A Child’s Seizure Linked to Household Fragrance Product
A three-year-old girl from New York City was rushed to the hospital after experiencing a severe seizure, which later was linked to exposure to a common household fragrance product. The incident highlights the potential dangers of everyday items that are often overlooked.
The child was brought to the emergency room after she collapsed and began seizing while walking toward the kitchen. The mother reported that the seizure lasted for five minutes, causing immediate concern. During a seizure, neurons in the brain fire uncontrollably, disrupting normal function and reducing oxygen supply to the brain, which can lead to cell death.
Initially, the girl appeared to be recovering well and was transferred to the pediatric intensive care unit (PICU) for observation. However, within a few hours, she experienced two more seizures. To assess her condition, doctors conducted an electroencephalogram (EEG), which involves placing non-invasive electrodes on the scalp to monitor brain activity. The EEG results were normal, but blood tests revealed high levels of salicylates — compounds derived from salicylic acid, commonly found in plant-based foods and over-the-counter medications like aspirin and Pepto-Bismol.
Salicylates are generally safe in low doses, but the child’s blood test showed levels of 19 mg/dL, indicating salicylate toxicity. For adults, a safe level is around 30 mg/dL, but even lower levels can be fatal for children. Salicylate toxicity can lead to respiratory failure, seizures, lethargy, and dehydration.
An investigation into the toddler’s home revealed that incense sticks were regularly burned in her bedroom. Incense is a substance made from spices or herbs that are burned to produce fragrant smoke. Some brands, however, may contain harmful substances like formaldehyde, a known carcinogen.
The brand of incense sticks involved in the case, which was not disclosed by the doctors, contained salicylate concentrations ranging from 10 to 20 percent. This likely contributed to the girl’s condition. Experts from NYC Health + Hospitals in Harlem warned that blood tests may not accurately measure chronic salicylate exposure, meaning the child’s condition could have been more severe than what the tests indicated.
The girl was diagnosed with chronic salicylate intoxication, a condition caused by prolonged exposure to salicylates. This type of poisoning is particularly dangerous for children and the elderly, as their immune systems are weaker. Doctors noted that chronic salicylate intoxication has a higher mortality rate compared to acute cases.
“Chronic salicylate intoxication is associated with higher mortality compared with single, acute ingestions,” the doctors wrote in the American Journal of Case Reports. They also explained that salicylates can accumulate in tissues beyond the blood-brain barrier, leading to inflammation and reduced cell function, which may trigger seizures.
Salicylates can be absorbed through 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 emphasized.
Despite the risks, the FDA does not strictly regulate the ingredients in incense products because they are not classified as food, drugs, or cosmetics. This means manufacturers are not required to list all ingredients on their packaging. While most incense contains wood powders, essential oils, spices, and herbs, the FDA has warned that some products may contain carcinogens like formaldehyde and benzene, which are linked to an increased risk of leukemia, nasal cancer, and lymphoma.
A 2009 study found that burning incense can trigger wheezing episodes in children with asthma. Although there is limited evidence on the benefits of incense, some studies suggest possible effects. A 2008 study in cell cultures and mice found that incense containing frankincense resin had psychiatric effects similar to antidepressants. A 2017 study found that certain compounds from frankincense and myrrh resins had anti-inflammatory properties in mice.
Most incense sticks burn for 60 to 90 minutes. However, doctors treating the toddler warned that many incense products lack proper labeling regarding their salicylate content and potential toxicity. “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,” they wrote.
