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Gao X, Wei W, Yang GD. Clinical factors for delayed neuropsychiatric sequelae from acute carbon monoxide poisoning: a retrospective study. Front Med (Lausanne) 2024; 11:1333197. [PMID: 38371510 PMCID: PMC10869438 DOI: 10.3389/fmed.2024.1333197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Background Delayed neuropsychiatric sequelae (DNS), which seriously affect the daily lives of patients, are the most common complications of carbon monoxide (CO) poisoning. No uniform screening tool is available for identifying high-risk groups. Therefore, in this study, we aimed to explore whether conventional laboratory indicators and imaging data from primary hospitals could predict the occurrence of DNS. Methods This retrospective observational study was conducted in a single-center primary hospital from January 1, 2021 to May 31, 2023. Participants included patients aged >18 years with acute CO poisoning. Patients with complete recovery in the acute phase were followed up by telephone and outpatient visits, and the presence of DNS was determined according to the occurrence of new neurological symptoms within 6 weeks after discharge. We obtained demographic, laboratory, and imaging data from the medical records and performed a univariate analysis. A multivariate logistic regression model was used to identify independent clinical predictors of DNS. Results A total of 73 patients were included in the study, of whom 25 (34.2%) developed DNS. Multivariate logistic regression analysis revealed that a longer duration of CO exposure (adjusted odds ratio (AOR): 1.262, 95% confidence interval (CI): 1.069-1.490) and the presence of acute brain lesions on diffusion-weighted imaging (DWI) (AOR: 5.117, 95% CI: 1.430-18.315) were independent risk factors for DNS. Receiver operating characteristic analyses of the duration of CO exposure were performed (area under the curve (AUC): 0.825; 95% CI: 0.731-0.918) with a cut-off value of 5.5 h, and DNS was predicted with a sensitivity of 96% and a specificity of 66.7%. Conclusion High cranial DWI signal within 24 h and duration of poisoning longer than 5.5 h are independent predictors of DNS. The predictive effects of conventional laboratory indicators require further standardized and large-sample studies.
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Affiliation(s)
| | | | - Guo-Dong Yang
- Department of Neurology, Jiu Jiang No. 1 People’s Hospital, Jiujiang, China
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Gordon BS, Malecki KMC, Camponeschi J, LeCaire TJ, Creswell PD, Schultz AA. For Submission to the Journal of Community Health: Carbon Monoxide Awareness and Detector Use in the State of Wisconsin. J Community Health 2024; 49:1-7. [PMID: 37284918 DOI: 10.1007/s10900-023-01235-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 06/08/2023]
Abstract
Carbon monoxide (CO) is a leading cause of poisoning. CO detectors are a known-effective prevention strategy, however, little is known about use of detectors or knowledge of risk. This study assessed awareness of CO poisoning risk, detector laws, and detector use among a statewide sample. Data collected from the Survey of the Health of Wisconsin (SHOW) included a CO Monitoring module added to the in-home interview for 466 participants representing unique households across Wisconsin in 2018-2019. Univariate and multivariable logistic regression models examined associations between demographic characteristics, awareness of CO laws and detector use. Less than half of households had a verified CO detector. Under 46% were aware of the detector law. Those aware had 2.82 greater odds of having a detector in the home compared to those unaware of the law. Lack of CO law awareness may lead to less frequent detector use and result in higher risk of CO poisoning. This highlights the need for CO risk and detector education to decrease poisonings.
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Affiliation(s)
- Bianca Silva Gordon
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, United States
| | - Kristen M C Malecki
- University of Illinois at Chicago School of Public Health, Chicago, United States
| | - Jennifer Camponeschi
- Wisconsin Department of Health Services, Bureau of Environmental and Occupational Health, Madison, United States
| | - Tamara J LeCaire
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, United States
| | - Paul D Creswell
- Wisconsin Department of Health Services, Bureau of Environmental and Occupational Health, Madison, United States
| | - Amy A Schultz
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, United States.
