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Bosshart N, Bearth A, Wermelinger S, Daum MM, Siegrist M. Childhood poisonings: Effects of ambiguous product characteristics on preschool children's categorization of household chemicals. Risk Anal 2024; 44:1193-1203. [PMID: 37698161 DOI: 10.1111/risa.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/17/2023] [Accepted: 08/22/2023] [Indexed: 09/13/2023]
Abstract
This study investigated preschool children's categorization and risk perception of products with ambiguous product characteristics (e.g., food-like packaging). These characteristics make it difficult for preschool children to categorize household chemicals correctly. This, therefore, increases the risk of unintentional poisoning. We hypothesized that ambiguity arises from different product characteristics, such as the type of packaging, the products' scent, or the packaging's color and transparency. In four behavioral tasks, N = 108 preschool children (M = 43 months, SD = 3) categorized different products and household chemicals with various types of packaging, colors, and scents. Individually wrapped dishwasher tablets were more likely to be categorized as edible than unwrapped ones. Furthermore, children who had interacted with any type of dishwasher tablet in the last 6 months performed better in identifying dishwasher tablets, regardless of packaging type. Household chemicals with a fruity scent were more likely to be categorized as drinkable than those with a chlorine scent. Finally, the children considered black bottles more dangerous and preferred them less than bottles of a different color. In contrast, bottle transparency generally did not seem to affect risk perception and preference. These findings confirm that ambiguous product characteristics influence children's categorization of unknown products and, thus, their risk perception and decision-making. Manufacturers and caregivers are advised to reduce the ambiguity of household chemicals by designing more neutral product packaging and choosing products with more neutral elements, respectively.
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Affiliation(s)
- Noah Bosshart
- Consumer Behavior, Institute for Environmental Decisions (IED), ETH Zurich (ETHZ), Zürich, Switzerland
| | - Angela Bearth
- Consumer Behavior, Institute for Environmental Decisions (IED), ETH Zurich (ETHZ), Zürich, Switzerland
| | - Stephanie Wermelinger
- Developmental Psychology: Infancy and Childhood, Department of Psychology, University of Zurich (UZH), Zürich, Switzerland
- Jacobs Center for Productive Youth Development, UZH, Zürich, Switzerland
| | - Moritz M Daum
- Developmental Psychology: Infancy and Childhood, Department of Psychology, University of Zurich (UZH), Zürich, Switzerland
- Jacobs Center for Productive Youth Development, UZH, Zürich, Switzerland
| | - Michael Siegrist
- Consumer Behavior, Institute for Environmental Decisions (IED), ETH Zurich (ETHZ), Zürich, Switzerland
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Sambuu T, Bayanbat BA, Naidan O, Badarch TU, Mukhtar Y, Ichikawa M. Home safety hazards associated with unintentional poisoning among children aged 0-5 years in Mongolia: A case-control study. Trop Med Int Health 2024; 29:273-279. [PMID: 38228503 DOI: 10.1111/tmi.13971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To examine the association between home safety hazards and unintentional poisoning in children in Mongolia. METHODS We conducted a case-control study using structured questionnaires to investigate safety behaviours, safety equipment use, and home hazards in households with or without children aged 0-5 years who had suffered from poisoning at home (i.e., cases and controls). We recruited 190 cases (105 medicinal and 84 non-medicinal poisonings, and one each) at the National Center for Maternal and Child Health and 379 controls in the communities between 1 March and 30 October 2021. RESULTS There were large differences between cases' and controls' households in safety behaviours and home hazards: the failure to store all medicines out of reach of children (68% of cases vs. 25% of controls), the failure to store all medicines safely (out of reach, locked or non-existent) (61% vs. 22%), the failure to put all medicines away immediately after use (77% vs. 43%), the presence of things that a child could climb on to reach high surfaces (82% vs. 67%), the presence of medicines transferred into different containers (28% vs. 9%) and the presence of household products transferred into different containers (28% vs. 16%). These home safety hazards were strongly associated with poisoning after controlling for confounders. CONCLUSION Children's risk of unintentional poisoning was strongly associated with the unsafe storage of potentially poisonous agents by caregivers and home hazards. Since unsafe storage is widespread, a fail-safe approach such as child-resistant closure of medicines and household products should be considered.
