A Toxic Tour of the Home Mark Ryan, Pharm.D. Director Louisiana Poison Center Assistant Professor Clinical Emergency Medicine LSU Health Sciences Center Shreveport
Where are problem areas of every home? Under the kitchen sink In the laundry room In the bathroom In outside storage areas Everywhere else!
Under the Kitchen Sink Liquid Dish Soaps Detergents Anionic, Nonionic Some products may have cationic detergents Automatic Dishwasher Detergents Enzyme detergents, builders Dilution is the solution to pollution! Vomiting, diarrhea self limited
Under the Kitchen Sink Furniture Polishes Hydrocarbons Asipiration concern Dilute. No emesis Drain cleaners Corrosive Liquefactive necrosis Dilute Irrigate x 30 minutes
Under the Kitchen Sink Roach Bait Boric Acid Nausea and Vomiting Blue Green Color Boiled Lobster syndrome Dilute & observe Oven Cleaners NaOH most common Dilute/Flush and observe
Under the Kitchen Sink Rodenticides Warfarin/Superwarfarin Affect Vitamin K dependent clotting factors No effects typically for 2-3 days after exposure Typical concentration of 0.005% Handful amount of pellets in a child should not cause effects. Observe for bleeding signs Treat with Vitamin K 1 Treatment may be required for weeks
Under the Kitchen Sink Ammonia Odor detectable at 1.3 to 1.75 ppm 5-10% concentration typical Reacts with water to produce NH 4 OH From irritation to burns depending on concentration Dilute/irrigate.. Observe Hypochlorite bleach reacts with ammonia to form chloramine Fresh air
Under the Kitchen Sink Mothballs Napthalene > 1 mothball can cause toxicity Can cause hemolysis G6-PD deficiency a concern Dilute/irrigate & observe Paradichlorobenzene Most common ingredient today Mainly an irritant Dilute/irrigate & observe
In the Laundry Room Laundry detergents Anionic and nonionic detergents typical Self limiting vomiting and diarrhea Dilute & observe New Pod Detergents Much more concentrated Protracted vomiting Respiratory distress
In the Laundry Room Laundry detergents Anionic and nonionic detergents typical Self limiting vomiting and diarrhea Dilute & observe Liquid Bleach 3-10% Sodium Hypochlorite Small ingestions typically cause N,V, irritation Dilute/irrigate & observe Self limiting vomiting New Concentrated Bleach 12-15%
In the Bathroom Toilet Bowl Cleaners Many contain acids Dilute/irrigate Do not neutralize Shower/Tub/Tile Products Detergents Hypochlorites Mixing hypochlorite containing products with acids results in chlorine production Dilute/irrigate
In the Bathroom Nail products Cyanoacrylates (super glue) Dry extremely fast Do not attempt to pry/peel to free Warm water soak Acetonitrile false nail removers Metabolized to cyanohydrin Older product. Newer types have less toxic ingredients Observe for symptoms
In the Bathroom Cold sore products Campho Phenique Camphor Seizure concern 2 tsp could be fatal in a child Rust Removers Contain HF Treat with Dermal, IV, or IA calcium Milk, Tums, CA supplement
In the Bathroom Mouthwash Typically ~25-30% ethanol Observe for signs of intoxication Cologne/Perfume Some > 98% ethanol Toilet Bowl deodorizers Paradichlorobenzene Irritant most common symptom seen Low toxicity Dilute and observe
Outside Automotive Products Antifreeze Ethylene Glycol Bitrex Seek medical care Washer fluids Methanol Summer and Winter formulas Seek medical care
Outside Wire Wheel Cleaners ammonium bifluoride Calcium Brake Fluid ethylene glycol and diethylene glycol Hydrocarbons motor oil, gasoline Dilute and observe Aspiration symptoms usually occur in first few hours
Outside Gopher Bait zinc phosphide release of phosphine gas Rotten egg odor Seek medical care if symptoms occur Herbicides Generally low toxicity to humans Roundup (Glyphosate) Surfactant vehicle causes most symptoms Dilute/wash and observe for irritation, GI
Outside Paint strippers methylene chloride Metabolized to CO HA, N, drowsy, confused Pool Chlorine Ca or Na Hypochlorite Strong irritant Fresh air To HCF if sx persist Beta agonist treatment
Home products as HAZMAT Acetone, HCl, Peroxide Gasoline and styrofoam Cold pack and newspaper Drano, water, aluminum foil Pool chlorine, alcohol Spackling paste, toilet bowl cleaner Rose fungicide, shower tub & tile cleaner
Learn the poison center hotline number Keep the number handy Don t hesitate to call 1-800-222-1222