A child was rushed to the hospital after being poisoned by a common household fragrance product.
An unidentified three-year-old girl from New York City was brought to the emergency room after having her first seizure. The child’s mother reported she was walking toward the kitchen as she fell to the ground and began seizing for five minutes.
Each minute of a seizure causes neurons in the brain to fire uncontrollably, disrupting normal function, reducing oxygen and killing cells.
The girl was transferred to the pediatric intensive care unit (PICU) for observation and appeared to be recovering normally at first.
However, within a few hours, she had two more seizures, prompting doctors to measure her brain activity with an electroencephalogram (EEG), which involves placing non-invasive electrodes on the scalp.
The EEG came back normal but blood tests came back showing the girl had high levels of salicylates, compounds derived from salicylic acid, which is found in plant-based foods like willow bark and berries, as well as over-the-counter medications like aspirin and Pepto-Bismol.
While salicylates are safe in low doses, the child’s blood test showed levels of 19 mg/dL, a sign of salicylate toxicity, which leads to respiratory failure, seizures, lethargy and dehydration. A safe level for adults is about 30 mg/dL, but doctors warn even lower levels can be fatal for children.
An investigation of the toddler’s home found incense sticks were regularly being burned in her bedroom. Incense is a substance such as spices or herbs burned to produce fragrant smoke, though some brands can contain known carcinogens like formaldehyde.
An unidentified three-year-old girl from New York City was rushed to the hospital with seizures linked to household incense (stock image)
The brand of incense sticks, which doctors did not reveal, contained salicylate concentrations of 10 to 20 percent, which likely caused the girl’s condition.
The experts from NYC Health + Hospitals in Harlem also warned that because blood tests cannot accurately measure chronic salicylate exposure, the burden on the girl’s body could have been more severe than tests showed.
The girl was diagnosed with chronic salicylate intoxication, which occurs from prolonged ingestion of salicylate. The condition is particularly dangerous in children and the elderly, as these groups have weaker immune systems.
‘Chronic salicylate intoxication is associated with higher mortality compared with single, acute ingestions,’ the doctors wrote in the American Journal of Case Reports.
Doctors treating the girl wrote that salicylate can gradually accumulate in tissues past the blood-brain barrier, causing inflammation and reducing cell function, which may lead to seizures.
Salicylates can also be absorbed by the stomach, liver, kidneys, lungs and heart, potentially causing multi-organ failure.
‘Chronic salicylate intoxication in children can present subtly yet carry life-threatening consequences,’ the doctors wrote.
The FDA does not strictly regulate the ingredients in incense products since they are not considered food, drugs or cosmetics. This means manufacturers are not required to list all ingredients.
Incense most often contains wood powders like sandalwood, essential oils, spices and herbs. However, the FDA has warned smoke from some incense products may contain probable human carcinogens like formaldehyde and benzene, which have been linked to an increased risk of leukemia, nasal cancer and lymphoma.
There is limited evidence supporting health benefits of incense, but some brands may contain known carcinogens (stock image)
A 2009 study also found incense burning triggered wheezing episodes in children with asthma.
There is limited evidence on the potential benefits of burning incense. One 2008 study in cell cultures and mice found incense using frankincense resin had similar psychiatric effects as antidepressants due to the feeling of warmth.
And a 2017 study found that some compounds isolated from frankincense and myrrh resins had an anti-inflammatory effect in mice.
Most incense sticks burn for 60 to 90 minutes.
‘Currently, many incense products and candles marketed for household use in the United States lack appropriate labeling regarding their salicylate content and potential toxicity,’ doctors treating the toddler wrote.
‘A detailed environmental history including prolonged incense use in enclosed spaces should be considered in any child presenting with unexplained seizures with concurrent acid-base imbalance.’
