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PubMed2005

An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

A retrospective analysis of poisoning calls received by the National Poisons Information Centre showed a total of 2719 calls over a period of three years (April 1999-March 2002). The queries were made on poisoning management (92%) and information (8%) about various products and functioning of the centre. The data were analysed with respect to age, sex, mode and type of poisoning. The agents belonged to various groups: household products, agricultural pesticides, industrial chemicals, drugs, plants, animal bites and stings, miscellaneous and unknown groups respectively. The age ranged from less than 1 to 70 years, with the highest incidence in the range of 14-40 years, with males (57%) outnumbering females (43%). The most common mode of poisoning was suicidal (53%), followed by accidental (47%). The route of exposure was mainly oral (88%). Dermal (5%), inhalation and ocular exposure contributed 7% to the total. The highest incidence of poisoning was due to household agents (44.1%) followed by drugs (18.8%), agricultural pesticides (12.8%), industrial chemicals (8.9%), animals bites and stings (4.7%), plants (1.7%), unknown (2.9%) and miscellaneous groups (5.6%). Household products mainly comprised of pyrethroids, rodenticides, carbamates, phenyl, detergents, corrosives etc. Drugs implicated included benzodiazepines, anticonvulsants, analgesics, antihistamines, tricyclic antidepressants, thyroid hormones and oral contraceptives. Among the agricultural pesticides, aluminium phosphide was the most commonly consumed followed by organochlorines, organophosphates, ethylene dibromide, herbicides and fungicides. Copper sulphate and nitrobenzene were common among industrial chemicals. The bites and stings group comprised of snake bites, scorpion, wasp and bee stings. Poisoning due to plants was low, but datura was the most commonly ingested. An alarming feature of the study was the high incidence of poisoning in children (36.5%). The age ranged from less than 1 to 18 years and the most vulnerable age group included children from less than 1 year to 6 years. Accidental mode was the most common (79.7%). Intentional attempts were also noticed (20.2%) in the age group above 12 years. The present data may not give an exact picture of the incidence of poisoning in India, but represents a trend in our country. The Poisons Information Centre plays a vital role in providing timely management guidelines including the supply of necessary antidotes from the recently established National Antidote Bank, thereby helping to save precious lives.

Adolescent↗
PubMed2006

The potential impact of poison control centers on rural hospitalization rates for poisoning.

OBJECTIVE: This study tested the hypothesis that underutilization of poison control centers is associated with increased rates of hospitalizations attributable to poisonings in rural areas. METHODS: To measure the potential impact of poison control centers on hospitalization rates in rural areas among people who visit emergency departments because of poisoning, we estimated the reduction in hospitalization rates associated with increased rates of calls to centers. We used the 2003 State Inpatient Database and State Emergency Department Database from the Healthcare Cost and Utilization Project to calculate the numbers of emergency department visits and hospitalizations for each county in the 12 states analyzed. We used Toxic Exposure Surveillance System data from the American Association of Poison Control Centers to calculate the number of human exposure calls per capita according to county. RESULTS: In rural counties, a 1% higher poison control center human poison exposure call rate was associated with a 0.19% lower hospitalization rate among people who visited emergency departments because of poisoning. If the observed association is causative, then 43.3 calls would prevent 1 hospital admission, yielding 7321 dollars in net cost savings and a return on investment of 5.9:1 (from the health care system perspective). CONCLUSIONS: Our results establish the existence of the hypothesized association between rural poison control center utilization rates and hospitalization rates among emergency department-treated poisoning patients.

Child↗
PubMed1975

Poisoning and poison control centres in Canada.

