THE ANTIDOTE News & Notes from The Blue Ridge Poison Center Featured this issue Lead Poisoning Bee Stings News and Notes BRPC Staff: Director Christopher Holstege, MD Nursing Director Beth Mehring, BSN Medical Toxicologists Nathan Charlton, MD Andy Baer, MD Medical Toxicology Fellows Josh King, MD Jennifer Parker-Cote, MD August 2014 www.brpc.virginia.edu Lead Poisoning Lasts a Lifetime October 19 ‐ 25, 2014, is Na onal Lead Poisoning Preven on Week. This brings a great opportunity to focus on the many ways parents can reduce a child's exposure to lead and prevent its serious health effects. W«ã ®Ý ½? Lead is a so , dense metal used to make many products. It may be found in fishing weights, bullets, ceramic dishes, glassware, car ba eries, electronics, and old plumbing, among other things. Years ago, it was added to gasoline and to paint. (Lead was banned from gasoline in 1995 and from paint in 1978.) Lead is toxic, or poisonous, to people if it gets inside the body. HÊó ÊÝ ½ û «®½ÙÄ Ý®»? Lead can damage many organs, especially the nervous system, brain, and kidneys. It can interfere with normal brain development, causing reduced IQ, learning disabili es, behavior problems, and hearing problems. This damage is permanent. At very high levels lead can cause seizures, coma, and even death. continued page 2 Epidemiologist Priyanka Vakkalanka, ScM Certified Poison Specialists Brenda Beech, RN, CSPI Andre Berkin, BSN, CSPI Jennifer Horn, BSN, CSPI Sue Kell, Ph.D, M.Ed, CSPI Teresa Kinzie, RN Christie Lee, RN, CSPI Kathy Mayo, RN, CSPI Scott Wiley, BSN, CSPI Public Health Educator Kristin Wenger, BS, MT Administrative Specialists Heather Collier Teresa Dorrier ‘BEE’ Aware A bee s ng is a painfully memorable experience. Most people suffer only minor problems. However, more people die from bee s ngs in the U.S. each year than from any other animal envenoma on. The Blue Ridge Poison Center at the University of Virginia Health System has already received 32 calls from vic ms of bee s ngs this summer, five of which required emergency medical care. continued page 4 1 POISON TRIVIA Not only does this U.S. state not have any venomous snakes, it does not have ANY snakes, period. What state is it? (answer on pg. 4) continued from front W«ã çÝÝ ½ ÖÊ®ÝÊĮĦ? The biggest source of childhood lead poisoning is paint in homes built before 1978 (before lead paint was banned). As the paint ages, it may chip and peel, or form invisible lead dust. Lead dust can also form when painted surfaces are repeatedly rubbed together, scraped, or sanded, like in a window frame or while a home is being renovated. The dust se les on places where babies and young children crawl and play. They swallow lead when they put dust‐covered surfaces, like their hands and toys, in their mouths. They may also eat chips of peeling paint. AÙ ã«Ù Êã«Ù ÝÊçÙÝ Ê¥ ½? Below is a list of some items that may contain lead. These items could cause lead poisoning if In 2006, a 4 year old Minnesota child died after swallowing this charm swallowed or if bracelet which came as a free gift with a children put them pair of Reeboks® shoes. Upon testing, in their mouths: the charm was found to be 99% lead. Lead Sources Toy or costume jewelry, par cularly if made outside of the U.S. Fishing weights or lures. Bullets, buckshot, and musket balls. Some toys, par cularly if made outside the U.S. Some Mexican candies. Certain folk medicines or remedies, like azarcon, Nzu, pay‐loo‐ah, or ayurvedic medicines. Handcra ed ceramic dishes made outside of the U.S. may contain lead that can get into food or drink. Also, adults can bring invisible lead dust into the home if they have a job or a hobby that exposes 2 them to lead. These include: house pain ng or home renova on; furniture refinishing; stained glass; firearms; recycling or making automobile ba eries. continued page 3 News and Notes Announcing a FREE webinar: BITES AND STINGS: AVOIDING VIRGINIA’S CREEPIEST ANIMALS. Open to anyone! This 45-minute live presentation happens online...all you need is a computer with internet access, and computer speakers or phone for audio. Date: Friday, September 12th, 9:00 am. All participants will receive a free poison prevention kit in the mail. Registration required; space limited. Presented by Kristin Wenger, Education Coordinator, Blue Ridge Poison Center. To register, go to www4.gotomeeting.com/register/814625519. If you have trouble with the link above, contact Kristin at 434-982-4386 or [email protected]. On July 10, Senator Bill Nelson (DFLA) and several co-sponsors introduced the bill The Child Nicotine Poisoning Prevention Act of 2014. The bill urges the U.S. Consumer Products Safety Commission (CPSC) to enact rules requiring safer, child-resistant packaging for any liquid nicotine sold to consumers. The following day, The American Association of Poison Control Centers issued a release commending the proposed bill, noting that “It’s an important initiative to make these products childresistant. The brightly colored bottles, fruit flavors, and the devices themselves [e-cigarettes] are attractive to children and we have no idea what effects some of the ingredients will cause.” For information: www.aapcc.org Lead Poisoning Lasts a Lifetime...continued from page 2 Damp mop floors and surfaces like windowsills o en to remove