ABSTRACT
Title
Analysis of toxic exposures to cosmetic products through the data base of the Poison Control Centre of the Niguarda Ca’ Granda Hospital
Authors
S. Ruggiero1, P.A. Moro2, F. Davanzo2, L. Sportiello1, A. Capuano1, F. Rossi1 and L. Sautebin3
1 Dept. of Experimental Medicine, Section of Pharmacology “Leonardo Donatelli”, Second University of Naples, Italy
2 Poison Control Centre, Niguarda Ca’ Granda Hospital, Milan, Italy
3 Dept. of Experimental Pharmacology, University of Naples Federico II, Italy
1 Dept. of Experimental Medicine, Section of Pharmacology “Leonardo Donatelli”, Second University of Naples, Italy
2 Poison Control Centre, Niguarda Ca’ Granda Hospital, Milan, Italy
3 Dept. of Experimental Pharmacology, University of Naples Federico II, Italy
Abstract
To the average consumer “cosmetics” are preparation used for beautifying the skin, hair and nails which are considered to not cause damage to human health in normal condition of use. Generally the “risk” associated to cosmetic use is underestimated due to the absence, in the majority of the European countries, of formal cosmetovigilance systems (Sautebin, 2008). We and others (Lindberg et al, 2004; Sportiello et al, 2009) in the last few years have addressed our interest in the knowledge of the frequency, severity and typology of the risk associated to cosmetic use with the limit of the size of the population involved. Poison Control Centres (PCC) provide specialized and rapid information for consumers and health care professionals to ensure management of events related to the exposure to different agents, including cosmetics (Settimi et al, 2010). Since Health professional of the PCC are available 24-hours a day, the number of collected exposures is very high and represents a unique source of information to investigate the frequency and type of exposures to cosmetic and the related risk, all over the Italian territory. To this aim we have analyzed the case data concerning human exposure to cosmetics collected from 2005 to 2010 by the PCC at the Ospedale Niguarda Ca’ Granda.
During this period, 11.634 human exposure cases related to cosmetic were entered into the database which accounted for 4.7%of the total human clinical cases. Almost the totality of the requests for assistance came from consumers (about 52%) and hospitals (41%). The most frequently reported site of exposure was the consumer’s own residence (94%). Exposure mainly involved children younger than 4 years (77%).The gender distribution among the total sample was not significantly different between female and male (49% and 51%, respectively). Interestingly cutaneous exposures accounted for only the 4.2% of the total whereasingestion for about 90% (71% and 92% in the group age of 0-6 and 7-12 months, respectively). Almost the totality of the exposures was unintentional (93%). Intentional inappropriate exposures, mainly related to suicide attempts, accounted for only the 6%and involved persons aged more than 12 years. The majority of the products utilized for unintentional exposures were in liquid state. In fact, personal hygiene products (30%), perfumes (including aftershaves) and hair care products (excluding hair dyes) (both 13%) were the most involved categories followed by skin and nail care products (9% and 7%,respectively).
Symptoms were present only in 27% of the total cases and were mostly referred to gastrointestinal system (40%). Most of the cases were managed at home (45%) whereas hospitalization was requested in 37% of the exposures.
Few cases of toxic events related to “normal” cosmetic use were recorded suggesting either a low incidence or perhaps a different way to manage them being usually of cutaneous type (Lindberg et al, 2004; Sportiello et al, 2009). However, our analysis shows that cosmetics should be considered as a possible cause of pediatric exploratory ingestion although this type of exposure results in no symptoms or symptoms limited to mild gastrointestinal upset. Nevertheless, although the low toxicity of the exposures, either the high request for assistance from hospital (41%) or the indication of hospitalization suggested by PCC (37%) reveal a cost for the National Health System that has to be taken into account. Moreover, since the exposure frequency seems more likely to reflect product availability and accessibility to ingestors, our results suggest to pay attention also to this type of hazard.
Sautebin (2008). Drug Safety 31: 433-436.
Lindberg et al. (2004). Acta Derm Venereol 84: 291–295.
Sportiello et al. (2009). Pharmacol Res 59: 101-106.
Settimi et al (2010). Rapporti ISTISAN 10/39:53.
During this period, 11.634 human exposure cases related to cosmetic were entered into the database which accounted for 4.7%of the total human clinical cases. Almost the totality of the requests for assistance came from consumers (about 52%) and hospitals (41%). The most frequently reported site of exposure was the consumer’s own residence (94%). Exposure mainly involved children younger than 4 years (77%).The gender distribution among the total sample was not significantly different between female and male (49% and 51%, respectively). Interestingly cutaneous exposures accounted for only the 4.2% of the total whereasingestion for about 90% (71% and 92% in the group age of 0-6 and 7-12 months, respectively). Almost the totality of the exposures was unintentional (93%). Intentional inappropriate exposures, mainly related to suicide attempts, accounted for only the 6%and involved persons aged more than 12 years. The majority of the products utilized for unintentional exposures were in liquid state. In fact, personal hygiene products (30%), perfumes (including aftershaves) and hair care products (excluding hair dyes) (both 13%) were the most involved categories followed by skin and nail care products (9% and 7%,respectively).
Symptoms were present only in 27% of the total cases and were mostly referred to gastrointestinal system (40%). Most of the cases were managed at home (45%) whereas hospitalization was requested in 37% of the exposures.
Few cases of toxic events related to “normal” cosmetic use were recorded suggesting either a low incidence or perhaps a different way to manage them being usually of cutaneous type (Lindberg et al, 2004; Sportiello et al, 2009). However, our analysis shows that cosmetics should be considered as a possible cause of pediatric exploratory ingestion although this type of exposure results in no symptoms or symptoms limited to mild gastrointestinal upset. Nevertheless, although the low toxicity of the exposures, either the high request for assistance from hospital (41%) or the indication of hospitalization suggested by PCC (37%) reveal a cost for the National Health System that has to be taken into account. Moreover, since the exposure frequency seems more likely to reflect product availability and accessibility to ingestors, our results suggest to pay attention also to this type of hazard.
Sautebin (2008). Drug Safety 31: 433-436.
Lindberg et al. (2004). Acta Derm Venereol 84: 291–295.
Sportiello et al. (2009). Pharmacol Res 59: 101-106.
Settimi et al (2010). Rapporti ISTISAN 10/39:53.