All substances are poison, all that matters is the dose, said Swiss physician Paracelsus (1493-1541). If you were to look around your home right now, are substances such as disinfectants and other household chemicals, which can be potential dangers, safely stored or out of the reach of children and pets?

Between 2013 and 2018, there were close to 1,000 hospitalisations caused by accidental exposure to poisonous substances across Trinidad and Tobago. The most vulnerable age group were the pediatric population (0 to 9 years old), contributing to approximately 60 percent of these hospitalisations. Adults (30 to 60 years old) made up 20 percent. The main poisonous substances implicated in these accidental exposures were household chemicals/solvents, medicines, and pesticides.

The COVID-19 pandemic has required people to spend much more time at home, especially children and adolescents who have been shifted to online learning since March 2020. In some instances, children may be left with minimal supervision and more time to explore their home surroundings.

An obvious source of poisonous substances in the home are the increased amounts of disinfectants and sanitisers now being used for surfaces and hands. In the first year of the pandemic we saw the use of methanol in hand sanitisers. The US Food and Drug Administration (FDA) has warned against the use of insufficient levels of ethanol or isopropyl alcohol and other ineffective ingredients in hand sanitisers, as well as packaging of these items in food and beverage containers. In T&T, the Ministry of Health has ensured that local manufacturers are compliant with set guidelines, and declared that approval by the Chemistry, Food and Drug Division must be granted before locally manufactured hand sanitisers can be sold.

In the same 2013 to 2018 period, there were over 1200 hospitalisations due to intentional self-harm by poisoning. Medications and various household and agricultural chemicals were used by adolescents (10 to 29 years old) and adults to harm themselves. In the current climate where mental health is also important, it may help if access to such substances is restricted.

A newer source of accidental exposures are online challenges on social media. These are often done under the guise of “getting high” without using illicit drugs, giving rise to things such as Benadryl, nutmeg and pass-out challenges. While these may seem like nonsense to responsible adults, to impressionable adolescents, these video-recorded challenges seem like their shot to fame. The onus is on parents and guardians to monitor the cyberspace that our children and adolescents occupy. So, let us take a good look around the home and see where improvements can be made.

Kitchen and Bathrooms:

• Ensure all types of cleaning chemicals are in locked cabinets or at least out of reach of young children. Shampoos, bubble baths and all the various bathing agents can be irritating to the eyes and harmful if swallowed in large amounts.
• Avoid the mixing of cleaning chemicals. Making a “Molotov cocktail’ of household cleaners will not make for a super cleaning compound. Bleach is highly corrosive and can react with other compounds such as vinegar, ammonium, rubbing alcohol and hydrogen peroxide to create other highly toxic compounds. When mixed or used in an excessive amount, they can cause irritation to mucous membranes and respiratory distress.
• Wear gloves and other personal protective equipment (PPE) such as goggles while using cleaning compounds to save your hands and eyes. The widely available face masks are mostly protective against particulate matter and do not protect against solvent vapors.
• Store all medications in a designated medicine cabinet with a locking mechanism if possible. While over-the-counter medications like painkillers are sold in restricted amounts and vitamins in child safe bottles to avoid overuse, prescription drugs are often sold in resealable plastic bags which are easy to open. Extra precautions need to be taken to safeguard these items.
• Safely dispose of any medicines that have expired or are no longer used.

Garden/Outdoors:

• Face car mufflers away from the house or enclosed spaces. If your car is parked for a long time, mechanics often advise that you start your car periodically while not in frequent use to keep it working optimally. If you have an enclosed garage, you can get a lethal buildup of carbon monoxide gas and other by-products of incomplete combustion in as little as two minutes. If your garage is attached to your house, these toxic gases can spread indoors.
• Use and store chemicals as directed and beware of unintentional exposure. As we pass the time safely at home, hobbies such as car repairs, do-it-yourself furniture restoration, gardening and being outdoors in nature have become essential to our wellbeing. Avoid unsafe storage and improper use of agricultural chemicals such as insecticides, herbicides and other pesticides. Hang appropriate signage on plants that have been recently sprayed and should not be consumed. Always use chemicals with appropriate PPE. Leave chemicals in their original containers and do not store them in food and beverage containers. Agricultural and other chemicals should be stored in designated locked cabinets. This not only limits accidental exposure but prevents impulsive events leading to self-harm.

For more information, visit The UWI St Augustine Poison Information Centre at https://sta.uwi.edu/pic/index.asp.

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Nalini Kalloo is a member of the Administrative, Technical and Support Staff (ATSS), a part-time lecturer in Clinical Toxicology and PhD candidate at UWI St Augustine. She works alongside the UWI Poison Information Centre.