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Affiliation(s)
- Tsetsegee Sambuu
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Bat-Amgalan Bayanbat
- Emergency Department, National Center for Maternal and Child Health, Ulaanbaatar, Mongolia
| | | | - Tumen Ulzii Badarch
- Department of Statistics and Surveillance, National Trauma and Orthopedic Research Center, Ulaanbaatar, Mongolia
| | - Yerkyebulan Mukhtar
- Department of Epidemiology and Biostatistics, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Masao Ichikawa
- Department of Global Public Health, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Alshahrani MM, Albogami HA, Asiri AA, Al haydhah KS, Aldeailej IM, Aldehaim MA, Lubbad MY, Alalyan LA, Alasmari AF, Al salem IY, Alqahtani A, Al Awadh AA. Epidemiological Trends of Acute Chemical Poisoning among Children over a Recent Three-Year Period in Saudi Arabia. Children (Basel) 2023; 10:children10020295. [PMID: 36832424 PMCID: PMC9955334 DOI: 10.3390/children10020295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
Acute intoxication from chemicals is a major medical emergency that can result in illness and mortality. This retrospective study aims to evaluate acute chemical poisoning incidents among children in Saudi Arabia from 2019 to 2021. A total of 3009 children were recorded as being chemically intoxicated. The SPSS/PC statistics package was used for the statistical analysis. The acute chemical poisoning incidents that occurred in the age groups were <1 year: 237 (7.8%), 1-5 years: 2301 (76.4%), 6-12 years: 214 (7.1%), and 13-19 years: 257 (8.5%). The mean rate of acute chemical poisoning in the northern region was 40.1%. The most common poisonous agents were organic solvents (20.4%) and disinfection agents (22.7%). Interestingly, there is a significant relationship between the different types of acute chemical poisoning and various factors, including gender, age, the location where acute chemical intoxication occurred, the type of exposure, and whether these were intentional or unintentional events. The data suggest that the northern region of Saudi Arabia has had the highest number of recorded incidents of acute chemical poisoning over the last three years (2019-2021). Individuals between 1-5 years old were the worst hit. Organic solvents and detergents were to blame for the acute unintentional chemical poisonings that took place in homes. Therefore, educating the public about chemical poisoning and reducing children's exposure to toxic chemicals requires educational programs, which may help to reduce chemical poisoning occurrence.
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Affiliation(s)
- Mohammed Merae Alshahrani
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Hussein Ayed Albogami
- General Directorate of Environmental Health, Ministry of Health, Riyadh 12431, Saudi Arabia
| | - Ali Ahmad Asiri
- General Directorate of Environmental Health, Ministry of Health, Riyadh 12431, Saudi Arabia
| | - Khaled Saad Al haydhah
- General Directorate of Environmental Health, Ministry of Health, Riyadh 12431, Saudi Arabia
| | | | | | - Mahmoud Yousef Lubbad
- General Directorate of Environmental Health, Ministry of Health, Riyadh 12431, Saudi Arabia
| | | | | | - Ismail Yahya Al salem
- General Directorate of Environmental Health, Ministry of Health, Riyadh 12431, Saudi Arabia
| | - Abdulaziz Alqahtani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 62529, Saudi Arabia
| | - Ahmed Abdullah Al Awadh
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
- Correspondence:
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Konopásek P, Uličný A, Rob F, Valentová B, Kotíková K, Švábová E, Zieg J. Salicylate poisoning after accidental skin application of salicylic acid in a child. Dermatol Ther 2022; 35:e15895. [PMID: 36194007 DOI: 10.1111/dth.15895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Patrik Konopásek
- Department of Paediatric Nephrology, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Andrej Uličný
- Toxicological Informational Centre, Department of Occupational Medicine, 1st Faculty of Medicine, General University Hospital in Prague, Czech Republic
| | - Filip Rob
- Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic
| | - Barbora Valentová
- Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic
| | - Kateřina Kotíková
- Toxicological Informational Centre, Department of Occupational Medicine, 1st Faculty of Medicine, General University Hospital in Prague, Czech Republic
| | - Eva Švábová
- Department of Paediatric Nephrology, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - Jakub Zieg
