The symptoms and effects of poisoning in humans can mimic those of other medical conditions and vary depending on the type of poison and the system of the body affected. Common symptoms include alterations in consciousness, abnormal body temperature, irregular heart rate, and changes in respiration. The severity and specific presentation of symptoms often depend on the nature and dose of the poison involved.
Certain poisons, particularly caustic or irritating substances, can cause direct injury to mucous membranes in the mouth, throat, gastrointestinal tract, and lungs. These injuries may result in symptoms such as pain, coughing, vomiting, and shortness of breath.
The termpoisoning refers to the harmful physiological effects that result from the exposure to a toxic substance, typically through ingestion, inhalation, injection, or skin absorption. It is derived from the wordpoison and is commonly used in medical, biochemical, and toxicological contexts to describe adverse interactions between a substance and a living organism.
Poisoning is sometimes used as a method ofself-harm andof suicide, particularly in cases of intentionalself-poisoning among individuals experiencingsuicidal ideation. According toTime Magazine, self-poisoning is one of the leading methods of suicide attempts amongadolescents, and has been identified as the third-leading cause of suicide-related deaths in this age group. A study published in theJournal of Pediatrics found that suicide attempts by poisoning among individuals under the age of 19 doubled between 2000 and 2018, increasing from nearly 40,000 cases to almost 80,000.
During theCOVID-19 lockdowns, reports indicated a 37% increase in cases of deliberate self-poisoning among adolescent girls. Inbiology, a poison is achemical substance causingdeath, injury or harm toorganisms or their parts. Inmedicine, poisons are a kind oftoxin that are delivered passively, not actively. In industry the term may be negative, something to be removed to make a thing safe, or positive, an agent to limit unwantedpests. Inecological terms, poisons introduced into the environment can later cause unwanted effects elsewhere, or in other parts of thefood chain.
The wordpoison was first recorded in English around the year 1200, meaning "a deadly potion or substance". It derives from theOld Frenchpoison orpuison (12th century; Modern French:poison), originally meaning "a drink", particularly a medicinal one. By the 14th century, the term had come to signify "a (magic) potion" or "poisonous drink". These uses trace back to theLatin wordpotionem (nominative:potio), meaning "a drinking" or "a drink", and more specifically "a poisonous drink", as seen in the writings ofCicero. The Latin root comes from the verbpotare, meaning "to drink".
The use of "poison" as an adjective in the form "poisonous" dates back to the 1520s. The practice of using "poison" in combination with plant names began in the 18th century. For example, the termpoison oak was first recorded in 1743, andpoison ivy appeared in usage by 1784. The expressionpoison gas was first used duringWorld War I in 1915.[1]
The term is also used in afigurative sense—for example: "His brother's presence poisoned the atmosphere at the party." In contrast, legal definitions of "poison" tend to be narrower. Some substances that are not legally required to carry a "poison" label may still cause medical conditions associated with poisoning.
Some poisons are also classified astoxins, which are toxic substances produced by living organisms. Examples include bacterialproteins responsible for conditions such astetanus andbotulism. While a distinction exists between "poison" and "toxin", the terms are often used interchangeably, even in scientific contexts. Related adjectives includetoxic andpoisonous, which are generally considered synonymous.
Poisonous substances introduced into the body bysting orbite are known asvenoms. In everyday usage, apoisonous organism is one that causes harm when ingested or touched, while avenomous organism uses venom actively to incapacitate prey or deter predators. Although rare, some organisms may be both poisonous and venomous.
All living organisms produce substances to defend themselves from being eaten. However, the term "poison" typically refers to substances that are toxic to humans. Substances that are toxic primarily to pathogens and not to humans are generally classified asantibiotics. For instance,Penicillium chrysogenum produces compounds toxic to bacteria, but not to humans, making them effective asantibacterial drugs. Similarly, humanantimicrobial peptides, which are toxic to viruses, fungi, bacteria, and cancerous cells; are considered part of theinnate immune system.
Innuclear physics, the termnuclear poison refers to a substance that absorbs neutrons and interferes with a nuclear reaction.
Substances classified asenvironmentally hazardous are not always poisonous, and vice versa. For example, wastewater from food processing, such as potato juice or milk; can be environmentally damaging by depleting oxygen in aquatic ecosystems (leading toeutrophication), but it poses no direct toxic threat to humans and is not considered a poison.
