A massive outbreak of food poisoning--a reminder of the importance of proper toxic waste control.

Because of rapid urbanisation in South Africa, scavenging from waste disposal sites by poor communities poses an increasing health risk. Reject cough lozenges, some of which contained larger amounts of dextromethorphan than usual, were illegally removed from a disposal site and, after resale by informal traders, caused moderately severe symptoms of toxicity in 171/540 (24%) primary school pupils. Although dextromethorphan was implicated as a cause, contributing effects of other toxins could not be excluded. Bacteriological cultures and a pesticide screen were negative. Had more toxic substances been involved, the consequences would have been disastrous. This incident supports calls for an integrated national waste management policy and waste control act to govern the management and control of waste from generation to disposal. Such a policy is necessary to prevent potentially serious incidents in the future.