Poisoning is a major and increasing health problem in the Western world. In 1972 the 310 poison control centres in Canada reported 53 531 enquiries about poisoning, 40% in adults. In 1964 the numbers of hospital admissions and deaths due to poisoning in this country were 2446 and 38, respectively, but in 1972 the figures were 6263 and 319, respectively. Most of the hospitalizations and deaths were among adults. Of 100 Canadian poison control centres two thirds were staffed by "any nurse in the emergency room", most of whom had received no training to answer the phone enquiries. However, two thirds agreed a training program is needed. Only 6.7% of 223 parents surveyed stated they would call a poison control centre if their child had accidentally swallowed a large amount of a poisonous substance. Regionalization of centres, a training program for personnel answering telephone enquiries, the need for crisis intervention as part of poison control programs, and public education about poisoning and poison control centres are the new challenges facing those providing health services.

Canada↗
PubMed1992

Poisoning prevention knowledge and practices of parents after a childhood poisoning incident.

This study investigated the effectiveness of a poison center-initiated mailed intervention on improving the preventive practices of families whose preschool child had recently experienced a poisoning incident. A low-cost, mailed poisoning prevention packet consisting of telephone stickers, a +f41 coupon for syrup of ipecac, one slide-style cabinet lock, a nine-step checklist for "poison-proofing" the home, pamphlets, and a cover letter was tested prospectively on a population of parents calling a poison center for advice about possible poisoning exposures involving their preschool children. Parents without ipecac 1 week after the incident were randomized so that half received the mailed intervention. A "blind" follow-up telephone interview was conducted 3 months later. Of the 336 original families enrolled in the study, 301 (90% retention) completed the follow-up interview. Those who had received the intervention were more likely to have a telephone sticker than control families (78% vs 39%; P < .0001) and were more likely to be using at least one slide lock in the home (59% vs 40%; P < .001). However, intervention families were no more likely to have ipecac on hand than control families (57% vs 52%; P = not significant) and did not indicate a higher rate of compliance with suggested changes in other behaviors and practices to prevent poisonings. A poisoning recurrence rate of 3.7% was seen in the total sample during the 3-month period of surveillance; there was no difference between groups in recurrence rate. Even after a poisoning event, parents may not be sufficiently motivated to take poisoning prevention measures on their own.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Home↗
PubMed1987

The role of the poison center in veterinary poisonings: a survey.

The number of veterinary poisonings presented to this poison center has grown to over 1200 cases annually. To make sure that the poison center is working cooperatively with local veterinarians, a survey was sent out to 237 veterinary clinics state-wide. Of particular interest was whether the poison center had a role to play in the treatment of minor poisonings in companion animals. The results of 77 returned surveys indicate that the poison center is currently a major source of poison information and 95% of responders were satisfied with the information received; 73% felt that all minor ingestions should be handled in the home whenever possible, and 70% felt it would be appropriate for poison center staff to perform this function. This survey indicates that the poison center can play a significant role in the treatment of poisonings in small companion animals.

Animals↗
PubMed2002

[Acute poisonings in Poland during the period 1997-1999. An analysis of files from the Krakow Poison Information Center].

This work analyses the 1997-1999 data received from Polish poison units at Gdańsk, Kraków, Lublin, Łódź, Poznań, Rzeszów, Tarnów, Sosnowiec, Warszawa, Wrocław on patients hospitalised there and patients treated at other hospitals but consulted by specialists of those centres. The analysis shows that drugs constituted the most frequent cause of the poisonings (over 45% all poisonings). Poisonings with: alcohols accounted for 17.6%, gases (primarily by carbon monoxide) for 5.3%, pesticides for 4.5%, substances of abuse for 4.1%, and with organic solvents for 4.0% total poisonings. Suicidal poisonings constituted about 36% total poisonings, accidental over 25%, poisonings resulting for street-drugs and alcohol abuse over 23%, chemical emergency or fire 1%, while occupational poisonings constituted only 0.9% total poisonings. In 1997-1999, the highest numbers of deaths were recorded after intake of: drugs (102), ethylene glycol (39), alcohols (49, including 16 after intake of methanol and 33 after intake of ethanol), pesticides (15 deaths).

Acute Disease↗
PubMed1997

Scombroid fish poisoning: an overlooked marine food poisoning.