- Department of Paediatric Nephrology, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
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Leonard JB, Laudone T, Hines EQ, Klein-Schwartz W. Critical care interventions in children aged 6 months to 12 years admitted to the pediatric intensive care unit after unintentional cannabis exposures. Clin Toxicol (Phila) 2022; 60:960-965. [PMID: 35384771 DOI: 10.1080/15563650.2022.2059497] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Cannabis exposures in children have risen sharply in recent years, resulting in increased hospital visits and admission to pediatric intensive care units (PICUs). The intent of this study was to describe the proportion of pediatric patients admitted to the PICU after unintentional cannabis ingestion that received critical care interventions (CCIs) along with describing trends over time in hospitalization, admission to the PICU, and clinical effects and treatments outside of the PICU. METHODS This was a retrospective database study utilizing the National Poison Data System (NPDS) from 1/1/2000 to 12/31/2020. Children 6 months to 12 years of age with single substance cannabis exposures were included. RESULTS A total of 12,882 cases were included. There was an increase in the proportion of cases seen in a hospital over time from 43.8% in 2000 to 54.6% in 2020 (range 29.1-62.6%). In patients seen in a HCF, the proportion admitted to the PICU was 9.5% in 2000 and 14% in 2020 (range: 5.6-29.0%). The 875 (6.8%) children admitted to the PICU were analyzed for the primary outcome. CCIs were performed in 69/875 (7.9%) cases that were admitted to the PICU. The most common CCIs in the PICU were intubation and sedation, 4.9 and 3.7%, respectively. CONCLUSIONS Unintentional pediatric cannabis exposures are associated with clinically significant effects, including respiratory depression, hypotension, and bradycardia, but fewer than 5% of exposures were treated with CCIs, like intubation or vasopressors, in patients admitted to the PICU. Further work should assess specific reasons for admission to the PICU.
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Affiliation(s)
- James B Leonard
- Department of Pharmacy Practice and Science, Maryland Poison Center, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Thomas Laudone
- Deparment of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA.,Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA
| | - Elizabeth Quaal Hines
- Department of Pharmacy Practice and Science, Maryland Poison Center, University of Maryland School of Pharmacy, Baltimore, MD, USA.,Department of Pediatric Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wendy Klein-Schwartz
- Department of Pharmacy Practice and Science, Maryland Poison Center, University of Maryland School of Pharmacy, Baltimore, MD, USA
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Close RM, Iqbal N, Jones SJ, Kibble A, Flanagan RJ, Crabbe H, Leonardi GS. Fatal Unintentional Non-Fire Related Carbon Monoxide Poisoning: Data from Narrative Verdicts in England and Wales, 1998-2019. Int J Environ Res Public Health 2022; 19:4099. [PMID: 35409782 DOI: 10.3390/ijerph19074099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 12/02/2022]
Abstract
Unintentional non-fire related (UNFR) carbon monoxide (CO) poisoning continues to cause fatalities. The narrative verdicts from coroners concerning fatal UNFR CO poisoning in England and Wales, 1998–2019, were collated by the Office for National Statistics. Search terms related to CO exposure were used to obtain information regarding the circumstances of death. Findings were grouped by the location of death, the source of CO, and the reason or behaviour underlying the exposure. There were 750 deaths (77% male). The annual number of deaths decreased over the period studied. Two thirds (68%) of the deaths occurred in the autumn or winter. From the records with information, 59% of deaths occurred within a dwelling (67% male). Males also predominated deaths within vehicles (91%) and garages or outbuildings (95%). From the deaths with information, domestic piped gas was the most common source of CO (36%) and the most frequent underlying factor was inadequate ventilation of exhaust gases (39%, 91% male). Despite the decrease in the annual number of deaths over the study period, there remains a clear need for measures that raise awareness of the dangers of CO poisoning, especially amongst men working alone in garages or outbuildings. Education campaigns and fitting and maintaining CO alarms in high-risk areas should be encouraged.