lead. Frequently wash your child’s hands, toys, and pacifiers. Feed your child a healthy, low fat diet with plenty of calcium and iron. Their bodies will be less likely to absorb lead. At this me, children and pregnant women should avoid candy from Mexico. Avoid using ceramic dishes purchased outside of the U.S. for food and drink. Avoid using folk or ayurvedic medicines. Stay alert to recalls of toys or products that IÝ Ãù «®½ ã ٮݻ? Lead poisoning can affect any child, but children under age 6 living in a home built before 1978, or living in poverty, are at the greatest risk. HÊó Ê I »ÄÊó ®¥ Ãù «®½ ®Ý ½ ÖÊ®ÝÊÄ? Some mes children with lead poisoning have stomach aches or irritability, but most of the me there are no symptoms at all. Your child’s doctor can do a blood test. A blood test is the only way to know for certain if your child is being exposed to lead. Talk to your health care provider. Most insurance companies, Medicaid, and FAMIS cover the cost of lead tests. Children at risk for lead poisoning should be tested even if they do not appear sick. CÄ I ÖÙÊãã Ãù «®½ ¥ÙÊà ½? Lead poisoning is completely preventable! These steps can help keep your child safe from lead: If you live in a home built before 1978, talk to your local health department before star ng any renova on projects. 3 may contain harmful amounts of lead. The U.S. Consumer Product Safety Commission (CPSC) keeps a list on their website: www.cpsc.gov. The list is updated o en. Don’t allow a child younger than 6 to wear or play with toy or costume jewelry, especially if made outside of the U.S. If you have a job or hobby that uses lead, take steps to keep the lead from entering your house, such as showering and changing clothes before coming home. For concerns about someone who may have been exposed to lead, contact your health care provider or the poison center: 1‐800‐222‐1222. For informa on about renova ng an older house safely, how to have your home tested for lead, or other lead poisoning preven on informa on contact Lead‐Safe Virginia: 1‐877‐668‐7987. website: h p://www.vdh.virginia.gov/leadsafe/ Bee Aware continued from page 1 Honeybees (family Apidae) leave their barbed s nger and its a ached venom sac embedded in their vic ms when they s ng. Each honeybee can only s ng one me, a er which it soon dies. If stung by a honeybee, remove the s nger and sac as quickly as possible because it may con nue to pump venom into the body for up to one minute. Scrape it from the body with a fingernail or something s ff like a credit card. Bumblebees, hornets, wasps, and yellow jackets all have smooth s ngers that remain func onally intact. Therefore they can inflict mul ple s ngs rapidly and do not die as a result of s nging a vic m. Some of these bees are par cularly aggressive and will readily a ack in great numbers if they feel their nest is in danger. Most people experience only mild symptoms from a s ng, including pain at the s ng site, redness and swelling, and itching. These mild symptoms can be treated by applying ice and using over‐the‐counter an histamines, pain relievers, and cor costeroid ointments. Always follow the instruc ons found on the drug facts label on any over‐the‐counter products. DANGER: Some people will develop severe allergic reac ons to bee venom. If any of these symptoms are present following a sƟng, seek immediate medical aƩenƟon: Large areas of swelling Difficulty breathing Tightness in the throat or chest Hives Dizziness or fain ng People known to be sensi ve to bee venom should wear medical alert jewelry and carry an emergency epinephrine autoinjector (such as an Epipen®) at all mes when outdoors where bees are ac ve. ‘BEE’ SAFE: AVOID STINGS Bees, wasps, etc. are a racted to sweet tastes and smells. In areas where bees are likely, avoid wearing perfume, cologne, or using heavily scented soaps or hair products. Outdoors: pour canned or bo led beverages into cups, so you can see if a bee falls in before you take a sip. If a bee lands on you, or is flying nearby, do not swing your arms around swa ng at it. This could cause the bee to sense you are a acking. Instead, stay calm and gently wave the bee along or move slowly away. When working outdoors in forested, brushy areas where you may encounter a hive or nest, wear long pants and long sleeves if possible. Experts at the Blue Ridge Poison Center are standing by 24‐hours a day, every single day, if you have any ques ons or concerns about bee s ngs: 1‐800‐222‐ 1222. Poison Trivia Answer: Alaska. (Hawaii has a few rare na ve sea snake species, plus a few introduced species which are probably the result of people releasing former pet snakes into the wild.) Swelling of the mouth or throat This quarterly newsletter is courtesy of the Blue Ridge Poison Center, serving Southwestern and Central Virginia and the Shenandoah Valley. We encourage you to print, post, or forward to others. Please share it entirely; do not cut out portions without permission. Comments? Suggestions for future articles? Want to join our mailing list? Contact Kristin Wenger, Health Educator, Blue Ridge Poison Center, University of Virginia Health System, Box 800-774, Charlottesville, VA 22908. 434-982-4386 or [email protected] Poison Safety Tips & More! Follow us on Twi er @blueridgepoison 4
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