Poisonings

Overview

A poison exposure is the ingestion of or contact with a substance that can produce toxic effects. A poisoning is a poison exposure that results in bodily harm. (Definitions adapted from personal correspondence with American Association of Poison Control Centers, 2002.)

Poison exposures can occur by accident without intent, and these exposures are defined as unintentional poisonings. In some situations, poison exposures are the result of a conscious, willful decision; these cases are defined as intentional poisonings.

Occurrence

• In 2000, poison control centers reported approximately 2.2 million poison exposures (Litovitz 2001).
• U.S. poison control centers handle an average of one poison exposure every 15 seconds (Litovitz 2001).
• More than 90% of poison exposures occur in the home (Litovitz 2001).
• Of the more than 2 million poison exposures, 52.7% occurred among children younger than age six (Litovitz 2001).
• In 2000, 475,079 poison exposures were treated in a health care facility (Litovitz 2001).
• The most common poison exposures for children were ingestion of household products such as cosmetics and personal care products, cleaning substances, pain relievers, foreign bodies, and plants (Litovitz 2001).
• For adults, the most common poison exposures were pain relievers, sedatives, cleaning substances, antidepressants, and bites/stings (Litovitz 2001).
• Childhood lead poisoning is considered one of the most preventable environmental diseases of young children yet approximately one million children have elevated blood levels (CDC 2001).
• Carbon monoxide (CO) results in more fatal unintentional poisonings in the United States than any other agent, with the highest number occurring during the winter months (CDC 1999).

Consequences

• In 2000, 920 poisoning deaths were reported to poison control centers. (Litovitz 2001); 19,741 poisoning deaths were reported to national vital statistics in 1999 (WISQARS).
• More than 100,000 poisonings resulted in hospitalization (Litovitz 2001).
• Elevated blood lead levels as low as 10ug/dL have been associated with adverse effects on cognitive development, growth, and behavior among children ages 1 to 5 years (CDC 2000).
• Prolonged periods of exposure to CO may cause headaches, dizziness, and sleepiness. Continued exposure brings on nausea, vomiting, and heart palpitations. Exposure to high levels of CO for prolonged periods can result in unconsciousness and death (CDC 1982).

Costs

• Medical spending for poisoning treatment totaled $3 billion in 1992. Spending averaged $925 (1992 dollars) per case (Miller and Lestina 1997).
• For every dollar spent on poison control services in 1992, an estimated $7 was saved in medical care payments by reducing the number of medically treated poisonings. The savings per poisoning call were $175 (Miller and Lestina 1997).

Groups at Risk

• Children, especially those under age 6, are more likely to have unintentional poisonings than older children and adults (Litovitz 2001).
• Adolescents are also at risk for poisonings, both intentional and unintentional. About half of all poisonings among teens are classified as suicide attempts (Litovitz 2001).
• Children ages 1 to 5 were more likely to have elevated blood lead levels if they are poor, of non-Hispanic African American race, or live in older housing. Children ages 1 to 5 enrolled in Medicaid have a prevalence of elevated blood lead levels three times greater than children not enrolled in Medicaid (CDC 2000).

Risk Factors

• The risk for lead exposure in children is determined primarily by environmental exposure in the child's home. The most common source for lead exposure for children is lead-based paint that has deteriorated into paint chips and lead dust (CDC 1997).
• Lead-based paint is more likely to be present in older houses (CDC 2000). In the United States, approximately 83% of privately owned housing units and 86% of public housing units built before 1980 contain some lead-based paint (CDC 1997).
• Carbon monoxide exposure occurs more often during the cold months of the year and in the northern and midwestern states (CDC 1992).

References

Centers for Disease Control and Prevention (CDC) Web Site, National Center for Environmental Health (NCEH) Fact Sheet "What Every Parent Should Know About Lead" Available at: http://www.cdc.gov/nceh/lead/faq/cdc97a.htm Accessed 3/22/02.

Centers for Disease Control and Prevention (CDC), Notice to Reader: National Lead Poisoning Prevention Week - October 21-27, 2001. MMWR 50(42); 927-8, 2001.

Centers for Disease Control and Prevention (CDC), Recommendations for Blood Lead Screening of Young Children Enrolled in Medicaid: Targeting a Group at High Risk. MMWR 49 (RR14);1-13, 2000.

Centers for Disease Control and Prevention (CDC), Carbon Monoxide Poisoning Deaths Associated with Camping - Georgia, March 1999. MMWR 48(32); 705-706, 1999.

Centers for Disease Control and Prevention (CDC), Update: Blood Lead Levels - United States, 1991-1994. MMWR 46(07); 141-146, 1997.

Centers for Disease Control and Prevention (CDC), Unintentional Carbon Monoxide Poisonings in Residential Settings -Connecticut, November 1993- March 1994. MMWR 44(41); 765-7, 1995.

Centers for Disease Control and Prevention (CDC), Unintentional Deaths from Carbon Monoxide Poisoning - Michigan, 1987-1989. MMWR 41(47); 881-883, 889, 1992.

Centers for Disease Control and Prevention (CDC), Perspectives in Disease Prevention and Health Promotion National Poison Prevention Week: 25 ^th Anniversary Observance. MMWR 35(10): 149-152, 1986.

Centers for Disease Control and Prevention (CDC), Perspectives in Disease Prevention and Health Promotion Carbon Monoxide Intoxication - A Preventable Environmental Health Hazard. MMWR 31(39); 529-31, 1982.

Consumer Product Safety Commission (CPSC) Web Site, Carbon Monoxide Questions and Answers - Document 466. Available at: http://www.cpsc.gov/cpscpub/pubs/466.htm Accessed 3/22/02.

Litovitz TL, Klein-Schwartz W, White S, Cobaugh D, Youniss J, Omslaer J, Drab A, andBenson B. 2000 Annual Report of the American Association of Poison Control Centers Toxic Exposures Surveillance System. American Journal of Emergency Medicine, 19(5): 337 - 396; 2001.

Courtesy of Centers for Disease Control and Prevention. National Center for Injury Prevention and Control.