A Toxic Tour Around the House
Protect Your Kids From Poisons
Poisoning is an important cause of injury and death in children. Most poisoning deaths are the result of children getting into drugs, whether they be prescription medications, over-the-counter, or illicit drugs. The drug class most involved in fatal poisonings is opioids. Opioids include drugs like morphine, oxycodone, fentanyl, hydrocodone, and methadone.
It’s crucial to keep medications stored where children cannot access them. And be alert when visiting the homes of friends and family. Many children get into pills or illicit substances when visiting someone else’s home.
This post is not about medications though. There are so many toxic substances in the home, many of which are not recognized as potential threats to children. This is an overview of some of the household product exposures that can land children in the hospital. It’s not an exhaustive list - more of a ‘highlights’ of unexpected culprits.
The Garage
The garage tends to be overlooked when child-proofing a home. Chemicals may not be placed out of reach. Even worse, an extremely dangerous practice that is incredibly common is pouring deadly chemicals into unlabeled plastic water or sports drink bottles. This has led to deaths of both children and adults.
Antifreeze – there are a few toxic alcohols that may be present in these products but the most dangerous is ethylene glycol. Even small ingestions can cause a build-up of acids in the blood, coma, and kidney damage.
Pesticides – these range from rat poisons and insecticides to herbicides and more. The specific toxicity depends on the product. Some may not cause much harm if ingested, but others are extremely dangerous. For example, just a few years ago a 2-year-old child in Florida died after taking some sips from a plastic water bottle that contained the herbicide diquat. (Someone had poured the herbicide from the original container into the water bottle)
Diquat and a similar herbicide, paraquat, cause burns and when absorbed they damage all the of the body’s organs. There is no antidote to poisoning by these agents and small ingestions can even land adults in the intensive care unit. Recently I evaluated a toddler who had come across a diquat containing product and was found with the liquid spilled on his clothes. Luckily he had not ingested the liquid, because there is very little to be done to help someone who accidentally drinks these herbicides. We can know the child ingested it, provide the best treatments we have right away, and they may still die. Best to make sure a child can never access this type of product.
Rust removers – these, as well as some wheel cleaners, may contain hydrofluoric acid. This acid not only causes skin burns, but when absorbed in the body it can also quickly lead to fatal heart arrhythmias. This is another example of a product that has been transferred from its original container to a plastic water bottle, leading to the death of a three year old who drank from the bottle.
The garage can contain an endless amount of chemicals. We sometimes see exposures to chemicals that were banned decades ago because they have been stored in the garage for that long. It’s important to consider the garage another room that requires careful child proofing.
The Laundry Room
Laundry detergents – Liquids and granules have a high pH and can cause burns if ingested. Especially dangerous are the single use laundry detergent pods. Since they first became available there have been improvements to the packaging to improve safety, but exposures continue. Burns to the eye or skin can happen if a child breaks open the pod and is exposed to the concentrated liquid. If a child eats a pod, very severe life-threatening illness can develop, including coma, breathing problems, and in some cases death. Burns to the esophagus or stomach can also occur.
Ammonia and bleach (household strength) – it is very unusual for children to ingest these chemicals because they are so irritating, but single gulps do happen sometimes. In these cases, mild burns might occur. Industrial strength bleach, on the other hand, can cause serious life-threatening injury. I once cared for a child who had mixed a powdered fruit punch using industrial strength bleach – again, it had been poured into an unmarked jug that she thought was water. Mixing ammonia and bleach can produce a toxic gas that can cause severe breathing problems.
Drain and toilet bowl cleaners - These are very strong acid or alkaline products and even a small ingestion can lead to devastating injury with lifelong ramifications.
The Bathroom
Ethanol – lots of products in the bathroom may contain ethanol, the same type of alcohol in beer or wine. Not surprisingly, this can lead to intoxication in a small child and in severe cases, coma. Ethanol may be present in mouthwashes, perfumes, hand sanitizers, hairsprays and other products. The concentration can easily exceed 25% (much higher than most wine or beer). As unlikely as it seems that a child would drink something as pungent as hairspray, it can happen. I once admitted a four-year-old who had to be placed on a breathing machine after drinking hairspray and having a very high level of ethanol in her blood. Some kids will drink anything.