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Tobaiqy M, Asiri BA, Sholan AH, Alzahrani YA, Alkatheeri AA, Mahha AM, Alzahrani SS, MacLure K. Frequency and Management of Acute Poisoning Among Children Attending an Emergency Department in Saudi Arabia. Pharmacy (Basel) 2020; 8:pharmacy8040189. [PMID: 33066543 PMCID: PMC7711722 DOI: 10.3390/pharmacy8040189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Acute poisoning is one of the common medical emergencies in children that leads to morbidity and mortality. Medications and chemical agents play a major role in these adverse events resulting in social, economic, and health consequences. Aims of the study: This study aimed to evaluate the frequency and management of acute poisoning among children attending the emergency room at East Jeddah Hospital, Jeddah city, Saudi Arabia. Methods: This study was a retrospective chart review of all acute pediatric poisoning incidences in children (0–16 years of age) from October-21-2016 to March-03-2020 who were attending the emergency department. Data were analyzed via SPSS software. Results: A total of 69 incidences of acute poisoning in children who attended the emergency department at East Jeddah Hospital; males (n = 38, 55.1%). Most children were aged 5 years or younger (n = 41, 59.4%). Unintentional poisoning occurred among 56.5% of observed cases of which 52.2% occurred in children younger than 5 years; 7.20% (n = 5) of patients were 12 to 16 years of age and had deliberate self-poisoning. The association between type of poisoning and age groups was statistically significant (chi-square = 28.5057, p = 0.0001). Most incidences occurred at home (n = 64, 92.8%). Medicines were the most common cause of poisoning (n = 53, 76.8%). An excessive dose of prescribed medicine poisoning accidents was reported in 10.1% cases. Analgesics such as paracetamol were the most documented medication associated with poisoning (39.1%) followed by anticonvulsants and other central nervous system acting medicines (18.8%). The most common route of poisoning was oral ingestion (81.2%). One mortality case was documented. Conclusion: Although not common, accidental and deliberate acute poisoning in children does occur. More can be done to educate parents on safe storage of medicines, household cleaning and other products associated with acute poisoning in children. Likewise, children can be taught more about the risks of poisoning from an early age. As importantly, clinicians need to include more detailed notes in the electronic medical records (EMR) or the system needs to be improved to encourage completeness to more accurately inform the research evidence-base for future service design, health policy and strategy.
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Affiliation(s)
- Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah 21512, Saudi Arabia
- Correspondence:
| | - Bandar A. Asiri
- College of Applied Medical Sciences, University of Jeddah, Jeddah 21512, Saudi Arabia; (B.A.A.); (A.H.S.)
- Inspection Department, Saudi Food and Drug Authority, Jeddah 21512, Saudi Arabia
| | - Ahmed H. Sholan
- College of Applied Medical Sciences, University of Jeddah, Jeddah 21512, Saudi Arabia; (B.A.A.); (A.H.S.)
| | - Yahya A. Alzahrani
- Department of Pharmacy, East Jeddah Hospital, Jeddah 22253, Ministry of Health, Saudi Arabia; (Y.A.A.); (A.A.A.)
| | - Ayed A. Alkatheeri
- Department of Pharmacy, East Jeddah Hospital, Jeddah 22253, Ministry of Health, Saudi Arabia; (Y.A.A.); (A.A.A.)
- Department of Pharmacology, College of Medicine, Umm al Qura University, Makkah 24381 8073, Saudi Arabia
| | - Ahmed M. Mahha
- Department of Emergency, East Jeddah Hospital, Ministry of Health, Jeddah 22253, Saudi Arabia; (A.M.M.); (S.S.A.)
| | - Shamsia S. Alzahrani
- Department of Emergency, East Jeddah Hospital, Ministry of Health, Jeddah 22253, Saudi Arabia; (A.M.M.); (S.S.A.)