Scombroid fish poisoning is a food-borne chemical intoxication caused by certain spoiled fish that contain a large amount of histamine and some biogenic diamines. It has gradually become a world-wide medical problem and probably is the most common cause of fish poisoning. As the data on the incidents of scombroid fish poisoning in Taiwan remains scarce, we report 2 incidents of scombroid fish poisoning in Northern Taiwan. We collected data of the 2 outbreaks of suspected fish poisoning which were reported to us in 1996. An epidemiological investigation was undertaken. Questionnaire interviews were given to persons who ate lunch in the same cafeteria in outbreak 2. The leftover fish were sent for species identification and toxin analysis. The first incident involving 4 women occurred in March 1996. All cases experienced flush, dizziness, blurred vision and skin rashes after eating lunch. A non-scombroid fish of Makaira with histamine levels as high as 84.13 mg/100 g flesh was implicated in this incident. In August 1996, another incident involving some cases who ate lunch at the same cafeteria were investigated. A total of 146 questionnaires were distributed with a return of 132 questionnaires (90.4%). Fifty-five employees reported positive signs or symptoms; 48 persons who ate fish and 7 women who did not eat fish were ill. Fish was the only food associated with the illness with an attack rate of 73.8% (p < 0.001). The incriminated fish was later identified as a scombroid fish of Euthynnus with a histamine content of 271.9 mg/100 g flesh in 1 leftover piece and 118.5 mg/100 g flesh in another piece. Most cases in these 2 outbreaks received treatment with antihistamines and had rapid and complete recovery. The diagnosis of scombroid fish poisoning could be misdiagnosed as food allergy or bacterial food poisoning if physicians are not aware of such poisoning. The nonspecific but characteristic symptomatology of histamine food poisoning and previous consumption of fish should alert physicians to the possibility of scombroid fish poisoning. Unless complicated with shock or respiratory distress, supportive treatment with antihistamines usually concludes with a good prognosis. Toxin analysis of the fish flesh remains the most important step in approaching a confirmed diagnosis.

Adolescent↗
PubMed1993

Poisoning in the elderly: characterization of exposures reported to a poison control center.

OBJECTIVE: To determine the incidence of poison center calls involving the elderly, characterize these poisonings, and compare them with poisonings that occur in people younger than 60 years of age. DESIGN: Concurrent, observational survey. SETTING: The Virginia Poison Center in Richmond, Virginia. PARTICIPANTS: All persons 60 years of age and older who were involved in a poison exposure reported to the Virginia Poison Center from October 1, 1991 through March 31, 1992. MEASUREMENTS: Incidence, type, route, location, management site, medical outcome of exposures and reasons for these exposures. RESULTS: Exposures in persons 60 years of age and older accounted for 2.3% of all poison center calls during the 6-month study period. These calls were most likely to involve women who unintentionally ingested extra doses of medications. The majority of these exposures occurred in the home and resulted in either no effect or minor effects. For those exposures that necessitated an emergency room visit, elderly persons were more likely to be admitted to the hospital than younger persons (P < 0.05). CONCLUSIONS: The majority of poisonings that occur in persons 60 years of age and older are unintentional and may be amenable to poison prevention education.

Age Factors↗
PubMedDate not supplied

[Childhood poisoning: data from the French Poison Control and Toxicovigilance Centres (2002)].

MATERIALS AND METHODS: Data for 2002 from a number of French poison control centres were analysed in terms of several age groups; 87 678 possible or established poisoning cases were counted, including 49 355 cases in the 0- to 18-year age group. RESULTS: The 0- to 3-year age group accounted for 71.7% of cases of childhood poisoning. Accidental poisoning was predominant up to 12 years, while from 13 to 18 years poisoning was essentially deliberate. The principal route of exposure was oral and involved liquids for babies and solid products for older children. The toxic agents most often implicated were pharmaceuticals and domestic products. The place of poisoning was mainly the home. A 'no-risk' evaluation was performed, and varied between 41.6% before the age of 3 years to 18.0% for the 13- to 18-year age group. The oldest children were more often managed in medical facilities. DISCUSSION: Fortunately, most of these poisoning cases were not serious (death rate: 0.026%). The poison control centres' information system is continuing to expand: it will allow an improvement in medical health monitoring associated with poisoning.

