UMEM Educational Pearls

Title: What's in that unlabeled container?

Category: Toxicology

Keywords: chemical transfer, unlabeled bottle, poison center (PubMed Search)

Posted: 10/29/2020 by Hong Kim, MD
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Transfer of chemical from their original container to an unlabeled or different container (e.g. Gatorade bottle) is one of the common causes of unintentional poisoning. 

A retrospective study of National Poison Data System from 2007 – 2017 identified 45,512 cases of unintentional exposure/ingestion of chemicals contained in unlabeled/incorrectly labeled containers. 

 

Result

Annual reported cases increased from 3,223 in 2007 to 5,417 in 2017.

  • Median age: 30 years (interquartile range: 6 – 53)
  • Female: 52%

Most commonly involved products included

  • Cleaning products: 38.2%
    • Bleach, 18.8%
    • Peroxides, 5.7%
    • Anionic cleaners, 4.6%
  • Disinfectants: 17.3%
  • Hydrocarbons: 5.0%

These exposures led to 

  • ED visits: 9,369 (20.6%) 
  • Hospitalization: 1,856 (4.1%) 
  • Deaths: 23 (0.1%)

The majority of these exposures were non-toxic in nature (72%) but serious outcomes were noted in 4.4% of the cases, including 23 deaths.

Highest morbidity was associated with:

  • Pesticides: 10.3%
  • Prescription medications: 9.8%
  • Herbicides: 7.6%

Deaths

  • Hydrofluoric acid and herbicides accounted for 13 of 23 deaths (57%), followed by cleaning products (7/23).

 

Conclusion

  • Transfer of a chemical to unlabeled/different container is a well-recognized risk factor of poisoning.
  • Although small in number, the annual reported cases to the regional poison center are increasing.

References

Carpenter JE et al. Poisonings due to storage in a secondary container reported to the National Poison Data System, 2007-2017. Clin Toxicol (Phila) 2020.

 

https://doi.org/10.1080/15563650.2020.1833026