The Poisoning Information Database Covers a Large Proportion of Real Poisoning Cases in Korea

Consumer knowledge and awareness of the toxicity and handling of household products at a tertiary care center in Beirut, Lebanon

Household products intoxication is a common and preventable problem. Household product hazard awareness is lacking among consumers in Lebanon, posing a public health hazard. A cross-sectional observational study was conducted at the American University of Beirut Medical Center by administering surveys to 176 adult participants. The surveys focused on demographics, awareness of product toxicity, practices used to avoid intoxication, and sources of information. Each participant was given a score for behavior and awareness. Informative brochures were handed to increase awareness among consumers. We surveyed 176 patients, of whom (84.7%) were females with a mean age of 42.2 ± 13.5 years. Most were married (77.3%), had a college education (76.7%), were employed (62.5%), and were in charge of household cleaning (76.7%). Toilet cleaners were the substances most perceived to be toxic (94.0%). Most people (86.4%) had low to medium scores on behavior, while most (77.3%) had high scores on awareness. Male gender and using product labels as sources of information were associated with higher behavior scores, while referring to a friend or a relative as a source of information on product intoxication was associated with a lower behavior score. Greater awareness scores were strongly associated with being married, having a higher monthly income, and referring to warning signs presented on the labels as a source of knowledge. Unsafe handling and storage of household products are common among consumers in our population. Therefore, it may be necessary to launch education campaigns to improve consumer handling of household products.

Minimum Data Set for a Poisoning Registry: A Systematic Review

Poisoning, as a well-known medical condition, puts everyone at risk. As a data management tool, a registry plays an important role in monitoring the poisoned patients. Having a poisoning minimum data set is a major requirement for creating a poisoning registry. Therefore, the present systematic review was conducted in 2019 to identify the minimum data set for a poisoning registry. Searches were performed in four scientific databases, i.e., PubMed, Scopus, Web of Science, and Embase. The keywords used in the searches included minimum data set, "poison", and "registry". Two researchers independently evaluated the titles, abstracts, and texts of the papers. The data were collected from the related papers. Ultimately, the minimum data set was identified for the poisoning registry. Data elements extracted from the sources were classified into two general categories: administrative data and clinical data. Ninety-eight data elements in the administrative data category were subdivided into three sections: general data, admission data, and discharge data. One-hundred and thirty-one data elements in the clinical data category were subdivided into five sections: clinical observation data, clinical assessment data, past medical history data, diagnosis data, and treatment plan data. The minimum data set is a prerequisite for creating and using a poisoning registry and data system. It is suggested to evaluate and use the poisoning minimum data set in accordance with the national laws, needs, and standards based on the opinion of the local experts.

The Characteristics of Elderly Individuals Who Attempted Suicide by Poisoning: a Nationwide Cross-sectional Study in Korea

BACKGROUND

Suicide among the elderly is a public health concern, as life expectancy is increasing rapidly and suicide rates increase with age. In Korea, self-poisoning is the most common method of attempted suicide. This study aimed to evaluate the characteristics of attempted suicide by self-poisoning among the elderly and to identify risk factors related to the suicide attempts.

METHODS

A cross-sectional observational study was conducted using the Emergency Department-based Injury In-depth Surveillance database in Korea. We included all adult patients visiting the emergency department (ED) who attempted suicide by poisoning between January 2011 and December 2017 and stratified according to age: the elderly (≥ 65 years old) and the younger group. Characteristics and risk factors for attempted suicide by poisoning among the elderly were evaluated using stepwise regression analysis.

RESULTS

Among 25,904 adult patients, 5,164 (19.9%) were classified as elderly. The elderly were more likely to be admitted to hospital and intensive care units, the average ED length of stay was longer, and total mortality was higher than that of the younger group. Male sex, low socioeconomic status, poor physical health, pesticide use, lower alcohol consumption, and fewer prior suicide attempts were found to be risk factors for suicide among the elderly.

CONCLUSION

Self-poisoning among the elderly is associated with poorer clinical outcomes than in younger adult patients. Suicide among the elderly is a potentially preventable public health problem, and with proper identification of the associated risk factors, appropriate multidisciplinary intervention strategies can be implemented.

Two health information systems to characterize poisoning in Brazil-a descriptive study

BACKGROUND

Poisoning is a worldwide public health problem that involves individuals of all ages and a wide range of chemicals. This study investigated the data from two health information systems to characterize poisoning events in the Federal District (DF), Brazil.

METHODS

Data related to the period from 2009 to 2013 were obtained from the poison information center (Centro de Informação Toxicológica, CIT) and the Notifiable Diseases Information System (Sistema Nacional de Agravos de Notificação, SINAN) of the DF.

RESULTS

A total of 3622 cases were reported to CIT-DF and 5702 cases to SINAN-DF. Most of the cases in CIT-DF (53%) occurred with children up to 9 years old, while this corresponded to 33.9% in SINAN-DF. Unintentional poisoning was the main circumstance involved in the cases. Pharmaceuticals were the main agent (44.3-47.1% of the cases), mainly clonazepan and paracetamol, and pesticides the most fatal (2.4% fatality rate). Out of the 47 fatal cases reported to the systems, only four were reported to both; six cases occurred with children up to 6 years.

CONCLUSION

Under-reporting and missing information were identified in both systems, but the data were complementary to describe the epidemiology of poisoning cases in the DF.

Characteristics of Drugs Ingested for Suicide Attempts in the Elderly

BACKGROUND

Suicide is a significant public health problem worldwide. Suicide rates among elderly persons (≥ 65 years of age) are three times higher than those of younger people in Korea. The emergency department is an important entry of drug-related suicide attempt patients. In this study, we compared the frequency of drug types by age subgroup. Furthermore, we provide suggestions for preventing suicide attempts in the elderly.

METHODS

We investigated 433 patients who were admitted to the emergency department for drug-related suicide attempts between 1 May 2015 and 30 April 2017.

RESULTS

The proportion of patients who overdosed on antidepressants was 32.5% in the non-elderly age group and 8.0% in the elderly group (≥ 65 years of age) (P < 0.001). Among the elderly, the most commonly ingested agent was hypnotics (59.1%) (P < 0.001). Compared with the non-elderly, the results showed that the elderly used fewer antidepressants (P < 0.001) and analgesics (P < 0.001). Meanwhile, the elderly used more hypnotics (P < 0.001). Over-the-counter drugs and other medications showed similar usage trends in both age groups (P = 0.664, P = 0.193).

CONCLUSION

The categories of drugs ingested for suicide attempts vary widely between different age groups. Younger people used antidepressants more frequently in suicide attempts, while the elderly used hypnotics more frequently. And the elderly required longer hospital stays. Suicide ideation and depressive mood in older patients who are prescribed hypnotics for various reasons should not be neglected. Further prevention efforts are needed to prevent suicide among the elderly.