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Andreychak EM, Tomasallo CD, Idowu D, Gummin DD, Meiman JG. Occupational Carbon Monoxide Poisoning in Wisconsin: Results From a Statewide Electronic Disease Surveillance System and From the Wisconsin Poison Center, 2018-2021. Public Health Rep 2023:333549231200850. [PMID: 37924239 DOI: 10.1177/00333549231200850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVES Prevention methods for carbon monoxide (CO) poisoning in Wisconsin address occupational and nonoccupational exposures together, but differences between the settings could inform new approaches to preventing occupational CO poisonings. We described occupational CO poisonings in Wisconsin from July 1, 2018, through July 1, 2021, using surveillance data from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. METHODS We identified cases of CO poisoning from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. Occupational CO poisonings were records where "workplace" was recorded as the location of exposure. We excluded records classified as suspect/not a case, those missing laboratory results or information on exposure source/location, and intentional poisonings. We compared characteristics between occupational and nonoccupational settings using odds ratios (ORs), and we estimated crude incidence rates of occupational exposures by occupation. RESULTS We identified 614 cases of CO poisoning, of which 168 (27.4%) were occupational exposures. When compared with patients with nonoccupational exposures, patients with occupational exposures were more likely to be male (OR = 3.8; 95% CI, 2.4-6.1), Hispanic (OR = 2.4; 95% CI, 1.4-4.2), and younger (mean difference [SD] = 6.6 [20.9]). Several CO sources were significantly associated with occupational poisonings: forklifts (OR = 58.4; 95% CI, 13.9-246.1; P < .001), pressure sprayers (OR = 2.4; 95% CI, 1.3-4.4; P = .003), and other gasoline-powered tools (OR = 3.8; 95% CI, 2.3-6.3; P < .001). The natural resources, construction, and maintenance occupation group had the highest crude incidence rate-45.0 poisonings per 100 000 full-time equivalent employees. CONCLUSIONS Incorporating data from the Wisconsin Poison Center improved data quality, but surveillance is limited by underreporting. Creating strategies to increase reporting would allow for a more comprehensive understanding of occupational CO poisoning.
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Affiliation(s)
- Elaina M Andreychak
- Bureau of Environmental and Occupational Health, Wisconsin Division of Public Health, Madison, WI, USA
| | - Carrie D Tomasallo
- Bureau of Environmental and Occupational Health, Wisconsin Division of Public Health, Madison, WI, USA
| | | | | | - Jon G Meiman
- Bureau of Environmental and Occupational Health, Wisconsin Division of Public Health, Madison, WI, USA
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Bucak IH, Tanrıverdi H, Kılıç FE. An evaluation of childhood carbon monoxide intoxications in a rural area using the Beaufort wind scale. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:1204. [PMID: 37702873 DOI: 10.1007/s10661-023-11748-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/18/2023] [Indexed: 09/14/2023]
Abstract
Climatic changes are known to affect CO intoxications. The purpose of this study was to examine childhood CO intoxications with the Beaufort wind scale (BWS) classification of wind speeds. The demographic data (age and sex) and information concerning the hour, day, and month of presentation to the emergency department for cases diagnosed with CO intoxication over a 7-year period between 2015 and 2021 in the pediatric emergency department of a tertiary training and research hospital in a rural area were examined. Wind speeds (m/s) measured on the days of presentation to the emergency department were recorded. The wind category on the BWS on the day of intoxication was then determined. Four hundred twenty-two patients, with a mean age of 95.12 ± 59.4 (1-215) months, 218 (51.7%) girls and 204 (48.3%) boys were diagnosed with CO intoxication over the 7-year study period. A comparison of wind speeds on the days of presentation to hospital revealed a significantly higher wind speed in 2020 than in the other years (p<0.001). A comparison of the groups in terms of the BWS revealed a significant difference between the years of presentation to hospital (p:0.001). This is the first study to investigate CO intoxications in the pediatric emergency department with the BWS. A significant association was observed between wind speed based on the BWS and childhood CO intoxications. Further studies evaluating wind in the rural setting and CO intoxications are now needed for protection against such intoxications.
