Evaluation of cosmetic product exposures reported to the Milan Poison Control Centre, Italy from 2005 to 2010
ABSTRACT Introduction. To the average consumer, "cosmetics" are not considered to cause damage to human health under normal conditions of use. Thus, cosmetic "safety" does not require any particular attention to the possibility that cosmetics may result in a toxic exposure, especially for children. Poison Control Centres (PCCs) provide specialized and rapid information for consumers and health professionals to ensure management of events related to the exposures to different agents, including Cosmetics. Poison Control Centres also represent a unique source of information to investigate the frequency and type of exposures to cosmetic and the related risks. Objective. An analysis of cases concerning human exposures to cosmetics collected from 2005 to 2010 by the PCC at the Ospedale Niguarda Ca' Granda (Milan, Italy) was performed. Results. During this period, 11 322 human exposure cases related to cosmetics were collected accounting for 4.5% of the total human clinical cases. Almost, all the requests for assistance came from consumers (53%) and hospitals (40%). The most frequently reported site of exposure was the consumer's own residence (94%). The exposures mainly involved children younger than 4 years (77%). No difference in gender distribution was observed (female 49%, male 51%). Almost, all of the exposures were unintentional (94%). Intentional exposures, mainly related to suicide attempts and accounted for 6% of cases involving persons aged more than 12 years. Personal hygiene products (30%), perfumes and hair care products (excluding hair dyes) (both 13%) were the most frequently involved categories. Symptoms were present only in 26% of the exposures and were mostly gastrointestinal (46%). Most of the cases were managed at home (43%) whereas hospital intervention was required in 38%. Conclusion. Since the exposure frequency seems more likely to reflect product availability and accessibility to ingestors, our results call for closer attention to this type of hazard, especially for children younger than 4 years of age.
[Show abstract] [Hide abstract]
ABSTRACT: Currently, cosmetics and toiletries are very popular and their use continues to increase because consumers consider physical appearance important and, at the same time, these products are considered to be safe. However, in spite of their safety and tolerability, during recent decades, we have become aware that adverse effects can occur. The number of adverse effects known so far is very low indeed. This is partly because such adverse effects are underestimated as a result of self-diagnosis and self-medication, which are common behaviours in the presence of mild-to-moderate reactions, as in the case of cosmetics. Moreover, such effects are underestimated because of the absence of formal and reliable monitoring systems ('cosmetovigilance'). This requires the creation of a standard reporting form, as well as resolution concerning professional categories authorized to report and the subsequent validation/evaluation of the collected forms. All these items are of great importance, not only to investigate but also to prevent risks caused by cosmetic use. A pilot project was undertaken to test the effectiveness of a notification system by the validation of either a reporting form or the role of dermatologists and community pharmacists as reporting categories. Collection of reporting forms began in July 2006 and it is still in progress; the preliminary data reported here refer to the period July 2006-June 2007 and mainly concern the recording and validation of the collected reporting forms. During this period, we have received 40 reporting forms (32 by dermatologists and 8 by pharmacists). The validation process of the recorded forms revealed several drawbacks, such as incompleteness (19 forms), inadequacy of the description of the suspected undesirable effect and its location (2), illegible handwriting (6) and mistaken statements (3). Six forms reported a misuse of a cosmetic product: four of these were related to the site of application while two were related to time. In one case, instructions for use were not followed. In conclusion, our experience regarding the notification of adverse effects of cosmetics, although limited to a restricted geographical area, suggests that for an efficient and reliable monitoring system to be in place, which includes all the necessary measures to protect public health, an education and training programme for all stakeholders (health professionals, consumers and appropriate authorities) is required.Drug Safety 02/2008; 31(5):433-6. DOI:10.2165/00002018-200831050-00010 · 2.62 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Cosmetics are largely diffused substances topically applied to wash, to perfume or to improve the look, nevertheless the number of reported adverse reactions is very low, probably because of underreporting. This could be due to self-diagnosis and self-medication that is common in the presence of not severe reactions. In fact adverse reactions to cosmetics are generally not serious and frequently related to skin alterations. The aim of our study was to assess, through a questionnaire supplied by community pharmacists to the customers, the prevalence and characteristic of adverse cosmetic events (ACEs) reported by interviewed and the consequent measures adopted. To this aim ten Naples' community pharmacies were involved and pharmacists agreed to submit a specific questionnaire to all the customers of the pharmacy for two weeks between 9:00 a.m.-01:00 p.m. and 04:00 p.m.-08:00 p.m. from 1 to 15 June. The subjects interviewed were 4373, of them 845 refused to fill the questionnaire. Females responding to the questionnaire were 2716 and males 812. The 98.5% of the respondents reported to use cosmetics. Cosmetic users who experienced at least one ACE were 848 and 18.2% of them reported more than one event. Total adverse cosmetic events reported were 1507. A significant higher prevalence of adverse cosmetic events in women was observed, since the 26.5% of female cosmetic users experienced an adverse cosmetic event, whereas the percent was 17.4 for males. Concerning the type of adverse event, the 95.9% was a cutaneous event, whereas systemic events accounted for 4.1%. Among cutaneous reactions burning and itching were the most prominent and accounted for 36.3 and 32.9%, respectively. The most frequently reported systemic event was headache (40.3%) followed by nausea (24.2%). Product change (45.7%) and product suspension (39.6%), were the main specific measures adopted in the presence of ACEs. The general practitioner or the pharmacist were consulted only in the 6.8 and 6.3% of the episodes, respectively. In the 56.5% of the episodes consultation was not requested, whereas in the 26% a specialist was consulted. In conclusions our results, although supply information about ACEs and the consequent measures adopted by consumers of a restricted geographical area suggest that, due to the large use of these products and the relative high incidence of reported ACEs, the problem of cosmetic related injuries and the need of a system able to report, collect and evaluate them, cannot be ignored.Pharmacological Research 02/2006; 53(1):16-21. DOI:10.1016/j.phrs.2005.08.003 · 3.98 Impact Factor
American Journal of Emergency Medicine 10/2005; 23(5):589-666. DOI:10.1016/j.ajem.2005.05.001 · 1.15 Impact Factor