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PubMed1992

[The STIZ and the epidemiology of poisoning in Switzerland (Swiss Toxicologic Information Center)].

Despite the fact that the danger and the sequelae of poisoning are regularly referred to in the media, comprehensive reports about type and frequency of poisoning in Switzerland are not available in the literature. Thus morbidity of poisoning can only be judged by the calls and written replies of treating physicians. According to the retrospective evaluation of the data available to us (1966 to 1991), the number of poisoning leading to severe life-threatening symptoms is tending to decline. This apparent success of prevention and treatment of poisoned patients in our country should be corroborated by extensively investigating quantitative and qualitative aspects of poisoning. Moreover, overall mortality of poisoning is increasing, especially because of the deaths caused by abusing habit-forming drugs. On the other hand, the number of suicides using medicaments shows a tendency to decline. Detailed statistical data about the circumstances and xenobiotics involved in poisoning could efficiently help to develop measures to prevent a fatal outcome.

Adult↗
PubMed2004

Medico-legal investigation of suspected fatal poisonings in Pretoria: 2000-2001.

Accurate data on the incidence and spectrum of fatal poisonings in South Africa is lacking. Most studies focus on "traditional poisons". This is a retrospective study on the medico-legal investigation of suspected fatal poisonings seen at the Pretoria Medico-Legal Laboratory. Post mortem records from January 2000 to December 2001 were examined. There were 153 cases of suspected fatal poisoning or overdose. However, toxicology results were conclusively positive in only 53 (34.64%) cases with some cases testing positive for more than one type or class of "poison". The fatal "poisons" identified in these 53 cases were as follows: pharmaceuticals (47.17%), illicit drugs (41.51%), agricultural poisons (20.75%), alcohol (13.21%), traditional medicines (3.77%) and heavy metals (3.77%). The average delay in completing toxicology analyses was 10 months. This study demonstrates that the current medico-legal investigation of fatal cases of suspected poisoning does not yield adequate results for definitive judicial administration in two-thirds of suspected cases. This creates a legal dilemma, as the primary medical cause of death remains unresolved.

Adolescent↗
PubMed2005

Deliberate self-poisoning in children.

This prospective study was aimed to analyze the nature of and the factors associated with deliberate self-poisoning in children below the age of 12 years. Children referred to the Child Guidance Clinic for evaluation after recovery from the effects of poisoning during the five-year period between 1999 and 2003 formed the subjects of the study. The children were evaluated for stress factors, psychiatric disorders and the nature and mode of deliberate self-poisoning. Deliberate self-poisoning constituted 0.9% of total admissions due to poisoning. There were 10 boys and 2 girls between the ages of 9 and 12 years. Both acute and chronic stress in the family and school were associated with deliberate self-poisoning. Majority of them had psychiatric disorders. Rat poison (zinc phosphide) was the commonest poison used. Two children got the idea from watching TV serials.

Child↗
PubMed2005

Unintentional deaths from drug poisoning by urbanization of area--New Mexico, 1994-2003.

New Mexico experienced an increase in poisoning deaths during the 1990s and in 2002 was the state with the highest death rate (14.1 per 100,000 population) from unintentional poisoning, more than twice the national rate (6.1). The majority of these unintentional poisoning deaths were caused by ingestion of drugs, including illicit, prescription, and over-the-counter drugs. New Mexico is geographically diverse, with communities ranging from urban centers to sparsely populated counties. To examine the relationship between the types of drugs causing poisoning deaths and the levels of urbanization where the decedents resided, the New Mexico Department of Health analyzed data provided by the New Mexico Office of the Medical Investigator (OMI) for 1994-2003. All counties in New Mexico were classified as metropolitan or micropolitan statistical areas, or as nonstatistical areas, by using 2001-2002 population estimates in accordance with 2003 Office of Management and Budget (OMB) classifications. This report summarizes the results of that analysis, which indicated that deaths from illicit-drug poisoning were twice as likely to occur in metropolitan areas as nonmetropolitan areas (i.e., micropolitan and nonstatistical areas combined). However, deaths from prescription-drug poisoning were most likely to occur in micropolitan and nonstatistical areas. Investigation of drug-poisoning deaths by level of urbanization can be useful to public health programs to prevent unintentional drug-poisoning deaths.

