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Toxicity of reed diffusers: a retrospective analysis of telephone enquiries to the UK National Poisons Information Service 2010–2012

Author/s Panchal B, Eddleston M, Thomas SHL, Thompson JP, Vale JA
Year 2014
Type of publication Journal article

Objective: To ascertain the reported toxicity of reed diffusers. Reed diffusers are vessels filled with fragranced liquid, “wicking” reeds and, sometimes, water beads. Their composition varies and includes essential oils, glycol ethers, isopropanol, petroleum distillates and ethanol.

Methods: We analysed retrospectively UK National Poisons Information Service (NPIS) enquiry data collected between 1 January 2010 and 31 December 2012.

Results: 324 UK patients were exposed to reed diffusers; the majority (n = 305) were children < 5 years. The identity of the reed diffuser was known in 221 cases (68.2%); most (n = 152) exposures were from the AirwickTM range, which contain propylene glycol monobutyl ether, petroleum distillates, essential oils, and fragrances. Ingestion alone was the most common route of exposure (305 of 324 patients) and involved the liquid alone (n = 247), the water beads alone (n = 36), the liquid and water beads (n = 11) or sucking on the reed (n = 11). The WHO/IPCS/EC/EAPCCT Poisoning Severity Score (PSS) was known in 304 ingestions: in 246 (80.9%) the PSS was 0 (asymptomatic); in 52 (17.1%) patients the PSS was 1 (minor toxicity); in 6 (2.0%) the PSS was 2 (moderate toxicity); there were no patients with PSS 3. Features included nausea and vomiting (n = 32); abdominal pain (n = 1); diarrhea (n = 1); decreased appetite (n = 1); coughing (n = 7); gagging (n = 3); lip swelling, redness or irritation (n = 3); facial oedema (n = 1); bad taste (n = 1); sore mouth (n = 2); tongue blistering (n = 1); dysphonia (n = 2); epiglottic swelling (n = 1); stridor (n = 1); bronchospasm (n = 2); hypoxia (n = 2); central nervous system depression/drowsiness (n = 4), one of whom suffered respiratory depression; sinus tachycardia (n = 2); ectopic beats (n = 1); tremor (n = 1); tonic-clonic convulsion (n = 1); pallor (n = 2) and fever (n = 1). Dermal exposure alone was reported in four patients, only one of whom was symptomatic with skin irritation. Three patients suffered eye exposure and complained of eye pain (n = 2) and conjunctivitis with irritation (n = 1). Multiple routes of exposure occurred in twelve patients: six were asymptomatic; in five the PSS was one and in one was unknown.

Conclusion: Although reed diffusers have a high potential to cause serious toxicity, the majority of patients in our study developed no or only minor symptoms, probably because most exposures involved the ingestion of only small quantities of fragranced liquid.


  • Persson H, Sjöberg G, Haines JA, et al. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol 1998; 36:205–213. 
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