Adolescent↗
PubMed2004

Evaluation of the effect of a public educator on calls and poisonings reported to a regional poison center.

There are few studies that use measurable outcomes to gauge the effect of a public educator on the mission of the poison center. Human exposures, penetrance and total call volume from 2 regional poison centers for 7y (1996-2002) were evaluated. In poison center 1 a dedicated educator was employed for the final 4y of data (1999-2002). Poison center 2 data acted as a control with no dedicated educator for the 7-y period. The 2 centers were comparable in a number of ways: similar demographic rural and urban populations; similar geographic and economic region; and served the entire state. Human exposures in poison center 1 increased 4.3 % after employment of a dedicated educator, while exposure continued to decline at center 2 (1.7%). A steep decline in penetrance in poison center 1 was reversed after employment of a dedicated educator. Human exposures and penetrance for poison center 2 continued to decline during the study years. Total calls to center 1 increased 13.8% while total calls to center 2 remained flat (0.2%). This is the first study to use measurable outcomes to evaluate the impact of a public educator on the mission of a poison center. The addition of a public educator was associated with a positive impact on human exposures and penetrance reported to a regional poison center.

Hotlines↗
PubMed1997

Sources of poisoning exposures in children during 1990-1995. An analysis of the National Poison Information Centre files.

Information protocols on the causes of acute poisoning exposures with chemicals in children up to 14 years old collected during 1990-95 at the National Poison Information Centre have been analyzed. Approximately 96% of intoxication were accidental, 44% of patients were poisoned with drugs, 22% with household products and 14% with pesticides. Almost 25% of drug poisonings were due to sedative and to psychotropic drugs, and 17% to drug mixtures. The frequency of mushrooms and plants poisonings were low - 6%. In Poland there are practically no acute poisoning departments which treat children (actually, there is only one Poison Unit in Kraków at Polish-American Children's Hospital), and thus these patients are treated in paediatric wards and paediatric hospitals, so complete data on the poisonings in children from over the whole territory of Poland are not available. However, we believe that the frequency of causes of children's intoxication in our country is properly reflected in our material. This allows us to draw conclusions of the prevention of poisoning in this age group.

Accidents↗
PubMed2006

Evaluation of the Be Poison Smart! poison prevention intervention.

BACKGROUND: Most poisonings to young children are preventable if parents/caregivers receive proper education and professional guidance. The Be Poison Smart! (BPS) (http:// www.bepoisonsmart.com) train-the-trainer intervention was designed to reach healthcare, education, and social service providers who impart the BPS message to parents/caregivers of young children. METHODS: Using the "Do You Know How to Be Poison Smart!?" Evaluation Tool, service providers and parents/caregivers were assessed pre- and 6 weeks post-BPS intervention to determine changes in poison prevention knowledge and poison prevention behaviors. The dependent variables were pre-post differences in total poison prevention knowledge score and in total poison prevention behaviors score. Data were analyzed descriptively and using one-way ANCOVA. Effect sizes were also calculated. RESULTS: Post-test response rates were 28.7% for the service providers (146 out of 509) and 12.4% for parents/caregivers (68 out of 549). The mean knowledge score for service providers showed a significant increase of 13% (95% Confidence interval (CI) = 8.35%, 17%) from a pre-test mean of 9.4 (total possible = 13). Poison prevention behaviors reported by service providers significantly improved by 24% (95% CI = 15.6%, 32%) from a pre-test score of 5.7 (total possible = 11). The mean knowledge score for parents/caregivers significantly increased by 16% (95% CI = 7.2%, 24%) from 8.1, and the mean number of poison prevention behaviors reported by parents/caregivers significantly improved by 11% (95% CI = 3%, 19%) from 6.9. The effect sizes ranged from 0.48 to 0.69. CONCLUSIONS: The BPS intervention increased the self-reported knowledge and behaviors of most participants.

