Epidemiology of poisoning due to pharmaceutical products, Poison Control Centre, Seville, Spain

A retrospective study of telephone calls concerning poisoning due to pharmaceutical products, attended by the Toxicological Information Service in Seville (Spain), is presented. The years 1993 and 1994 were analized. Demographic data including the age and sex of the patient, route of exposure, cause, type of poisoning and the therapeutic group, was obtained. The great majority were cases of acute poisoning due to domestic accident, attempted suicide took second place. Ingestion was the principal route of entry, and more males than females were affected. 35.2% were children under two. In general, the medicines most frequently involved were those affecting the nervous system (28.1%) – principally analgesics, anxiolytics and antidepressants – followed by dermatological agents (13.7%) – such as antiseptics and disinfectants – and those affecting the respiratory (medicines to treat common cold, bronchodilators, antitussives) and digestive systems (laxatives, antiacids). It is hoped that with knowledge of data from as many poisons centres as possible, an improvement may gradually be seen in the prevention of the such poisoning in the future.     

沈阳地区某三甲医院6902例急性中毒患者流行病学分析

目的 分析沈阳地区某三甲医院急诊科6 902例急性中毒患者的临床和社会人口学模式,为本地区急性中毒的抢救和防治提供参考。方法 对2012年1月1日—2018年12月31日期间该院所有急诊科就诊的中毒病例的人口统计数据进行统计分析,了解急性中毒流行病学特征。结果 共发生6 902名中毒患者就诊,占所有急诊病例的0.6%。其中,中毒死亡93例,病死率1.3%。男女比例为1∶1.14。患者的平均年龄为(36.2 ± 15.1)岁。中毒发生率最高的年龄组为20~29岁(约占30.1%)。大多数的患者暴露类型被归为自杀性中毒(3 835例,55.6%)。在自杀性中毒和滥用性中毒之间存在性别差异(χ²=289.14,P<0.001):即女性比男性更容易发生自杀性中毒,而男性比女性更容易发生滥用性中毒。口服是最常见的中毒途径(86.1%)。最常见的四类有毒物质按组别依次为治疗性药物、农药、酒精以及气体;849例(12.3%)服用两种或两种以上的中毒物质。就具体物质而言,酒精、百草枯、一氧化碳和镇静催眠药是最常见的中毒物质。农药中毒发生率最高的季节为夏季而气体中毒最常见的季节为冬季。结论 2012—2018年间,总体中毒人数呈下降趋势,本地区的急性中毒特征与十年前相比发生了变化。     

Therapeutic strategy in phosgene poisoning

For the treatment of phosgene poisoning, glucocorticoids and positive pressure ventilation can be recommended as well as supporting measures such as physical rest, antitussives, buffers, sedatives, antibiotics, antispasmodics and possibly diuretics. Roentgenological evaluation of the lungs is advisable. A therapeutic strategy is presented which is based on the phosgene exposure intensity.     

Accidental poisoning among children and adolescents in a county in southern Brazil

This study analyzes the characteristics of accidental poisoning among children and young adolescents (< 15 years) in Londrina, Paraná State, Brazil, in 2001. Data were obtained from patient records in general hospitals, the local Poison Control Center, and the municipal Mortality Information Center. There were 473 cases of poisoning, with an incidence rate of 339.8 per 100,000, 58.5% due to poisonous substances and 39% due to venomous animals and plants. Increased risk was observed in the 1-3-year age group, due to poisonous substances. Medications (47.5%), pesticides (14.1%), and cleaning products (11.3%) were the main substances involved (284 cases), and 17.2% of children were hospitalized. Among 189 cases of contact with venomous animals and plants, caterpillars (29.1%), bees (25.9%), and spiders (22.8%) were the main agents, with a 1.1% hospitalization rate. Incidence of poisoning is high, and there are important differences in the types of agents involved according to age group, which may help orient the prevention of such accidents.     

Pesticide poisoning and its related factors among Korean farmers

This study has been carried out to assess the health damages due to pesticide use and its related risk factors among Korean farmers. Data regarding pesticide handling and poisoning symptoms were collected by means of a questionnaire filled in by 1,032 farmers from two provinces. The results showed that during summer farming 21.9% of the subjects experienced suspected pesticide poisoning. 18.8% mild poisoning, and 2% more serious poisoning. Univariate and logistic regression analyses between "no poisoning", including the "suspected poisoning" and "poisoning" groups, were performed to select significant variables related to pesticide poisoning. Four variables were significantly associated: sex, days of consecutive pesticide use, hours of pesticide use per day, having received safety education (weakly associated), and compliance with safety guidelines for application. Safety education was weakly associated with poisoning, while age, education, wearing protective gear, and compliance with safety guidelines for personal hygiene after pesticide use were not significant risk factors to determine pesticide poisoning.     

