MYTOXDATA MYTOXDATA: A TOXICOLOGICAL DATA MANAGEMENT FOR NATIONAL POISON CENTRE

The aim of the present paper is to evaluate the Malaysian Toxicological Database (MyToxData), a newly developed system for toxicological data management. MyToxData is a local system for collection of case reporting and toxicity statistics as well as its database of chemical products and toxicity information. An online questionnaire using JotForm was distributed among healthcare professionals in Malaysian hospitals. The participants were asked to perform tasks on MyToxData system before rating their satisfaction experience. The questionnaire was adopted from previous literature and comprised 12 items, each having a five-point scale that ranged from Strongly Disagree to Strongly Agree. The collected data were then analysed using the SPSS software package. Based on the results, the satisfaction testing showed a high satisfaction score for the login at 95.7% and case registration and toxicological/poisoning case notification at 65.2%. The poisoning substance identification component received a 78.2% agreement on the usefulness with a very high acceptance of 91.3% on the treatment and clinical information retrieval made available on the system. One sample t-test found that all constructs for the satisfaction testing of MyToxData, namely, accuracy, content, ease of use, format and timeliness, were significant. The higher acceptance by healthcare professionals on the satisfaction testing of MyToxData has identified the effectiveness of the development and subsequent usage of a dedicated system for toxicological data management.

Exposures and suspected intoxications during SARS-CoV-2 pandemic: preliminary results from an Italian poison control centre

Data on cleaner and disinfectant exposure and misuse-related acute intoxications in Italy during SARS-CoV-2 pandemic are still lacking. The aim of the present study was to analyse and describe cleaner and disinfectant-related intoxications during SARS-CoV-2 pandemic in an Italian poison control centre. Data were obtained from the toxicological consultations requested to the Toxicology Unit and Poison Centre, Careggi University Hospital, Florence (Italy). We compared data from January 1st to April 30th of 2019 and 2020. Data concerning probable or acute intoxication from any causative agent in the general population (all age groups), from private individuals or from Regional and National health structures, were included in the analysis. A toxicological evaluation was also performed to calculate the Poisoning Severity Score.In 2019, 451 phone counselling sessions were performed and compared to a total of 410 calls received during the same period of 2020. In both periods, the majority of events occurred in paediatric (0–17 years) and adult (18–65 years) patients, who were mainly exposed to one toxic agent, and intoxications took place principally at home due to domestic accidents. The oral route of intoxication was the most frequently observed one, followed by inhalation of toxic agents, which increased by 4.7% in 2020. In 2020, sanitizers and cleaners were reported in 21.6% of cases compared to 12.5% in 2019. This is the first study describing cleaner and disinfectant-related intoxications in Italy. Our results suggested a possible misuse of these products during the SARS-CoV-2 pandemic, underling the effects of home isolation on mental health and unintentional toxic exposures.

Epidemiology in oral antidiabetic poisoning in children and adolescents – a four-year study in a pediatric poison centre

Oral antidiabetics have become a common etiology associated with acute poisoning in children. The study shall carry out an analysis of the demographic characteristics, circumstantial characteristics and clinical profile associated with oral antidiabetic poisoning. An observational, descriptive and retrospective study was carried out over a period of 4 years including children confirmed with the diagnosis of acute poisoning with oral antidiabetics. In the study group, there is a prevalence of voluntary acute poisoning in female patients in the 15 to 18 year age group. bIn the group study biguanides were the most frequent pharmaceutical dugs involved. The predominant clinical manifestations associated with oral antidiabetic intoxications were gastrointestinal.

Increases in exposure calls related to selected cleaners and disinfectants at the onset of the COVID-19 pandemic: data from Canadian poison centres

Little is known about the use or misuse of cleaning products during the COVID-19 pandemic. We compiled data from January to June in 2019 and 2020 from Canadian poison centres, and report on calls regarding selected cleaning products and present year-overyear percentage change. There were 3408 (42%) calls related to bleaches; 2015 (25%) to hand sanitizers; 1667 (21%) to disinfectants; 949 (12%) to chlorine gas; and 148 (2%) to chloramine gas. An increase in calls occurred in conjunction with the onset of COVID-19, with the largest increase occurring in March. Timely access to Canadian poison centre data facilitated early communication of safety messaging for dissemination to the public.

