Household poisoning exposure among children of Mexican-born mothers: an ethnographic study.
OBJECTIVE: To explore reasons for high rates of unintentional poisoning among Latino children under 5 years old. DESIGN: Ethnographic interviews were carried out using a sample of mothers identified via door-to-door canvassing in an area with documented high injury rates among Latino children. Interviews included many open-ended and follow-up questions to elicit a detailed family history and emphasized observation of conditions and behaviors in the homes. SETTING: Low-income neighborhoods of Southern California. SUBJECTS: Fifty mothers born in Mexico with children under 5 years old. RESULTS: Children were exposed to potential poisoning agents in more than 80% of homes. Contributory factors related to culture included favorable attitudes toward iron as a healthful substance; extensive use of products that lack child-resistant packaging, such as rubbing alcohol and medicines from Mexico; high prevalence of shared housing; limited familiarity with toxic household chemicals not widely used in Mexico; and inability to read warning labels in English. CONCLUSION: Current Poison Control Center outreach efforts should be expanded. Clinicians are uniquely positioned to advise parents about the safe use and storage of toxic substances, including widely used products lacking child-resistant packaging. Medicines should be labeled in Spanish for those who do not know English. (+info
Poison exposure in children before Passover.
BACKGROUND: Extensive cleaning of homes in Israel before Passover may result in increased exposure of children to cleaning substances. OBJECTIVES: To evaluate the potential danger of Passover cleaning to children, and to study the risk factors in order to identify areas for prevention. METHODS: All cases of poison exposure in Jewish and Arab children under the age of 15 years reported to the Israel Poison Information Center during 1990-95 (n = 5,583) were analyzed for the 6 weeks before and 6 weeks after Passover. Poison exposures in Jewish children < 15 years old were studied in seven pediatric emergency rooms for the 2 weeks before and 6 weeks after Passover (n = 123). RESULTS: The IPIC data showed a highly significant 38% increase in the average weekly poison exposure rate for the 2 weeks before Passover compared with the remaining 10 weeks. Data recorded by the pediatric emergency rooms showed a twofold increase in cleaning substance poisoning during the 2 weeks before Passover compared with the following 6 weeks. The rise in exposures to cleaning substances was observed among children from secular, religious and ultra-orthodox families. In these exposures, the substance was found in open containers in 70% of cases. CONCLUSIONS: The extensive cleaning of homes among Jewish families in preparation for Passover poses the danger to young children of cleaning substance poisoning. Increasing public awareness, closer observation of children, and keeping these substances in closed containers should increase children's safety during this annual cleaning. (+info
Acute poisoning in children.
BACKGROUND: Childhood poisoning continues to challenge the diagnostic and treatment skills of the pediatrician. Generally, childhood poisoning can be attributed to suboptimal parental supervision and accessibility of products with poisoning potential. OBJECTIVE: To evaluate the pattern of acute poisoning in children with relation to different age groupings. METHODS: Pediatric patients hospitalized for acute poisoning at the Soroka Medical Center over a 5 year period (1994-98) were evaluated retrospectively. Special attention was given to poisoning in relation to age groupings. RESULTS: During the years 1994-98 a total of 1,143 children were admitted for acute poisoning to the Soroka Medical Center. The majority of cases occurred in children aged 2-5 and 14-18 years. Males under 14 had a higher frequency of poisoning, the poisoning usually being unintentional, whereas poisoning in females occurred mostly in the 14-18 age group and was intentional. Drugs were the most common agent of poisoning in infants (0-1 year), in older children (10-13 years), and in adolescents (14-18 years), while in children aged 2-5 and 6-9 years either cleaning products or drugs were the usual agents of poisoning. Most poisonings in children aged 2-13 occurred between 4 and 8 p.m., and for most adolescent patients (14-18 years old) between 4 p.m. and midnight. Poisoning in children aged 2-13 were usually due to accessible home products, and to medicinal errors such as overdose and improper drug administration. CONCLUSIONS: This study defines the characteristic pattern of pediatric poisoning with respect to different age groups and gender. Unintentional childhood poisoning predominated in males and occurred mostly because of accessible home products and suboptimal parental supervision during critical hours of the day. Most adolescent poisoning occurred in females and was intentional. Parental education and intensified child supervision are indicated measures of prevention for unintentional poisoning. (+info
A fatality due to accidental PineSol ingestion.
