- NEW YORK (Reuters
Health) - One of the most important steps in childproofing a home is keeping
dangerous household chemicals, such as cleaning agents, out of the reach
of children. A report published recently in the journal Chest points out
that these chemicals are also dangerous to elderly people with dementia,
who may drink them by mistake.
- The report, from Drs. James A. Walker and Gary P. Zaloga
of Washington Hospital Center in Washington, DC, includes details of a
case of an 88-year-old woman with Alzheimer's disease who drank 10 ounces
of a pine oil-based cleaning solution.
- Over 10,000 such cases, in which people drank pine oil-based
cleaning products, are reported each year in the US, making these products
second only to gasoline as the most common type of substance involved in
accidental toxic poisoning, the authors note. The researchers also point
out that since many incidents go unreported, the actual number of such
cases is probably much higher.
- ``We've done a great job on preventing unintentional
childhood poisoning... we think it's one of the great success stories of
public health. But the issue of older people unintentionally swallowing
substances is much more complicated,'' said US Product Safety Commission
spokesman Ken Giles, when asked to comment about the problem.
- The Alzheimer's patient in the report was being cared
for at home by her grandson. Mentally disoriented but physically functional,
she had been left alone in her bathroom for approximately 5 minutes --
during which time she swallowed the cleaning solution. She was quickly
brought to an emergency department, put on a mechanical ventilator and
treated for poisoning, but subsequently died of pneumonia and multiple
- In an interview with Reuters Health, Giles said that
such accidents in the general population --and particularly in children
under the age of 5 -- have greatly diminished in the US since the passage
of the Poison Prevention Packaging Act in 1970. However, he emphasized
that in the 28 years since the first child-resistant packaging was designed
for aspirin in 1972, the focus has been on the protection of children,
not the elderly, which involves a different set of concerns and strategies.
- ``Children under 5 put things in their mouth because
that's their approach to learning about their world,'' he said. ``But with
older people you begin to have a lot of other factors... not reading the
label, not turning the light on at night, mixing substances together, so
that you get a bad synergistic effect -- lots of issues that are not there
- However, the investigators point out that both the demented
elderly and children have in common the ability to move about their environment
while doing so with limited cognitive faculties, leaving both groups vulnerable
to the dangers of toxic ingestion.
- Walker and Zaloga also note that less than 0.1% of reported
cases of toxin ingestion have fatal outcomes. Elderly patients account
for about 17% of these fatal cases, and the risk of dying from ingesting
a toxin rises with age. Because of physical changes associated with aging,
the elderly are likely to be exposed to toxins for longer periods after
ingestion than children.
- The researchers advise medical practitioners to become
familiar with the treatment of pine oil intoxication. Quick response to
signs of ingestion -- which include the aroma of pine on the breath of
the patient, blurred vision, headache, sore throat, vomiting, and abdominal
pain and respiratory failure -- is important to prevent serious and potentially
fatal complications. SOURCE: Chest 1999;116:1822-1826.