Female↗
PubMed2005

Frequency and pattern of poisoning in adult and adolescent Kraków population in 2003 and 1983.

The pattern (frequency, type of exposure, toxic substance) of adolescent and adult poisonings in Kraków in 2003 is compared with 1983. The analysis includes data for poisoned patients treated at the Kraków Department of Clinical Toxicology and all on the spot fatal cases subjected to post-mortem autopsy and toxicological examinations at the Department of Forensic Medicine Jagiellonian University Medical College in both the years. As much as 4341 poisoning cases (2852 males; 1489 females) were treated in 2003 compared with 2132 (1078 males; 1054 females) in 1983. In 1983 in group of 154 poisoned persons who died at the place of accident there were 138 (89.6%) men and 16 (10.4%) women. In 2003 among 121 deaths at the scene there were 93 (76.9%) males and 28 (23.1%) females. Poisonings due to suicidal attempts decreased significantly from 53.6% in 1983 to 19% in 2003. Incidence of poisoning per 10 000 of general Kraków population increased from 36.17 in 1983 to 57 in 2003 or up to 65.7 if the population of adults and teenagers (above 15 years old) was only considered. Pharmaceuticals (40.6%) followed in frequency by ethanol (25%) and ethanol co-ingested with pharmaceuticals (12.2%) and carbon monoxide (10.6%) were the most common reasons for poisoning in 1983. In 2003 the most common cause of poisonings was ethanol (46.2%) followed by pharmaceuticals alone (25%) or co-ingested with ethanol (6.4%) and carbon monoxide (6.2%). An ingestion of mixed pharmaceuticals (55.1%) followed In frequency by non-barbiturate hypnotics and psychotropic drugs (26.3%) were a most common in 1983 whereas a non-barbiturate hypnotics and psychotropic drugs (34.4%) followed by mixed pharmaceuticals (32.9%) in 2003. A mortality both concerning only the people who died in hospital and also those who died on the spot (prior to any treatment) was significantly higher in 1983 compared with 2003.

Adolescent↗
PubMed2005

Comparative assessment of blood and urine analyses in patients with acute poisonings by medical, narcotic substances and alcohol in clinical toxicology.

Acute poisonings by medical, narcotic substances and alcohol are actual in Russia in the recent years. Comparison of analytic facilities of modern analytical techniques: chromatographic (HPLC, GC, GC-MS) and immuno-chemical (FPIA) in clinical toxicology for urgent diagnostics, assessment of the severity of acute poisoning and the efficacy of the treatment in patients with acute poisonings by psychotropic drugs, narcotics and alcohol have been done. The object of the study were serum, blood, urine of 611 patients with acute poisonings by amitriptyline, clozapine, carbamazepine, opiates and also alcohol. Threshold concentrations (threshold, critical and lethal) of the toxicants and their active metabolites which corresponded to different degrees of poisoning severity have been determined. The most comfortable and informative screening method for express diagnostics and assessment of severity of acute poisonings by psychotropic drugs and narcotics showed the HPLC with using automatic analyzers. FPIA using the automatic analyzer could be applied for screening studies, if group identification is enough. GC-FID method is advisable in case of poisoning by medical substances and narcotics in view of repeated investigation for assessment of the efficacy of the therapy. GC-MS could be advisable for confirming the results of other methods. GC-TCD possess high sensitivity and specificity and is optimal for express differential diagnostics and quantitative assessment of acute poisoning by ethanol and other alcohols.

Acute Disease↗
PubMed2005

Understanding poison control and protecting its future.

Poison centers save money and lives. Individual patients and their doctors benefit from local poison center availability, as do healthcare facilities and insurance companies. All have a stake in a stable poison control system. It is likely that the greatest contribution of poison control centers to society has yet to be realized. Poison control centers already possess an efficient, realtime surveillance mechanism (TESS). With increased funding, this can be expanded and made more available outside the poison control community. TESS can be used to detect chemical releases or attacks and environmental and infectious disease outbreaks as they occur - long before individual healthcare providers could connect the dots. In conclusion, while the value of a nationwide poison control system to society is well recognized, its future is not as clear. Establishing a stable system to monitor and treat poisonings in the US will take political will at the local, state, and federal levels to ensure full funding for years to come.

