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The costs and outcomes of restricting public access to poison control centers. Results from a natural experiment.

OBJECTIVES: The authors examined the costs and outcomes resulting from a natural experiment during which direct public access to poison control centers was restricted and then restored. METHODS: Both societal and health care purchaser perspectives were used. Probability data were obtained from a natural experiment during which public callers from a large county in California were electronically blocked from directly accessing the poison control center. Callers were referred to 911, which had direct access to the poison control center, if they thought they had a poisoning emergency. We conducted telephone interviews of: (a) persons who attempted to call the poison control center for a child's poisoning exposure but who did not have direct access (n = 270) and (b) persons who called the poison control center after direct access was restored (n = 279). Cost data were obtained from primary data collection and from other sources. The outcome measure was the appropriateness of the treatment location (at home or at a health care facility). Caller-reported outcomes were also examined. RESULTS: The average additional cost per blocked call was $10.89 from a societal perspective, or $33.14 from a health care purchaser perspective. Fourteen percent of callers with restricted access were treated at an inappropriate location, compared with only 2% of callers with direct poison control center access. Also, 14% did not obtain any professional advice after they attempted to call the poison control center, although 66% of these cases involved potentially toxic substances. Results were robust across a range of sensitivity analyses. CONCLUSION: Restricting direct public access to poison control centers created additional costs to society, the health care sector, and callers.

California↗

The utility of the history and clinical signs of poisoning in childhood: a prospective study.

The authors aimed to evaluate the utility of the history and clinical signs for predicting ingestion of poisons in children. A prospective cohort study was performed of all patients presenting with suspected poisoning to a pediatric emergency department over a 13-month period. Clinical data were collected on a preformatted consultation sheet. Urine drug screens (UDS) were analyzed by gas chromatography/mass spectrometry (GC/MS). Serum toxicologic tests were performed when clinically indicated. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the history and clinical signs were calculated, first using UDS and, second, using all available toxicologic tests as the gold standards. Of 249 patients, 110 (46%) had a UDS performed. The purported poison ingested was potentially identifiable by GC/MS in 57 (52%) of these UDS. Only the results from these 57 UDS were included in our statistical analysis. Overall, the suspected poison was identified in 33 (58%) of the 57 UDS. Similarly, in the less than 5 years age subgroup, 28 (56%) of 50 UDS were positive. Odor on the breath (PPV 100%), followed by symptoms consistent with poisoning (PPV 92%) and presence of poison on clothes (PPV 86%) were the most useful predictors of a positive UDS. Similar results were obtained when all available toxicologic tests were used as the gold standard. The best clinical predictors of poisonous ingestion in children were found to be odor on the breath, symptoms consistent with poisoning, and presence of poison on the patient's clothes. Approximately 40% of children who present with poisoning have not been exposed to the putative toxin.

Adolescent↗

Risk factors for acute pesticide poisoning in Sri Lanka.

This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self-poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide-poisoning cases, which were admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self-poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self-poisoning. Case fatality was 18% with extremely high case fatality for poisoning with the insecticide endosulfan and the herbicide paraquat. Cases were generally younger than controls, of lower educational status and were more often unemployed. No agricultural risk factors were found but a family history of pesticide poisoning and having ended an emotional relationship in the past year was clearly associated with intentional self-poisoning. The presence of mental disorders could only be assessed for a subsample of the cases and controls and this showed that alcohol dependence was a risk factor. This study shows that acute pesticide poisoning in Sri Lanka is determined by a combination of sociodemographic and psychological factors. Suggestions are given for interventions that could control the morbidity and mortality due to acute pesticide poisoning in developing countries.

Acute Disease↗

Self-poisonings with psychopharmacological agents in Zagreb.

1. A 5-year retrospective study of 1743 episodes of self-poisoning in 1608 adult patients, was undertaken to determine the frequency of self-poisoning with psychopharmacological agents, the frequency of each toxic agent usage and the epidemiological characteristics of the poisoned population. 2. The annual incidence of self-poisoning in Zagreb was 38.7 per 100,000 adult inhabitants. The anxiolytic-antipsychotic-antidepressant usage ratio was 8.8:1.5:1.0 in total self-poisoning, whereas it was 4.9:1.5:1.0 in patients with a previous history of self-poisoning. The use of anxiolytics decreased and the use of antidepressants increased during the 5 years. 3. The female-male ratio was 3.8:1 and 77% of self-poisoned persons were aged 15-44 years. The incidence of self-poisoning was 74% higher in the urban than in the rural population. The proportion of self-poisoned persons was 204% higher among the unemployed than in the population as a whole. There were 76% more repetitors among highly educated and 43% fewer repetitors among students than in the general population. The use of antipsychotics was 120% higher in males than in females. The use of antidepressants was 107% higher in the highly educated. 4. The increased use of antidepressants in self-poisoning is an alarming signal and caution in their prescription seems to be indicated.

