Toxic or Not?

December is a much-decorated month and the season comes with warnings of the toxicity of the greenery. Of the plants used, poinsettia plant has the largest numbers of calls to the poison control centers. Despite a long-standing belief in the legend of poinsettia toxicity, there is little data to support this. The toxic reputation stems from a single unconfirmed death of a 2-year-old in Hawaii in 1919. Poinsettia is in the same plant family as natural rubber latex and shares 2 common allergen proteins. Forty percent of individuals with a latex allergy develop cross-sensitivity with the poinsettia plant. A vast majority of exposures, however, result in either no effect or minor gastrointestinal upset and nausea with occasional vomiting. Contact dermatitis is very rare.

Holly is the third most common reported plant exposure. The berries containing the toxin saponin are poisonous; the leaves are not. The primary clinical effects observed, which occur exclusively with large ingestions, include nausea, vomiting, abdominal cramping, and occasionally dermatitis. In adults, one must eat 20-30 berries before becoming symptomatic, whereas children only have to consume five.

All sections of mistletoe are potentially harmful as they contain the toxin phoratoxin. Most ingestions result in little physical reaction, although some patients may experience gastrointestinal symptoms. The only cases involving deaths likely related to mistletoe are cases in which there were ‘teas’ infused with the fruits and other parts of the plants. The only two reported deaths from ingestion of mistletoe in the past 25 years were patients who ingested beverages made from mistletoe parts steeped in hot water; 11% of ingestions were suicide attempts.

An article from the NIH can help make wise decorating choices.