Acetone – Rubbing alcohol contains isopropanol, which is metabolized in the body to acetone. Acetone may also be found in some nail polish removers. Drinking either of these products can result in vomiting and intoxication with decreased consciousness.
The Bedroom
Button (disc) batteries – these are the small round batteries used in watches, remote controls, hearing aids and many other items. If a child eats one of these batteries it is a true, life-threatening emergency and they need to go to the hospital immediately. These batteries damage tissue through an electrical current and a chemical burn. This can lead to destruction of tissues near the battery. The most recent annual poison center report in the U.S. included four deaths of toddlers from button batteries. Keep close track of these batteries in your home.
Carbon monoxide – this toxic gas is often the product of an improperly working stove or furnace in the home, although anything that burns fuel may produce carbon monoxide (for example, simply smoking cigarettes leads to higher concentrations of carbon monoxide levels in the blood than what is found in non-smokers). It’s important to have working carbon monoxide monitors since the symptoms of poisoning may mimic routine viral illnesses, with headache, nausea, vomiting, and feeling tired. Children may develop serious poisoning more quickly than adults. Poisoning can also occur outside the home. Children have been poisoned while swimming in poorly ventilated areas near boat engines or generators, or when parents bring camp stoves inside tents.
Vick’s VapoRub – along the lines of ‘some kids will eat anything’, ingestions of Vick’s VapoRub are not all that uncommon. Situations when this occurs typically involve the child having a cold and the parent applied some Vick’s and then left the container at the bedside. Vick’s Vaporub contains camphor, which in higher doses can cause vomiting, decreased consciousness, and seizures.
The Kitchen
Baking soda – this is sodium bicarbonate. Ingesting a lot of baking soda can dangerously raise sodium concentrations and pH of the blood. Deaths are usually in adults who are misusing it in an attempt to alter their urine before a drug test, or are using it as a home remedy for acid reflux. Infant deaths have occurred when a caregiver gave it to the child as a home remedy.
Dishwasher detergents – like laundry detergent, the dishwasher granules or liquid, and especially the concentrated pods, can cause burns if ingested.
Salt – The risks of salt (sodium chloride) are similar to those of baking soda (sodium bicarbonate). If ingested in large amounts, blood sodium concentration can rise quickly, which can lead to death. As little as one tablespoon of table salt can be lethal to a small child. Deaths have occurred when infant formulas have been prepared incorrectly or when caregivers have given salt to children as a home remedy to treat constipation.
The ‘Party’ Room
Marijuana edibles – children access marijuana products these days in every room of the house, but it seems that entertaining guests brings a greater variety of edible products into the mix and a lower level of supervision of children. I cannot count the number of young children I’ve admitted to the hospital, some on a breathing machine, since marijuana became legal in my state. About 5000 marijuana edibles exposures were reported to poison centers in 2023 in children under 5 years old.
Lamp oils – these and other fuels (kerosene, petroleum, paraffin) may be used in oil lamps, lanterns or torches in the home. They may be colored or scented. These are hydrocarbons which are easily aspirated into the lungs when ingested. Children may have coughing and vomiting, and in some cases develop serious lung injury. Prolonged contact with the skin can also result in burns.
Liquid nicotine – used in e-cigarettes or vaping devices, liquid nicotine is very concentrated and a small ingestion in a child can lead to serious poisoning or death.
One important point I hope I conveyed:
Never transfer chemicals from the original container into an unlabeled plastic drink container.
This practice is responsible for injury and death in people of all ages.
As my mother likes to say, DANGER LURKS EVERYWHERE. Most of the items I listed can be found anywhere in the home. And just because I’ve not included something on this list doesn’t mean it’s safe. Don’t ever hesitate to call your regional poison center 1-800-222-1222 if your child gets into anything unusual.