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Affiliation(s)
- Ibrahim Hakan Bucak
- Department of Pediatrics, Adiyaman University School of Medicine, Altınsehir Neighborhood 3012 Street Manas Site G Bloc Floor: 7 No: 32, Postal Code: 02040, Adiyaman, Turkey.
| | - Hüseyin Tanrıverdi
- Department of Pediatrics, Adiyaman University School of Medicine, Altınsehir Neighborhood 3012 Street Manas Site G Bloc Floor: 7 No: 32, Postal Code: 02040, Adiyaman, Turkey
| | - Fedli Emre Kılıç
- Department of Pediatrics, Adiyaman University School of Medicine, Altınsehir Neighborhood 3012 Street Manas Site G Bloc Floor: 7 No: 32, Postal Code: 02040, Adiyaman, Turkey
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Han E, Yu G, Lee HS, Park G, Chung SP. Prevalence of Carbon Monoxide Poisoning and Hyperbaric Oxygen Therapy in Korea: Analysis of National Claims Data in 2010-2019. J Korean Med Sci 2023; 38:e125. [PMID: 37069816 PMCID: PMC10111047 DOI: 10.3346/jkms.2023.38.e125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/24/2023] [Indexed: 04/19/2023] Open
Abstract
This study aimed to investigate the prevalence of carbon monoxide (CO) poisoning and the provision of hyperbaric oxygen therapy (HBOT) in South Korea. We used data from the Korea Health Insurance Review and Assessment service. In total, 44,361 patients with CO poisoning were identified across 10 years (2010-2019). The prevalence of CO poisoning was found to be 8.64/10,000 people, with a gradual annual increment. The highest prevalence was 11.01/10,000 individuals, among those aged 30-39 years. In 2010, HBOT was claimed from 15 hospitals, and increased to 30 hospitals in 2019. A total of 4,473 patients received HBOT in 10 years and 2,684 (60%) were treated for more than 2 hours. This study suggested that the prevalence of both CO poisoning and HBOT in Korea gradually increased over the past 10 years, and disparities in prevalence were observed by region.
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Affiliation(s)
- Eunah Han
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gina Yu
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Goeun Park
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Sung Phil Chung
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Goldberg R, McKelvey W, Lane K, Parton H, Su MK. Evaluation of Data Sources for Carbon Monoxide Poisoning Surveillance in New York City. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E560-E565. [PMID: 34446640 PMCID: PMC8781230 DOI: 10.1097/phh.0000000000001422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Carbon monoxide (CO) exposure can be life-threatening. Suspected and confirmed cases of CO poisoning warranting health care in New York City (NYC) are reportable to the NYC Poison Control Center (PCC). OBJECTIVES We evaluated 4 hospital-based sources of CO surveillance data to identify ways to improve data capture and reporting. DESIGN Suspected and confirmed CO poisoning records from October 2015 through December 2016 were collected from the NYC emergency department (ED) syndromic surveillance system, New York State Statewide Planning and Research Cooperative System (SPARCS) ED billing data, NYC PCC calls made from hospitals, and the Electronic Clinical Laboratory Reporting System (ECLRS). Syndromic and SPARCS records were person- and visit-matched. SPARCS and ECLRS records were also matched to PCC records on combinations of name, demographic characteristics, and visit information. SETTING Hospitals in NYC. PARTICIPANTS Individuals who visited NYC hospitals for CO-related health effects. MAIN OUTCOME MEASURES We assessed the validity of syndromic data, with SPARCS records as the gold standard. We matched SPARCS and ECLRS records to PCC records to analyze reporting rates by case characteristics. RESULTS The sensitivity of syndromic surveillance was 60% (225 true-positives detected among 372 visit-matched SPARCS cases), and positive predictive value was 46%. Syndromic records often missed CO flags because of a nonspecific or absent International Classification of Diseases code in the diagnosis field. Only 15% of 428 SPARCS records (total includes 56 records not visit-matched to syndromic) and 16% of 199 ECLRS records were reported to PCC, with male sex and younger age associated with higher reporting. CONCLUSIONS Mandatory reporting makes PCC useful for tracking CO poisoning in NYC, but incomplete reporting and challenges in distinguishing between confirmed and suspected cases limit its utility. Simultaneous tracking of the systems we evaluated can best reveal surveillance patterns.
