Nicotine poisoning

Nicotine poisoning
Nicotine
SpecialtyToxicology, emergency medicine

Nicotine poisoning describes the symptoms of the toxic effects of nicotine following ingestion, inhalation, or skin contact. Nicotine poisoning can potentially be deadly, though serious or fatal overdoses are rare.[1] Historically, most cases of nicotine poisoning have been the result of use of nicotine as an insecticide.[2][3] More recent cases of poisoning typically appear to be in the form of Green Tobacco Sickness, or due to unintended ingestion of tobacco or tobacco products or consumption of nicotine-containing plants.[4][5][6]

Standard textbooks, databases, and safety sheets consistently state that the lethal dose of nicotine for adults is 60 mg or less (30–60 mg), but there is overwhelming data indicating that more than 500 mg of oral nicotine is required to kill an adult.[7]

Children may become ill following ingestion of one cigarette;[8] ingestion of more than this may cause a child to become severely ill.[5][9] The nicotine in the e-liquid of an electronic cigarette can be hazardous to infants and children, through accidental ingestion or skin contact.[10] In some cases children have become poisoned by topical medicinal creams which contain nicotine.[11]

People who harvest or cultivate tobacco may experience Green Tobacco Sickness (GTS), a type of nicotine poisoning caused by skin contact with wet tobacco leaves. This occurs most commonly in young, inexperienced tobacco harvesters who do not consume tobacco.[4][12]

  1. ^ Cite error: The named reference Lavoie was invoked but never defined (see the help page).
  2. ^ McNally WD (1920). "A report of five cases of poisoning by nicotine". Journal of Laboratory and Clinical Medicine. 5: 213–217.
  3. ^ McNally WD (1923). "A report of seven cases of nicotine poisoning". Journal of Laboratory and Clinical Medicine. 8: 83–85.
  4. ^ a b Schep LJ, Slaughter RJ, Beasley DM (September 2009). "Nicotinic plant poisoning". Clinical Toxicology. 47 (8): 771–781. doi:10.1080/15563650903252186. PMID 19778187. S2CID 28312730.
  5. ^ a b Smolinske SC, Spoerke DG, Spiller SK, Wruk KM, Kulig K, Rumack BH (January 1988). "Cigarette and nicotine chewing gum toxicity in children". Human Toxicology. 7 (1): 27–31. doi:10.1177/096032718800700105. PMID 3346035. S2CID 27707333.
  6. ^ Furer V, Hersch M, Silvetzki N, Breuer GS, Zevin S (March 2011). "Nicotiana glauca (tree tobacco) intoxication--two cases in one family". Journal of Medical Toxicology. 7 (1): 47–51. doi:10.1007/s13181-010-0102-x. PMC 3614112. PMID 20652661.
  7. ^ Cite error: The named reference MayerNewLethalDose2013 was invoked but never defined (see the help page).
  8. ^ Martin T, Morgan S, Edwards WC (August 1986). "Evaluation of normal brain sodium levels in cattle". Veterinary and Human Toxicology. 28 (4): 308–309. PMID 3750811.
  9. ^ Malizia E, Andreucci G, Alfani F, Smeriglio M, Nicholai P (April 1983). "Acute intoxication with nicotine alkaloids and cannabinoids in children from ingestion of cigarettes". Human Toxicology. 2 (2): 315–316. doi:10.1177/096032718300200222. PMID 6862475. S2CID 29806143.
  10. ^ Brown CJ, Cheng JM (May 2014). "Electronic cigarettes: product characterisation and design considerations". Tobacco Control. 23 (Supplement 2): ii4–i10. doi:10.1136/tobaccocontrol-2013-051476. PMC 3995271. PMID 24732162.
  11. ^ Davies P, Levy S, Pahari A, Martinez D (December 2001). "Acute nicotine poisoning associated with a traditional remedy for eczema". Archives of Disease in Childhood. 85 (6): 500–502. doi:10.1136/adc.85.6.500. PMC 1718993. PMID 11719343.
  12. ^ Gehlbach SH, Williams WA, Perry LD, Woodall JS (September 1974). "Green-tobacco sickness. An illness of tobacco harvesters". JAMA. 229 (14): 1880–1883. doi:10.1001/jama.1974.03230520022024. PMID 4479133.