Document Type : Original Article

Authors

1 Department of forensic medicine and clinical toxicology, Faculty of Medicine, Alexandria University, Egypt.

2 Department of medical education, Faculty of Medicine, Alexandria University, Egypt.

Abstract

Background: Poisoning remains one of the health problems that causes significant patient mortality and morbidity worldwide regardless of a country's development or culture. It can occur secondary to exposure to natural ingredient or chemical substance.
Methods: This study was conducted to evaluate Alexandria Poison Center (APC) data for trends and modes of poisoning exposure over a 5-year period and to evaluate the characteristics of human exposure based on the cases received by APC. The data was collected retrospectively from 1st of January   2017 to 31st of December 2021 and all patients admitted through this time (36853 cases) were included.
Results: The study revealed that poisoning occurs significantly more in females than males and the highest incidence of poisoning occurred in adult category. Pesticides were accountable for the highest number of poisoning cases; also, pesticides were responsible for more than 70% of deaths. So, Pesticides were selected as a model to be analyzed in detail. On the side of the study, the effect of COVID-19 was studied and revealed no significant changes in profile of acute poisoning cases, however, suicidal tendency remarkably increased in 2020 and 2021 in comparison to other studied years.
 
 

Keywords

  1. References

    1. Gregory Tsoucalas and Markos Sgantzos. The Death of Cleopatra: Suicide by Snakebite or Poisoned by Her Enemies? In: Toxicology in Antiquity. Philip Wexler ed (Second Edition). Academic press 2019, Pages 83-92. https://doi.org/10.1016/B978-0-12-815339-0.00004-4
    2. Li Z, Xiao L, Yang L, Li S, Tan L. Characterization of acute poisoning in hospitalized children in southwest China. Frontiers in pediatrics. 2021:1225.
    3. WHO Guidelines for establishing a poison centre. https://www.who.int/news/item/18-01-2021-who-guidelines for-establishing-a-poison-centre.
    4. Hasabeleul G. Mortality and associated factors of acute poisoning in adults at felege hiwot comprehensive specialized hospital, bahir dar, amhara region, northwest ethiopia IN 2021 E.C. URI: http://ir.bdu.edu.et/handle/123456789/13268
    5. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Hassanian-Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Human & experimental toxicology. 2007 Sep;26(9):753-6.
    6. Mehrpour O, Akbari A, Jahani F, Amirabadizadeh A, Allahyari E, Mansouri B, et al. Epidemiological and clinical profiles of acute poisoning in patients admitted to the intensive care unit in eastern Iran (2010 to 2017). BMC Emerg Med 18, 30 (2018). https://doi.org/10.1186/s12873-018-0181-6.
    7. Laborde A. New roles for poison control centres in the developing countries. Toxicology. 2004; 198(1-3):273-7.
    8. Singh B, Unnikrishnan B. A profile of acute poisoning at Mangalore (South India). J Clin Forensic Med 2006; 13(3):112-6.
    9. Nithyashri J, Kulanthaivel G. Classification of human age based on Neural Network using FG-NET Aging database and Wavelets. In2012 Fourth International Conference on Advanced Computing (ICoAC) 2012 Dec 13 (pp. 1-5). IEEE.
    10. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corporation; 2012.
    11. Kirkpatrick LA, Feeney BC. A simple guide to IBM-SPSS statistics for version 20.0. Bemont, CA: Wadsworth, Cengage Learning; 2013.
    12. Poison Statistics -National Data 2020- Reports to U.S. Poison Control Centers. https://www.poison.org/poisonstatistics-national (reached on 9-2-23)
    13. Kaka R, Ghanem M, Sigairon M, Elabdeen H, Mostafa H. A Retrospective Analysis of Acute Poisoning Cases Admitted to Alexandria Poison Center: Pattern and Outcome. Asia Pacific Journal of Medical Toxicology. 2022 Jun 1;11(2).
    14. Resiere D, Kallel H, Oxybel O, Chabartier C, Florentin J, Brouste Y, et al. Clinical and Epidemiological Characteristics of Severe Acute Adult Poisoning Cases in Martinique: Implicated Toxic Exposures and Their Outcomes. Toxics. 2020 Apr 9;8(2):28. doi: 10.3390/toxics8020028. PMID: 32283693; PMCID: PMC7356022.
    15. Saikia D, Sharma RK, Janardhan KV. Clinical profile of poisoning due to various poisons in children of age 0- 12 years. J Family Med Prim Care. 2020 May 31;9(5):2291-2296. doi: 10.4103/jfmpc.jfmpc_365_20. PMID: 32754490; PMCID: PMC7380753. 8
    16. Halhalli HC, Uslu T. Evaluation of Pediatric Patients Admitted to the Emergency Department Due to Drug Intoxication. Cureus. 2021;13(2): e13366. Published 2021 Feb 16. doi:10.7759/cureus.13366.
    17. Abdelhamid W. Evaluation of Severity of Poisoning Exposures among Patients Presented to Poison Control Center, Ain Shams University Hospitals, Egypt during 2019. Ain Shams J Forensic Med Clin Toxicol 1/2021 (36): 106-22.
    18. Woyessa AH, Palanichamy T. Patterns, Associated Factors, and Clinical Outcomes of Poisoning among Poisoning Cases Presented to Selected Hospitals in Western Ethiopia: Hospital-Based Study. Emerg Med Int. 2020; 2020:5741692. doi: 10.1155/2020/5741692. PMID: 32455021; PMCID: PMC7225863.
    19. Galahitiyawa M, Weerawansa M, Lekamwasam J. Gender differences among patients admitted following poisoning: a prospective study in Southern Sri Lanka . Galle Medical Journal, Vol 13: No. 1, September 2008
    20. Sulaiman A, Shalam M. Hussain, Ibrahim M Alnughaymishi, Abdullah M Alnuqaydan, Pattern of food, drug, and chemical poisoning in Qassim region, Saudi Arabia from January 2017 to December 2017, Toxicology Reports, Volume 7,2020; 1438-42.
    21. Tawfik H and Khalifa E. Evaluation of Poisoning and Drug Overdose among Cases Presented to Poison Control Centre, Ain Shams University Hospital during the Year 2015. Ain Shams Journal of Forensic Medicine and Clinical Toxicology; 2017, 29: 100-112
    22. Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci. 2015; 40(4):219-21.
    23. Khan M, Khurram M, Raza S. Gender based differences in patients of poisoning managed at a Medical Unit. J Pak Med Assoc. 2019; 69(7):1025-28.