From a biological standpoint, virtually any substance can be toxic in sufficient quantity. Even something as essential aswater can be fatal when consumed in excessive amounts; a condition known aswater intoxication. Many drugs used inmedicine, such asfentanyl, have a median lethal dose (LD50) only slightly higher than their effective dose (ED50), highlighting the thin margin between therapeutic benefit and toxicity. Some classification systems differentiate between lethal substances with therapeutic value and those without.
Medicinal fields (particularlyveterinary medicine) andzoology often distinguish poisons fromtoxins andvenoms. Both poisons and venoms are toxins, which aretoxicants produced by organisms in nature.[3][4] The difference between venom and poison is the delivery method of the toxin.[3] Venoms are toxins that are actively delivered by being injected via a bite or sting through avenom apparatus, such asfangs or astinger, in a process calledenvenomation,[5] whereas poisons are toxins that are passively delivered by being swallowed, inhaled, or absorbed through the skin.Unantidoteable refers to toxins that cannot be neutralized by modern medical technology, regardless of their type.[3]
Industry,agriculture, and other sectors employ many poisonous substances, usually for reasons other than theirtoxicity to humans. Examples include medicines (e.g.anthelmintics used on chickens[6][7]),solvents (e.g. rubbing alcohol, turpentine),cleaners (e.g. bleach, ammonia),coatings (e.g.arsenic wallpaper), andfeedstocks. The toxicity itself sometimes has economic value, when it serves agricultural purposes such asweed control andpest control.
Pesticides are one group of substances whose prime purpose is their toxicity to various insects and other animals deemed to be pests (e.g.,rats andcockroaches). Natural pesticides have been used for this purpose for thousands of years (e.g. concentratedtable salt is toxic to manyslugs andsnails).Bioaccumulation of chemically-prepared agriculturalinsecticides is a matter of concern for the many species, especiallybirds, whichconsume insects as a primary food source. Selective toxicity, controlled application, and controlledbiodegradation are major challenges inherbicide and pesticide development and inchemical engineering generally, as all lifeforms on earth share an underlyingbiochemistry; organisms exceptional in their environmental resilience are classified asextremophiles, these for the most part exhibiting radically different susceptibilities.
A poison which enters thefood chain—whether of industrial, agricultural, ornatural origin—might not be immediately toxic to the first organism thatingests the toxin, but can become further concentrated inpredatory organisms further up the food chain, particularlycarnivores andomnivores, especially concerningfat soluble poisons which tend to become stored in biological tissue rather than excreted inurine or other water-basedeffluents.
Apart from food, many poisons readily enter the body through theskin andlungs.Hydrofluoric acid is a notorious contact poison, in addition to itscorrosive damage. Naturally occurringsour gas is a fast-acting atmospheric poison, which can be released byvolcanic activity ordrilling rigs. Plant-based contact irritants, such as that possessed bypoison ivy, are often classed asallergens rather than poisons; the effect of an allergen being not a poison as such, but to turn the body'snatural defenses against itself. Poison can also enter the body through faultymedical implants, or byinjection (which is the basis oflethal injection in the context ofcapital punishment).
In 2013, 3.3 million cases of unintentional human poisonings occurred.[8] This resulted in 98,000 deaths worldwide, down from 120,000 deaths in 1990.[9] In modern society, cases ofsuspicious death elicit the attention of theCoroner's office andforensic investigators.
Of increasing concern since the isolation of naturalradium byMarie andPierre Curie in 1898—and the subsequent advent ofnuclear physics and nuclear technologies—areradiological poisons. These are associated withionizing radiation, a mode of toxicity quite distinct from chemically active poisons. Inmammals, chemical poisons are often passed from mother to offspring through theplacenta during gestation, or throughbreast milk duringnursing. In contrast, radiological damage can be passed from mother or father to offspring through geneticmutation, which—if not fatal inmiscarriage orchildhood, or a direct cause ofinfertility—can then be passed along again to a subsequent generation. Atmosphericradon is a natural radiological poison of increasing impact since humans moved fromhunter-gatherer lifestyles andcave dwelling to increasingly enclosed structures able tocontain radon in dangerous concentrations. The 2006poisoning of Alexander Litvinenko was a notable use of radiological assassination, presumably meant to evade the normal investigation of chemical poisons.
Poisons widely dispersed into the environment are known aspollution. These are often ofhuman origin, but pollution can also include unwanted biological processes such as toxicred tide, or acute changes to the natural chemical environment attributed toinvasive species, which are toxic or detrimental to the prior ecology (especially if the prior ecology was associated with human economic value or an established industry such asshellfish harvesting).
The scientific disciplines ofecology andenvironmental resource management study the environmental life cycle of toxic compounds and their complex, diffuse, and highly interrelated effects.
