Toxicovigilance I: A survey of acute poisonings in South Africa based on Tygerberg Poison Information centre data

Abstract

Background. The incidence and spectrum of acute poisonings in South Africa are unknown. Poisoning data can be derived from sources such as hospital admission records and poison information centre (PIC) records. Objectives. This study was conducted to examine the extent of the problem and to identify trends and toxicovigilance issues using PIC data. Methods. A survey was conducted based on Tygerberg Poison Information Centre (TPIC) consultations over 1 year. TPIC consultation forms were analysed for patient demographics and causes of poisoning. Results. The TPIC dealt with 4 771 consultations related to human exposures to poisonous substances. The study showed that accidental exposure was more common than intentional poisoning (65.2% v. 34.8%); that 55.8% of cases were adults, of which 57.6% were females; and that 61.4% of adult cases were intentional exposures, and of these 64.3% were females. There was a predominance of accidental exposures (98.8%) and a male predominance (59.7%) in children. Categories of poisoning exposures across all age groups were non-drug chemicals (52.7%), medicines (35.2%) and biological toxins (12.6%). Pesticides (34.8%), irritant/corrosive substances (27.7%) and volatile hydrocarbons (8.3%) were the most common classes of non-drug chemical exposures. Cholinesterase inhibitors (8.8%), anticoagulant rodenticides (7.1%) and pyrethroids (5.0%) were the most commonly ingested non-drug chemicals. Aldicarb and amitraz poisoning were identified as toxicovigilance targets. Analgesics (26.1%) were the most common class of medicine-related exposure, and paracetamol (15.8%), benzodiazepines (9.2%) and antihistamines (5.2%) were the most common medicine-related exposures. Conclusion. The study provided information on evolving trends and identified toxicovigilance targets and the need for continuing toxicology education programmes.