Comprehension↗
PubMed2006

Characteristics of poisoning cases in adult intensive care unit in Sanliurfa, Turkey.

OBJECTIVE: The aim of this prospective study was to analyze the rate and characteristics of acute poisoning cases admitted to adult intensive care unit (ICU). METHODS: All cases of acute poisoning admitted to ICU of the Harran University Hospital, Turkey, between July 2002 and May 2005, were included in this study. Clinical, laboratory, and demographic characteristics, type of poison and patient's outcomes were recorded. RESULTS: There were 86 poisoning cases among 844 patients admitted to the ICU. The mean age was 26 +/- 9 years and the majority of the patients (56.9%) were 15-24 years of ages. Eighty percent of acute poisonings were self-inflicted and 65.2% of these patients were singles. Medical drugs overdose were the major cause (51.2%) of intoxication followed by agricultural chemicals (37.2%). The most frequently involved medicinal drugs were benzodiazepines, antidepressants and analgesics. Eleven patients in pesticides-rodenticides and 9 patients in other medical drugs poisoning have required mechanical ventilation between 1-12 days. The duration of the intensive care stay was 6.4 +/- 4.3 days. Five cases (5.8%) with acute poisonings were fatal. CONCLUSION: There was a high rate of suicides attempt in young singles, predominantly female population. These data were the highest agricultural activity of the country that provide important information about the characteristics of poisoning at the city.

Adolescent↗
PubMed2006

[The etiology and rescue modalities of 1692 cases of acute chemical poisoning].

OBJECTIVE: To investigate the etiology and characteristics of rescue of acute chemical poisoning. METHODS: A total of 1692 cases of acute chemical poisoning were analyzed retrospectively. The kinds of chemicals, the modes of exposure, the characteristics of poisoning and the methods of treatment were analyzed. RESULTS: Poisoning was due to occupational exposure to chemicals in 44.91%, daily life exposure to chemicals in 38.82% and environment chemical pollution in 16.25% of the cases. The total number of chemicals harming the patients was 173. The most common three of the chemicals were pesticides, harmful gases and organic solvents. Recently, the accidents of mass poisoning were increasing in number. CONCLUSIONS: To know the numerous chemicals responsible for acute chemical poisoning is essential for enhancing the pre-hospital care, emergency treatment and follow-up treatment. Further more, extensive clinical knowledge and numerous biologic laboratory tests are need to improve the diagnosis and rescue of acute chemical poisoning. In cases of chemical emergency that involves mass exposure, the majority of the affected persons are likely to be exposed to the poisoning chemicals, though some are exposed minimally. Moreover, resources to provide psychological support must be available both for the family member of casualties and the affected personnel.

Acute Disease↗
PubMed1991

Accidental poisoning in south west Maharashtra.

A retrospective analysis of accidental poisoning (oral and parenteral) in children admitted to the Pediatric Ward of Krishna Hospital and Medical Research Centre, Karad over the past five years (1984-1988) was done. Overall incidence of accidental poisoning in children was 1.8% (oral 1%, parenteral 0.8%). Mean age of children was 6.5 years, with male-female ratio 2:1. Oral poisoning was more common in children below 5 years whereas parenteral poisoning was common in children above 5 years. Kerosene oil was the commonest oral poison (30%). Oral poisoning was more common in summer (61%) and parenteral in the rainy season (51%). Rural children were more commonly involved than urban children (ratio being 5:2). Gastrointestinal symptoms were commoner with oral poisons. No mortality was noted with oral poisons; 3% children died due to snake bite.

Accidents↗
PubMed1991

[An epidemiological study of poisoning in children under 18 years old in the Bloemfontein area].

An epidemiological study of the incidence of poisoning in children in the Bloemfontein area during 1 year was carried out. Deliberate and accidental poisonings were studied relative to: (i) age and sex of poisoned children; (ii) type of poison involved; and (iii) the time the poisoning occurred. This study showed that deliberate poisoning occurred more frequently in girls than in boys (67.5% v. 32.5%), that accidental poisoning occurred mostly in the preschool years and then more frequently in boys than in girls (65.1% v. 34.9%) and that drugs were involved in most poisonings.