Adolescent↗
PubMed2000

[Poisonings by selected drugs: analysis of 1995-1999 data files of the Clinic of Acute Poisonings Institute of Occupational Medicine in Łódź].

Over the period of 1995-1999 a total number of 439 cases were admitted to the Clinic of Acute Poisonings, Łódź, Poland, due to poisoning with opiates, opioids, amphetamine, cannabis products, LSD and cocaine. Most of the patients were males, the male to female ratio was 1:1.5 (266 to 173). The distribution by age indicated the persons aged 21-30 yr as the highest risk group, then those aged 14-21 yr. Over the period under study the structure of poisonings changed significantly. Since 1997 the number of poisonings with amphetamine and cannabis products increased dramatically, while that of opiate poisonings declined. Approximately 84% of cases were found to be addicted to a combination of drugs and psychotropic agents, mostly benzodiazepine and ethyl alcohol. Drug addiction was reported by over 80% patients with opiate poisoning, 44.8% with tetrahydrocannabinole poisoning and only 9.5% with amphetamine poisoning. The efficacy of treatment in cases of drug addiction is very low. Repeated treatment was reported by almost 100% of patients who had attempted to quit drug abuse. Among opiate poisoning cases, only 8 out of 45 patients did not question the effectiveness of the withdrawal treatment.

Acute Disease↗
PubMed2005

[The reporting system of acute pesticides poisoning and general situation of pesticides poisoning in China].

OBJECTIVE: To introduce the reporting system of acute pesticides poisoning and analyze epidemiologic characteristics of pesticides poisoning from reported cases in China. METHODS: Case reports in the data base of reporting system for occupational diseases were computed by Excel for windows and statistical significance by SAS 6.12. RESULTS: A total of 108 372 cases were reported from 1997 to 2003. Among them, the incidence of occupational poisoning, and non-occupational poisoning accounted for 25.39%, and 74.61% respectively. The fatality rate was 6.86%. The average age was 36.83 years for all pesticides poisoning patients, and 15-59 years old patients accounted for 84.11%. Among 0-14 years old non-occupational poisoning patients, 0-4 years children accounted for 33.51%. Male patients were in the majority in occupational pesticides poisoning, female in non-occupational. Insecticides especially organophosphorus insecticides such as methamidophos, parathion, and omethoate comprised a higher proportion, accounting for 86.02% of the pesticides poisoning. CONCLUSION: More attention should be paid to pesticides poisoning by the government and medical workers engaged in public health.

Adolescent↗
PubMed1991

A poison information service for small animals offered by a regional poison center.

Since 1985 the Hennepin Regional Poison Center has provided the same quality service to veterinarians and pet owners that parents of small children, physicians and other health care providers have enjoyed for many years. To facilitate this service, the poison center has expanded its data base to include information on small animal poisonings and has periodically mailed newsletters state-wide to veterinarians. In addition, the poison center began to routinely assist per owners in the home treatment of minor ingestions in dogs, and enlisted the aid of a veterinary toxicologist who is on-call for consultation. Prior to 1985, animal-related exposures totaled 1,092 cases, which comprised 3.9% of the center's total annual cell volume. As a result of the above efforts, calls from veterinarians and pet owners increased to approximately 2,000 cases annually for the period 1986-88 (average 6.3%). Recently, the poison center received the financial support of the Minnesota State Veterinary Association for the printing of telephone stickers promoting a line exclusively for pet calls (337-PETS). This Pet Poison Information Service appears well received, resulting in an additional 58% increase in pet-related calls. During 1990 this center consulted on over 3,500 exposures in companion animals. Based on our experience, veterinarians and pet owners appear to have been relatively neglected by poison centers. Poison centers may play an important role in the treatment of poisonings in pets.

Animals↗