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Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry

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Abstract

Introduction

In the developing world, occupation has been identified as a risk factor for snake bite. Such an association has not been described in the USA. The objective of this study was to describe the epidemiology and clinical manifestations of occupational snake bite in patients reported to the ToxIC North American Snakebite Registry (NASBR).

Methods

This was a prospective case series of patients reported to the ToxIC NASBR between January 1, 2014 and November 5, 2015. Variables collected included snake species, patient demographics, date and location of exposure, occupation, bite location, clinical manifestations, and management.

Results

Of 180 adult snake bites reported, 25 (13.9 %; 95 % CI 9.2–19.8 %) were occupational in nature. Rattlesnake envenomations were common (80 %). Most snake bites (96 %) occurred in men. Occupations most associated with snake bite were landscaping (28 %) and working directly with snakes (24 %). Fifty-six percent of bites occurred in an outdoor work environment. Seventy-six percent of envenomations were to the upper extremities. Intentional interaction occurred in 40 % of cases, all of which sustained finger envenomations. No cases presented with apparent acute ethanol intoxication.

Conclusions

The majority of occupational snake bites occurred in men working outdoors and were unintentional injuries. Bites involving the upper extremity tended to result from intentional interactions. Acute ethanol intoxication did not appear to be involved with occupational envenomations.

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Acknowledgments

The authors express gratitude to the staff at the American College of Medical Toxicology (ACMT) for support of the North American Snakebite Registry (NASBR) within the ToxIC Registry project. We would also like to thank the members of the 2015 ToxIC Snakebite Study (TICSS) group: Anna Arroyo-Plascencia, Vikhyat S. Bebarta, Michael C. Beuhler, William Boroughf, Jeffrey Brent, Daniel Brooks, E. Martin Caravati, James D. Cao, Nathan Charlton, Steven Curry, Michael Darracq, William Dribben, Kimberlie Graeme, Spencer Greene, Benjamin Hatten, Kennon Heard, C William Heise, Janetta Iwanicki, Aaron Min Kang, William P Kerns II, Thomas Kibby, Joshua King, Ronald Kirschner, Kurt Kleinschmidt, Ken Kulig, Michael Levine, Rachel Levitan, Elizabeth Moore, Philip Moore, Michael Mullins, Eleanor Oakley, Ayrn O’Connor, Nancy Onisko, Angie Padilla-Jones, Tammy Phan, Frank LoVecchio, Anne-Michelle Ruha, Steven A. Seifert, Daniel J Sessions, Aaron Skolnik, Eric Smith, Meghan Spyres, An Tran, S. Eliza Halcomb, Evan S. Schwarz, Shawn M. Varney, Rais Vohra, Brandon J. Warrick, Sam G. Wang, Paul Wax, and Brian J. Wolk.

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Authors and Affiliations

  1. Department of Medical Toxicology, Banner-University Medical Center Phoenix, 925 E. McDowell Road, 2nd Floor, Phoenix, AZ, 85006, USA

    Meghan B. Spyres, Anne-Michelle Ruha & Angela Padilla-Jones

  2. New Mexico Poison Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA

    Steven Seifert

  3. North Texas Poison Center, Parkland Health and Hospital System, Dallas, TX, USA

    Nancy Onisko & Eric Anthony Smith

Authors
  1. Meghan B. Spyres
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  2. Anne-Michelle Ruha
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  3. Steven Seifert
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  4. Nancy Onisko
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  5. Angela Padilla-Jones
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  6. Eric Anthony Smith
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Corresponding author

Correspondence to Meghan B. Spyres.

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Conflicts of Interest

Authors Meghan Spyres MD, Anne-Michelle Ruha MD, Steven Seifert MD, Nancy Onisko DO, Angela Padilla-Jones RN, and Eric Smith MSIS have no conflicts of interest to declare.

Funding

There was no direct funding for this project.

BTG International sponsored an unrestricted grant to ACMT for the NASBR registry.

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Spyres, M.B., Ruha, AM., Seifert, S. et al. Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. J. Med. Toxicol. 12, 365–369 (2016). https://doi.org/10.1007/s13181-016-0555-7

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  • DOI: https://doi.org/10.1007/s13181-016-0555-7

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