Adolescent↗
PubMed1991

Description of a scale for rating the clinical response of cattle poisoned by larkspur.

Larkspur poisoning is a major cause of acute death of cattle on mountain and high plains rangelands of western United States. A nonlethal method to quantify dose response in cattle is needed to better estimate the toxicity of larkspur plants and the response of cattle to larkspur poisoning and to provide a basis for reference during studies. A numerical system of rating the clinical signs of larkspur poisoning was developed and used to describe the response of 10 Hereford cows given a repeated single daily dose of larkspur (Delphinium occidentale x barbeyi) by gavage. Larkspur poisoning resulted from a short-term cumulative effect, and a statistically significant increase in score was essentially maximal by 4 days. At the dose given, this effect did not persist for more than 4 days after cessation of dosing. Poisoning was most severe between 5 and 9 hours after dosing. Early signs of poisoning can be subtle and sometimes brief. The effect of larkspur poisoning can be exacerbated temporarily by exertion. Therefore, cattle could probably repeatedly consume an otherwise toxic daily dose, without manifesting marked signs of poisoning, if consumption decreased to a sufficient degree intermittently at 2- to 4-day intervals.

Animals↗
PubMed1990

[Acute poisoning by carbon monoxide from personal examinations 1966-1985].

Acute poisoning by carbon monoxide (CO) in Kraków takes the third place after drug and alcohol poisoning. When natural gas came into use, the incidence of acute CO poisoning decreased profoundly. But mortality rate of this poisoning can still tell how severe it is. The authors presented the relation between the incidence rate, complications and mortality rate of CO poisoning and the source of this gas emission. 243 subjects were treated in the intensive Toxicological Care Unit from 1966 to 1985, and during the first 10 years lighting gas was the main cause of the poisoning but during the second the poisoning was mainly caused by CO produced by incomplete combustion of some components of natural gas. This 20-year period was characterized by routine treatment. The change of CO emission source introduced in 1976 had not radical statistical influence on the clinical picture, complications, mortality of CO poisoning.

Adolescent↗
PubMed1990

[Evaluation of the risk of acute poisoning with chemicals in inhabitants of Krakow in from 1983 to 1987].

In Kraków in 1983-1987 11,664 cases of acute poisoning by chemical substances were reported: 11,123 patients were hospitalized; 541 patients died before was given any medical intervention. Among those patients who were treated there were 9725 adult patients older than 14 years--hospitalized in Toxicological Department and 1398 children who were treated in the pediatric departments of many hospitals in Kraków. The cases of the poisoning due to suicidal attempt in the studied period mean 43% and during this time the decreasing tendency was evident (from 47.6% in 1983 to 34.4% in 1987). Narcotic and drug addicts covered only 2% of the whole material concerning the cases of the acute poisoning. Overall incidence rate of poisoning by chemical substances per 10,000 inhabitants of Kraków ranged from 33.9 in 1983 to 32.7 in 1987, and it was always higher in adult population (32.6 in 1983-35.0 in 1987) than in children (24.5 in 1983-23.4 in 1987). During the whole studied period and its successive years the most common poisoning was the poisoning due to: drugs (mean 50%), ethyl alcohol (mean 22%), and carbon monoxide (mean 18%). The highest incidence rate of the acute poisoning was presented to the hospital or clinic in January and October; on Mondays, Tuesdays, and Thursdays; between 12 p.m. and 12 a.m., whereas the lowest was noted during summer months; on Sunday; between 4 a.m. and 8 a.m. Our studies gave us a real picture of the poisons the population in Kraków is exposed to; and total mortality rate amounts 0.8%, yet being calculated on the base of clinical studies goes up to 5.4% when forensic data are taken into account.

Adolescent↗
PubMedDate not supplied

Epidemiology of childhood poisonings leading to hospitalization in the United States, 1979-1983.

