Preventing Childhood Poisoning : Lead Poisoning, Iron Poisoning

by Food and Drug Administration (FDA)

(Page 2 of 4)

Garages and utility rooms should also be checked for potential poison hazards. Antifreeze, windshield washing fluid, and other products should be stored out of children's reach in a locked cabinet. Childproof safety latches can be purchased at your local hardware store.

In the living room or family room, know your plants' names and their poison potential. Although most houseplants are not poisonous, some are. To be on the safe side, keep houseplants out of the reach of young children. Although much has been made of problems with poinsettias (blamed for a death as early as 1919), recent studies indicate it is not as highly toxic as was once believed. Although ingesting it may cause some stomach irritation and burning in the mouth, it's unlikely to be fatal.

"Plants are mostly a problem for children, since it's a natural response for children to taste things. Few adults eat houseplants," Rodgers points out. "Plants have a high capacity for making you sick, but they are usually low-risk for producing life-threatening symptoms." After poison-proofing your home, prepare for emergencies. Post the numbers of your regional poison control center (which can be found on the inside cover of the Yellow Pages or in the white pages of your phone directory) and your doctor by the phone. Keep syrup of ipecac on hand — safely locked away, of course. (See "Antidotes.") Never administer any antidote without first checking with your doctor or poison control center.

Lead Poisoning

Although lead levels in food and drink are the lowest in history, concern remains about lead leaching into food from ceramic ware. Improperly fired or formulated glazes on ceramic ware can allow lead to leach into food or drink.

Long recognized as a toxic substance, adverse health effects can result from exposure to lead over months or years.

After a California family suffered acute lead poisoning in 1969 from drinking orange juice stored in a pitcher bought in Mexico, FDA established "action levels" for lead in ceramic ware used to serve food. Over the years, these original action levels have been revised as research has shown that exposure to even small amounts of lead can be hazardous. The last revision for ceramic foodware was in 1991. On Jan. 12, 1994, FDA published a regulation for decorative ceramic ware not intended for food use, requiring a permanently affixed label on high-lead-leaching products.

"Most lead toxicity comes from multiple exposure and is a slow accumulation over time," says Robert Mueller, a nurse and poison information specialist at the Virginia Poison Center, headquartered at The Medical College of Virginia Hospitals in Richmond. "Refusing to eat, vomiting, convulsions, and malaise can all be symptoms of lead poisoning." Because lead poisoning occurs over time, such symptoms may not show up right away. A blood test is the surest way to determine that your child has not been exposed to significant amounts of lead.

"In general, if a consumer purchases ceramic ware in the U.S. marketplace today, it meets the new action levels," says Julia Hewgley, public affairs specialist with FDA's Center for Food Safety and Applied Nutrition. "But if you travel abroad and buy ceramic ware, be aware that each country has its own safety regulations. Safety can be terribly variable depending on the type of quality control and whether the piece is made by a hobbyist." To guard against poisonings, Hewgley advises that ceramic ware not be used to store foods. Acidic foods — such as orange, tomato and other fruit juices, tomato sauces, vinegar, and wine — stored in improperly glazed containers are potentially the most dangerous. Frequently used products, like cups or pitchers, are also potentially dangerous, especially when used to hold hot, acidic foods.

"Stop using any item if the glaze shows a dusty or chalky gray residue after washing. Limit your use of antique or collectible housewares for food and beverages," she says.

"Buy one of the quick lead tests available at hardware stores and do a screening on inherited pieces."

Iron Poisoning

Iron-containing products remain the biggest problem by far when it comes to childhood poisoning. Between June 1992 and January 1993, five toddlers died after eating iron supplement tablets, according to the national Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report of Feb. 19, 1993. The incidents occurred in a variety of ways: Children ate tablets from uncapped or loosely capped bottles, swallowed tablets found spilled on the floor, and, in one case, a 2-year-old fed an 11-month-old sibling tablets from a box found on the floor.

Iron is always included in prenatal vitamins prescribed for pregnant women, and is often included in multivitamin formulas and children's supplements. Usually available without prescription, iron supplements can be found in grocery stores, drugstores, and health food stores in a wide variety of potencies, ranging from 18 milligrams (mg) to 150 mg per pill. For a small child, as little as 600 mg of iron can be fatal.

Because iron supplements are typically brightly colored, some people are concerned they may look like candy, and, therefore, are particularly attractive to children. In 1993, the Nonprescription Drug Manufacturers Association (NDMA), which manufactures about 95 percent of nonprescription OTC medicines available to Americans today, adopted formulation provisions for iron products containing 30 mg or more of elemental iron per solid dosage form. These provisions also stipulated that such products would not be made with sweet coatings. That same year, NDMA manufacturers also independently agreed to develop new voluntary warning labels for these products. The voluntary labels read: "Warning: Close tightly and keep out of reach of children. Contains iron, which can be harmful or fatal to children in large doses. In case of accidental overdose, seek professional assistance or contact a poison control center immediately."

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.