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Poison Control News Helpful Information & Safety Hints from the New England Regional Control Centers

Fall 2004

The Poison Control News is an informative quarterly newsletter produced in collaboration by the four New England Regional Poison Control Centers. Working together through a grant from the Health Resources and Services Administration, this newsletter focuses on topics such as seasonal poison prevention tips, access to poison centers and understanding the risks and avoidance of envi- ronmental . If you have any questions or concerns, call your poison center using the national toll-free number 1-800-222-1222. You will be connected to your designated poison center: Connecticut Poison Control Center, Massachusetts/Rhode Island Regional Center for Poison Control and Prevention, and Northern New England Poison Center serving Maine, New Hampshire & Vermont.

Spotlight on….. Protect People & Pets while Protecting Your Car

By: Rebecca Miller, RN, Northern New England Poison Center

lthough antifreeze and fluid improves visibility in cold wiper fluid usually contains Awindshield wiper fluid and stormy weather by melting . Both are toxic. As improve driving safety, both ice and cleaning the wind- little as one tablespoon of eth- are poisons. Antifreeze, some- shield. Both can cause serious ylene glycol can cause kidney times labeled effects if swallowed, even in failure or death. Even smaller “antifreeze/coolant,” keeps the small amounts. amounts of methanol, one tea- engine from freezing in the spoon, can cause blindness or winter and overheating in the Antifreeze usually contains death. Be aware that other summer. Windshield wiper ethylene glycol. Windshield products such as brake fluids

1 and de-icing products may also If an antifreeze or windshield • Vision problems contain methanol or ethylene wiper poisoning occurs, DO • “Snowy” vision glycol. NOT “wait and see” if a per- • Blurred or double vision son or pet will have a problem. • Blindness, which may be Fortunately, not all “glycols” You may not notice ill effects permanent are a problem. Propylene gly- for several hours or longer. • Nausea and vomiting col, found in some cosmetics, • Heart rhythm changes inks, room deodorants and Possible effects of • Seizures food preservative, is not very antifreeze/coolant or wind- • Coma toxic. shield wiper fluid poisoning: • Kidney and/or liver failure

SPANISH TRANSLATION Anticongelante y Limpiador Parabrisa

By: Vilma Rodrigues, Rhode Island & Massachusetts Poison Center

roteja su automóvil sin poner en peligro la El liquido de frenos y otros anticongelantes con- Psalud de la gente y sus mascotas. El anticon- tienen metanol y también etilenglicol. gelante y el limpiador de parabrisas mejoran el mantenimiento de su vehículo pero a su ves El glicol no siempre presenta un peligro. El gli- ambos son venenosos. El uso del anticonge- col proplenico es menos toxico y se encuentra lante impide que su automóvil se congele en el en cosméticos, tintas, desodorantes, y en los invierno y también que se sobre caliente en el preservativos de alimentos. verano. Usted lo conoce come el “coolant”. El limpiador de parabrisas ayuda a mantener su Pueden pasar horas antes de sentir los efectos visibilidad durante fuertes lluvias y nevadas. del consumo del limpiador de parabrisas y el Ambos pueden afectar su salud y también las de anticongelante. Uno nunca debe de esperar a su mascotas si son ingeridas. buscar ayuda si sospecha envenenamiento. El etilengicol de glicol es un químico que se encuentra en el anticongelante. El limpiador de El consumo de antiparabrisas y el anticonge- parabrisas también contiene un químico conoci- lante pueden causar: do como el metanol. Ambos pueden intoxicar a la gente y también a los animales. Una cuchara- • Problemas de visión da de etilengicol puede causar un fallo renal o - visión borrosa aun la muerte. Solamente una cucharada del - visión nublada metanol puede causar la muerte o la ceguera en - ceguera (puede ser permanente) los niños.

2 Many children, and adults, • Keep caps tightly closed. accidentally drink antifreeze or • Store products out of sight windshield wiper fluid when it and reach. is stored in drink containers. • Keep products in the original Also, animals sometimes drink containers. antifreeze that spills or leaks • Clean up radiator spills or out of radiators. It has a sweet leaks immediately. taste. For more information, call Prevent antifreeze and wind- your poison center at 1-800- shield wiper fluid poisoning. 222-1222.