Cassava leaves containcyanide and can thus cause poisoning if not prepared correctly.
Poisoning can be either acute or chronic, and caused by a variety of natural or synthetic substances. Substances that destroy tissue but do not absorb, such aslye, are classified ascorrosives rather than poisons.
Acute poisoning is exposure to a poison on one occasion or during a short period of time. Symptoms develop in close relation to the exposure. Absorption of a poison is necessary for systemic poisoning. Furthermore, many common household medications are not labeled with skull and crossbones, although they can cause severe illness or even death. Poisoning can be caused by excessive consumption of generally safe substances, as in the case ofwater intoxication.
Agents that act on thenervous system can paralyze in seconds or less, and include both biologically derivedneurotoxins and so-callednerve gases, which may be synthesized forwarfare or industry.
Most biocides, includingpesticides, are created to act as acute poisons to target organisms, although acute or less observable chronic poisoning can also occur in non-target organisms (secondary poisoning), including thehumans who apply the biocides and otherbeneficial organisms. For example, the herbicide2,4-D imitates the action of a plant hormone, which makes its lethal toxicity specific to plants. Indeed, 2,4-D is not a poison, but classified as "harmful" (EU).
Many substances regarded as poisons are toxic only indirectly, bytoxication. An example is "wood alcohol" ormethanol, which is not poisonous itself, but is chemically converted to toxicformaldehyde andformic acid in theliver. Manydrug molecules are made toxic in the liver, and the genetic variability of certain liverenzymes makes the toxicity of many compounds differ between individuals.
Exposure to radioactive substances can produceradiation poisoning, an unrelated phenomenon.
Two common cases of acute natural poisoning aretheobromine poisoning ofdogs andcats, andmushroom poisoning in humans. Dogs and cats are not natural herbivores, but a chemical defense developed byTheobroma cacao can be incidentally fatal nevertheless. Many omnivores, including humans, readily consume ediblefungi, and thus many fungi have evolved to becomedecisively inedible, in this case as a direct defense.
Chronic poisoning is long-term repeated or continuous exposure to a poison where symptoms do not occur immediately or after each exposure. The person gradually becomes ill, or becomes ill after a long latent period. Chronic poisoning most commonly occurs following exposure to poisons thatbioaccumulate, or arebiomagnified, such asmercury,gadolinium, andlead.
Injected poisons (e.g., from the sting of animals) can be treated by binding the affected body part with apressure bandage and placing the affected body part in hot water (with a temperature of 50 °C). The pressure bandage prevents the poison being pumped throughout the body, and the hot water breaks it down. This treatment, however, only works with poisons composed of protein-molecules.[10]
In the majority of poisonings the mainstay of management is providing supportive care for the patient, i.e., treating the symptoms rather than the poison.
Activated charcoal is the treatment of choice to prevent poison absorption. It is usually administered when the patient is in the emergency room or by a trained emergency healthcare provider such as a Paramedic or EMT. However, charcoal is ineffective againstmetals such assodium,potassium, andlithium, andalcohols andglycols; it is also not recommended for ingestion of corrosive chemicals such asacids andalkalis.[11]
Cathartics were postulated to decrease absorption by increasing the expulsion of the poison from thegastrointestinal tract. There are two types of cathartics used in poisoned patients; saline cathartics (sodium sulfate,magnesium citrate,magnesium sulfate) and saccharide cathartics (sorbitol). They do not appear to improve patient outcome and are no longer recommended.[12]
Emesis (i.e. induced byipecac) is no longer recommended in poisoning situations, because vomiting is ineffective at removing poisons.[13]
Gastric lavage, commonly known as a stomach pump, is the insertion of a tube into the stomach, followed by administration of water or saline down the tube. The liquid is then removed along with the contents of the stomach. Lavage has been used for many years as a common treatment for poisoned patients. However, a recent review of the procedure in poisonings suggests no benefit.[14] It is still sometimes used if it can be performed within 1 hour of ingestion and the exposure is potentially life-threatening.
Nasogastric aspiration involves the placement of a tube via the nose down into the stomach, the stomach contents are then removed by suction. This procedure is mainly used for liquid ingestions where activated charcoal is ineffective, e.g.ethylene glycol poisoning.