    24 Ali I, Sawlani K, Himanshu D, Chaudhary SH, Usman K, Atam V, et.al. Study of pattern and outcome of acute poisoning cases at tertiary care hospital in north India January 2017. Journal of Evidence Based Medicine and Healthcare 4(6):326-31.

    1. 2019 Annual Report from the Maryland Poison Center. Available from: https://mdpoison.com/media/SOP/mdpoisoncom/factsandreports/reports/annualreports/2019MPCAnnualReport _Final.pdf
    2. Asawari R, Atmaram P, Bhagwan K, Priti D, Kavya S, Jabeen GA. Toxicological Pattern of Poisoning in Urban Hospitals of Western India. J Young Pharm. 2017; 9(3):315-20
    3. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxietyand-depression-worldwide
    4. Behera A, Singla N, Sharma N, Sharma N. Paradigm shift in pattern and prevalence of poisoning during COVID-19 pandemic. J Family Med Prim Care. 2022;11(1):208-14
    5. Mittal C, Singh S, Kumar-M P, Varthya SH. Toxicoepidemiology of poisoning exhibited in Indian population from 2010 to 2020: a systematic review and meta-analysis. BMJ Open 2021;11: e045182. doi: 10.1136/bmjopen-2020- 045182 9
    6. Boedeker W, Watts M, Clausing P. The global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review. BMC Public Health 20, 1875 (2020). https://doi.org/10.1186/s12889- 020-09939-0
    7. Sornlorm K, Mahato RK, Polnakoo W and Aunthakot K. Spatial association of land-use areas and disease occurred by pesticide poisoning in Thailand [version 1; peer review: awaiting peer review]. F1000Research 2022, 11:1386 (https://doi.org/10.12688/f1000research.126554.1)
    8. Eddleston M. Poisoning by pesticides, Medicine. 2019; 48, 3; 214-217.
    9. Ghimire R, Utyasheva L, Pokhrel M, Rai N, Chaudhary B, Prasad P, et al. Intentional pesticide poisoning and pesticide suicides in Nepal, Clinical Toxicology 2022. 60:1; 46-52, DOI: 10.1080/15563650.2021.1935993.
    10. Mahmoudvand Z, Shanbehzadeh M, Shafiee M, Arpanahi H. Developing the minimum data set of the corrosive ingestion registry system in Iran. BMC Health Serv Res 22, 1207 (2022). https://doi.org/10.1186/s12913-022- 08576-0