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Iron

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Critical Care Toxicology

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Abstract

Iron poisoning is a well-respected historically significant toxicologic problem. In the pediatric population, iron has been regarded as the most fatal of all toxic exposures [1]. Fortunately because of regulations on packaging in the USA and other countries, serious poisonings have declined [2]. Visible warning labels and dispensing of tablets and capsules in blister packages have limited the dose a child might consume. For example, iron poisoning fatalities in children less than 6 years of age in the USA decreased from 29 in 10 years before the packaging regulation to one death in the 5 years after [3]. Total reported exposures in children younger than 6 years old have declined from 3026 in 1995 to 2139 in 2013 in the USA [4, 5]. The other patient population at risk is suicidal patients, most notably women of childbearing age with access to iron products. In 2013, 28 % of iron exposures in the USA occurred in patients who were teenagers or older [5]. Despite the significant toxic potential of iron, death and serious sequelae are uncommon because most exposures are unintentional and involve negligible amounts.

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Authors and Affiliations

  1. Cook County Hospital (Stroger), Chicago, IL, USA

    Sean M. Bryant

  2. University of Chicago Pritzker School of Medicine, Glenview, IL, USA

    Jerrold B. Leikin

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  1. Sean M. Bryant
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Correspondence to Sean M. Bryant or Jerrold B. Leikin .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Bryant, S.M., Leikin, J.B. (2016). Iron. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_26-1

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