• Vómitos y nauseas • Cambios en el ritmo del corazón Fall Clean-up • Infartos By: Amy Hanoian Fontana, MS - CT Poison • Coma Control Center • Fallo renal/ hepático Fall clean-up routines come with cooler weather. New Englanders must close up boats, secure A menudo muchos niños y adultos ingieren el camping equipment and check furnaces. anticongelante y el limpiador de parabrisas • Snakes and : cuando estos líquidos no se encuentran en sus Critters like snakes and spiders may be hiding in envases originales. Los animales lo encuentran dark covered places. Steer clear of a bite. Do not en los charcos causados por derrames y escapes disturb them. Do not place hands or feet in dark en los radiadores en los automóviles. El sabor areas when you cannot see what is there. dulce del anticongelante atrae a los animales y también las mascotas. • Carbon Monoxide: Prevent carbon monoxide (CO) poisoning. Inspect Usted puede evitar el envenenamiento a causa all fuel burning equipment and appliances. A pro- el anticongelante y el limpiador de parabrisas. fessional should clean and check ventilation each year. Install a CO detector in your home, preferably near sleeping areas. It could save lives. • Mantenga las tapas de sus envases fuertemente apretadas • Los productos deben sé guardados fuera del alcancé y de la vista de los niños Back to School! • Mantenga estos productos en sus envases de Remember that your friendly origen school nurse has the poison cen- ter number in case of poisoning • Limpie los derrames y los escapes de líquidos inmediatamente during the school day. School nurses and other health staff can Para obtener mas información sobre este asunto, be a great resource for learning about poisons and poison preven- llame a su centro de envenenamiento al numero tion. Ask around. See what your 1-800-222-1222. school has to offer!

3 Seasonal Poison (Part 1) Prevention Tips By: Avery Adam, MS, MA/RI Regional Center for Poison Control & Prevention

ou may have read the is a danger to humans. Black pain of a bite. Black widow recent news headlines widows may be found in antivenin is seldom nec- Yabout black widow spi- Connecticut, Massachusetts, essary, but may be considered ders. There are primarily two Rhode Island, and the south- in very young children, the spiders in the United States ern parts of Maine, New elderly or pregnant women if that are harmful to humans: Hampshire and Vermont. they do not respond to stan- the brown recluse and the However, true black widow dard therapy. black widow. Occasionally a spider sightings or bites are The brown recluse brown recluse or black widow uncommon in New England. (Loxosceles reclusa) measures will make its way to this part If a black widow spider approximately two-fifths of an of the country. Usually the bites, do not panic! No one in inch in length, with long legs spiders are only “passengers” in the United States has died (3/4"). A dark violin shape boxes, crates or even cars that from a black widow spider bite located behind its three pairs have originated from warmer in over 10 years. Very often, of eyes gives it the name "fid- climates. no serious symptoms develop. dle back" spider. Color may Bites from all spiders can Black widow bites may go range from yellow to pale or result in mild redness and unnoticed or feel like a sharp dusky brown. Most active at pain; treatment consists of pinprick. These spiders may night, this shy, solitary spider washing the and apply- bite more than once and may is called a "recluse" because it ing an ointment. A hold on for a few seconds. hides and is not commonly cool compress may help. The The wound site may show one found out in the open. The victim should seek medical or two small puncture . brown recluse is not native to attention if there are signs of Within 20-40 minutes the any of the New England an infection, an ulcer that patient usually experiences a States. “Brown does not heal, or a bite is dull ache or numbing sensa- bites” in this area of the coun- accompanied by nausea, vom- tion near the bite site. Pain try are usually caused by other iting, fever, rash, or if severe progresses and spreads to the spiders or bugs, or are other pain or cramping spreads from abdomen (stomach cramps), medical, non-bite, problems. the bite to other parts of the back, and extremities. At first, the bite of the body. If muscle cramps develop or brown recluse may go unno- Black widow spiders pain is severe, take the patient ticed, although slight pain has () measure approx- to the nearest hospital. Some been reported. Within the imately one-half inch in victims need to be evaluated first hour, a local length and have a shiny black at a healthcare facility. There burning/stinging sensation body with red, yellow, or is treatment for a black widow develops. The bite area orange markings on the spider bite that can take care becomes red and skin tempera- abdomen. This mark may of the symptoms. Various med- ture increases. Within four assume an hourglass appear- ications are used to treat the hours, the area exhibits a ance. Only the female spider muscle cramps, spasms and "bull's-eye" appearance, form-

4 ing a in some cases. This blister may rupture in 8- 36 hours, creating an ulcer. There is no special treat- RESOURCES ment or used to treat a National Poison Control http://www.epa.gov/epa- bite. If infection develops, Hotline: home/educational.htm are used. If a wound 1-800-222-1222 Environmental Protection becomes deep and infected, Agency The USDA's occasionally is needed. Site has poison informa- Cooperative State Anytime there is a bite or a tion geared towards Research, Education, and wound that is not healing and younger kids and stu- Extension Service getting worse, see a physician dents, coloring activities, http://www.reeusda.gov for evaluation. science fair advice, envi- Part II will include Massachusetts rofacts (check for , , Daddy Longlegs Department of Public air quality, etc in your zip- and jumping spiders. Health, Bureau of code). Environmental Health poisoncontrol.uchc.edu Assessment Connecticut Poison PREVENTION OF http://www.state.ma.us/dph/ Control Center SPIDER BITES: beha/whowe.htm • Keep attics, garages, and http://www.maripoison- U.S. Environmental basements clean. center.com/ Protection Agency - • Wear gloves, shoes, and Regional Center for Region 1, New England socks when gardening, Poison Control and http://www.epa.gov/region1/ cleaning the garage, or Prevention serving cutting/carrying fire- www.poisonprevention.org Massachusetts and Rhode wood. Poison Prevention Week Island • Do not leave soiled Council www.fahc.org shoes outside where spi- Site includes fact sheet, (type ‘poison center’ into ders may crawl in. listing of national events, the search box) • Inspect and shake cloth- and list of educational Northern New England ing before use. Do not materials available. Poison Center (serving hang clothes against www.18002221222.info Maine, New Hampshire walls. American Association of & Vermont) • Seal small openings Poison Control Centers where spiders may enter Website includes infor- house. mation on poisons, • Place bed so it doesn't national poisoning statis- touch the wall. tics, Poison Help jingles • Avoid reaching into in English and Spanish, dark closets, boxes or and links. other places where spi- ders may live without looking first.

