Childhood Poisoning Involving Transdermal Nicotine Patches

Woolf, Alan D.; Burkhart, Keith; Caraccio, Thomas R.; Litovitz, T. A.

doi:10.1542/peds.99.5.e4

Cited by 50 publications

(34 citation statements)

References 18 publications

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“…Used nicotine patches have been ingested and applied dermally by children [98]. Used patches may be more likely than new medications to be accessed by children because they can be forgotten once removed.…”

Section: Namentioning

confidence: 99%

Environmental footprint of pharmaceuticals: The significance of factors beyond direct excretion to sewers

Daughton¹,

Ruhoy²

2009

Enviro Toxic and Chemistry

200

113

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Abstract-The combined excretion of active pharmaceutical ingredients (APIs) via urine and feces is considered the primary route by which APIs from human pharmaceuticals enter the environment. Disposal of unwanted, leftover medications by flushing into sewers has been considered a secondary route-one that does not contribute substantially to overall environmental loadings. The present study presents the first comprehensive examination of secondary routes of API release to the environment and for direct but unintentional human exposure. These include bathing, washing, and laundering, all of which release APIs remaining on the skin from the use of high-content dermal applications or from excretion to the skin via sweating, and disposal of unused and partially used highcontent devices. Also discussed are the health hazards associated with: partially used devices, medication disposal practices of consumers, and interpersonal dermal transfer of API residues. Understanding these secondary routes is important from the perspective of pollution prevention, because actions can be designed more easily for reducing the environmental impact of APIs compared with the route of direct excretion (via urine and feces), for reducing the incidence of unintentional and purposeful poisonings of humans and pets, and for improving the quality and cost-effectiveness of health care. Overall, unintentional exposure to APIs for humans via these routes is possibly more important than exposure to trace residues recycled from the environment in drinking water or foods.

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Section: Namentioning

confidence: 99%

Environmental footprint of pharmaceuticals: The significance of factors beyond direct excretion to sewers

Daughton¹,

Ruhoy²

2009

Enviro Toxic and Chemistry

200

113

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show abstract

“…5,10 In cases of dermal exposure to a nicotine solution such as the one in this case report, contaminated clothing should be removed and affected areas should be washed thoroughly with mild soap and copious amounts of cold water to reduce absorption. Activated charcoal is recommended if patients present shortly after ingestion, owing to the possibility of nicotine-induced seizures, provided the risks do not outweigh the anticipated benefits.…”

Section: Discussionmentioning

confidence: 99%

E-Cigarette Liquid Nicotine Ingestion in a Child: Case Report and Discussion

Gill

Sangha

Poonai

et al. 2015

CJEM

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Nicotine poisoning is well described in the pediatric population, and even small oral doses may result in toxic effects. The source of nicotine is usually tobacco products and nicotine replacement products such as gum and patches. With the more frequent use of novel products such as e-cigarettes, concern has arisen regarding liquid nicotine. As there are no regulations regarding childproof bottling and packaging, there may be increased potential for unintentional ingestion of these colorfully and appealingly packaged products by children. We present and discuss a case of this nature, as we feel emergency physicians should be aware of this new mode of poisoning, and public health efforts should be made to minimize such exposures. RÉSUMÉL'intoxication à la nicotine est bien connue chez les enfants, et même de faibles doses orales peuvent produire des effets toxiques. Les sources habituelles de nicotine sont les produits du tabac et les produits de remplacement de la nicotine comme les gommes à mâcher et les timbres. Toutefois, l'utilisation de plus en plus grande de nouveaux produits tels que la cigarette électronique soulève des craintes en ce qui concerne la nicotine liquide. Comme ces articles ne font l'objet d'aucune réglementation au regard de l'emballage et de la mise en bouteilles à l'épreuve des enfants, il existe un risque accru d'ingestion accidentelle, par les enfants, de cette substance à utiliser dans des produits attrayants et aux couleurs vives. À preuve le cas ici exposé, suivi d'une discussion; les auteurs sont d'avis que les médecins d'urgence devraient être sensibilisés à cette nouvelle forme d'intoxication, et les autorités en matière de santé publique devraient tâcher de réduire ces risques au minimum.

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“…34 Nicotine is highly toxic with a lethal dose of 0.5-1.0 mg per kg body weight in adults and probably as little as 0.1-0.2 mg per kg body weight in children. 35 A refill may contain up to 24 mg of nicotine. Children are clearly more susceptible than adults.…”

Section: It Ignores Nicotine and Its Harmful Effectsmentioning

confidence: 99%

Electronic Cigarettes: Vulnerability of Youth

Schraufnagel

2015

Pediatric Allergy, Immunology, and Pulmonology

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Childhood Poisoning Involving Transdermal Nicotine Patches

Cited by 50 publications

References 18 publications

Environmental footprint of pharmaceuticals: The significance of factors beyond direct excretion to sewers

Environmental footprint of pharmaceuticals: The significance of factors beyond direct excretion to sewers

E-Cigarette Liquid Nicotine Ingestion in a Child: Case Report and Discussion

Electronic Cigarettes: Vulnerability of Youth

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