Symptoms of Poisonous Household Product Ingestion in Children

Young children are curious creatures, an endearing characteristic that can create a great amount of trouble when combined with toxic household items. Most poisonings in children are the result of inquisitive children and irresponsible adults who leave drugs and household chemicals within reach.

Approximately 88% of ingestions are unintentional. Unintentional ingestions are most common in children age 1 to 5 years old. In older children, toxic ingestions are actually most often due to suicide attempts. The vast majority of unintentional poisonous ingestions in children do occur in the home and, fortunately, cause no toxicity. However, 17% of toxic ingestions by children are associated with at least minor toxicity and 0.01% actually result in the death of the child.

Home chemicals that can cause systemic toxicity in young children include trichloroethane (common in spot remover), toluene (a solvent), and hydrocarbon additives (found in insecticides). Some household chemicals can cause a local toxicity when aspirated. The toxicity is caused by direct damage to tissue that the toxic agent comes in contact with. These agents include mineral oil, furniture polish, turpentine, kerosene, charcoal lighter fluid and toluene.

For many toxic substances, the diagnosis can be established by evaluating the level of consciousness, determining the size of the pupils, and evaluating the child for the presence of muscle fasciculations, cardiac arrhythmias, seizures or hypothermia.

Additionally, some household chemicals are associated with toxic ingestions syndromes. These syndromes are combinations of signs and symptoms that are specifically associated with certain toxic agents. Recognized toxic ingestions syndromes, also called toxidromes, of household chemicals include:

Carbon monoxide- The most common source of carbon monoxide in a household is from car exhaust. Carbon monoxide poisoning in children is associated with headache, dizziness, coma, and skin bullae (large fluid filled welts) among other systemic effects.

Cyanide- A common source of cyanide in homes is poison used to kill ants. Some rat poisons also contain cyanide. Poisoning from cyanide ingestion causes convulsions, hyperpnea (fast breathing rate), a bitter almond odor, and often coma.

Ethylene glycol- Ethylene glycol is antifreeze. The ingestion of antifreeze is associated with metabolic acidosis (low blood pH), hypocalcemia (low blood calcium levels), hyperosmolarity (high concentration of osmols in the blood), and oxalate crystalluria (oxalate crystals in the urine).

Cholinergic agents- Certain pesticides and insecticides contain cholinergic chemicals known as organophosphates. Nicotine is another common cholinergic agent found in the households of smokers. Ingestion of cholinergics often causes miosis (constricted pupils), salivation, urination, diaphoresis, lacrimation (tearing), bronchospasm, muscle weakness and fasciculations, emesis (vomiting), defecation, coma, confusion, pulmonary edema, bradycardia (slow heart rate), reduced levels of the enzyme cholinesterase in erythrocytes (red blood cells) and serum, and a late peripheral neuropathy.

The unintentional ingestion of household chemicals is most often nontoxic. However, the risk of systemic toxicity, local toxicity and even death depends on the chemical that is ingested. If a toxic ingestion is suspected in a child, it is essential to seek medical help. Physicians will use symptoms, signs, lab tests and recognition of toxic ingestion syndromes in order to deliver appropriate care to a poisoned child.

Source: Behrman R. Nelson Essentials of Pediatrics. 4th Ed. W.B Saunders Co. 2002.