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Acute Toxic Effects

Hypernatremia is a term used to describe an abnormally high sodium level in the blood. It can be common in the elderly, especially those living in nursing homes, as a result of dehydration (1).

However, isolated cases of deaths, caused by excess ingestion of table salt leading to hypernatremia, have been reported across all age ranges. These cases have been summarised in the table below (2):

Age Sodium/Salt Intake and Reason for High Intake
Children (<5 years)

15 fatalities

  • 8 cases - salt mistaken for sugar
  • 4 cases - salt used to induce vomiting
  • 3 cases - abuse cases

Most doses were unknown but reported doses were 7-13g of sodium (17.8-33g salt)

Children (5-10 years)

1 fatality

A girl was fed a minimum of 5 teaspoons of salt by her parents, equivalent to 11.4g sodium or 29g salt

Adolescents (10-18 years) No reported fatalities
Adults (19-83 years)

19 reported fatalities

  • 12 cases - salt used to induce vomiting
  • 3 cases - salt was mistaken for sugar
  • 3 cases - exorcism rituals
  • 1 case - unknown

Range of salt ingested: 34.5-1016g salt

 

By limiting salt intake to a maximum of 5g per day and staying properly hydrated, hypernatremia can be avoided.

Current Salt Intake & Dietary Advice

Almost everyone around the world eats too much salt. The World Health Organisation recommends that we eat no more than 5g of salt a day (equivalent to a level teaspoon); average intakes around the world are double this amount.

People with or considered at risk of kidney disease or renal failure should ensure that they keep their salt intake below the recommended maximum of 5g. This can be achieved by simple changes, such as consuming less processed foods and checking product labels before purchase.



References
1. Orfan, Y., Lavi, D., Opher, T., Weiss, T. and Elinav, E. Fatal voluntary salt intake resulting in the highest ever documented sodium plasma level in adults (255 mmoll-1): a disorder linked to female gender and psychiatric disorders. Journal of Internal Medicine, 2004; 256: 525-528
2. Campbell, N. and Train, E. A systematic review of fatalities related to acute ingestion of salt. A need for warning labels? Nutrients, 2017; 9: 648-655

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