Pesticide poisonings at a tertiary children's hospital in South Africa: an increasing problem.
نویسندگان
چکیده
CONTEXT Exposure of children to pesticides and overt poisoning are an increasingly important problem in South Africa. OBJECTIVE This study describes the profile of acute paediatric pesticide exposures and poisonings presenting to Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town South Africa from 2003 to 2008, identifies those poisonings due to illicit pesticides sold on the streets ("street pesticides") and assesses the number of incidents in which the statutory requirement of notification to the local health authority is met. Methods. Cases were identified by review of the RCWMCH case and notification records and the local health authority notification records. RESULTS There were 306 patients with 311 incidents of acute pesticide exposure or poisoning. This represents 11% of all paediatric exposures and poisonings (N=2868) seen over the 6-year period. The number of pesticide incidents increased annually. Two hundred seventy-eight (91%) children were under 6 years old and 164 (54%) were males. Two hundred seventeen (70%) patients came from six socio economically diverse suburbs in the Cape Town Metropole, each of which ranges from informal settlements with extreme poverty to formal housing with lower to middle class populations. There was a summer predominance of acute pesticide exposures and poisonings. The commonest group of pesticides were 203 cholinergics (includes organophosphates and carbamates), 35 anticoagulants and 45 unknowns. One hundred incidents were classified as exposures as they were asymptomatic. Two hundred eleven symptomatic incidents, termed pesticide poisonings, required admission; 121 to High Care or Intensive Care Unit (ICU). The median length of stay in hospital was 3 days (range 0-52). There were 6 (2%) deaths. The large group of cholinergic exposures and poisonings (203) required 195 (96%) admissions; 120 (59%) to High Care or ICU. Of the 44 "street pesticide" exposures and poisonings, 33 were cholinergic poisonings and 21 required High Care or ICU. Eighty-seven (41%) of 211 poisonings requiring notification were recorded at the local health authority; all were instances of cholinergic poisoning. CONCLUSION The increasing number and the morbidity and mortality of acute paediatric pesticide exposure and poisoning is of great concern. Furthermore, the magnitude of the problem is masked by inadequate notification with the relevant health authorities.
منابع مشابه
The changing trends of childhood poisoning at a tertiary children's hospital in South Africa.
CONTEXT Information on childhood poisoning in the developing world, including South Africa, is scarce, despite its contribution to morbidity and mortality. OBJECTIVE We describe the profile of children with exposures and poisonings presenting to Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town, South Africa, from 2003 to 2008 and compare the trends of causative agents over the...
متن کاملLocal Diagnostic Reference Levels for Common Computed Tomography Procedures at a Tertiary Hospital in South Africa
Introduction: An operational computed tomography (CT) scanner is a major source of human exposure to ionizing radiation. Exposure increases the risk of cancer and aplastic anaemia. All radiation exposures should be justified and optimized to meet the clinical objective. In order to avoid the administration of excessive radiation dose to patients, diagnostic reference l...
متن کاملImproving poisoning diagnosis and surveillance of street pesticides.
An effective surveillance system is required to reduce pesticide exposures and poisonings, especially from street pesticides (illegal, unlabelled, and decanted agricultural pesticides used predominately for urban household purposes). Poisoning from any pesticide class, not only organophosphates, constitutes a medically notifiable condition in South Africa. Current practice, however, is to repor...
متن کاملOn-Year Study on Pattern of Acute Pharmaceutical and Chemical Poisoning Cases Admitted to a Tertiary Care Hospital in Thrissur, India
Background: Identification of regional pattern of poisoning is essential for health care authorities for proper planning on prevention programs and optimized management of antidote stockpiles. This study was designed to evaluate one-year epidemiologic pattern of acute poisoning cases treated at a tertiary care hospital in Thrissur, India. Methods: In this retrospective cross sectional study, me...
متن کاملEstablishment of Diagnostic Reference Levels and Estimation of Effective Dose from Computed Tomography Head Scans at a Tertiary Hospital in South Africa
Introduction: Head scans are the most frequently performed computed tomography (CT) examinations worldwide. However, there is growing concern over the probability of increased cancer risks among the exposed populations. Diagnostic reference levels (DRLs) identify radiation dose that is not commensurate with clinical objectives. The aim of this study was to establish DR...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Clinical toxicology
دوره 48 9 شماره
صفحات -
تاریخ انتشار 2010