The Toxins in Your Neighborhood

We don’t like to think about it, but city life exposes us to a lot of potentially dangerous or toxic substances.

“From potentially toxic plants in parks to street vendors selling illegal pesticides and stores selling legal highs, the city is full of opportunity for someone to get very sick,” says toxicologist Adam Blumenberg, MD, MA. He sees the consequences of these exposures in the emergency department and other parts of the hospital. And he knows what chemicals, plants, substances, and situations are most likely to have an impact. Knowledge that reduces the chances of severe sickness or death.

To prepare other CUIMC doctors, nurses, and staff for what toxic reactions they might encounter, Blumenberg leads walks through Washington Heights, highlighting the prevalence of harmful substances. He specializes in the diagnosis and management of poisoned or possibly poisoned patients.

“The more aware we are of what’s out there, the better we can help people avoid permanent health damage or death,” says Blumenberg. “The doctors, nurses, and students who join these toxicology walks are exceptionally intelligent and knowledgeable. But there’s always more to learn, and seeing how accessible and available toxic substances are in our community can be an eye opener.”

Recognizing the signs and symptoms of poisoning and understanding how to treat them is vital to patient health and survival. We asked Blumenberg what to look for in the world around us and what it takes to prevent poisoning at home.

Toxic Plants in Cities

There are toxic plants in CUIMC’s neighborhood of Washington Heights, and that’s true of many urban areas. But generally speaking, a toxic plant growing on the side of the road will not hurt you if you do not eat it or make tea with it.

People rarely eat these plants, but the potential is real. The list of look-do-not-eat plants and flowers includes:

• Lily of the Valley – Sometimes, people searching for ramps, which are edible, make a foraging error and accidentally harvest lily of the valley because the plants look similar. Eating a large number of lily of the valley can slow down or stop your heart – just ask the writers of Breaking Bad.
• Foxglove – This plant contains a few toxins, though the main one is digoxin, which is also medicine. The amount of toxin in each plant varies. It’s safe to touch, but eating large amounts or concentrated forms, like tea, can slow down or stop your heart.
• Jimson Weed – If eaten, the beautiful white flowers of Jimson weed can cause very fast heart rate, high body temperature, and confusion that can last for hours to days.

The Most Prevalent Toxins Around New York City 

While plants can be dangerous, the more significant threat might be in your home. Take extra care when using and storing medications, especially:

• Blood pressure medications: When used as prescribed, these drugs can be lifesaving, but if someone takes too much, their blood pressure can drop so low that there's not enough blood flowing to the vital organs, causing critical illness and death.
• Acetaminophen: Found in Tylenol and present in a lot of other over-the-counter medications, acetaminophen can cause liver damage or failure in large doses.

Outside of medications, illegal pesticides can present big problems as well. Sometimes sold in stores and on the street, certain pesticides are really effective at killing rats and roaches but are banned because they harm people, too. These include:

• Sniper DDVP is an organophosphate, the same chemical family as nerve agents like sarin. Pesticides do not have the same strength or potency as military agents but have the same health effects. A person is unlikely to get sick from it unless you eat it, but if it gets inside the body, it can be hazardous.

• Aluminum phosphide is a very, very dangerous pesticide because the amount it takes to cause harm is very low. It becomes a gas, so anyone breathing the air in an enclosed space, like a bedroom or living room, can get sick. Entire families have gotten critically ill, and there have been fatalities just from being in the same room as aluminum phosphide tablets.

What to Do if You Suspect Poisoning

While at-home poisoning can affect anyone, toddlers are particularly at risk because they have a habit of touching and sometimes eating things that they should not. But adults can sometimes mix up medications or accidentally overdose, too, especially if they are sick or not at their best. So what do you do if that happens?

The first step is to call poison control. Usually, someone exposed to something that could be dangerous is not in any meaningful danger, and 90 to 95% of calls can be resolved at home. One call can save a lot of stress, worry, time, and money. But if the situation is more serious, the poison control center may tell you to go to the hospital.

Take Steps to Protect Yourself

Dr. Blumenberg recommends taking the following steps to keep yourself safe:

• Up and Away: Toxicologists use this phrase a lot when talking about things that could be dangerous to a child, like medication, alcohol, cleaning products, laundry pods, and batteries. Store them out of reach and out of sight of children.
• Use good judgment when it comes to using all substances. Use them as directed; if something seems wrong, just don’t use them.
• Take medications exactly as prescribed and avoid extra doses.

But the most important advice Dr. Blumenberg offers? Call 1-800-222-1222 if you have any questions about poisoning or toxicity or if you suspect you or someone you know might have been exposed. It’s a 24/7, free resource staffed by experts.