Making Christmas Merry And ... Safe

More On Holiday Hazards

Are mistletoe and poinsettia really holiday hazards? Poison expert Edward Krenzelok explains how to avoid accidental poisonings this season, and keep the holidays toxin-free.

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IRA FLATOW, host:

This is Talk of the Nation, Science Friday. I'm Ira Flatow. A bit later in the program, we're going to run down the top techy jargon words for 2008. So, if you have any suggestions, get them ready and call in, or you can Twitter your tweets to us at @scifri. There you go - Twitter, tweet - some good techy jargon words. They haven't been around for very long - just the kind we're looking for.

But first, the holiday season is a time to gather with family and friends and to celebrate - you eat, you drink, you're merry. But it's also a busy time for calls to the poison control center. You know, we have all heard about the poisonous properties of mistletoe and poinsettias. I have reported on them for many years. Well, wow, it turns out now that the dangers they pose have been overblown. Instead, something much more common and available is a much greater poisoning threat, especially as we approach New Year's Eve.

And here to talk about is Dr. Edward P. Krenzelok. He is director of the Pittsburgh Poison Center at the University of Pittsburgh Medical Center. He is professor of pharmacy and pediatrics at the University of Pittsburgh. Thanks for being with us today, doctor.

Dr. EDWARD P. KRENZELOK (Director, Pittsburgh Poison Center, Children's Hospital Pittsburgh; Professor, Pharmacy and Pediatrics, University of Pittsburgh): Well, thank you for the invitation. It's nice to be here.

FLATOW: So, that whole thing about poinsettia being poisonous is a myth?

Dr. KRENZELOK: 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 to choose to call them sort of a glass of milk for the child, a tincture of reassurance for the parent.

(Soundbite of laughter)

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: Hmmm. 1-800-989-8255, if you have questions about holiday poisoning situations - 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 - especially if 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 and 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: Mm hmm. 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, that 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.

FLATOW: Let's go to Mark in San Jose. Hi, Mark.

MARK (Caller): Hi.

FLATOW: Hi, there. Go ahead.

MARK: This isn't a question about holiday poisonings. I'm a lifeguard instructor and I teach First Aid classes that ideal with certain types of poisonings. And one of the things they talk about is snake bite poisoning. They talk about a lot of the do-nots from the old wives' tales. And there's one do not that I wondered if the caller new anything about, like the history of it, because it says do not use electrical shock, such as from a car battery, which is, like, ridiculous. And I just wondered if you knew, like, why people would have done that in the first place?

Dr. KRENZELOK: Well, they do that to basically denature the poison. It doesn't work. I think people probably are at greater risk of electrical shock than anything else. But yeah, that's - the old cut-and-suck theory, a variety of those things - tourniquets, put it in ice - but none of those things should be used. The person should be transported to an emergency department where a snake anti-venom can be administered, if necessary.

FLATOW: Thanks, Mark. Happy holiday.

MARK: Thank you.

FLATOW: Let's go to Marilyn, Marilyn in Richfield, Washington. Hi, Marilyn.

MARILYN (Caller): Hello.

FLATOW: Hi, there. Go ahead.

MARILYN: Yes, I have two cats and I'm a big cat lover. And I was hoping that your guest could speak about the effect…

(Soundbite of cat meowing)

MARILYN: …one of my cats just meowed in the background - of poinsettias and some of the other plants on cats.

Dr. KRENZELOK: Well, it's a good question. And we have - at our poison center in Pittsburgh, we have about 7,000 calls a year involving animals, especially companion animals and plant ingestions. And again, cats and dogs are very vulnerable because they're at low levels and cats are so agile they can get up on the table and chew on those. Generally, small ingestions of, say, the poinsettia don't present a problem. There's been a lot of research conducted involving animals and poinsettia exposures. And most of it comes out being fairly innocuous. So, in large amounts, yes, it's potentially harmful with maybe some stomach upset and some vomiting and things like that. But in large part, casual exposures don't present any particular problem to cats.

FLATOW: Thanks, Marilyn.

MARLENE: Thank you.

FLATOW: Take care. 1-800-989-8255 is our number. Chris in Chapel Hill. Hi, Chris.

CHRIS (Caller): Hi, there.

FLATOW: Hi, there.

CHRIS: Well, we have two children and in the wintertime we use cool mist humidifiers in their room because they just get so dry and it helps when they have cold. But I'm always deathly afraid that we're like - sometimes they smell and I try to clean them out because I know about molds and bacterias and so forth. But I'm just curious - is it possible that you can, like, aerate mold or fungus into the air and actually cause your kids more harm than good when you're trying to just keep them moist and their nasal passages moist in the winter?

Dr. KRENZELOK: Sure. That's a great question. It's a little bit out of my area of expertise, but the best thing to do is to keep those types of devices just clean. Wash them out frequently with soap and water and the likelihood of there being any fungal types of problems are very, very small, as long as you keep them clean. That's really the key thing. If you let the water sit for weeks and weeks and weeks or days, yes, there is a potential problem. But if you're constantly replenishing the water and keeping the vessel that it's stored in clean, it shouldn't present a problem.

FLATOW: Now, I understand there is one big national number that everybody could call if they don't know their local center. It will get them to their local poison center.

Dr. KRENZELOK: Absolutely. It's 1-800 - and it's real easy to remember - 1-800-222-1222. So, it's three two's, a one, and three more two's. Remember, when you call that number, your call will be routed to the nearest poison center. So, if you're traveling somewhere now over the holidays, call the number, it'll take you to the nearest poison center. You don't have to worry about remembering your local poison center number. Remember that number, it will get you 24-hour assistance by a certified specialist in poison information and clinical toxicologists and help to relieve any anxiety you have and prevent any problems as they may occur.