The case history and toxicological findings of a fatal PineSol intoxication are presented. An 89-year-old white female with Alzheimer's disease accidentally drank PineSol and was subsequently brought to the hospital where she was pronounced dead on arrival. Significant autopsy findings included acute erosive gastritis. There appeared to be no aspiration of PineSol into the lungs. Isopropanol along with 1-alpha-terpineol are the two major toxic ingredients of PineSol. The toxicological screening and quantitiation of 1-alpha-terpineol in postmortem fluids was performed by gas chromatography-mass spectrometry using a simple one-step extraction. Postmortem blood, urine, and gastric levels of 1-alpha-terpineol were 11.2 mg/L, 5.76 mg/L, and 15.3 g/L, respectively. Postmortem blood, vitreous humor, urine, and gastric acetone concentrations were 25, 31, 33, and 28 mg/dL. Postmortem concentrations of isopropanol were less than 10 mg/dL in the blood, vitreous humor, urine, and gastric contents. The cause of death was ruled acute 1-alpha-terpineol intoxication due to accidental ingestion of PineSol, presumably caused by confusion related to Alzheimer's disease. (+info
Methods to study everyday use of products in households: The Wageningen Mouthing Study as an example.
Several methods exist to study human behaviour in everyday life: e.g. an oral or written interview, measurement of physical variables and observation. All of them have their advantages and disadvantages, which are described in this paper. When a clear picture of actual human behaviour and information about an entire activity are required, for example to assess risks of exposure to chemical substances, it is best to use a combination of available methods. In this way the advantages of all methods can be combined. This was done in the Wageningen mouthing study of which some results are presented. (+info
Household solvent exposures and childhood acute lymphoblastic leukemia.
OBJECTIVES: This study explored the risk of childhood acute lymphoblastic leukemia (ALL) associated with participation by household members in hobbies or other home projects involving organic solvents. METHODS: Participants in this case-control study were 640 subjects with ALL and 640 matched controls. RESULTS: Childhood ALL was associated with frequent (> 4 times/month) exposure to model building (odds ratio [OR] = 1.9; 95% confidence interval [95% CI] = 0.7, 5.8) and artwork using solvents (OR = 4.1; 95% CI = 1.1, 15.1). We also found elevated risk (OR = 1.7; 95% CI = 1.1, 2.7) among children whose mothers lived in homes painted extensively (> 4 rooms) in the year before the children's birth. CONCLUSIONS: In this exploratory study, substantial participation by household members in some common household activities that involve organic solvents was associated with elevated risks of childhood ALL. (+info
Lead poisoning from homemade wine: a case study.
A 66-year-old man suffered the symptoms of severe lead poisoning for 2 years before diagnosis. The man had a blood lead level (PbB) on admission to hospital of 98 microg/dL. A detailed investigation revealed that the poisoning occurred as a result of drinking a homemade red wine, for which analyses showed a lead concentration up to 14 mg/L--70 times the Australian maximum limit for lead in wine. The source of the lead was a highly corroded enamel bathtub in which grape crushings and juice were stored for a week prior to bottling. The corrosion of the enamel surface of the bathtub had resulted in pitted patches up to 1 mm in depth along the side of the bathtub. Powdering of the tub surface was evident below a level where wine had been in contact with the sides of the tub. The homemade wine had a pH of 3.8, which would have greatly contributed to the solubilization of metals from the glaze. We conducted a test in which commercial red wine of similar pH and containing < 0.2 mg/L lead was placed in this tub for 7 days. Subsequent testing revealed a lead level of 310 mg/L. This high lead concentration is consistent with the surface area of enamel on the bathtub being in contact with a small liquid volume as in the case of the leaching test using commercial red wine. This case study highlights the importance of the use of food-grade materials for the preparation and storage of homemade beverages or food. (+info
Cloning of a phenol oxidase gene from Acremonium murorum and its expression in Aspergillus awamori.
Fungal multicopper oxidases have many potential industrial applications, since they perform reactions under mild conditions. We isolated a phenol oxidase from the fungus Acremonium murorum var. murorum that was capable of decolorizing plant chromophores (such as anthocyanins). This enzyme is of interest in laundry-cleaning products because of its broad specificity for chromophores. We expressed an A. murorum cDNA library in Saccharomyces cerevisiae and subsequently identified enzyme-producing yeast colonies based on their ability to decolor a plant chromophore. The cDNA sequence contained an open reading frame of 1,806 bp encoding an enzyme of 602 amino acids. The phenol oxidase was overproduced by Aspergillus awamori as a fusion protein with glucoamylase, cleaved in vivo, and purified from the culture broth by hydrophobic-interaction chromatography. The phenol oxidase is active at alkaline pH (the optimum for syringaldazine is pH 9) and high temperature (optimum, 60 degrees C) and is fully stable for at least 1 h at 60 degrees C under alkaline conditions. These characteristics and the high production level of 0.6 g of phenol oxidase per liter in shake flasks, which is equimolar with the glucoamylase protein levels, make this enzyme suitable for use in processes that occur under alkaline conditions, such as laundry cleaning. (+info