5 In the News... Poisoning by Mistaken Identity

By: Karen Simone, PharmD, DABAT, Managing Director Northern New England Poison Center

oisoning is often a case of mistaken identity. The following items may be confused: PMany cases involve poisons that look like Product: Looks Like: food, drink or candy. Hemorrhoid cream and Bleach Water diaper rash ointment are mistaken for tooth- paste. Calls to Poison Centers are from people Chocolate laxatives Chocolate candy who have swallowed , bleach or other cleaners that were poured into drinking glasses Iron tablets or drink containers. Others swallow the wrong or prenatal vitamins Candy medicine or someone else’s medicine. Red lamp oil Cranberry Many household products look like food, juice drink or candy. Because young children cannot Pine cleaners Apple juice read, they are sometimes unable to tell the dif- ference. Children often bite or a swallow poi- Windshield wiper fluid Blue sports sons before realizing their mistake. drink Take a tour around the house. Check for poisons within reach. Pay special attention to Some of these products are dangerous in small poisons that may look like something good to amounts. Many do not have child resistant eat or drink. packaging. Tips to prevent “look alike poisoning”: • Keep products in the original, labeled con- tainer. • Never call medicine “candy.” • Put medicine and household products away after use. • Clean out your medicine cabinet regularly. • Turn the lights on before taking or giving medicine. • Put glasses on (if you need them) before tak- ing or giving medicine. • Keep the poison center telephone number nearby. For more information, call your poison center at 1-800-222-1222.

6 Have a Safe Thanksgiving

The last thing that you want at Thanksgiving dinner is an uninvited guest: food poisoning. In The News….. Food poisoning is generally a mild illness that results from poor food handling. Symptoms id you know that poison centers in the eight may include vomiting, diarrhea, abdominal dis- DNortheastern states (New England, New York comfort, fever, and headache. The culprit is and New Jersey) worked together to write a bacteria or toxins made by bacteria. Proper Poison Data Book for the Northeast handling and cooking of your turkey can pre- Prevention Network? are a public vent food poisoning: health problem in each state and across the • Do defrost a frozen turkey by refrigeration or region. a cold-water bath. Consider a few new facts for the eight * In a cold-water bath, change the water every 30 minutes. Northeastern States: • 3,246 deaths from poisoning each year • Do allow 1 day for every 5 pounds if thawing in the refrigerator. • 34,276 hospitalizations due to poisoning each year * A 20-pound turkey will take 12 hours to thaw in cold water. • 279,446 poison center calls about poisoning each year • Do use a meat thermometer to check if the turkey is done cooking (180°). Not all poisonings involve young children getting • Do put leftovers in the refrigerator as soon into containers of bleach or vitamins. The data as possible after the meal. book shows that teens, adults and seniors are also • Do wash your hands before and after han- victims of poisoning. Older adults have problems dling. with . Teens and adults take nar- • Do keep all utensils, dishes, kitchen equip- cotics and hallucinogens to get high, and attempt ment and work surfaces clean with a diluted suicide. Poisoning affects everyone. Contact bleach solution. your local poison educator for more information. Poison Centers need your support. The Institute of Medicine of the National Academies of Science recently issued a report about the future of poison centers. Write to state and national legislators and let them know that your poison center is a needed and valued service. You can find the report at http://www.nap.edu/books/0309091942/html/.

• Do not defrost a turkey on the counter at room temperature. • Do not refreeze a thawed uncooked turkey. • Do not partially cook the turkey one day and continue roasting the next day. • Do not cook stuffing inside the turkey • Do not leave leftovers on the counter longer than 2 hours.

7 Rebecca Miller Northern New England Poison Control Center Maine Medical Center Portland, ME http://www.mmc.org [email protected] (207) 842-7224 For poison emergencies anywhere in the U.S.A. Vilma Rodriguez call 1 (800) 222-1222 Regional Center for Poison Control and Prevention Serving Massachusetts & Rhode Island The following names are the poison center Children’s Hospital educators serving the New England region. Boston, MA Amy Hanoian-Fontana http://www.maripoisoncenter.com/ Connecticut Poison Control Center [email protected] University of CT Health Center (617) 355-4163 Farmington, CT http://poisoncontrol.uchc.edu Kelly Cota, Editor [email protected] Northern New England Poison Control Center (860) 679-4422 Fletcher Allen Healthcare Burlington, VT http://www.fahc.org [email protected] (802) 847-0888