Acute pesticide poisoning: a major global health problem

The global problem of acute pesticide poisoning has been confirmed as extensive by a variety of independent estimates. Further, it is also recognized to be a problem confined to the developing countries. Most estimates concerning the extent of acute pesticide poisoning have been based on data from hospital admissions which would include only the more serious cases. The latest estimate by a WHO task group indicates that there may be 1 million serious unintentional poisonings each year and in addition 2 million people hospitalized for suicide attempts with pesticides. This necessarily reflects only a fraction of the real problem. On the basis of a survey of self-reported minor poisoning carried out in the Asian region, it is estimated that there could be as many as 25 million agricultural workers in the developing world suffering an episode of poisoning each year. This article emphasizes the need to control the problem on a collaborative basis by all concerned, including national governments, agrochemical industries, international agencies, scientists and victims.     

深圳市某塑胶工厂一起由植物皂素导致的食物中毒事件调查

目的 调查分析一起某塑胶工厂食堂发生的植物皂素中毒事件的原因和特点,为皂素中毒事件预防控制提供参考。 方法 使用食物中毒个案调查表收集深圳市某塑胶工厂中毒患者资料,通过现场调查和电话访问等方法收集本次中毒事件相关信息,通过回顾性队列研究分析事件发生的可疑餐次和可疑食品。 结果 此次皂素中毒事件共发现患者8例,员工罹患率为28.57％(8/28)。患者临床症状以头晕(100%)、呕吐(87.50%)为主。员工食用4月10日公司食堂提供的中餐者罹患率(50.00%)显著高于未食用当日中餐者(0%)(P=0.008, RR=+∞),当日中餐食用薯蓣骨头汤者罹患率(100%)高于未食用者(0%)(P<0.001)。检测患者呕吐物、剩余食品(薯蓣)样品和食品原材料(生薯蓣)皂素毒素阳性。 结论 该事件为一起皂素毒素中毒事件,致病因子为4月10日中餐未煮熟的薯蓣骨头汤。薯蓣属食物含有植物皂素,食用时需煮熟煮透避免引起中毒。     

Drug poisoning in children in Vojvodina]

Epidemiological characteristics of acute drug poisoning in children were investigated over a period of two years (1988-1989). The total number of poisonings was 450. Among causes of poisoning psychopharmaca, especially benzodiazepine, came first (33.3%). They were followed by drugs affecting the nervous system (9.1%), usually by analgoantipyretics, and by drugs affecting the cardiovascular system (7.8%). In 10.6% of the cases poisoning was due to two or more drugs. In 12.3% of the poisonings drug was unknown. Sodium fluoride was the most frequent single cause of acute poisoning. The average age of the poisoned children was 5.1 years. Poisoning with drugs was more frequent among girls than among boys (55:45%). In more than half poisoning accidents there was no one present when poisoning occurred. A major number of poisonings were an attention-getting gesture or a suicidal attempt. There were 11 cases of repeated poisoning with the same drug.     

Unintentional child poisoning risk: A review of causal factors and prevention studies

Unintentional child poisoning represents a significant public health priority in the United States and globally. This article was written to accomplish three goals: (a) outline and discuss a conceptual model of factors that lead to unintentional poisoning incidents among children under 5 years of age, including the roles of individual people, the environment, packaging and labeling of toxic products, and community and society; (b) review published literature concerning interventions designed specifically to reduce unintentional child poisoning; and (c) draw conclusions about what is known and what gaps exist in the current literature on unintentional child poisoning prevention to inform development, evaluation, and implementation of empirically supported, theoretically based prevention programs. The need for multi-faceted, multi-disciplinary, team-based approaches to prevention is emphasized.     

2006-2015年中国大陆地区食物中毒特征分析

目的 分析中国大陆地区2006-2015年十年间食物中毒发生的一般规律及其特性,探索有效的食源性疾病预防控制策略。 方法 通过整理2006-2015年十年间公开发布的关于中国大陆地区食物中毒事件情况的通报,分别从食物中毒的基本情况、月份分布、中毒原因和发生场所进行数据分析。 结果 2006-2015年中国大陆地区食物中毒情况总体呈持续下降的趋势,报告起数最多的出现在8月份或者9月份。“微生物性”一直是导致食物中毒的主要原因,而造成死亡人数最多的原因为“有毒动植物及毒蘑菇”。致病因素构成比年度分析发现,“有毒动植物及毒蘑菇”报告起数、死亡人数构成比随着年份增加有明显的上升趋势。发生在家庭的食物中毒报告起数和死亡人数都是最多,发生在集体食堂导致的中毒人数最多。家庭发生的食物中毒报告起数构成比随着年份增加有明显的上升趋势,而发生在集体食堂的食物中毒构成比下降明显。 结论 2006-2015年中国大陆地区食物中毒的报告起数、中毒人数和死亡人数均呈现下降趋势。但是“有毒动植物及毒蘑菇”引起的食物中毒仍需宣传重视。     

