It's not hard to understand how children are accidentally exposed to toxic substances. It often happens when they imitate their parents' use of a cleaning product, when they think an aspirin is an M&M, or when they're simply curious about what lipstick tastes like. But adults can also suffer from an unintentional poisoning. Like children, adults are often poisoned by the misuse of household and chemical products and medication.
The recommendations for the immediate treatment of ingested poisons for both adults and children are currently in flux. Although professional organizations such as the American Academy of Pediatrics (AAP) have long recommended keeping 1 oz bottle of ipecac in the home to use to induce vomiting, if advised to do so by a physical or poison control center, the AAP now recommends that people throw out any ipecac they may have in the medicine cabinet because it does not appear to be beneficial. The AAP also believes it is currently premature to recommend activated charcoal as a poison treatment.
Below, Roseanne Soloway, associate director of the American Association of Poison Control Centers, discusses some of the most common reasons for toxic exposures among adults, and how such poisonings can be avoided or treated.
What are the reasons poisonings occur in adults?
There are any number of reasons why a poison exposure might occur. They include taking medicines incorrectly or inappropriately. Someone might take the wrong dose or the wrong medicine. They might take a deliberate overdose or not follow product labels.
Unintentional poison exposures account for nearly 85 percent of all of the cases for adults and children.
What are the different ways in which people can be exposed to poison?
People can experience a poison exposure at home or on the job. There are a number of ways that people can be exposed to a poison depending on what exactly it is and what form it takes. A poison is a substance that can cause physical harm if it's introduced into your body, or in the case of contact substances, if you have physical contact with the substance. It can be swallowing or inhaling a poison, spilling or splashing poison on the skin or in the eyes, as well as injecting something through the skin. We tend to think of that in terms of injectable drugs, but that can also include snakebites, spider bites and scorpion stings.
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What are some of the substances most often involved in adult exposures?
For people over the age of 19, the substances most frequently involved include pain relievers, sedatives, hypnotics, antipsychotic drugs, antidepressants and cleaning substances. Also, bites and envenomations such as those you can get from a snake or spider bite.
What kind of cleaning substances are commonly involved?
Because the majority of poison exposures happen in a residence, it makes sense that they are caused by the most commonly used products. So if you're talking frequency, things like bleach, glass cleaners, dishwashing detergents and laundry detergents rank near the top.
But quite frankly we're not so concerned with frequency. What we're really concerned about is danger. So the cleaning substances that we're most concerned about are those that can cause immediate chemical burns. That includes things like drain openers, toilet bowl cleaners, rust removers and oven cleaners.
What substances are most likely to cause deaths?
Most fatalities among adults are due to intentional poisonings. The substances involved in or associated with the largest number of fatalities include pain relievers, sedatives, hypnotics and antipsychotic drugs, antidepressants, stimulants, street drugs and cardiovascular drugs.
What nutritional supplements have been found to cause adverse reactions?
Ephedra certainly has come to the fore because the effects can be dramatic, acute and unpredictable. They also have affected people who were otherwise young and healthy.
Why are older adults at higher risk for poisoning?
As we get older, we tend to need to take more medicines. The more medicines that we take the easier it is to inadvertently make a mistake with one of them. And also the more medicines you take, the greater the chance that there might be side effects or drug interactions.
Also, as we get older, it might be harder to read the labels or keep all of our medicines straight. That's why it's so important to put on your glasses if you need to, turn on the lights if you need to and, for someone who might need to take a number of medicines, to develop a system to be sure that you're taking only the correct medicines at the correct time. Everyone needs to figure out a system that will work best for him or her.
What steps can adults take to prevent toxic exposure from medications?
There are a few very commonsense steps that adults can take to prevent toxic exposures to medicines. First of all, read the correct use or dose instructions on the label. If you're preparing to take a medicine, read the label. Be sure that you're using it correctly and that you're taking the correct dose at the correct time.
If you are experiencing an unexpected effect, even after taking the correct medicine in the correct dose or using a product in a correct manner, then you certainly can call the Poison Control Center to ask your question or to get assistance immediately.
Do you have advice about using household products to avoid exposure?
Again, following the label instructions for correct use is really important. Select the correct product for the job, so you won't need to use any more of it than you otherwise might. Follow label instructions for correct use. For example, if the area is supposed to be ventilated, be sure that you do so. If you're supposed to wear goggles or gloves, be sure that you do so. If this is a product that should not be mixed together with some other product, be sure to follow that instruction as well.
What are some of the immediate steps one should take if they think they or someone else has been exposed?
If someone is unconscious, not breathing or having seizures, call 911 or your local emergency ambulance number immediately.
If someone has splashed something in their eyes, rinse it with running water for 15 to 20 minutes and call the Poison Control Center. The same instructions apply if something has been spilled or splashed on the skin.
If someone has inhaled a fume, get to fresh air and call the Poison Control Center. If someone has swallowed a cleaning product or chemical, you can drink a small amount of milk or water and then call the Poison Control Center right away. And if someone has taken a drug, call the Poison Control Center immediately.
What kind of information should you be prepared to give the Poison Control Center?
You need to say exactly what happened and include things such as the name of the drug or the product; how much is missing; how long ago it happened; and of course, whether or not the person is having any symptoms at that time.
If there is other information needed based on the answers to those questions, then the Poison Control Center will ask whatever clarifying information it needs to determine whether or not something dangerous may have happened and what exactly needs to be done.
What are common mistakes people make when it comes to poisoning?
One of the most dangerous things that people can do is wait to see if anything might happen instead of calling the Poison Control Center right away. If you call immediately, we can probably be sure that nothing dangerous will happen. However, if you wait until someone is having symptoms, then whatever that substance is has already been absorbed and it will be much more difficult to treat.
The telephone number for the Poison Control Center is 1-800-222-1222. You can call that number from any place in the country to be automatically connected to the closest poison center.
