42nd International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) 24-27 May 2022, Tallinn, Estonia

Abstract

Objective: Similar to the UK National Health Service, the German Climate and Health Alliance published a list of drugs problematic during heat waves containing many psycholeptics and cardiovascular drugs [1,2]. We investigated whether temperature elevation affects exposure to these drugs. Method(s): In a retrospective study we compared cases of exposure to psycholeptics (PSL-EC) and cardiovascular drugs (CVD-EC) in therapeutic dose and in overdose reported to the Poisons Information Centre (PIC) Erfurt in the heat months June to September of the heat wave years 2003, 2006, and 2015-2019 (HY) with mean air temperature of 17.6 degreeC and the non-heat wave years 2004-2005, and 2007-2014 (NHY) with mean air temperature of 16.2 degreeC. Data collected included frequency of cases of exposure, symptom severity, circumstances of exposure, age, and sex of involved persons. Result(s): In the heat months of 2003 to 2019 we observed a discontinuous increase of PSL-EC (2003: 556, 2019: 1007) and CVDEC (2003: 153, 2019: 210). During HY, similar rates of asymptomatic or mild PSL-EC (64.4% versus 64.0%) but higher rates of asymptomatic or mild CVD-EC (72.3% versus 67.9%) and lower rates of moderate PSL-EL (13.6% versus 12.5%) and CVD-EC (9.3% versus 7.8%), as well as severe PSL-EC (5.7% versus 4.3%) and CVD-EC (4.9% versus 3.4%) were observed than during NHY. Accidental PSL-EC (11.5% versus 9.7%) and CVD-EC (41.6% versus 36.8%) were higher, and PSL-EC (66.9% versus 68.5%) and CVDEC (48.0% versus 51.0%) in suicidal intention were less frequent. During HY, the proportion of adolescents (5.6% versus 4.3%), middle-aged adults (60.1% versus 50.0%), and seniors (14.7% versus 10.1%) was higher in PSL-EC and that of babies (2.3% versus 1.0%), and seniors (19.1% versus 15.9%) was higher in CVD-EC than in NHY. The proportion of genders in PSL-EC (male: 36.2% versus 35.2%, female: 61.0% versus 61.7%) and CVD-EC (male: 43.5% versus 43.0%, female: 50.6% versus 50.2%) remained unchanged during HY and NHY. Conclusion(s): Although in comparison to non-heat wave years no higher rates of moderate or severe exposure to psycholeptics or cardiovascular drugs were detected in heat wave years, medication of patients on psycholeptics or cardiovascular drugs should be observed critically during heat waves because they affect the body's usual cooling mechanisms.