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Dubious herbal mixtures and dangerous mushrooms

10/2012, 02.03.2012

20 years worth of reports on incidents of poisoning: brochure "Cases of Poisonings reportet by Physicians 2010" published

Herbal mixtures are not always as harmless as they sound, especially when they are smoked: in the year 2010, 15 cases were reported to the Federal Institute for Risk Assessment (BfR) in which youths and young adults showed symptoms of poisoning, because they had smoked "herbal mixtures" or "incense". According to the packaging, the mixtures were supposed to contain plants with a cannabis-like effect but in actual fact synthetic cannabinoids had been added to the products. These cases are described in detail in the brochure "Cases of Poisonings reportet by Physicians". The brochure also focuses on 12 cases in which poisoning with death caps occurred. Death caps are the cause of 80 to 90 percent of all cases of fatal mushroom poisoning. Roughly 10 percent of poisoning incidents reported to the BfR are attributable to poisonous plants or mushrooms, whereas the majority of cases are the result of handling chemical products. In the year 2010, the BfR documented a total of 3939 incidents of poisoning. It became compulsory for doctors to report incidents of poisoning 20 years ago. The annually published report "Cases of Poisonings reportet by Physicians" provides an informative overview of the risks of poisoning as well as priorities and trends in the medical reports submitted to the BfR.

Poisoning by “herbal mixtures” that are smoked causes a range of symptoms in patients including dizziness, nausea and vomiting and even impaired consciousness. Consumers often mistake such products for harmless and legal herbal mixtures. However, studies have shown that in some cases synthetic cannabinoids had been added to such mixtures. The health risks of these substances are difficult to evaluate, because hardly any research exists on their potential effects. Some substances pose the risk of a fatal overdose.

In most cases, mushroom poisoning occurs when poisonous mushrooms are erroneously assumed to be edible. The most dangerous poisonous mushrooms are death caps: among other things, they contain amatoxins of which as little as 5 to 7 mg can be sufficient to kill an adult.

The brochure “Cases of Poisonings reportet by Physicians of Intoxications” lists all cases reported to the BfR in 2010. Overall, the Centre for Documentation and Assessment of Poisonings received 3939 reports in the reporting year. Since 1990, it has been compulsory according to the German Law on Chemicals to report cases of poisoning and adverse product effects: treating doctors, professional associations, doctors working for the health service, poison control centres and other institutions must provide the Centre for Documentation and Assessment of Poisonings at the BfR with relevant information on such incidents. Cases of poisoning by chemical household and hobby products, cosmetics, chemical products at the workplace, chemical products injurious to health in the environment or resulting from chemical accidents in particular must be reported. However, incidents of poisoning through plants or animals must also be recorded.

The goal is to infer measures for the treatment and prevention of poisoning from the case assessments. In practice, the significance of this notification duty manifests itself in various examples. Thus in recent years, dangerous products such as lamp oils, grill lighter fluids and lime and rust removers containing nitric acid have been banned. Other products such as baby powder and impregnating sprays now come with warning labels. In addition, new toxicological assessments are available for a wide range of poisonous plants.

The brochure (also in English translation) is geared first and foremost to doctors, clinics and ambulance personnel and can be obtained from the BfR free of charge. The printed version can be ordered by e-mail or fax, whereas the electronic version is available for download from the BfR Internet page:

E-Mail:             publikationen@bfr.bund.de
Fax:                 +49-(0)30-18412-4970
Internet:           www.bfr.bund.de

About the BfR

The Federal Institute for Risk Assessment (BfR) is a scientific institution within the portfolio of the Federal Ministry of Food, Agriculture and Consumer Protection (BMELV). It advises the Federal Government and Federal Laender on questions of food, chemical and product safety. The BfR conducts its own research on topics that are closely linked to its assessment tasks.

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