What is Incense Poisoning?

• Incense is an aromatic material that is burnt during certain religious and ceremonial occasions. It is of two types - direct-burning and indirect-burning. Most incense are available in the form of sticks, coils, or other shapes, while some are marketed as liquid incense
• Incense Poisoning is the accidental or intentional intake of the compound. The intake may be through swallowing incense liquid or inhaling its fumes
• The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Incense Poisoning may be also referred to as the following:

• Agarbathi Poisoning
• Incense Stick Poisoning
• Incense Toxicity
• Joss-Stick Poisoning

What are the Causes of Incense Poisoning?

• Incense Poisoning is caused by the ingestion or inhalation of Incense. The chemical may also get into the eye, resulting in eye-related symptoms
• This intake could be accidental, or in some cases intentional, to bring self-harm
• Incense products are available in stick form, powder form, or liquid form. Ingesting liquid incense can be very hazardous, while inhaling incense stick/cone/coil smoke in poorly-ventilated spaces can lead to breathing difficulties
• The composition of incense may be natural plant-based or synthetic. It varies widely from one geographical region to another. The gases emanated on burning include oxides of nitrogen, sulfur, and carbon, volatile organic compounds and polycyclic aromatic hydrocarbons

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Incense Poisoning?

The signs and symptoms of Incense Poisoning can vary from one individual to another. It may be mild in some and severe in others. It also depends on the type of chemical involved. Several systems of the body, such as the digestive system, respiratory system, vascular system, skin and ENT may be affected.

The signs and symptoms of Incense Poisoning may include:

• Burning and associated pain in the mouth and throat; this may affect the nose, ears, and eyes
• Respiratory difficulties, if substantial amount of the incense fumes is inhaled
• Bluish discoloration of skin beneath fingernails and on lips
• Headache and lethargy
• Nausea, vomiting 
• Bloody or watery stools
• Stomach and abdominal pain that may be cramping
• Reduction in blood pressure (hypotension)
• Low level of alertness or response; sleepiness
• Individuals act ‘drunk’ or agitated
• Unable to walk properly; lack of coordinated movements
• Seizures
• Coma

How is First Aid administered for Incense Poisoning?

First Aid tips for Incense Poisoning:

• Call 911 or your local emergency help number immediately, for emergency assistance
• Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
• Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
• Carefully remove the individual from the exposure area; move them to region of fresh air immediately
• Confirm that the airways are protected; also, ensure breathing and the presence of pulse
• If exposure of the eye has occurred, then wash thoroughly with copious amounts of water. Any paint on skin may be washed away
• Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
• Following an ingestion of the substance, immediately give water or milk to drink
• In case of symptoms that indicate difficulty in swallowing including vomiting or decreased alertness, do not give anything by way of mouth
• Take individual to emergency room (ER) for further treatment
• Always try to take the compound bottle/container to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

• Monitor vital signs
• Medically manage symptoms and provide breathing support, if necessary
• Administer medication to counter the effects of the toxic substance
• Gastric lavage for elimination of the substance from the stomach (irrigation using special solutions)
• Administer laxatives for elimination of the substance from the body
• Wash eyes or skin repeatedly and thoroughly (irrigation), to eliminate any remaining compound
• Administer fluids by an intravenous drip line

Who should administer First Aid for Incense Poisoning?

First aid for Incense Poisoning is administered by healthcare professionals.

• The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
• They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Incense Poisoning?

• The prognosis of Incense Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
• If the individual can recover from the symptoms, with appropriate medication and early support, the outcome is generally good
• Swallowing large quantities of incense that is in liquid form can result in severe symptoms and complications, which can even be fatal

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Incense Poisoning be Prevented?

Incense Poisoning can be prevented by:

• While using incense sticks, keep the space/room well-ventilated
• Always following instructions for usage of any household products
• Keeping cosmetics, medications, and other healthcare products out of reach of children in child-proof containers
• Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
• Keep all poisons correctly labeled and in suitable storage locations
• Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

• Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
• Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
• It would be helpful if the following information is readily available:
  • Type, amount and time of consumption of the substance
  • Age and weight of the individual
  • And, the overall health status of the individual