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Affiliation(s)
- Rebecca Goldberg
- Bureau of Environmental Surveillance and Policy (Mss Goldberg and Lane and Dr McKelvey) and Bureau of Communicable Diseases (Ms Parton), New York City Department of Health and Mental Hygiene (NYC DOHMH), New York City, New York; and New York City Poison Control Center (NYC PCC), New York City, New York (Dr Su)
| | - Wendy McKelvey
- Bureau of Environmental Surveillance and Policy (Mss Goldberg and Lane and Dr McKelvey) and Bureau of Communicable Diseases (Ms Parton), New York City Department of Health and Mental Hygiene (NYC DOHMH), New York City, New York; and New York City Poison Control Center (NYC PCC), New York City, New York (Dr Su)
| | - Kathryn Lane
- Bureau of Environmental Surveillance and Policy (Mss Goldberg and Lane and Dr McKelvey) and Bureau of Communicable Diseases (Ms Parton), New York City Department of Health and Mental Hygiene (NYC DOHMH), New York City, New York; and New York City Poison Control Center (NYC PCC), New York City, New York (Dr Su)
| | - Hilary Parton
- Bureau of Environmental Surveillance and Policy (Mss Goldberg and Lane and Dr McKelvey) and Bureau of Communicable Diseases (Ms Parton), New York City Department of Health and Mental Hygiene (NYC DOHMH), New York City, New York; and New York City Poison Control Center (NYC PCC), New York City, New York (Dr Su)
| | - Mark K. Su
- Bureau of Environmental Surveillance and Policy (Mss Goldberg and Lane and Dr McKelvey) and Bureau of Communicable Diseases (Ms Parton), New York City Department of Health and Mental Hygiene (NYC DOHMH), New York City, New York; and New York City Poison Control Center (NYC PCC), New York City, New York (Dr Su)
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Chua ISY, Tan KBK, Ponampalam R. Carbon monoxide poisoning in a group of restaurant workers: lessons learnt and how to prevent future occurrences. Singapore Med J 2021; 65:288-290. [PMID: 34823325 PMCID: PMC11182455 DOI: 10.11622/smedj.2021217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/04/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Ivan Si Yong Chua
- Department of Emergency Medicine, Singapore General Hospital, Singapore
| | | | - R Ponampalam
- Department of Emergency Medicine, Singapore General Hospital, Singapore
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Jabbari M, Eskandari D, Farhang Dehghan S, Saeedi R, Vaziri MH, Pourtaghi G. Comprehensive analysis and investigation of accident/occupational disease responsibility rates: A case study for accidental CO poisoning. Sci Justice 2021; 61:493-504. [PMID: 34482929 DOI: 10.1016/j.scijus.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/29/2021] [Accepted: 05/10/2021] [Indexed: 02/08/2023]
Abstract
One of the major problems of courts and insurance companies is the lack of a proper technique to determine the rate of responsibility of the parties involved in the accident. The aim of this study was to determine the Accident/Occupational Diseases Responsibility Rates (AOD RR) for complex events. Accordingly, a case study of a complex accident of carbon monoxide (CO) poisoning was selected and Occupational Accident Tree Analysis (OATA) and Occupational Accident Component Analysis (OACA) techniques, which were solely used to investigate occupational accidents, were used with the new names Accident/Occupational Disease Tree Analysis (AOD TA) and Accident/Occupational Disease Component Analysis (AOD CA) to evaluate their applicability to investigate non-occupational accidents and occupational diseases. For this purpose, causes of CO penetration to victims' room was assessed using gas tracking methods. Finally, Fuzzy Accident/Occupational Disease Tree/Component Analysis (FAOD TA and FAOD CA) techniques were developed and used for determining AOD RR in fuzzy environment. The results showed that the AOD RR obtained by AOD TA and AOD CA based on the average of