized swelling and itching; for some, anaphylactic shock, a very serious condition may develop. Stings to the throat or neck may cause swelling and obstruction to airways. Multiple bites or stings can have a dangerous cumulative effect of more severe reaction.

Why children are at risk of accidental poisoning

Children aged between 1 and 2 years are most at risk of accidental poising but the risk remains high for all children under the age of 6 years. More boys are poisoned than girls.

Very young children are in an oral stage of development and explore with their mouths.
Children love to mimic what parents do.
Young children lack life experience to know the difference between what is good for them or bad.
Young children are inquisitive and may provoke animals and insects increasing the risk of a bite or sting.

How childhood poisoning can be prevented

Poison-proofing your home is the key to preventing childhood poisonings.

1. Medicines

Poisoning from an accidental dose of iron-supplements is the leading cause of poisoning pediatric deaths in children under 6 years in USA.

Always check with your doctor or pharmacist before giving any medicines to your child.
Try to buy products with child resistant packaging. But remember child resistant packaging is NOT child proof packaging. Some children are very inquisitive and can figure it out in time.
Always keep medicines in their original containers.
Store medicines, poisons and household cleaning products in a high locked or child resistant cupboard. Never store medicines on the countertop or bedside table.
Clean out the medicine cabinet periodically and safely dispose of unneeded and outdated medicines.
Do not store medicines in the refrigerator unless advised to do so by your pharmacist. Store refrigerated medicines in a lockable container such as a key lock computer disc container.
Be aware of medicines visitors may bring into your house. Make sure visitors do not leave medicines easily accessible to children e.g. in an unattended purse or bag.
Don't call medicines "candy".
Avoid taking medicines in front of your child. Children often copy their parents.
Always turn on the light before giving your child medicine. Read directions carefully.
Do NOT give your child medicines prescribed for other people.
Alcohol drinks can be very dangerous to children if swallowed. Ensure alcohol drinks are kept well out children's reach.
Vaporizer fluids, chest rubs and essential oils can make a child sick if swallowed, keep out of children's reach. Store in a locked cupboard.

2. Household products

Your house is a source of a large assortment of chemicals which are safe when used in the way they are intended but TOXIC when swallowed. The kitchen and bathroom are the most likely unsafe areas.

Ensure crayons, pencils, play materials are non-toxic.
Always store products in their original containers. NEVER transfer left over products to cups or soft drink bottles.
Keep cleaning and household products in a locked cupboard.
Keep the dishwasher door closed. Fill detergent container only when you are ready to use it. Remove left over detergent before your child can access it.
Do not use toilet rim blocks.
Do not leave paint brushes to soak in mineral turpentine.
Make-up and perfumes can be harmful if swallowed. Keep well out of reach.
Keep ashtrays and cigarette packets out of sight and reach of children. Do not leave cigarette butts on the ground. (If swallowed 2 cigarette butts can be toxic to a small child.) Matches may also cause illness if swallowed.

3. Plants & Garden

Your garden, garage or back shed often contain plants or chemicals that are potentially poisonous to children.

Know your plants; identify poisonous plants. Some indoor plants can also cause poisoning.
Never mix household chemicals together. A poisonous gas may be created.
Avoid bringing industrial strength chemicals into the home.
Store pool chemicals in a locked cupboard.
Read labels carefully.
Do not burn fuels or charcoal, or use gasoline powered engines in a poorly confined space.
Turn the fan on and open windows when using chemicals.
Avoid using rat bait pellets or snail pellets.
Keep cockroach baits well out of reach.
Liquid or powdered ant killer made with honey or other sweetener can be harmful if ingested.

What is a poison?

A poison is any substance that can cause harm if it gets into the body.

Just about any chemical can cause harm if enough gets into the body. Some chemicals can be harmful in only tiny amounts; whereas others are only harmful if a large amount is taken. Even chemicals that can be helpful in small amounts, such as vitamins and medications, can become harmful if too much is taken i.e. overdose.

Our environment contains varying amounts of many different heavy metals. An accumulation of heavy metals in our bodies can cause harmful effects. The heavy metals most often implicated in human poisoning are lead, mercury, arsenic and cadmium. Some heavy metals such as zinc, iron, copper, chlomium and manganese are required in the body in small amounts but become toxic in larger quantities.

