Exposures and suspected intoxications during SARS-CoV-2 pandemic: preliminary results from an Italian poison control centre

Abstract

Data on cleaner and disinfectant exposure and misuse-related acute intoxications in Italy during SARS-CoV-2 pandemic are still lacking. The aim of the present study was to analyse and describe cleaner and disinfectant-related intoxications during SARS-CoV-2 pandemic in an Italian poison control centre. Data were obtained from the toxicological consultations requested to the Toxicology Unit and Poison Centre, Careggi University Hospital, Florence (Italy). We compared data from January 1st to April 30th of 2019 and 2020. Data concerning probable or acute intoxication from any causative agent in the general population (all age groups), from private individuals or from Regional and National health structures, were included in the analysis. A toxicological evaluation was also performed to calculate the Poisoning Severity Score.In 2019, 451 phone counselling sessions were performed and compared to a total of 410 calls received during the same period of 2020. In both periods, the majority of events occurred in paediatric (0–17 years) and adult (18–65 years) patients, who were mainly exposed to one toxic agent, and intoxications took place principally at home due to domestic accidents. The oral route of intoxication was the most frequently observed one, followed by inhalation of toxic agents, which increased by 4.7% in 2020. In 2020, sanitizers and cleaners were reported in 21.6% of cases compared to 12.5% in 2019. This is the first study describing cleaner and disinfectant-related intoxications in Italy. Our results suggested a possible misuse of these products during the SARS-CoV-2 pandemic, underling the effects of home isolation on mental health and unintentional toxic exposures.

Metabolic management of accidental intoxication

“…A calamitous once in a century event like the COVID-19 pandemic also affected the mental health of the world population and impacted patterns of intentional and unintentional toxic exposures. A study from Italy during the COVID-19 pandemic regarding suspected or potential intoxications revealed the increased incidence of cleaners and sanitizers in unintentional toxic exposures (from approximately 12.5% in pre-COVID-19 period to 21.6% during COVID-19) [5]. A large study (almost 20 000 patients) from Saudi Arabia, conducted after the onset of COVID-19 pandemic found household chemicals and alcohol sanitizers' poisoning as the leading cause of accidental in toxication [12].…”

“…There is a great difference in the patterns, rate, frequency and different substances which are used as poisons in different countries and in different regions of large countries [4–6,7 ▪ ]. Various factors are at play including but not limited to religion, economic status, and cultural connotations.…”

“…Accidental intoxication has bimodal incidence with one peak in the pediatric (1-5 years) age group and another peak in the elderly [4][5][6]7 ]. Prescription drugs and household chemicals are frequent culprits.…”

Pharmacovigilance and Pharmacoepidemiology as a Guarantee of Patient Safety: The Role of the Clinical Pharmacologist

“…During the SARS-CoV-2 pandemic, great attention was paid to the risk associated with the involuntary intoxication and to the need for correct information concerning the in-home utilisation of several medical and non-medicinal products (i.e., cleaners and disinfectants, medical devices, etc. ), thus representing a further field of action in which the clinical pharmacologist can guarantee a fundamental contribution [ 26 ]. Actually, the role of clinical pharmacologists, particularly those working in a poison control center, is valuable in the identification and management of exposures and suspected intoxications in the general population or in specific subgroups [ 27 ].…”

Benzalkonium Chloride Poisoning in Pediatric Patients: Report of Case with a Severe Clinical Course and Literature Review

“…As a result of the increased use of disinfectants, there has been a corresponding rise in the number of cases of poisoning with these substances. According to poison control centers, there was a significant increase in the number of reports during the pandemic, with rates of 16.4% in the United States, 60.4% in South Africa, and 121.5% in France [ 7 , 8 , 9 , 10 , 11 ]. In addition, the severity of disinfectant poisoning worsened during the pandemic, with a greater number of symptomatic cases having been observed [ 1 , 9 ].…”