Surveillance of paediatric exposures to liquid laundry detergent pods in Italy

Objective To analyse paediatric exposures to pod and traditional laundry detergents in Italy and changes in exposure trends. Methods Analyses of a series of patients aged <5 years and exposed to laundry detergents between September 2010 and June 2015, identified by the National Poison Control in Milan. Results In comparison with patients exposed to traditional laundry detergents (n=1150), a higher proportion of those exposed to pods (n=1649) were managed in hospital (68% vs 42%), had clinical effects (75% vs 22%) and moderate/high severity outcomes (13% vs <1%). Exposure rates were stable over time for traditional detergents (average 0.65 cases/day), but an abrupt decline in major company pods was seen in December 2012, 4 months after the introduction of opaque outer packaging (from 1.03 to 0.36 cases/day and from 1.88 to 0.86 cases/million units sold). The odds of clinical effects was higher for exposure to pods than for traditional detergents (OR=10.8; 95% CI 9.0 to 12.9). Among patients exposed to pods, the odds of moderate/high severity outcomes was four times higher for children aged <1 years than for the other age groups (OR=3.9; 95% CI 2.2 to 7.0). Ten children exposed to laundry detergent pods had high severity outcomes while no children exposed to traditional laundry detergents developed high severity effects. Conclusions The study confirms that exposure to laundry detergent pods is more dangerous than exposure to traditional detergents. In Italy, 4 months after the introduction of opaque outer packaging by a major company, product-specific exposure rates decreased sharply, suggesting that reducing visibility of laundry detergent pods may be an effective preventive measure. Further efforts are needed to improve safety

239 Surveillance of toxic exposures to liquid laundry detergents in pods in Italy

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Analytical aspects of diterpene alkaloid poisoning with monkshood.

A sensitive and specific method for aconitine extraction from biological samples was developed. Aconitine, the main toxic alkaloid from plants belonging to Aconitum species (family Ranunculaceae), was determined in plant material by an external standard method, and by a standard addition calibration method in biological fluids. Described here is one fatal case and five intoxications of accidental aconitine poisoning following the ingestion of aconite mistaken for an edible grass, Aruncus dioicus (Walt.) Fernald, "mountain asparagus", and Cicerbita alpina (L.) Wallroth. The aconitine content in urine was in the range 2.94 μg/mL (dead patient) – 0.20 μg/mL (surviving patients), which was almost two to four times higher than that in plasma

Surveillance of plant protection pesticides-related poisonings and injuries

Background Regulation 2009/1185/EU on sustainable use of pesticides requires reporting from European Member States on plant protection pesticide (PPP) poisonous exposures. These data can provide information to identify emerging problems and populations at risk, support the development of preventive and regulatory measures and evaluate their effectiveness. In Italy, a surveillance of acute PPP-related poisonings (SAPReP), based on Poison Control Centres data, has been implemented since 2001. In this contribution are presented the main characteristics of cases exposed in Italy in 2007–2012. Methods series of cases identified by the National Poison Control Centre in Milan, reviewed and classified by the Italian National Institute of Health according to standard procedures. Results In 2007–2012, SAPReP identified 2,108 cases of accidental PPP-related poisonings and injuries. Male patients were 1,442 (68%) while females were 442 (20%). Gender was unknown in 12% of cases (No. 224) Severity of poisoning was low in 84% of cases (No. 1,774), moderate in 14% (n. 305), high in 1% (n. 28). One case of death was identified. About 50% of poisonings occurred at work, in agricultural settings, and 36% at home. Some 70% of exposures occurred between May and September. Insecticides/acaricides were responsible in 42% of poisonings, fungicides/bactericides in 16%, herbicides in 15%, and soil sterilants in 13%. Five mass exposures were identified: two incidents were caused by off-site drift of metam sodium, a soil sterilant, and involved 86 and 103 by-standers, respectively; two incidents were caused by chlorpyrifos methyl, an organophosphate insecticide/ acaricide (one occurred in a hospital, 10 cases; one occurred in agricultural setting, 20 agricultural workers); one incident was caused by phenthoate and involved 40 agricultural workers Conclusions Surveillance based on data collected by Poison Control Centres provides an important tool to identify emerging problems and associated risk factors. The observations available in Italy on PPP-related poisonings and injuries suggest that greater efforts are needed to prevent these types of incidents

Animal poisoning in Europe, part 1: farm livestock and poultry

The lack of a reference Veterinary Poison Control Centre for the European Union (EU) means that clinicians find it difficult to obtain information on poisoning episodes. This three-part review collates published and unpublished data obtained from Belgium, France, Greece, Italy and Spain over the last decade in order to provide a broader toxicoepidemiological perspective. The first article critically evaluates the national situation in the five European countries and concludes that information for livestock and poultry is limited and fragmentary compared to other animal groups. The analysis has revealed that clinical cases of poisoning are only occasionally studied in depth and that cattle are the species most frequently reported. Several plants and mycotoxins, a few pesticides and metals, together with contaminants of industrial origin, such as dioxins, are responsible for most of the recorded cases

Animal poisoning in Europe, part 2: companion animals

This is the second in a series of three review articles on animal poisoning in Europe and focuses on cases in pet animals and horses in five European countries (Belgium, France, Greece, Italy and Spain) reported over the last decade. In the participating countries, dogs were the most commonly poisoned species, particularly younger animals. The majority of cases in companion animals resulted from exposure to insecticides, although rodenticides (especially anticoagulants and strychnine) posed a significant risk. In all five countries, horses and cats appeared to be more susceptible to plant toxins. Intoxications with herbicides, metals, household products and drugs for veterinary and human use were reported sporadically. The review demonstrates the importance of increased awareness so as to minimise poisoning episodes and emphasises the need to establish a European system for the recording of poisoning data