Adult↗

Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey.

AIM: This study was conducted to determine the biological effects of acute poisoning, the nature of agents involved and the pattern of poisoning in Diyarbakir City, in the Southeast Anatolian region of Turkey, during 2000. METHOD: Hospital records of all admissions to the Emergency Department (ED) of Dicle University Hospital following acute poisoning were revised and all data from January to December 2000 were analysed. The present study included 44 (25.9%) male (M) and 126 (74.1%) female (F), a total of 170 patients. The M/F ratio was 1.0/3.5. RESULTS: The mean age of patients was 23.3+/-6.3 years; 63 (37.1%) of them were under 20 years of age and 147 (86.5%) were under 30 years of age. Most intoxication cases occurred during the summer season (93 of 170 patients). On a monthly basis, admissions during April, May and July were most common (24, 26 and 30 patients, respectively). Sixty-two (36.5%) cases involved accidental poisoning while 108 (63.5%) involved deliberate poisoning. In suicide attempts, intoxications were more common in females (77 cases, 71.3%, P < 0.05), and in unmarried persons (74 cases, 68.5%, P < 0.05). There were only two deaths (1.2%) among the 170 admissions of acute poisonings. One of the deaths was due to pesticide poisoning and the other was due to medical drug abuse. Tachycardia (59, 34.7%), vomiting (55, 32.4%) and loss of consciousness (42, 24.7%) were frequently observed, whereas hypersecretion (15, 8.8%), bradycardia (5, 2.9%), convulsion (8, 4.7%) and hypertension (2, 1.2%) were less frequent. Among pesticide poisoning cases the incidence of convulsion (6, 10.2%), miosis (6, 10.2%), and hypersecretion (12, 20.3%) were significantly higher when compared to other cases (P=0.018, P <0.0001 and P <0.0001, respectively). CONCLUSION: In the Southeast Anatolian region of Turkey, pesticide intoxication is common especially among young, unmarried females and most of these intoxications are intentional self-poisonings. The annual rate of poisoning-related ED visits and mortality were found to be within expected ranges; psychoactive agents being the most common cause.

Acute Disease↗

Severe lead poisoning in pregnancy.

BACKGROUND: Lead freely crosses the placenta. Consequently, gestational lead poisoning is not only harmful to the woman but also to the developing fetus, invariably producing congenital lead poisoning. The scope and consequences of severe lead poisoning in pregnancy (blood lead level > or =45 microg/dL) have not been well characterized. METHODS: We reviewed our experience in the management of women with severe gestational lead poisoning. Additionally, we reviewed the literature on this disorder in an effort to identify patterns in etiology and outcome. RESULTS: Over a 3-year period treatment was provided to 7 severely lead-poisoned women. A 25-year review of the medical literature identified an additional 8 cases. Among these 15 women, 70% were Hispanic, all of whom developed lead poisoning from the ingestion of soil, clay, or pottery ("tierra"). Other sources of lead poisoning were paint chip ingestion (n = 2), household renovation, and use of a complementary-alternative medication (bone meal). Lead poisoning was discovered in the third trimester in 12 (86%) subjects after the women presented with subtle but characteristic findings of severe lead poisoning, including malaise, anemia, or basophilic stippling on blood smear; one woman was identified when she presented after a generalized seizure, having a blood lead level of 104 microg/dL. Five women received chelation therapy during pregnancy with CaNa(2) EDTA, dimercaprol, or succimer. At delivery mean maternal blood lead level was 55 microg/dL, whereas mean neonatal lead level was 74 microg/dL (P =.009). Thirteen neonates underwent chelation, all within the first 28 days of life. No infant in the current series had an identifiable birth defect. CONCLUSIONS: On the basis of this experience we conclude that severe lead poisoning in pregnant women has the following characteristics: 1) it most often occurs because of intentional pica, 2) its presenting features are subtle, often consisting only of malaise and anemia, and 3) blood lead levels in the neonate are higher than simultaneous maternal lead levels.

