Poisoning Causes and Risk Factors

Causes and Risk Factors for Poisoning

Poisoning can occur when a toxic substance (toxin) is swallowed (ingested) or breathed in through the mouth or nose (inhaled), gets on the skin or in the eyes, or is injected under the skin (e.g., through a bite or sting). In some cases, exposure to a very small amount of toxin can cause poisoning and in other cases, a large amount of toxin is needed. At high enough levels, just about any substance can be poisonous.

Common substances that can cause poisoning in children include the following:

• Automobile fluids (e.g., gasoline, antifreeze, windshield fluid)
• Cosmetics and other personal care products
• Household cleaning products (e.g., drain cleaners, dishwasher detergent)
• Over-the-counter or prescription medications (e.g., analgesics such as acetaminophen, cough and cold medicines, vitamins)
• Foreign objects (e.g., toys, batteries)
• Paints and paint thinners
• Pesticides (e.g., insecticides, weed killers, rodenticides)
• Plants
• Art supplies and office supplies
• Alcohol
• Food products
• Herbal medicines

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Most cases of poisoning in children occur in the home, involve children under the age of 6, and are unintentional (also called accidental poisoning). Boys between the ages of 1 and 3 years are at the highest risk for poisoning.

A child's home environment can increase his or her risk for poisoning. For example, young children who live in older homes that contain lead paint are at increased risk for lead poisoning. Children and adolescents who live in homes that have an older or malfunctioning heating system are at increased risk for carbon monoxide poisoning.

Pediatricians and other health care providers should speak with parents about poisoning prevention during wellness exams beginning when infants are about 6 months of age. Up to 25% of children who have been poisoned by ingesting a toxic substance experience another exposure within 1 year, often because parents or caregivers have not taken sufficient action to prevent the child from having access to poisonous substances. Repeat childhood poisonings require intervention (e.g., social services).

Intentional poisoning, also called self-poisoning may indicate manipulative behavior, chemical or drug abuse, or attempted suicide in older children and adolescents. Certain mental health conditions (e.g., depression, general anxiety disorder) and family dysfunction increase the risk for intentional poisoning. According to the National Institutes of Health (NIH), self-poisoning in adolescents is relatively rare, but it is becoming more prevalent in recent years. Adolescent girls are eight times more likely than adolescent boys to attempt suicide by intentional self-poisoning, which often involves drug overdose.

Munchausen syndrome by proxy is a form of child abuse in which a parent or caregiver (often the child's mother) seeks attention by intentionally causing or by faking symptoms in a child. In some cases, adults with this serious psychological disorder expose the child to small amounts of toxic substances. Munchausen syndrome by proxy, which is not well understood, is one of the most harmful forms of child abuse and is relatively uncommon. When this disorder is suspected, the child is removed from the home environment to reduce the risk for poisoning and other types of harm.

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