家庭因素与儿童急性中毒发生的相关性研究

目的探讨家庭因素对儿童急性中毒发生的影响。方法对2001年1月～2010年12月244例发生急性中毒的儿童进行回顾性研究分析,同时随机抽取50名因呼吸道感染住院治疗的儿童作对照。结果两组儿童一般状况差异无统计学意义,家庭因素作多元逐步回归分析表明:患儿母亲的职业、患儿母亲的文化程度、家庭经济状况及家庭居住地等为主要危险因素。结论家庭因素与儿童急性中毒的发生关系密切,改善家庭环境是减少儿童急性中毒发生的重要途径。     

Acute pesticide poisoning in England and Wales.

Between 1979 and 1983 less than 1% of admissions from acute poisoning in the UK were due to pesticides and fewer than 4% of admissions in those under 5 years were from this cause. Organochlorine, organophosphorus and carbamate insecticides account for only 10% of the total in both children and adults. Suspected pesticide poisoning was the cause of fewer than 0.3% of home accidents in those under 10 years of age and less than 4% of suspected poisonings documented by the Home Accident Surveillance System. Rodenticides were thought to be involved in 62% of these cases. Of children who presented to hospital 42% were admitted and 93% of these were discharged home within 2 days. In the UK, the morbidity from acute pesticide poisoning in children is low and the mortality is nil and there is therefore no evidence to support the view that paediatric pesticide intoxication is a significant clinical problem. Though no fatalities were recorded in children, pesticides were responsible for 1.3% of all deaths due to poisoning in the UK between 1979 and 1983. In adults admitted to hospital, the mortality from pesticide poisoning is approximately 12% and three quarters of these deaths are due to the deliberate ingestion of paraquat. The general term pesticide refers to a group of products that are used as insecticides, acaricides, fungicides, herbicides, rodenticides, and plant growth agents. Chemically, the group includes bipyridilium compounds, carbamates, chloralose, chlorates, coumarins, dinitro compounds, dithiocarbamates, fluoroacetates, organochlorine organophosphorus and organotin compounds, pentachlorophenol, phenoxyacetates, phosphine (as magnesium and aluminium phosphides), pyrethrins, pyrethroids and triazines.(ABSTRACT TRUNCATED AT 250 WORDS)     

儿童急性中毒相关因素与干预措施

目的:探讨儿童急性中毒的原因,以寻求相应的干预措施。方法:回顾性分析我院儿科2000年1月-2004年12月收治的126例儿童急性中毒病例的临床资料。结果:126例儿童急性中毒中,药物中毒(过量)70例(55.56%);1-3岁儿童中毒73例(57.94%);家中发生中毒98例(77.78%);乡村儿童中毒75例(59.52%);城市儿童药物中毒(过量)72.55%,乡村药物中毒(过量)44.0%,其次灭鼠药及农药中毒30.67%;急性中毒死亡率3.17%。结论:儿童急性中毒乡村高于城市,均以药物中毒为首要因素,家中的急性中毒发生率明显高于户外;1-3岁小儿是急性中毒高发年龄,与这一年龄段的发育特点有关,儿童急性中毒应以预防为主。     

Rural work and pesticide poisoning

Pesticide use is intensive in Brazilian agriculture. Population-based studies on the characteristics of pesticide use and pesticide poisoning are scarce. This study describes the profile of occupational exposure and pesticide poisoning incidence. Farm characteristics and pesticide occupational exposure were evaluated using a cross-sectional design. Among 1,379 farmers/farm workers, annual incidence of pesticide poisoning was 2.2 episodes per 100 exposed. Based on Poisson regression, applying pesticide, reentering crop fields after spraying, and working with pesticides on more than one farm were the types of exposure that presented a positive correlation with pesticide poisoning. The results may be useful for planning activities aimed at reducing occupational pesticide poisoning among rural workers.     

Gas poisoning

Poisoning by gases in our area is an important problem due to its high incidence. In the specific case of carbon monoxide poisoning, this is the main cause of death by poisoning in our environment, on many occasions coexisting with cyanide poisoning. Both poisonings can be severe, their diagnosis being based on the mere suspicions of the doctor. Besides, their importance lies in the fact that both poisonings have a very specific treatment. Normo or hyperbaric oxygenotherapy is the treatment for carbon monoxide poisoning. In the case of cyanide poisoning, hydroxocobalamin is nowadays the treatment of choice, since it has proved itself to be an efficient antidote.     

Food poisoning in hospitals in Scotland.