Since 1979 unintentional childhood poisonings have accounted for about 75 deaths annually in the United States, and for each death thousands of ingestions are reported to poison control centers. Little is known about childhood ingestions that lead to hospitalization. To address this issue, we analyzed National Hospital Discharge Survey data from the National Center for Health Statistics for 1979-1983. For these years, an estimated 108,280 children from birth to 9 years of age were hospitalized because of unintentional poisonings. Overall, the annual rate for hospitalization because of childhood poisoning was 65.1 per 100,000 children aged 0-9 years. Hospitalization rates for poisoning were highest for children aged 1 and 2 years (216.2 and 184.3 per 100,000, respectively) and lowest for those aged 5-9 years (11.3 per 100,000). Rates for children less than 1 year old and for those 3-4 years old were moderate. Children of other races had higher hospitalization rates for poisoning than did white children (124.2 per 100,000 compared with 51.9 per 100,000). White male patients were hospitalized more frequently than white female patients, but this sex difference did not occur in children of other races. Rates were consistently highest for children in the Northeast and South and lowest for children in the West. From 1979 to 1983, the length of a hospital stay for childhood poisoning declined by 26 percent. Our results provide new information on childhood poisonings requiring hospitalization.

Age Factors↗
PubMed1987

A program of poison center services to business and industry.

Poison information centers have been developed to serve the poison information, treatment, and prevention education needs of the residents within their regions. These services are generally provided and funded by hospital-based centers. A limited number of centers receive local and state government financial support. In general poison information centers are nonrevenue-generating and rely upon these sources of fiscal support. As cost containment within the health care industry becomes more critical, poison centers are falling victims to budget cuts and even being eradicated in the interest of saving money. The private sector has provided grants to poison centers, but this represents a short term solution to a long term problem--the need for consistent funding. Business and industry have been overlooked as a source of potential revenue. Our poison center has developed an extensive program of services for the private sector. These include providing 24-hour-a-day poison information service on their behalf; developing a workers' right-to-know program; identifying epidemiologic trends with their products, preparing exposure reports; etc. These services are provided for a specific fee which is determined by anticipated call volume, number of products to be included, medical and legal liability, etc. By providing services to the private sector, we have reduced the financial liability of our poison center by over 25%.

Commerce↗
PubMed1984

A poison education program for primary school.

A program with which to teach children in grades 1 and 2 to identify poisons and hazard symbols, to learn where poisons should be stored and to recognize a poisoning and contact a poison control center in the event of a poisoning was developed. Each objective was taught in one 30-minute lesson by the children's school teachers. Evaluation of the approximately 400 children who received the program by pre- and post-tests demonstrated that they learned to identify poisons, to recognize hazard symbols and the telephone number of the local poison control center. The children were also asked to identify their source of knowledge about poisons and cited parents, television and school as their most important sources.

Child↗
PubMed1995

The evaluation of the threat of acute chemical compound poisonings among the adult inhabitants of Kraków in the years 1983 and 1993.

The aim of this study is to compare the frequency, kind and structure of acute poisonings of the Kraków residents in years 1983 and 1993. The group of 2132 people treated for acute poisonings in the year of 1983 consisted of 50.6% men and 49.4% women, in 1993 the group of 2311 patients consisted of 60.7% men and 39.3% women. The group of 154 poisoned who died at the place of accident in 1983 consisted of 89.6% men and 10.4% women, whereas in 1993 the group of 220 such cases included 83% men and 17% women. The overall coefficient of poisonings during the years compared was 36.2 for 1983 and 42.0 for 1993. The coefficient of poisonings in the years examined of 1983, 1993 were 39.4 and 50.4 for men, and respectively 33.4 and 28.0 for women. In 1983 the poisonings with drugs (40.6%) were most numerous, ethanol came second (25%). In 1993 the first place took ethanol (31.8%), the second drugs (31.3%). The number of poisonings with carbon monoxide increased from 9.87% in 1983 to 13.6% in 1993. The comparison of numbers concerning the mortality rate of the treated patients and of those who died at the place of accident prior to any treatment, shows a considerable growth in mortality rate in 1983 from 1.1% up to 7.8% and in 1993 from 0.8% to 9.4%. Such a significant growth in this mortality rate is influenced by poisoning with ethanol and carbon monoxide at the place of accident.

Acute Disease↗