experts' personal opinions and consensus between experts, and AOD TA and AOD CA in a fuzzy environment were close to each other, with the power terminal and the power cable crossing route being the main routes of transmission and penetration of CO to the victims' room. Also, the owner, contractor, tenant, and serviceman were responsible for the CO poisoning of victims. It can be concluded that any hole, crack, or fission in the building can result in CO penetration to the individuals' living rooms, and gas tracking in early winter, especially in older buildings, plays a very significant role in preventing residents' poisoning. Further, due to the uncertainty of AOD TA and AOD CA techniques, it is recommended to use FAOD TA and FAOD CA techniques for increasing the accuracy of the results. This will enhance the court and insurance companies' trust in the opinions of accident investigation experts, decrease delays in the proceedings, and prevent any violation of the individual rights.
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Affiliation(s)
- Mousa Jabbari
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Eskandari
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Somayeh Farhang Dehghan
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Saeedi
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Health, Safety and Environment, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Vaziri
- Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Health, Safety and Environment, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamhossein Pourtaghi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Chow TYA, Chan CK, Ng SH, Tse ML. Hong Kong Poison Information Centre: Annual report 2019. HONG KONG J EMERG ME 2021. [DOI: 10.1177/10249079211038841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The Hong Kong Poison Information Centre (HKPIC) provides consultation service to health care professionals and collect epidemiological data on poisoning in Hong Kong since 2005. Objective: To report and analyse the data of Hong Kong Poison Information Centre on poisoning in 2019. Methods: This was a retrospective review of all poisoning cases recorded in the Poison Information and Clinical Management System of Hong Kong Poison Information Centre in 2019. Results: A total of 4016 poisoned cases were analysed, which involved 1698 men (42.3%), 2312 women (57.6%) and 6 sex-unspecified patients (0.1%). Majority of cases (77.3%) were between 13 and 69 years of age, and 10.5% were teenagers 13–19 years of age. Self-harm/suicidal attempt (42.1%), unintentional exposure (18.1%) and abusive substance use (11.1%) were common reasons of poisoning. Excluding ethanol, which was the common co-ingestant, the five most common types of poison were benzodiazepines, paracetamol, household products, zopiclone and Chinese herbal medicine. While most patients were managed with supportive treatment, 16.5% and 16.8% of the consultation cases were treated with decontamination and antidotes, respectively. Majority of cases recovered uneventfully, but 1.0% died and 4.7% had a major outcome. A total of six interesting cases and two outbreaks were discussed in this report. Conclusion: This 14th annual report provided updated epidemiological information on the pattern of poisoning in Hong Kong and highlighted a number of important changes compared with our previous reports.
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Affiliation(s)
- Tin Yat Anthony Chow
- Hong Kong Poison Information Centre, K3A, United Christian Hospital, Kwun Tong, China
| | - Chi Keung Chan
- Hong Kong Poison Information Centre, K3A, United Christian Hospital, Kwun Tong, China
| | - Sze Hong Ng
- Hong Kong Poison Information Centre, K3A, United Christian Hospital, Kwun Tong, China
| | - Man Li Tse
- Hong Kong Poison Information Centre, K3A, United Christian Hospital, Kwun Tong, China
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