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Hammond FM, Ketchum J, Dams-O'Connor K, Corrigan JD, Miller C, Haarbauer-Krupa J, Faul M, Trexler LE, Harrison-Felix C. Mortality Secondary to Unintentional Poisoning after Inpatient Rehabilitation among Individuals with Moderate to Severe Traumatic Brain Injury. J Neurotrauma 2020; 37:2507-2516. [PMID: 32438850 DOI: 10.1089/neu.2020.7038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Studies have shown reduced life expectancy following moderate-severe traumatic brain injury (TBI) with death from unintentional poisoning (UP) being 11 times higher following TBI than in the general population. The characteristics of those who die of unintentional poisoning are compared with the characteristics of those who die of other causes (OC) in a retrospective cohort who received inpatient rehabilitation following TBI and enrolled in the TBI Model Systems National Database between 1989 and 2017 (n = 15,835 cases with 2,238 deaths recorded). Seventy-eight cases (3.5%) of deaths were the result of UP, 76% were the result of OC, and 20.5% were from an unknown cause. Among the UP deaths, 90% involved drugs (of these, 67% involved narcotic drugs and 14% involved psychostimulants), and 8% involved alcohol. Age-adjusted risk for UP death was associated with: white/non-Hispanic race/ethnicity, living alone, non-institutionalization, pre- and post-injury illicit drug use and alcohol/drug problem use, any alcohol use at last follow-up, better Functional Independence MeasureTM (FIM) scores, history of arrest, moderate disability (vs. severe disability or good recovery), less supervision needed, and greater anxiety. Adults who receive inpatient rehabilitation for TBI who die from UP are distinguishable from those who die of OC. Factors such as pre-injury substance use in the context of functional independence may be regarded as targets for prevention and/or intervention to reduce substance use and substance-related mortality among survivors of moderate-severe TBI. The current findings may have implications for medical care, surveillance, prevention, and health promotion.
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Affiliation(s)
- Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
| | - Jessica Ketchum
- Research Department, Craig Hospital, Englewood, Colorado, USA.,Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John D Corrigan
- Department of Physical Medicine & Rehabilitation, Ohio State University, Columbus, Ohio, USA
| | - Cate Miller
- National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, Department of Health and Human Services, Washington, DC, USA
| | - Juliet Haarbauer-Krupa
- Traumatic Brain Injury Team, Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark Faul
- Traumatic Brain Injury Team, Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lance E Trexler
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
| | - Cynthia Harrison-Felix
- Research Department, Craig Hospital, Englewood, Colorado, USA.,Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado, USA
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Ashraf L, Agrawal P, Rahman A, Salam SS, Li Q. Burden of Lesser-Known Unintentional Non-Fatal Injuries in Rural Bangladesh: Findings from a Large-Scale Population-Based Study. Int J Environ Res Public Health 2019; 16:E3366. [PMID: 31547240 PMCID: PMC6766074 DOI: 10.3390/ijerph16183366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/17/2022]
Abstract
Around 90% of all fatal and non-fatal unintentional injuries occur in low- and middle-income countries (LMICs). The magnitude of unintentional injuries is unclear due to limited research and data. This paper describes the burden of lesser-known injuries (LKIs-cut injuries, unintentional poisoning, machine injuries, electrocution, injury by blunt objects, and suffocation) in rural Bangladesh, using data from the Saving of Lives from Drowning (SoLiD) project in Bangladesh. Descriptive statistics were used to report counts and rates of injuries by socio-demographic factors, injury characteristics, and circumstantial details. The annual morbidity rate of LKIs was 6878 injuries per 100,000 persons, involving 3.4% (40,520) of the population. Cut injury (44,131.2/100,000 per year) and injury by blunt objects (19768.6/100,000 per year) attributed in large numbers to the overall burden of LKIs. Males (66.1%) suffered more injuries than females. More than half (52.9%) occurred among people aged 25 to 64 years. Those involved in agriculture suffered the most injuries, mainly cut injuries (9234.1/100,000 per year) and machine-related injuries (582.9/100,000 per year). Most injuries occurred in the home setting. Increased awareness about packaging, storage, and the proper handling of appliances can help lower the frequency of LKIs. Safe architecture and awareness about home injuries is required to reduce injuries occurring in the home environment.
