Living amidst poison?

Household poisoning - second leading cause for poisoning in Sri Lanka :

by Carol Aloysius

Darshini (name changed) a young mother was frantic when her toddler son of four years had accidentally swallowed a few gulps of poisonous liquid from her toilet cleaner which she had placed on the floor in the family bathroom.

Advised to take the child to the nearest hospital by the National Poisons Information Center (NPIC) which she had the presence of mind to contact, she waited anxiously as doctors went into immediate action to eliminate the toxic substance he had accidentally ingested.

Thankfully, the child made a full recovery in a short time and Darshini was able to take her son home after being warned to keep all household cleaning agents away from the reach of young children in future

Piyal who had just celebrated his second birthday was less fortunate. Having swallowed most of the contents of wood preservative his carpenter father had carelessly stored in a cupboard easily reachable by his toddler son, the little boy was rushed to hospital in a serious condition after his father had tried to treat him with home remedies. By the time he reached the hospital it was too late and despite doctors battling to save his life, he succumbed to the highly toxic poison.

Nimali a young housewife, tired of using the same washing powder every day, decided to experiment with a new product in the market. What happened next unfolded like a tale of horror for the mother of three who began shedding the skin of her hands making them painfully tender. ‘She’s a classic example of contact dermatitis’, a skin specialist told the Sunday Observer.

Emerging trend

Household poisoning has increased in recent years with more people able to afford cleaning agents, washing machines, and other products that contain harmful chemicals.

From seemingly harmless products such as washing powder and kapuru oil, moth balls, air fresheners, nail polish and skin creams to disinfectant, frequently used for minor injuries, bleaching powder, to cleaning agents, very few realize the hidden dangers they contain. Yet, each of them has at least one toxic ingredient which can maim, and even kill when ingested or inhaled by family members accidentally.

As these toxic chemicals swirl around us and stream into the ground water, they also pollute the environment in which we live, the water we drink, the food we eat.

“Our households will become toxic places to live, in future, unless more awareness is raised about the dangers they pose to householders”, warned National Poisons Information Centre Head Dr Waruna Gunathileka.

Doctors

To compound matters, doctors mostly from the private sector have been reported to be unsure about the exact treatment to be given for a specific case of poisoning brought to their attention.

According to recent data from the NPIC, the majority (99%) of calls on its hotline (5449) for advice on clinical management of poisoning were from private general practitioners. Regretfully, only a negligible number of inquiries had been made from family members of the victims.

To fill that void and taking note that the number of calls had peaked from 8a.m to 12 noon and 12 noon to 6 p.m, the NPIC decided to start a 24 hour on call service from January 2014, so that its team of dedicated professionals could make their services available to any caller at any time of the day or night.

Toxic household products

Are all household products toxic? Or do only certain products fall into this category?

In response to our question, Dr Gunathileka listed a number of common products some of which he said had negligible outcomes since they were low grade toxicity substances, while others had much more serious impacts on human health as well as the environment.

Listing them according to the number of reported cases, he said washing powder headed the list, followed by Volatile oil (Kapuru oil) , automobile fluid, Naphthalene (Moth balls), skin creams, Gum/glue, machine oil, antiseptic, cleaners, thinner, match sticks, paint, wood preservatives, air fresheners, rat poisons, nail polish, mosquito coils and ant killer chalk. “The majority of cases are asymptomatic i.e. do not show any symptoms or very slight symptoms, as in silver gel, and kukul saya, or even ingesting mercury in thermometer bulbs. But in other instances, such as when a housewife attempts to sweep away the broken bits of a say CFL bulb, just inhaling the vapour emanating from it can cause serious harm to her health”, he warned. “While the degree of exposure to such poisons matters, all these products are poisonous when ingested or inhaled in excessive doses”, he warned.

Cleaning products more dangerous

He especially warned against the imminent dangers of exposure to tile and toilet cleaning agents. “They are corrosive and cause tissues to burn. They can lead to gut perforation. Keep them far away from children’s reach”, he reiterated. Rodenticides (Rat poison) and mosquito coils cause internal and external bleeding - of the nose, gut and ears. Mothballs used to keep insects away from our clothes and give them an added scent, must also be stored properly. If a toddler picks up one and swallows it or ingests it, it result in multiple systemic health impacts which affects the whole body system.”

Self harm

The NPIC report also draws attention to attempted self harm by mostly young adults between 20 – 40 years, using freely available items found in any household such as non prescribed drugs and insect sprayers. To cite two examples from the 2015 data, at least two pregnant women attempted to end their pregnancy prematurely resorting to such methods: one by ingesting an overdose of paracetamol and the other in a stranger than fiction incident of actually spraying a popular insect killer into her mouth deliberately!

Attempts at deliberate self harm it appears is once again on the rise driving home the need to attack this fearful trend before it gets out of control. The fact that more females are prone to suicidal thoughts, and an increasing number of elderly women now prefer to end their lives in their twilight years, without living out their full life span gracefully and peacefully, is an indictment on our society as a whole.

Proof

The number of callers to the NPIC in 2014, are proof of this alarming new trend.

To quote their figures: Out of the total cases of poisoning, the highest numbers (53.7%) of poisoning were recorded as deliberate self harm. The data also revealed that most common route of exposure was found to be ingestion (98%), and that females (343) were higher than males (222) in 2014 admitted to hospitals from poisoning. A further breakdown showed that, of the total number of 565 victims of self harm, 62 were students. Most admissions to the NHSL were direct admissions and the majority was middle aged females, the report noted.

Dr Gunathileke was concerned his unit had received very little response from authorities over his concerns of increasing exposure to mosquito coils use and mosquito sprays which particularly affect persons with allergic conditions and asthma. The negative impacts of rat poisoning as experienced among people living in unsanitary environments are another of my concerns. Such people have a Hobson’s choice of being bitten by rats and other rodents or being exposed to the danger of inhaling the vapours of the insect sprays which are as harmful”, he observed.

Launch of website on social media

Reiterating that all poison cases were preventable and their risks could be minimized, Dr Gunathileke said, several interventions had been made towards making Sri Lankan households poison free. To this end, he said, during the National Poisons Information week last year, the NPIC, had launched a new website (Toxbase) which can be accessed on facebook (https:/www.facebook.com/NTPICSL) Twitter, (https:// twitter.com /PoisonCenter SL) and You tube Poison CenterNHSL as well as e-mail – [email protected]. “Now that we are already in cyberspace, we are constantly updating the information which can be downloaded free”, he said, adding, “We are now reaching out to social media to get our messages across since it is a collective responsibility on our part to end this growing danger to our lives.”

Additionally, the NPIC will also publish posters on poisons for distribution to all hospitals and conduct informal discussions on the subject among schools and parents. Four booklets in Sinhala and Tamil will also be printed on the subject which will include information on almost every type of poison known in Sri Lanka, including marine poisoning and snakebite poisoning which is the third leading cause of hospitalization in the country. Children, pregnant women and the agriculture community will be the special focus of attention during the forthcoming week.

For further information contact the National Poisons Information Centre on 0112676193.