Toxicology

Biography

Biography: Sharda Shah Peshin

Abstract

Indiscriminate and unsafe use of different chemicals in the form of pesticides, household products, drugs, industrial chemicals etc has led to an increasing incidence of accidental and intentional poisoning, resulting in morbidity and mortality. To determine the incidence and trend of poisoning due to various agents over a period of five years (Apr.2009-Mar. 2014), we analyzed the data of the telephonic consultations by treating physicians, to the National Poisons Information Centre, from different parts of India. The substances commonly involved in poisoning were classified into eight groups’ viz household products, agricultural pesticides, industrial chemicals, drugs, bites and stings, plants, unknown and miscellaneous classes. Age ranged from < 1yr - 70yrs.Data in children were divided into four age groups (Gp.I: 0-6yrs.,Gp.II: >6-12yrs.,Gp.III : >12-16yrs.,Gp.IV :>16-18 yrs.).The Centre received a total of 8958 calls during the five year period, with 94.77% calls on management of poisoning and 5.22% seeking information about various products and functioning of the Centre. Males outnumbered females (M=62.14%, F=37.85%). Mode of poisoning was predominantly unintentional (58.61%) followed by intentional mode (39.70%). The common routes of exposure were oral (94.86%) dermal (3.6%),inhalation, (0.9%) and ocular routes(0.4%) respectively. The household products were most commonly implicated (45.04%) with highest number of calls due to pesticides(16.64%) followed by detergents and corrosives (14.40%). Drugs (22.15%) mainly comprised of benzodiazepines, analgesics and anticonvulsants. Amongst the agricultural pesticides (16.14%) organophosphates, aluminium phosphide and pyrethroids were commonly implicated. Industrial chemicals (7.71%) chiefly included copper sulfate. Bites and stings (2.99%) comprised mainly snake bites and plants(2.34%) paticularly involved Dhatura. Calls due to unknown and miscellaneous products were few (1.55%, 2.04%). A striking feature of the study was a high incidence of poisoning in children (51.76%) with Gr.I being most affected (71.66%).The exact magnitude of poisoning in the country is not known because the data is scattered. The Poisons Centre data also may not be a true reflection of the scenario in India because a large number of calls are never reported to the Centre. However, the results of the present study highlight an increasing use of household products and their misuse. Easy accessibility and careless storage coupled with negligible parental supervision in case of children could be the possible reasons for poisoning. The study stresses the need to identify high risk circumstances, susceptible age groups, common products and environmental toxins involved in poisoning and implementation of prevention programmes in order to reduce morbidity and mortality.