Female↗

Epidemiology of acute organophosphate poisoning in hospital emergency room patients.

Acute organophosphate (OP) poisoning is a major health issue in developing countries. Organophosphate insecticides inhibit cholinesterase (ChE) enzymatic activity, thereby eliciting cholinergic signs and symptoms. Victims of OP poisoning require immediate hospital emergency room (ER) treatment to prevent a fatal outcome. We present an epidemiologic review of acute OP poisoning in hospital ER patients. Areas of interest include countries with acute OP poisoning, nature of exposure, gender and age of patients, clinical cholinergic features, ChE activity, and health outcome, including recovery rate, case fatality rate, and post-ER complications. The review comprises case reports, hospital surveys, and clinical studies on acute OP poisoning. More studies were conducted in developed than in developing countries. Suicidal and occupational OP poisoning in agricultural workers was prevalent in developing countries, whereas accidental OP poisoning was prevalent in developed countries. Healthcare workers in the ER were also affected by OP poisoning. Both males and females were affected. Children accounted for 35% of the OP-poisoned victims. Patients presented with a classic cholinergic syndrome and serum ChE depresssion, with a recovery rate above 90%. Neurologic impairment was the most frequent complication. Preventing environmental OP exposure and increasing the awareness of pesticide toxicity would reduce acute OP poisoning and protect human health.

Acute Disease↗

Epidemiologic characteristics of death by poisoning in 1991-2001 in Korea.

The purpose of this study was to investigate the epidemiologic characteristics of the death by poisoning in Korea. We recoded the Death Certificates Database by injury based on the short version of the International Classification of External Causes of Injuries (ICECI). We evaluated the mortality rate by total injury and poisoning, and analyzed the mortality rate by age, gender, year and month, toxic agent, and intent. Adjusted odds ratios were calculated to evaluate the effects of socioeconomic factors on suicidal poisoning death. The total number of death cases by injury was 346,656. The proportion of death cases by injury decreased from 13.53% of all death cases in 1991 to 11.89% in 2001. However, the mortality rate by poisoning increased rapidly from 1998, and then remained stable. The number of suicidal poisoning deaths has gradually increased, and its mortality rate was 6.41 (per 100,000) in 2001. Major toxic agents were pesticides and herbicides (50.90%) in 2001. Adjusted odds ratios of suicidal poisoning versus other poisonings showed significant differences in education attainment, region, and marital status. In conclusion, the mortality rate by poisoning has increased, and the proportion of suicidal poisoning also has increased compared to that of accidental poisoning.

Adolescent↗

Fish and shellfish poisoning.

OBJECTIVE: To review history, biology, and medical aspects associated with fish and shellfish poisoning. DATA SOURCES: Current literature, various Web sites, and Halstead's Volume II of Poisonous and Venomous Marine Animals. STUDY SELECTION: Determined by author. DATA SELECTION: Determined by author. DATA SYNTHESIS: Fish and shellfish poisoning occur through the natural event of the food chain. Fish and shellfish consume algae that contain toxin-producing dinoflagellates. As a result they become contaminated and the toxin is concentrated as it moves up the food chain. Fish and shellfish can tolerate high levels of toxins, thereby appearing healthy while posing a significant danger to man. The toxin cannot be detected by sight, smell, or taste and is not destroyed by cooking or freezing. Thus man becomes an unsuspecting victim. There are several types of poisoning that occur through fish and shellfish consumption. They are ciguatera and scombroid fish poisoning; and paralytic, diarrheic, neurotoxic, and amnesic shellfish poisoning. A different toxin produces each of these poisonings; however, sources and symptoms may be similar among these poisonings making them difficult to diagnose. These intoxications can vary in severity from mild to fatal depending on the type and amount of toxin ingested. Age and underlying illnesses may also contribute to the outcome of these poisonings. CONCLUSION: Though people are aware of health warnings and may think they are important, it is human nature to think that "this could not possibly happen to me". Therefore, they fail to make the necessary changes required to reduce the incidence of fish and shellfish poisoning.

Animals↗

Frequency and clinical course of acute carbon monoxide poisoning in relation to the kind of emission gas.