Some plants, animals, insects, snakes and marine creatures produce poisons that are toxic to humans. Some contain poisonous substances that are harmful only if they are eaten; others produce venom which they inject into the skin by a bite or sting.

Even food and water can potentially be source of poisoning. When food is not handled, stored or prepared correctly it can become contaminated by dangerous bacteria that produce toxins. Drinking water can become contaminated with chemicals, heavy metals, and/or organisms such as viruses, bacteria or protozoa.

Poisoning can be acute or chronic. ACUTE poisoning is when the effects occur soon after exposure; often only a single exposure is involved. CHRONIC poisoning is when a poisoning occurs following repeated exposure of small amounts of a toxic substance (e.g. lead poisoning).

The outcome from exposure to a poisonous substance can range from MILD symptoms (e.g. nausea, headache) to SEVERE (e.g. breathing difficulties, organ failure, death). The consequences are DOSE related, meaning it depends on how TOXIC the substance is and how much of the poison has entered the body.

The effects may be confined to a LOCAL area (i.e. one area in or on the body) or may be SYSTEMIC (i.e. wide spread, affecting other body systems). Whether a poison produces a local or systemic effect depends on the exact action of the poison; as different poisons will affect the body in different ways.

Signs of poisoning in children

Most poisons, with the exception of heavy metals (e.g. lead), work fairly quickly. You would become alert to the POSSIBILITY of poisoning if your otherwise well child UNEXPECTEDLY develops unusual symptoms. Symptoms can VARY but may include...

Unexplained nausea, vomiting or diarrhea.
Chest or abdominal pain.
Headache.
Blurred vision; your child can't follow you with his eyes.
Dizziness.
Confusion.
Numbness, tingling or chills.
A burn or rash on lips, mouth or skin.
Bluish lips.
Unusual drooling.
Unusual breath odor.
Coughing or difficulty breathing.
Sudden change in behavior (i.e. unexplained sleepiness, irritability or jumpiness).
Weakness, stupor or loss of bladder control.
Muscle twitching, seizures, convulsions or unconsciousness (only in extreme cases).

You may suspect a possible poisoning if you find an opened or spilled bottle of pills or if your see suspicious stains on your child's mouth or clothing.

First aid treatment

ALWAYS have emergency numbers handy. Hopefully you will never need to use them. These numbers would include...

emergency number (relevant for your country)
ambulance
your doctor
local hospital
poisons information line

1. Swallowed poison

Do NOT try to make your child vomit unless told to do so by a professional. Some poisons can burn the inside linings of the stomach, throat and mouth and will do more damage if your try to induce vomiting. Pick up the container and take it to the telephone. Call the poisons information line.

2. Poison on the skin

Remove contaminated clothing, taking care to avoid further contact with the chemical. Flood the skin with lukewarm running water. Wash gently with soap and water and rinse well. Call the poisons information line.

3. Poison in the eye

Holding the eyelid open; flood the eye with water from a cup, jug or slowly running tap. Continue for 10 to 15 minutes. Call the poisons information line.

4. Inhaled poison

Get the person to fresh air quickly without placing yourself at risk. Open the doors and windows if safe to do so. Call the poisons information line.

5. Stings and bites

Remove the sting if present; wash the affected area with soap and warm water; pat dry. Call the poisons information line.

IMPORTANT: If your child has collapsed or has difficulty breathing call the emergency telephone number IMMEDIATELY.

Where to find more information

Check the front page of your local telephone directory for emergency telephone numbers relevant for your country and your area.

International Program on Chemical Safety
Provide contact details of poisons centers world wide.
http://www.intox.org/firstpage.htm

Medical Toxicology Unit - UK
Provides a vast archive of newsletters containing information of different medications, products, plants, chemicals etc.
http://www.medtox.org/info/PDQ.asp

Active First Aid Online
An online manual to help first aiders in an emergency situation.
http://www.parasolemt.com.au/Manual/index.html

Canadian Poisonous Plants Information System
http://www.cbif.gc.ca/pls/pp/poison?p_x=px

Queensland Poisons Information Centre - Australia
http://www.health.qld.gov.au/PoisonsInformationCentre/homepage.htm

MedlinePlus
Provide medication and drug related information.
http://www.nlm.nih.gov/medlineplus/druginformation.html

American Association Poisons Control Centers
www.aapcc.org

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