TOXICOLOGICAL PROBLEMS RESULTING FROM EXPOSURE TO TRADITIONAL REMEDIES AND FOOD SUPPLEMENTS

The National Poisons Unit, London, carried out a pilot survey to inves tigate the frequency and severity of adverse effects/toxicity from exp osure to traditional medicines and food supplements reported to the Un it. Enquiries related to suspected poisoning events were reviewed retr ospectively from January 1983 to March 1989, and prospectively in 1991 . Further information about cases identified by the prospective review was obtained, when appropriate, by follow-up questionnaire, clinical consultation by a consultant toxicologist, toxicological analyses of s amples from patients and from products, and botanical identification o f dried plant material. In total, 5536 enquiries were identified. Symp toms were reported in 657 (12%) of these. There was a large number of reports of accidental ingestion of vitamin preparations by children un der 5 years. Appropriate assessment was possible in only relatively fe w cases, due to insufficient documentation, and poor labelling of cert ain products. A probable link between exposure and adverse effects was identified in 42 cases, and was highly probable in two. Heavy metal p oisoning resulting from use of contaminated traditional remedies was c onfirmed in 5 cases. There was evidence that some patients took excess ive doses of food supplements, without realising that this might resul t in toxic effects. The results of this pilot study suggest that there is a need for further surveillance to provide an appropriate risk ass essment of food supplements and herbal remedies, improved quality cont rol and labelling of these products, and increased awareness of their potential hazard.