The conversion of domestic supply from illuminating to natural gas in 1975 in Kraków was expected to diminish, or even eliminate the threat of CO intoxication. The aim of the study was to compare the frequency and clinical course of CO poisonings (early or delayed medical complication or death) regarding the source of CO (illuminating or natural gas). Under analysis there were adult inhabitants of Kraków treated at the Department of Clinical Toxicology from 1972 to 1974 when the main source of CO was illuminating gas and those treated from 1994 to 1996 i.e. after the conversion of domestic gas supply from illuminating to natural gas. All the cases of people who died at the scene of the accident prior to any treatment were also included. The frequency of acute poisonings among the inhabitants of Kraków was expressed by the incidence rate per 10,000 inhabitants with regard to age and sex. The severity of CO poisoning was estimated considering age, duration of exposure, carboxyhemoglobin (COHb) level, and the neurological state of patients on admission to the Clinic. Significantly higher frequency of suicidal poisonings was noted in the group of patients poisoned with illuminating gas compared to those poisoned with CO produced by incomplete combustion of natural gas (p < 0.001). No significant differences were noted considering the age of patients hospitalised in both periods. Duration of exposure was significantly longer and carboxyhemoglobin level was significantly higher in the group of patients poisoned with illuminating compared to natural gas. Significantly higher frequency of severe poisonings was noted in the group of patients intoxicated with illuminating gas compared to those intoxicated with natural gas. The frequency of acute CO poisonings in the population of Kraków determined by the incidence rate per 10,000 inhabitants was approximated to 2.4 in all the years analysed. The conversion of domestic supply from illuminating to natural gas significantly decreased the mortality rate. No differences in the number of patients suffering from medical complications were found between the two study periods. A higher incidence of late sequalae (psychoorganic and depressive syndromes) was found in the group of patients poisoned with CO produced by incomplete combustion of natural gas compared to illuminating gas.

Adolescent↗

Developmental risk factors for unintentional childhood poisoning.

OBJECTIVE: To identify main risk factors for unintentional childhood poisoning in Ahwaz, Iran and to suggest possible causes and preventative measures. METHODS: This is an epidemiological description and a case-control study. The study was undertaken in Ahwaz, Iran in 1996-1997. Cases were 100 children who were taken to one of the 17 Accident and Emergency Departments due to poisoning. For every case two controls were selected. Age, gender, hospital and date of attendance to Accident and Emergency Department were matched between cases and controls. All parents of the children were interviewed by using a questionnaire that included demographic and poisoning characteristic information. RESULTS: Children without adult supervision (odds ratio = 4.8), and those with previous poisoning (odds ratio = 5.2) were at increased risk of poisoning (P < 0.05). Drug poisoning was more common among children (60%), and most poisoning occurred inside the home (89%). Boys (65%), and children aged 2-4 years (79%) had more poisoning than others. In 75% of cases, poisonous products were accessible. CONCLUSION: Adequate parental supervision and safe packing, storage and disposal of potentially hazardous substances could be the most important activities for prevention of childhood poisoning. Furthermore, manufactures and traders must by law put certain toxic household products and drugs in child resistant containers, and mark toxic medicines with warning labels or signs.

Case-Control Studies↗

[Emergency department visits for poisoning: epidemiological changes in the last 10 years].

OBJECTIVE: To study the epidemiological changes observed in pediatric poisonings treated in our Emergency Department between 1988 and 1999. PATIENTS AND METHODS: Descriptive, observational study performed in three 12-month periods (1988, 1993 and 1999). The circumstances surrounding the visit, treatment in the Emergency Department and clinical evolution were registered. RESULTS: Consultations for possible poisoning decreased between 1988 and 1999 (279 vs. 161, p 0). This decrease was noted both in poisonings caused by household products (91 vs. 48, -47 %) and those caused by drugs (112 vs. 87, -22 %). Antipyretics caused one-third of drug poisonings and psychotropics caused approximately 11 %. The most commonly implicated agent is currently paracetamol. Caustic alkali were the most common household products causing poisoning although the number of such poisonings decreased (48 episodes in 1988 and 18 in 1999). Hydrocarbons were the second most frequent cause of household product poisoning (12-16/year). Most episodes occurred at home. The poison, mainly household products, was kept in a container other than the original in nearly 5 % of episodes in 1988 and in 13.7 % in 1999. The number of children receiving treatment in the Emergency Department decreased between 1988 and 1993 and remained stable between 1993 and 1999 (62 % in 1988 and approximately 35 % in 1993 and 1999; p 0.000003). The number of admissions also decreased from 17 children in 1989 (6.0 %) to six in 1999 (3.7 %, p 0.39). No deaths were recorded. CONCLUSIONS: In the last ten years, visits for possible episodes of pediatric poisoning have decreased, mainly those due to mild poisoning caused by household products. Paracetamol has replaced acetyl-salicylic acid as the most frequently implicated drug.

