UMEM Educational Pearls

Title: What's in that unlabeled container?

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

Posted: 10/29/2020 by Hong Kim, MD, MPH
Click here to contact Hong Kim, MD, MPH

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