Graphite poisoning; Swallowing pencils
This article discusses the health problems that may occur if you swallow a pencil.
This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Poisonous Ingredient
Despite common belief, pencils have never contained lead. All pencils are made of graphite, which is a soft form of carbon. Carbon is a completely different element than lead.
Symptoms
Graphite is relatively nonpoisonous. There may be no symptoms. If symptoms do occur, they may include stomachache and vomiting, which could be from a bowel obstruction (blockage).
The person may choke while swallowing the pencil. This can cause symptoms such as repeated coughing, chest pain, shortness of breath, or rapid breathing.
Sometimes, children will place a piece of a pencil in their nose. This can cause symptoms such as nose pain and drainage, and breathing problems. Infants may become irritable.
Home Care
Graphite is relatively nonpoisonous. Contact poison control for further information.
Before Calling Emergency
Have this information ready:
- The person's age, weight, and condition
- Type of pencil (if known)
- The time it was swallowed
- The amount (size) swallowed
Poison Control
Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.
A procedure may be needed to remove the pencil that is stuck in the airways, stomach, or intestines.
Outlook (Prognosis)
Recovery is likely.
References
Goodloe JM, Soulek J. Foreign bodies. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 51.
Hammer AR, Schroeder JW. Foreign bodies in the airway. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 414.
Pfau PR, Benson M. Foreign bodies, bezoars, and caustic ingestions. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 28.
Version Info
Last reviewed on: 11/2/2023
Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
