How COVID-19 Lockdown in Italy Has Affected Type of Calls and Management of Toxic Exposures: a Retrospective Analysis of a Poison Control Center Database From March 2020 to May 2020

Abstract

Introduction Between early March 2020 and the end of May 2020, Italy issued strict measures to limit further spread of coronavirus disease 2019 (COVID-19) and became the first European country that imposed a lockdown on the population. The aim of this study was to assess the impact of these restricted conditions on the activity of the Poison Control Center (PCC) of Policlinico Umberto I Hospital-Sapienza University of Rome. Methods This was a retrospective analysis of calls received by the PCC during the lockdown period March 9, 2020 through May 31, 2020 compared to the same time period in year 2019 (reference). Results We observed a reduction in calls from hospitals and emergency departments and an increase in calls from private citizens about exposures to products or intoxications during the lockdown. There were increases in unintentional exposures and exposures to hand and surface sanitizers among household and cleaning products. There was a decrease in calls concerning medications, which were mostly from hospitals and emergency departments. We observed increases in exposures requiring clinical observations among adults and referral to the emergency department among pre-school children. Conclusions Public health protection measures against COVID-19 to improve hygiene and maintain clean environments can increase exposures to hazardous products in the domestic environment. We observed an increase in unintentional exposures to household and cleaning products during the lockdown and an increase in ED referrals for pre-school children compared to the previous year. Our data suggest the need for improvements in public campaigns that promote safer handling of household products and prevent unnecessary exposures during a lockdown. The public health promotion activity can benefit the community after the pandemic and prepare the community for lockdowns in the future.

Significant variations of dangerous exposures during COVID-19 pandemic in Italy: a possible association with the containment measures implemented to reduce the virus transmission

“…This evidence could highlight a tendency of the population not to access hospitals or general practitioners if not strictly necessary, a fact in line with the recommendations given during COVID-19 pandemic. Other Italian [ 5 , 23 ] and European [ 4 ] PCs also reported this trend.…”

Transfer of chemicals to a secondary container, from the introduction of new labelling regulation to COVID‐19 lockdown: A retrospective analysis of exposure calls to the Poison Control Centre of Rome, Italy, 2017–2020

“…This was expected, as the COVID‐19 outbreak and relative “lockdown” measures enforced in 2020 have been associated with a surge in exposures to household products, in particular disinfectants and hands and surfaces sanitizers. 11 , 24 , 25 , 26 In contrast to our expectations, however, the increase in cases involving a TSC did not occur during the “lockdown” months between March and June 2020, but in the “post‐lockdown” months of the remaining part of the year. The prevalence rate in this time frame was in fact about three‐fold higher than in the same period of 2018 and 2019.…”

“…Another main finding in the present study is the reincrease in the prevalence of exposures to chemicals transferred to a secondary container in 2020 compared with the previous 2 years. This was expected, as the COVID‐19 outbreak and relative “lockdown” measures enforced in 2020 have been associated with a surge in exposures to household products, in particular disinfectants and hands and surfaces sanitizers 11,24–26 . In contrast to our expectations, however, the increase in cases involving a TSC did not occur during the “lockdown” months between March and June 2020, but in the “post‐lockdown” months of the remaining part of the year.…”

“…The total number of first calls (follow‐up calls excluded) received between 1 January 2017 and 31 December 2020 was 7986. As we previously reported, a sensible reduction in information calls during the 2020 “lockdown,” 11 calls for information requests were excluded, leaving 6269 calls regarding actual exposures and intoxications for the analysis. A case involving a TSC was defined as an unintentional exposure to a chemical product either (i) transferred to an unlabelled or mislabelled secondary container (diluted or not) or (ii) transferred and stored in an unlabelled container following the recommended dilution.…”

“…10 We had previously shown that the lockdown had an impact on the type of calls received by the PCC, with an increase in exposures to household products such as hands and surface sanitizers. 11 In the present analysis, we thus assessed whether the lockdown also affected exposures to chemical products transferred to a secondary container.…”