The Truth About Holiday Hazards

Are mistletoe and poinsettia something to be worried about this time of year? Poison expert Edward Krenzelok explains how to avoid accidental poisonings this season, and how to keep the holidays toxin-free. Originally broadcast Dec. 26, 2008.

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IRA FLATOW, host:

Time for a SCIENCE FRIDAY flashback.

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FLATOW: Wondering if it's safe to have poinsettias and mistletoe in the house for the holidays? Here is Edward P. Krenzelok, director of the Pittsburgh Poison Center and a professor of pharmacy and pediatrics at the University of Pittsburgh. So, that whole thing about poinsettia being poisonous is a myth?

Dr. KRENZELOK (Director, Pittsburgh Poison Center, Children's Hospital Pittsburgh): It really is. You know, there was a Swiss physician from the Middle Ages by the name of Paracelsus who said, everything is poisonous and what differentiates a poison from a remedy is the dose. And that's sort of it with poinsettia. If you eat enough, you'll become ill, but the typical poinsettia exposures that we encounter, whether they're, you know, being contacted by the sap from a bract or the leaf or ingesting some, really don't amount to anything. I always choose to call them sort of a glass of milk for the child, a tincture of reassurance for the parent.

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FLATOW: And mistletoe and holly and all that stuff, mythology?

Dr. KRENZELOK: Well, you know, mistletoe has been called the kiss of death, but there's a European variety and an American variety. And the American variety has very little toxicity associated with it when it's ingested in small amounts. I think the biggest hazard with mistletoe would be, when you buy mistletoe and there are plastic berries attached to it, if the berries happen to fall on the floor, I think they pose more of a choking hazard for a child. And then holly berries are very attractive and they're red and enticing to a small child, but if you ingest enough of them, yes, you may have some stomach discomfort and so on. But typically kids ingest small amounts and it doesn't present a problem.

FLATOW: So, all that advice to give anybody - kids ipecac and make them throw it all up is bad advice?

Dr. KRENZELOK: Well, it really is. And you know, we abandoned ipecac in -formally in 1997. And so, while it makes you vomit, there's no evidence out there that shows that it changes the outcome of a patient. So, even if someone ingests a large amount of some medication, we never use ipecac anymore because it just doesn't change patient outcome.

FLATOW: So, the remedy is worse than the illness in this case?

Dr. KRENZELOK: Well, I think you hit it right on the nose.

FLATOW: Wow. Is today or this holiday season, is it a particularly busy day at the poison control center?

Dr. KRENZELOK: Well, not any more so than any other time. I think children are attracted to a lot of the nuisances that may be under a Christmas tree, so there may be choking hazards from small parts that are from toys. It may be a situation where there's some perfume or cologne or some hand lotion or something that someone received that a child might accidentally get in their eyes, on their skin, perhaps ingest a little bit. So, I think the type of exposure that we see on days like today after Christmas and through the holiday season are a bit different. But the volume isn't any higher, actually.

FLATOW: Talking with Dr. Edward Krenzelok, director of the Pittsburgh Poison Center. So, is there a more dangerous or something that we could classify as the most dangerous thing about the holidays?

Dr. KRENZELOK: Well, you know, I think it's alcohol. And that would pertain to both adults and children. But children are particularly vulnerable because if - let's say there's party, and mom and dad go to bed, don't clean up the beverage glasses after the party is over, the children are up early in the morning before mom and dad, and they consume some of these diluted alcoholic beverages that are sweet, taste good. It could actually cause alcohol poisoning in a small child. And children are vulnerable, too, because it can lower their blood sugar quite precipitously. So, I think - for me, I think the one with the greatest potential out there to cause harm is alcohol.

FLATOW: Huh. And you know, we never think about that, that...

Dr. KRENZELOK: Or a present as well...

FLATOW: Yeah.

Dr. KRENZELOK: ...during this time of the year.

FLATOW: Especially if you're staying over at relatives houses and you're not used to the place or they're not used to you being there.

Dr. KRENZELOK: That's right. And I - a little bit - a word of advice for people when they're going to grandma or grandpa's house or somewhere else, and it may seem kind of silly. And if you have a 2-year-old, an 18-month-old, a 3-year-old - and they're sort of the poison-prone ones - crawl through the house on your hands and knees. Because then you'll be at the level of the small ones and you can see what they can see, whether it be some medications that are low or some cleaning products that are low or something else that might be hazardous to a child.

FLATOW: What about - you know, kids now have - the toys are there, it's the day of the holiday, after Christmas, and kids are playing with their toys. Can we be relatively sure that the lead paint is gone, the Chinese imported lead or paint that's bad for them is not going to be on those toys?

Dr. KRENZELOK: Well, you know, that's really an unknown. But I think it's - in large part, I think there's a lot of embellishment about that. Yes, if they swallow something, it's hazardous. But, you know, most of the paint that's on toys is in a good state. It's not something that a child is likely to have a problem with unless they're chewing on it. So, if they just happen they have on their hands, playing with it, even hand-to-mouth behavior of products that contain lead that are in good shape where they're already covered over with paint or something, I don't see those as a general hazard.

But if they're ingesting things like that and especially chronically, over time - and maybe even some heirloom ornaments from the Christmas tree that are peeling and have lead paint on, the children are attracted to the little bright specks of paint that might be on the rug and putting them in their mouth, that does pose somewhat of a hazard. But again, I think, to a large extent, it's over-embellished.

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FLATOW: That's all the time we have, thank you for listening.

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