Child, Preschool↗

Oxidative damage in intermediate syndrome of acute organophosphorous poisoning.

BACKGROUND & OBJECTIVES: The main cause of morbidity due to organophosphate poisoning is intermediate syndrome (Type II paralysis) that can occur 48-72 h after poisoning. Mechanisms that underlie the intermediate syndrome are not known. This study investigates the role of oxidative damage to muscles as a possible mechanism underlying the development of the intermediate syndrome. METHODS: Nineteen patients with acute organophosphate poisoning were evaluated from admission to discharge from intensive care for the severity of poisoning and the development and duration of the intermediate syndrome. Blood cholinesterases and parameters of oxidative stress were studied daily and their temporal profiles analysed according to the severity of poisoning and the development and duration of the intermediate syndrome. RESULTS: Fifteen patients had severe poisoning and 16 developed intermediate syndrome. There was a positive association between the severity of poisoning and the occurrence of intermediate syndrome. There was no association between the organophosphate ingested and the development of intermediate syndrome. Erythrocyte membrane acetylcholinesterase and serum butyrylcholinesterase levels at admission and over the course of poisoning were significantly (P < 0.001) reduced in patients compared to controls. There were significantly (P < 0.05) higher levels of lipid peroxidation, conjugated dienes and protein thiols in erythrocyte membranes of patients who developed the intermediate syndrome compared to healthy controls, in patients who developed intermediate syndrome compared to those who did not and in patients with long compared to short duration intermediate syndrome. INTERPRETATION & CONCLUSION: In acute organophosphate poisoning, severe and prolonged acetylcholinesterase inhibition is associated with oxidative stress, detected in erythrocyte membranes, that occurs early in the course of poisoning and may contribute to the development and severity of intermediate syndrome.

Acetylcholinesterase↗

[Logistic regression analysis of factors influencing clinical therapeutic effect on acute tetramine poisoning].

OBJECTIVE: To investigate the factors affecting clinical therapeutic effect on acute tetramine poisoning. METHODS: Using Logistic regression to analyze the relationships among the degree of tetramine poisoning, time of onset, time of admission, exposure history, sex, age, unithol, gastric lavage, etc with the death of poisonded patients. RESULTS: The fatality rate of patient with tetramine poisoning who got gastric lavage was less than that who did not (5.85% vs 38.00%, P < 0.01). In patients who got gastric lavage, the fatality rates were increased with the degree of tetramine poisoning (control: 0%, mild poisoning: 3.07%, severe poisoning: 9.14%, P < 0.05). There was no significant difference in fatality between using unithol and not using patients (7.22% vs 8.25%, P > 0.05). CONCLUSION: Unithol has no significant influence of clinical therapeutic effect on tetramine poisoning patients and dose not reduce the fatality rate of patient with tetramine poisoning, but gastric lavage and the degree of tetramine poisoning do. Logistic regression analysis showed that gastric lavage is the main factor affecting the therapeutic effect on tetramine poisoning.

Acute Disease↗

MS 04-044: demographic features of drug and chemical poisoning in northern Malaysia.

Acute poisoning is a significant health problem all over the world. In Malaysia, nationwide data on poisoning pattern is scarce and incomplete. The objectives of our study were to determine the pattern of acute drug and chemical poisoning at Penang General Hospital (PGH), in the northern region of Malaysia, and to compare poisoning characteristics between different ethnic groups. The study was a retrospective case review of all poisoned patients admitted to PGH during the years 2000-2002. We collected data concerning demographic parameters of patients, information about the agent(s) implicated, and circumstances surrounding the event. There were 493 poisoning incidents. Nearly two-thirds of the poisoned cases involved female patients. The predominant mode of poisoning was intentional (51.5%). The age group 15.1-30 years ranked at the top, constituting 55.2% of all cases. Drugs were the predominant agents implicated. Among cases associated with drugs, paracetamol was the main causative agent (44.7%). Chinese patients constituted 37.7% of all poisoning cases, followed by the Indians (31.6%) and Malays (26.6%). Between ethnic groups, Indian patients were found to have the highest rate of poisoning admission of 75.2 per 100,000 persons.

