Essential Oils and Poison Center Reports

A note in the previous post referenced data about poison center reports for essential oils.  This piqued my curiosity, so I read the article in the New York Times and then looked up the original data to gain some perspective.

The NYT article turns out to be an opinion piece based on a book that appears to be part of Big Pharma's attack on natural supplements and natural products. The linked version is rife with corrections that had to be made after publication. The original article was trying to make the case that there were all sorts of "poisonings" that took place from vitamins, supplements, and natural products, and that this was a very bad thing. The corrections begrudgingly pointed out that the data were based on calls to poison centers, and were really about "exposures" and not about actual "poisonings." And they still didn't do a good job of putting it all in a real perspective, failing to mention that half of all poison reports are about pharmaceuticals.

I'm going to focus here on essential oils, which after all are the subject of this blog. Table 22 from the report lists the essential oils (I've omitted details on age, reason, and minor outcomes--look at the full report for that):

Essential oils	No. of Exposures	Adverse Reaction	Treated in Health Care Facility	Outcome Major/Death
Clove oil	446	22	101	0/0
Cinnamon oil	599	29	48	0/0
Eucalyptus oil	522	5	99	3/0
Pennyroyal oil	36	5	14	0/0
Tea tree oil	951	35	151	2/0
Other/unknown	4728	53	406	1/0
Category total	7282	149	819	6/0

Let's put that in perspective--this is out of 2,765,665 total exposures. There were only 6 cases with major outcome and no deaths. In the overall, approximately half of exposures (51%) were for pharmaceuticals, and 49% were non-pharmaceuticals. Essential oil exposures were about .0000263% of all the exposures.  Or for more perspective, there were 17,725 exposures to Soap, with 329 adverse reactions, 5 major outcomes, and no deaths. Perfume got 16,495 exposures, and there was actually 1 death.

The vast majority of EO exposures were to children under the age of six (5422 or 75%) with a smaller number (537) to older children and 1239 to adults. There is a good reason why we put a warning on the bottles about keeping out of reach of children, but I guess some people don't heed it.

The EO's broken out in the listing are probably the most common ones available and are sold in most pharmacies for a variety of uses. It would be unfair to assume that they are the most dangerous.

Just for drill, I looked at the 2006 annual report and it had similar data, with the total number of EO exposures rising slightly to 7377.

The problem with these data is that they are only the exposures actually reported, and in order to calculate the true risk we need to know the number of users. Ideally it would be good to be able to refer to the risk per 1000 users and compare it to other substances similarly. However, since we can only estimate the number of users, and there are no data here, we are just guessing.

The comparison to soap may be useful.  Everyone (well, almost) uses soap and has it available where it can probably be reached by children. If essential oils are just as safe as soap, then the roughly double exposure would suggest that half of people have essential oils in their home.  Since that probably isn't true, then we can assume that essential oils are less safe than soap.

The main thing we can conclude from these data is that we should keep essential oils out of the reach of children, and that they haven't caused any deaths.

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