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Poisonous poinsettias, harmful holly and malicious mistletoe: what's the evidence?

Peter Gill
Last edited 23rd December 2011

The recent post on whether Christmas is bad for you inspired further questions on the evidence behind holiday season myths. There is a common misconception that poinsettias (Euphorbia pulcherrima for the botanists) are poisonous. Grandparents tell stories to new parents that they must be vigilant to ensure that children don’t ingest the plant’s leaves.

But what is the evidence?

A study published in 1996 in the American Journal of Emergency Medicine sought to provide an answer. The authors evaluated 849,575 plant exposures reported to the American Association of Poison Control Centers. Poinsettia exposures accounted for 22,793 cases, or nearly 3%, of which nearly all occurred in December and January. Not surprisingly, 94% of poinsettia exposures were in children.

But were they poisonous? No. None were fatal. In fact, only 4% of patients required treatment in a health care facility and fewer than 7% developed toxicity. Most reactions were mild - children that ingested leaves may experience diarrhea and vomiting or have an allergic reaction to the skin.

Poinsettias are not toxic. They don’t stalk family homes waiting for the opportune time to poison children with their attractive red leaves. Children that accidentally ingest poinsettia leaves rarely require treatment. In fact, the real concern is that they may be a choking hazard.

Well what are the real hazards around Christmas time? The Children's Hospital of Philadelphia website highlights the harms that children need to worry about. An unsuspecting culprit took the top spot: alcohol. Alcohol is a serious hazard in children that can lead to major health problems if ingested by children, even in small quantities. Be wary of leaving empty glasses around the house that could break and be ingested by children.

Similar to alcohol if you are in a cold enough climate, windshield washer fluid and antifreeze are serious hazards. The sweet tasting liquid that looks like Kool-Aid can lead to blindness, seizures, heart-rhythm changes and even death if ingested.

Other quintessential botanical Christmas symbols that are poisonous: holly. A handful of berries from the Illex opaca shrub can produce nausea, vomiting, diarrhea and drowsiness in children. The toxicity of kiss causing mistletoe is not supported by the evidence with most cases having a similar outcome as with poinsettia exposure. But with all substances, beware of large amounts.

Be on the look out for disc batteries (coin shaped circular ones) that can be a choking hazard if swallowed. If they become stuck in the esophagus or stomach, they can begin to leak their caustic contents and cause severe burns.

Irrespective of the hazard, most children swallow these objects when they are left unattended. When enjoying the holiday season this year, keep an eye on the curious children putting objects in their mouth and dispel the old urban myths that lack evidence. Happy Holidays.

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