Accidents↗

Drug poisoning in childhood.

OBJECTIVES: To determine and present the pattern of poisoning with drugs in Princess Rahmat Hospital, Irbid, Jordan, and to assess the effects of variables such as age, season, gender and agent on poisoning frequency. METHODS: We performed this retrospective cross-sectional study on 126 cases of poisoning with drugs hospitalized in Princess Rahmat Teaching Hospital, Northern Jordan, during a 6-year period from 1996 to 2001. The data collected included: age, gender, seasonal variation, material ingested, symptomatic or not on admission, time and place of ingestion, history of similar problem among the patient or his siblings, whether the parent induced vomiting before seeking medical help or not and the outcome regarding mortality and morbidity. We considered chi-square and values for the statistical analysis. RESULTS: There were 126 children (<12 years of age) admitted during the study period. Among the children, 54 (42.9%) were girls and 72 (57.1%) were boys. The majority (89.7%) was <6 years. There were seasonal variations of poisoning events with a higher frequency in the Spring (39%) and in Summer (35%). We considered severity mild in 60%, moderate in 27% and severe in 13% of cases. The large majority of drugs were psychotropic agents (56%) and principally diazepam's (39%). Self-poisonings were the most frequent cause of poisonings among children <12 years of age (mostly accidental poisonings such as drug poisonings). None of the children died or had a permanent sequel. CONCLUSION: Although we recorded no deaths in this study, drug poisoning in children remains a frequent problem, highlighting the need to develop an education program on primary prevention in our region. Parental education and intensified child supervision are the indicated measures of prevention for unintentional poisoning.

Accidents, Home↗

A study of poisoning cases in emergency Kathmandu Medical College Teaching Hospital.

OBJECTIVE: To determine the pattern and severity of poisoning cases in emergency Kathmandu Medical College Teaching Hospital. DESIGN: Retrospective observational study. MATERIALS AND METHODS: All the poisoning cases due to various agents who attended Emergency from 1st of April 2002 to 30th of March 2003 were evaluated retrospectively. RESULTS: A total of 67 poisoning cases attended emergency Kathmandu Medical College Teaching Hospital over a period of one year. The overall female to male ratio was 1.09:1. Most poisoning occurred in the age group 21-30 for adults (38.8%) and 2-5 yrs for the children. Organophosphorous was the most common poisoning for the adults where as kerosene was common in children. Oral route was the most common route of administration which accounted 86.57%. Students (35.8%) and housewife (23.3%) were commonly involved in self poisoning. Intentional poisoning comprised 58.2% of all poisonings. CONCLUSION: Majority of the intentional poisoning occurred in the female housewife & students of younger age group but accidental poisoning was found common in children under five years mostly with kerosene ingestion.

Adolescent↗

[Occupational lead poisoning in Poland].

During the years 1970-1996, 8,414 cases (8,176 among men and 238 among women) of lead poisoning, recognised as occupational disease, were registered with the peak in 1972-1976 (500-800 cases per year). An in-depth analysis of 7,893 (men) reported in the period between 1970 and 1992 revealed that repeated poisonings in the same person were observed quite frequently. Among 4,556 men poisoned by lead during the period under study, in every third men the disease was diagnosed at least twice. Almost half of men with occupational lead poisoning received the occupational disease certification after the exposure lasting less than five years. The majority of persons poisoned by lead (64.3%) were employed in plants located in the Katowice voivodship. More than half of men with occupational lead poisoning (54.1%) was exposed to maximum concentrations of lead, exceeding MAC values by two hundred times. A diminishing number of occupational lead poisoning observed during the 1990s does not reflect a real-level of occupational exposure. The majority of cases reported apply to large plants or industrial complexes where the prevention of poisonings is rather well organised. But dispersed small production and service enterprises, where acute cases of poisoning may lead to irreversible organic changes create a great problem. One of the prerequisites for effective prevention of occupational lead poisoning is to identify and to make a complete inventory of workplaces where lead occurs, as well as to identify workposts hazardous to worker's health, and to monitor lead concentrations in the air.

Adult↗