A review of 50 hospital-based outbreaks of food poisoning which were reported in Scotland during 1973--7, is described. At least 1530 persons consuming hospital-prepared food were involved. Thirty-one episodes were associated with Clostridium perfringens (C. welchii), 11 were due to food-borne salmonella infection, three to enterotoxigenic Staphylococcus aureus, and five incidents were of undetermined aetiology. This differs noticeably from the experience in England and Wales where salmonellas appear to predominate as the main cause of hospital outbreaks. Twenty-two incidents occurred in hospitals for psychiatric or mentally subnormal patients, and ten others were located in geriatric units. Only 33 hospitals were involved in the 50 outbreaks as nine hospitals experienced two or more episodes. The role of the hospital in the occurrence of food poisoning may be over-emphasized in comparison with other catering establishments, as outbreaks are more readily recognized and laboratory facilities are usually available for investigation, but it is also believed that many episodes may not be reported. The peculiar problems of the hospital-catering service and particularly those of the older long-stay hospitals, are discussed in relation to preventive measures which would minimize the hazards of food poisoning.     

Deaths from poisoning in Barcelona (Spain), 1986-1989.

Between 1986 and 1989, 3226 violent deaths were recorded in Barcelona, 489 of which were due to poisoning. The yearly distribution of these 489 deaths was: 1986, 74; 1987, 98; 1988, 134; and 1989, 183. Of all poisoning deaths, 316 were due to narcotic opiates use, 54 to the inhalation of toxic gases, 49 to the use of psychoactive agents, 37 to caustic products and the others 33 cases to various toxic agents (insecticides, methanol, solvents, mushrooms, etc.). Opioid use is currently the leading cause of death by poisoning in Barcelona, and affects a young population with a mean age between 25 and 27 years. In the groups corresponding to toxic gases and psychoactive drugs, the mean ages are 48 and 45.7 years, respectively. The oldest population was found in the group where death was caused by caustic agents, where the mean age is 56.5 years. The male sex was predominant in all groups except that of caustic agents, where 56.8% of the victims were women. This study confirms the notable increase in opiate- related deaths in the city of Barcelona (up from 27 cases in 1987 to 158 in 1989) and shows stability in the numbers for the other groups. Among the different hypotheses concerning of this remarkable increase in deaths related to opiate use, the aging of consumers and changes in the purity or composition of the product seem to be the most probable.     

Hospital-based survey of pesticide poisoning in Japan, 1998--2002

Data concerning clinical cases of pesticide poisoning from 1998 to 2002 from the hospitals affiliated with the Japanese Association of Rural Medicine were analyzed. 346 cases of poisoning by agricultural chemicals were reported from 65 hospitals. Suicides accounted for 70% of pesticide poisoning cases, followed by accidental exposures during spraying work (16%) and accidental ingestion (8%). The majority of cases were acute or subacute systemic poisonings (90%), followed by acute dermatitis (5%) and chemical burns (3%). Organophosphate insecticide was the most frequent inducer of clinical cases (36%), followed by bipyridylium herbicide (20%) and carbamate insecticide (6%). The death rate from poisoning by the herbicide paraquat was more than 70% of clinical cases, even though it is a low-concentration product, whereas those from the alternative herbicides, glufosinate and glyphosate, were less than 10%.     

急性有机磷农药中毒的临床护理

本文主要分析了急性有机磷农药中毒患者的临床护理办法。主要从一般护理,特殊护理,心理护理以及使用解毒药物这几方面进行了讲解。最后得出,对于急性有机磷农药中毒患者首先要详细了解中毒的情况,然后再根据每位中毒者的实际情况,采取合理有效的护理措施。只有这样才能尽快地消除患者体内的毒物,使其尽快的康复。     

Accidental poisoning with household detergents

Caustic substances and home detergent poisoning remain a threat to the health of young children. The aim of the present work was to estimate the occurrence of household poisoning due to detergents and to study some demographic and behavioral correlates. MATERIAL AND METHODS: Through systematic random sampling technique one tenth of all women attending pediatric and family medicine clinics in King Khalid University Hospital over two months were selected and interviewed to complete questionnaire. They were asked about history of poisoning due to detergents in their family in addition to their demographic-and practice regarding storage, use and disposal of detergents. RESULTS: The sample amounted to 318 mothers with mean age 34.2+/-7 13 years. 55(17 3%) reported history of poisoning due to detergents in their families Housewife mothers mothers with ?5 children, not reading detergents' labels, using detergents' containers for food and mixing different detergents; all were significantly associated (P<0.05) with higher rates of detergents poisoning in families (24.6%, 25.3%, 30.6%, 35.7% and 50%, respectively). RECOMMENDATIONS: health education programs concentrating with storage, use and hazards of detergents are recommended for mothers.