Acute Poisonings
Taiwan: Findings from a hospital-based study analyzing poisoning incidents and poisoning-related fatality (19.10.09)
Poisoning is a significant public health problem worldwide and is one of the most common reasons for visiting emergency departments (EDs), but factors that help to predict overall poisoning-related fatality have rarely been lucidated. Using 1'512 subjects from a hospital-based study, they sought to describe the demographic and clinical characteristics of poisoning patients and to identify predictors for poisoning-related fatality.
Between January 2001 and December 2002 the study group prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. Comparisons were made between survival and fatality cases, and used logistic regressions to identify predictors of fatality.
A total of 1'512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits.
These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%), and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%), followed by pesticides (14.5%). Of the 1'512 patients, 63 fatalities (4.2%) occurred.
Paraquat exposure caused the highest fatality rate (31 of 43 [72.1%] exposed) and was the major agent involved in fatalities (46.3%).
Paraquat (24% w/v) is one of the most commonly used herbicides in Taiwan and has been the most common lethal agent of poisoning for a long time [2,24,44,45].
There are various explanations for the relatively large number of pesticide poisonings in Taiwan. In particular, Taiwan is located in an agricultural area, making pesticides easily accessible, and appropriate storage containers are not generally used. Another factor may be a lack of knowledge amongst the general public about the toxic effects of these chemicals. In addition to the measures that have been taken by authorities, including banning some of the most toxic pesticides (e.g., endosulfan and parathion) and promoting less use of pesticides, there is a need for greater efforts aimed at reducing the number of deaths caused by pesticide poisoning.
In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality.
It was demonstrated that even though the toxicity of paraquat is well recognized, it continues to stand out as the dominant agent for poisoning-related fatalities in some parts of the world. The results of this study should act as a reminder to clinicians, public health professionals and the general public of the serious consequences of exposures to this agent.
Source:
Lee HL, Lin HJ, Yeh STY , Chi CH & Guo HR (2008):Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study. BMC Public Health 8:7
Between January 2001 and December 2002 the study group prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. Comparisons were made between survival and fatality cases, and used logistic regressions to identify predictors of fatality.
A total of 1'512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits.
These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%), and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%), followed by pesticides (14.5%). Of the 1'512 patients, 63 fatalities (4.2%) occurred.
Paraquat exposure caused the highest fatality rate (31 of 43 [72.1%] exposed) and was the major agent involved in fatalities (46.3%).
Paraquat (24% w/v) is one of the most commonly used herbicides in Taiwan and has been the most common lethal agent of poisoning for a long time [2,24,44,45].
There are various explanations for the relatively large number of pesticide poisonings in Taiwan. In particular, Taiwan is located in an agricultural area, making pesticides easily accessible, and appropriate storage containers are not generally used. Another factor may be a lack of knowledge amongst the general public about the toxic effects of these chemicals. In addition to the measures that have been taken by authorities, including banning some of the most toxic pesticides (e.g., endosulfan and parathion) and promoting less use of pesticides, there is a need for greater efforts aimed at reducing the number of deaths caused by pesticide poisoning.
In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality.
It was demonstrated that even though the toxicity of paraquat is well recognized, it continues to stand out as the dominant agent for poisoning-related fatalities in some parts of the world. The results of this study should act as a reminder to clinicians, public health professionals and the general public of the serious consequences of exposures to this agent.
Source:
Lee HL, Lin HJ, Yeh STY , Chi CH & Guo HR (2008):Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study. BMC Public Health 8:7
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