FLATOW: Do you get a lot of food poisoning questions or calls? And how do you know when you've been food poisoned or other kind of poisoned?

Dr. KRENZELOK: That's a difficult one because sometimes food poisoning mimics carbon monoxide poisoning and vice versa and the flu. So, it's kind of difficult maybe to know. But I would say, if you have several people in your family that ate the same thing that come down with the same symptoms - now, it could be carbon monoxide poisoning, it could be the flu, but if they're very pronounced effects, it's very likely that it would be food poisoning.

And food poisoning is one of our very, very common types of poisoning that we encounter, especially this time of the year. Simple word of advice: Keep cold foods cold - try to keep them 40 degrees or less; keep warm foods warm - 140 degrees or greater - and that will minimize the amount of bacterial growth in those foods and minimize your chance of experiencing food poisoning.

FLATOW: And washing your hands a lot helps?

Dr. KRENZELOK: That's the best thing. And if you're preparing foods, you know, don't use that same cutting board that you just cut the chicken up on to do your fresh salad. Make sure that that's cleaned thoroughly. Don't use wooden cutting boards for things like that because they're porous and bacteria reside in the crevices and so on of the board. Use plastic or glass types of cutting boards and wash them thoroughly between the different products, wash your knives. And you can really minimize food poisoning chances.

FLATOW: All right. Thank you very much, Dr. Krenzelok. And have a happy New Year to you and happy holiday season.

Dr. KRENZELOK: Thank you and all of your listeners. Thank you.

FLATOW: You're welcome. Dr. Edward P. Krenzelok is director of the Pittsburgh Poison Center at the University of Pittsburgh Medical Center, also professor of pharmacy and pediatrics at the University of Pittsburgh. We're going to take a short break and come back. We're going to talk lots more about different kinds of stuff and making New Year's resolutions - how you might be able to stick to them this year. Stay with us. We'll be right back.

(Soundbite of "Talk of the Nation" theme)

FLATOW: I'm Ira Flatow. This is Talk of the Nation, Science Friday from NPR News.

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Don't Burn The Gift Wrap

Though experts advise against it, some people toss holiday wrapping paper into a fireplace. i i

Though experts advise against it, some people toss holiday wrapping paper into a fireplace. iStockphoto.com hide caption

itoggle caption iStockphoto.com
Though experts advise against it, some people toss holiday wrapping paper into a fireplace.

Though experts advise against it, some people toss holiday wrapping paper into a fireplace.

iStockphoto.com
Strips of holiday wrapping paper that were sent for lead testing. i i

Strips of holiday wrapping paper that were sent for lead testing. All of the samples were determined to be lead-free. Kathleen Masterson/NPR hide caption

itoggle caption Kathleen Masterson/NPR
Strips of holiday wrapping paper that were sent for lead testing.

Strips of holiday wrapping paper that were sent for lead testing. All of the samples were determined to be lead-free.

Kathleen Masterson/NPR

Christmas morning in many homes means unwrapping gifts in front of a cozy fireplace. And every year, local fire departments across the country warn people not to toss all that wrapping paper into the flames, for very good reason: It might start a serious chimney fire.

Still, some people do it. And if they do, they might see strange colors in the flames, like blue and green.

"Just think about fireworks," says Sidney Katz, a chemist who is just starting his retirement after a long career at Rutgers University. He explains that when people watch fireworks on the Fourth of July, "the colored pyrotechnics are different chemical compounds at high temperature."

Something similar can happen in a fireplace if people burn colored gift wrap. Some metals found in certain ink pigments will react with heat. Barium-based pigments are used in some red ink, for example, and when burned could produce a green flame.

About three decades ago, Katz made news during the holiday season because he had bought a bunch of gift wrap, tested it in the lab, and found high levels of toxic metal. He says back then, yellow pigment was often lead chromate.

"My concern was what you do with Christmas wrapping papers," says Katz, noting that "if you burn it, you create airborne particulates which are inhaled."

Or, he says, young children might even chew on the stuff.

Over the years, Katz says, U.S. manufacturers have switched to safer, alternative pigments. "If it's made by Hallmark and it's made with American pigments, it's probably OK," he says. But he adds that it would be impossible for a consumer to look at gift wrap made overseas and know what pigments are in it.

Gary Jones is director of environmental, health and safety affairs for a trade group called Printing Industries of America. He says today's printing ink does use safe pigments, but when something is burned, it can change.

"You know, you're not dealing with a pigment at that point — you're looking at what happened as a result of burning a pigment, or burning a metal," Jones says. He says you would not want to breathe that smoke, or really any smoke at all.

Neal Langerman agrees that breathing any kind of smoke is generally a bad idea. He runs a consulting firm called Advanced Chemical Safety in San Diego. Still, he didn't seem too concerned about the whole wrapping-paper-in-the-fireplace scenario.

"I'll bet I've tossed a crumbled up gift-wrap paper ball in a fire on a holiday on occasion," Langerman says, adding that it's nothing to worry about. He says a fireplace ensures that smoke really doesn't come into the room and produce any meaningful exposure. Instead, it goes up the chimney.

But beware: Burning pieces of paper could also float up the chimney and start a fire. So experts say the safest thing to do is throw out that holiday paper, or recycle it.

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