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Affiliation(s)
- Lamisa Ashraf
- MPH 2019 Graduate, Johns Hopkins Bloomberg School of Public Health; 615 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Priyanka Agrawal
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Aminur Rahman
- Center for Injury Prevention and Research, Bangladesh, House B 162, Rd No. 23, Dhaka 1206, Bangladesh.
| | - Shumona Sharmin Salam
- International Center for Diarrheal Disease Research, Bangladesh, 68, Shaheed Tajuddin Ahmed Sarani Mohakhali, Dhaka 1212, Bangladesh.
| | - Qingfeng Li
- International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
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Abstract
CONTEXT Poisoning is an important category of avoidable deaths in Norway and an important public health issue. Close monitoring of any development in this field is essential for effective preventive measures. OBJECTIVE To assess the pattern and trends of poisoning mortality in Norway from 2003 to 2012 based on official mortality data. MATERIALS AND METHODS This is a population-based registry study. We analyzed the underlying external cause of death data, in order to assess poisoning deaths (ICD-10) by accidents (X40-X49); intentional self-harm (suicide) (X60-X69); assault (homicide) (X85-X90); and poisoning of undetermined intent (Y10-Y19). We compared poisoning deaths to other injury mechanisms and used multiple injury cause data to identify substances involved in poisoning deaths. Poisson regression was applied to estimate the trend. RESULTS Poisoning was the second leading mechanism of injury deaths in Norway from 2003 to 2012, causing between 424 and 496 deaths each year. The rates of poisoning deaths varied between 8 and 11 per 100,000 inhabitants, with a peak in 2004. About 3366 of the 4620 poisoning deaths in the decade were accidental. Opioids were the most common causative agents. Heroin caused 150 deaths in 2004. The numbers fell to 63 in 2012 but showed great yearly variations. Deaths by methadone increased from 24 in 2003 to 61 in 2012. DISCUSSION Poisoning mortality rates declined from 2003 to 2012. Interpretation of the data, however, should be done with caution, and comparison with other countries may be biased due to differences in data production procedures. Evaluation of the effect of preventive measures to reduce mortality should be emphasized. CONCLUSION Poisonings remain a significant cause of mortality by injury in Norway. Emphasis should be placed on following the trends closely, especially regarding methadone deaths.
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Affiliation(s)
| | - Erik Andrew
- b School of Pharmacy , University of Oslo , Oslo , Norway
| | - Finn Gjertsen
- c Department of Psychosomatics and Health Behavior , Norwegian Institute of Public Health , Oslo , Norway
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11
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Glogan D, Levitan RD, Brooks DE, Gerkin RD. Unintentional use of mistaken insulin products: a retrospective review of poison center data. J Emerg Med 2013; 45:547-53. [PMID: 23684475 DOI: 10.1016/j.jemermed.2013.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 12/20/2012] [Accepted: 01/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND There are no guidelines for the management of accidental insulin administration. We hypothesized that home monitoring of asymptomatic patients (pts) was safe following unintentionally insulin administration. METHODS Retrospective review of poison center (PCC) charts from 1/1/2000-12/31/2010 looking for accidental insulin administrations. INCLUSION CRITERIA pt must be prescribed insulin. Information recorded from charts: pt age/gender, "intended" and "mistaken" insulin formulations/doses, use of oral diabetic agents, management site, Emergency Department (ED) referral, symptoms, blood glucose values, and treatments. Defined outcomes: symptoms (e.g., altered sensorium); hypoglycemia (<60 mg/dL); management site; health care facility (HCF) admission; and death. Multiple logistic regression was used to determine outcome predictors. RESULTS 652 charts met inclusion criteria. Mean age was 56.4 years; most (58.5%) were women. Most (89%) calls originated from home, 10.7% from a HCF, 0.3% from Emergency Medical Services (EMS). Overall, 397 (60.9%) pts were managed at home. Two pts managed at home were later evaluated by EMS; neither required admission. Symptoms developed in 56 (8.6%) pts. There were no deaths. Only 40 (6.1%) pts were admitted to a HCF; 18 (45%) pts were hypoglycemic. The development of hypoglycemia (odds ratio [OR] 5.94; p < 0.001) and amount of insulin accidentally administered (OR 1.04; p < 0.001) predicted HCF referral. The type and dose of insulin administered did not predict symptoms. CONCLUSIONS Based on a retrospective analysis of a single PCC's cases, home observation of asymptomatic patients after unintentional administration of a wrong insulin formulation appears safe.
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Affiliation(s)
- Diane Glogan
- Banner Good Samaritan Poison Control and Drug Information Center, Phoenix, Arizona
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