A regional poison center's experience with poisoning exposures occurring in schools.

The nature of and response to poisonings in the school setting has not been characterized. To define these problems a retrospective review of calls to a Regional Poison Information Center (RPIC) involving school exposures was done for the 1988-89 academic year. 362 cases were reported; 74% were reported by school nurses, 10% by other school employees, 10% by parents, 5% by health care facilities, and 1% by students themselves. Ingestions accounted for 45% of exposures, dermal 24%, ocular 19%, inhalation 7%, with the remainder being combinations of routes. Correct treatment prior to RPIC consultation occurred in only 40% of the cases. None developed major symptoms, 23% had minor and 10% had moderate symptoms. High school students accounted for the greatest number (20) of suicide gestures, while middle schools reported more cases of substance abuse. School nurses often were unaware of situations until several hours later. 61% of suicide gestures were referred to an HCF; 7 of these developed moderate symptoms. Exposures to chemicals in science or vo-tech classes accounted for 102 cases; 28% were referred to a HCF and 15% had moderate symptoms. There was often a delay in evaluation by the school nurse and initial decontamination was inadequate or absent. Parents were often instructed by school personnel to contact the RPIC for information and then relay it to the school. These delays could have resulted in greater toxicity. School nurses should be targeted for educational programs by poison centers, but teachers and other school employees must also be included since often they are the first at the scene. Students should be instructed to report exposures to a teacher immediately.

Cinnamon oil abuse by adolescents.

Reports in the literature about cinnamon oil toxicity are limited to allergic reactions and local irritant effects from dermatologic exposure. Cinnamon oil is easily obtained from pharmacies in 5-10 ml amounts for use as a flavoring agent and in craft items. Within a 5-mo period the Pittsburgh Poison Center (PPC) documented 32 cases of cinnamon oil abuse; all cases involved males aged 11-16 y and were reported to the PPC by school nurses. Sucking on toothpicks or fingers which had been dipped in cinnamon oil was the primary method of abuse. A rush or sensation of warmth, facial flushing, and oral burning were the experiences reported by the users. Some children complained of nausea or abdominal pain but no systemic effects were reported. Eight patients with dermal exposure had irritation ranging from erythema to welts, which resolved after thorough soap and water decontamination. Two ocular exposures resulted in mild irritation and were successfully treated with irrigation or dilution. The recent popularity of cinnamon oil abuse appears to be related to the ease with which it can be carried, engendering little fear of discovery or chastisement. Despite the relatively low toxicity of cinnamon oil, medical professionals should be aware of its potential for misuse.