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A Systematic Review of Fatalities Related to Acute Ingestion of Salt. A Need for Warning Labels?

21 July 2017

Norm R. C. Campbell and Emma J Train

Globally a high salt intake is the leading dietary risk for death and disability, which are largely related to hypertension or gastric cancer. Recently marketing campaigns such as #Salt4Syria, which tasked participants to ‘taste’ a spoonful of salt, or the ‘eat salt challenge’ which challenged participants to consume a tablespoon of salt, have caused isolated cases of extremely high salt intake.  Therefore this systematic review focuses on another potential danger of dietary salt - acute toxic effects.

The authors searched for all studies that reported fatalities from salt intake and categorised fatalities by age:


Sodium/salt intake and reason for high intake

Children (<5 years)

15 fatalities  

  • 8 cases - salt was mistake for sugar
  • 4 cases - salt was used as an emetic (induce vomiting)
  • 3 cases - abuse cases

Most doses were unknown but reported doses were 7g to 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 (age range 19-83)

19 reported fatalities

  • 8 cases - salt was used as an emetic
  • 2 cases -emetic and lavage
  • 2 cases - healthcare professional administered emetic
  • 3 cases - salt was mistaken for sugar
  • 3 cases - exorcism rituals
  • 1 case - unknown


In 2 children the lethal dose of sodium was less than 10g which is less than 5 teaspoons of salt. In 4 adults, the lethal dose was less than 25g sodium which is less than 4 tablespoons of salt, and is just twice as high as the upper range of daily salt consumption in the Chinese population. Fatality was linked to hypernatremia, which is a high sodium level in blood at a level ≥145mmol/l.

Although the sodium content of food is lower and is absorbed more slowly than salt by itself or in a solution, and therefore is generally considered ‘safe’ as a food additive, the authors suggest that warning labels on salt may increase awareness of the dangers of high salt consumption and discourage ‘salt challenges’ or rituals.

To view the full paper, please click here.



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