Hospital referrals of patients with acute poisoning by the Belgian Poison Centre: analysis of characteristics, associated factors, compliance and costs

ObjectiveAims were (1) to assess the characteristics, associated factors and compliance of patients with acute poisoning advised by the Belgian Poison Centre (BPC) to go (conditionally) to the hospital, (2) to assess the compliance and potential health-economic impact.MethodsThree types of referrals to the hospital of patients who called the BPC between 1 January and 30 June 2018 were analysed: referrals in case of deterioration in the patient’s condition (Hosp-watchful-wait), referrals (Hosp-referral) or urgent referrals (Hosp-urgent-referral). Factors associated with type of recommendation were registered. A survey was conducted on a second dataset of patients who called the BPC between 1 March and 15 May 2019 and referred (conditionally) to the hospital.Results5476 referrals were included: 72.4% accidental poisoning, 25.3% intentional self-harm, 1.2% substance abuse and 1.1% unclear intentionality. There were 2368 (43.2%) Hosp-watchful-wait cases, 2677 (48.9%) Hosp-referrals and 431 (7.9%) Hosp-urgent-referrals. In Hosp-watchful-wait cases, soaps and detergents were represented most (20.5%). In Hosp-referrals and Hosp-urgent-referrals, benzodiazepines (12.7% and 15.1%, respectively) predominated. Factors associated with hospitalisation type were number of symptoms, intentionality, type of agent(s) involved and advising antidotes. The survey showed that 7.8% of Hosp-watchful-wait patients went to the hospital versus 57.3% of Hosp-referrals and 59.6% of Hosp-urgent-referrals. The mean cost for Hosp-watchful-wait patients, Hosp-referrals and Hosp-urgent-referrals was estimated at €127, €767 and €796, respectively.ConclusionOnly a small proportion of patients followed the advice of the BPC to go (conditionally) to the hospital. A systematic follow-up of cases is warranted to examine the appropriateness of referrals and the compliance of patients.

Epidemiology and risk factors of pesticide poisoning in Malaysia: a retrospective analysis by the National Poison Centre (NPC) from 2006 to 2015

ObjectivePesticide poisoning is a global health problem, and its progressive deterioration is a major cause of concern. The objective of this study is to assess epidemiological characteristics and identify risk factors of pesticide poisoning in Malaysia.SettingPesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.ParticipantsTelephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).OutcomesThe outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.ResultsWithin the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.ConclusionsDeliberate pesticide ingestion as a method of suicide has become a disturbing trend among Malaysians. Therefore, regulation of highly hazardous pesticides must be enforced to ensure controlled and limited access to these chemicals by the public.

Evaluation and Management of Patients with Methomyl Poisoning – A Case Report

The Apulian Poison Centre (PC) of Foggia, Italy, annually manages numerous consultations concerning certain or suspected poisonings from pesticides, starting at the same time a careful activity related to the risk assessment phase. The management of the exposure to pesticides and to other chemicals, and the alerting of the “National center for chemicals, cosmetics and consumer protection” at the Istituto Superiore di Sanità (ISS), actively contributes to the improvement of products quality and safety. Thus, leading to a reduction in the number of intoxications - and therefore of the accesses to the emergency services - allows greater protection for workers, bystanders, residents and consumers. The reported case of methomyl poisoning has been of fundamental importance both from the medical point of view and for the management of the intoxicated patient, both for the risk assessment actions, and for cooperation with the competent authorities, generating discussion points on the regulations in force between PCs and National Competent Authority. It follows that the feedback of intoxication in an emergency can lead to improvements in the management and risk mitigation measures in order to reach a greater protection of human, animal, and environmental health. In addition, the regulatory feedback deriving from these reports is an input to the increase product quality improvement (mixtures, labels, packaging, and risk communication) leading to a greater protection of potential exposed subjects. The importance of creating an information and management network that allows the optimization of the flow of information deriving from PCs arises. The actions taken are therefore described, both relating to the management of the emergency, and relating to the subsequent information flow and to the measures for containing the consequent risks.

Prevalence and Mortality Incidence of Poisoning Cases in Serdang Hospital

In Malaysia, there were more than 35,000 poisoning cases enquiries were reported to the poison centre since its establishment from the year 1995 to 2014. The objective of our study is to determine the prevalence of poisoning cases and antidote used in Serdang Hospital. All poisoning cases admitted to the Serdang Hospital between January 2007 to December 2016 were evaluated retrospectively by using consecutive sampling. Data were obtained from Electronic Hospital Information System (eHIS) by using data collection form. Descriptive statistic was used to analyse the data. 903 patients were included in our study. The prevalence of poisoning cases during the study period is 0.22%. The fatality rate was 1.8% (n=16). More detailed data reveals that young adults aged between 18 to 29 years old, 44.2% (n=399) has the preponderance of poisoning cases, and females, 59.7% (n=539) admission dominated over males. Most poisoning cases were intentional, 74.5% (n=673) and related to the use of non-opioid analgesics, 35.7% (n=322). In summary, these trends of poisonings provides a foundation to recognise areas for training and education on self-injury prevention among healthcare providers and public society.