Correction; Revisiting a Poison Control Database on Supplement Risks
A national poison control database suggests that some diet supplements may pose risks to consumers, raising questions about a 1994 federal law stating that 'safety problems with the supplements are relatively rare.' But an essay in Science Times on Jan. 16 about those risks overstated the number of adverse reactions to supplements reported in the database.
The essay said the database, issued by the American Association of Poison Control Centers, reported 125,595 incidents of poisonings in 2005 related to vitamins, minerals, essential oils, herbs and other supplements, and a total of 1.6 million such incidents from 1983 to 2005. In fact, the figures refer to reports of exposures to those substances.
The poison control association defines 'exposures' as calls to poison centers from the public or health professionals reporting 'actual or potential exposure to a substance (e.g., an ingestion, inhalation or topical exposure).' In an e-mail message, Dr. Susan Smolinske, a spokeswoman for the association, said that 'some exposures to diet supplements result in unknown or benign outcomes, rather than adverse outcomes.' She cited an August 2005 report in the journal Clinical Toxicology suggesting that about 10 percent of exposures result in 'moderate to major' medical outcomes.
The database has no category for poisoning incidents, so that number is not known. While it does have a column headed 'adverse reactions,' that category refers only to reports of reactions 'occurring with normal, prescribed, labeled or recommended use of the product,' leaving out overdoses and cases where the dose was unknown.
The number given for 'adverse reactions' is lower than the number of people treated in health care facilities after exposure to a substance. It is also generally lower than the number of medical outcomes ranging from minor to fatal that were associated with the substance.
The 2005 figures in the essay should have been reported as follows:
St. John's wort: 203 exposures, 25 adverse reactions, 79 visits to health care facilities, 36 medical outcomes ranging from minor to fatal.
Homeopathic products: 7,049 exposures, 178 adverse reactions, 564 health care visits, 267 medical outcomes.
Glucosamine: 813 exposures, 65 adverse reactions, 108 health care visits, 62 medical outcomes.
Echinacea: 483 exposures, 33 adverse reactions, 55 health care visits, 32 medical outcomes.
Melatonin: 2,001 exposures, 53 adverse reactions, 535 health care visits, 320 medical outcomes.
Vitamins: 62,446 exposures (including 48,604 in children under 6), 1,938 adverse reactions (these are not broken down by age), 6,322 health care visits, 3,800 medical outcomes.
All diet supplements: 125,595 exposures, 5,334 adverse reactions, 17,843 health care visits, 12,314 medical outcomes.
Correction:  February 6, 2007, Tuesday  An essay in Science Times on Jan. 16 about risks associated with diet supplements referred incorrectly to statistics taken from annual reports by the American Association of Poison Control Centers. The statistics were for exposures to various substances, not adverse reactions to those substances. A corrective article appears today on Page F6.