Whole bowel irrigation cleanses the bowel. This is achieved by giving the patient large amounts of apolyethylene glycol solution. The osmotically balanced polyethylene glycol solution is not absorbed into the body, having the effect of flushing out the entiregastrointestinal tract. Its major uses are to treat ingestion of sustained release drugs, toxins not absorbed by activated charcoal (e.g.,lithium,iron), and for removal of ingested drug packets (body packing/smuggling).[15]
In 2010, poisoning resulted in about 180,000 deaths down from 200,000 in 1990.[16] There were approximately 727,500 emergency department visits in the United States involving poisonings—3.3% of all injury-related encounters.[17]
Poisonous compounds may be useful either for their toxicity, or, more often, because of another chemical property, such as specific chemical reactivity. Poisons are widely used in industry and agriculture, as chemical reagents, solvents or complexing reagents, e.g.carbon monoxide,methanol andsodium cyanide, respectively. They are less common in household use, with occasional exceptions such asammonia andmethanol. For instance,phosgene is a highly reactivenucleophile acceptor, which makes it an excellent reagent for polymerizingdiols anddiamines to producepolycarbonate andpolyurethane plastics. For this use, millions of tons are produced annually. However, the same reactivity makes it also highly reactive towards proteins in human tissue and thus highly toxic. In fact, phosgene has been used as achemical weapon. It can be contrasted withmustard gas, which has only been produced for chemical weapons uses, as it has no particular industrial use.
Biocides need not be poisonous to humans, because they can target metabolic pathways absent in humans, leaving only incidental toxicity. For instance, the herbicide2,4-dichlorophenoxyacetic acid is a mimic of a plant growth hormone, which causes uncontrollable growth leading to the death of the plant. Humans and animals, lacking this hormone and its receptor, are unaffected by this, and need to ingest relatively large doses before any toxicity appears. Human toxicity is, however, hard to avoid with pesticides targeting mammals, such asrodenticides.
The risk from toxicity is also distinct from toxicity itself. For instance, the preservativethiomersal used in vaccines is toxic, but the quantity administered in a single shot is negligible.
Deaths from poisonings per million persons in 2012
The termpoison is also used in a figurative sense. The slang sense of alcoholic drink is first attested 1805, American English (e.g., a bartender might ask a customer "what's your poison?" or "Pick your poison").[24]Figurative use of the term dates from the late 15th century.[25] Figuratively referring to persons as poison dates from 1910.[25] The figurative termpoison pen letter became well known in 1913 by a notorious criminal case in Pennsylvania, U.S.; the phrase dates to 1898.
^Chippaux, JP; Goyffon, M (2006). "[Venomous and poisonous animals--I. Overview]".Médecine Tropicale (in French).66 (3):215–20.ISSN0025-682X.PMID16924809.
^Gupta, Ramesh C., ed. (24 March 2017).Reproductive and developmental toxicology. Saint Louis: Elsevier Science. pp. 963–972.ISBN978-0-12-804240-3.OCLC980850276.
^American Academy of Clinical Toxicology; European Association of Poisons Centres Clinical Toxicologists (2004). "Position paper: Ipecac syrup".J Toxicol Clin Toxicol.42 (2):133–143.doi:10.1081/CLT-120037421.PMID15214617.S2CID218865551.
^Villaveces A, Mutter R, Owens PL, Barrett ML.Causes of Injuries Treated in the Emergency Department, 2010. HCUP Statistical Brief #156. Agency for Healthcare Research and Quality. May 2013.[1]Archived 2017-01-20 at theWayback Machine
^Kautilya suggests employing means such as seduction, secret use of weapons, poison etc. S.D. Chamola,Kautilya Arthshastra and the Science of Management: Relevance for the Contemporary Society, p. 40.ISBN81-7871-126-5.
^Kautilya urged detailed precautions against assassination—tasters for food, elaborate ways to detect poison.Boesche Roger (2002). "Moderate Machiavelli? ContrastingThe Prince with theArthashastra of Kautilya".Critical Horizons: A Journal of Philosophy.3 (2):253–276.doi:10.1163/156851602760586671.S2CID153703219..
^Julius Friedenwald and Samuel Morrison (January 1940). "The History of the Enema with Some Notes on Related Procedures (Part I)".Bulletin of the History of Medicine.8 (1): 113.JSTOR44442727.
^Needham, Joseph (1986).Science and Civilization in China: Volume 5, Part 7. Taipei: Caves Books, Ltd. Page 180.
![Disability-adjusted life year for poisonings per 100,000 inhabitants in 2004.[18] no data <10 10–90 90–170 170–250 250–330 330–410 410–490 490–570 570–650 650–700 700–880 >880](/mt/?noimg=&dark=on&url=http%3a%2f%2fen.wikipedia.org%2fwiki%2fFile%3aPoisonings_world_map_-_DALY_-_WHO2004.svg)
