Toxicoepidemiology of poisoning exhibited in Indian population from 2010 to 2020: a systematic review and meta-analysis

Abstract

ObjectiveTo determine the prevalence of pesticide, corrosive, drugs, venom and miscellaneous poisoning in India.SettingSystematic literature search was done in PubMed Central, Cochrane and Google Scholar databases for studies that satisfied the inclusion criteria. Systematic review and meta-analyses of all observational studies published in the English language from January 2010 to May 2020 were included in this review.ParticipantsPatients exposed to poisoning reported to hospitals were included.Primary and secondary outcome measuresThe prevalence of pesticide poisoning was analysed. The prevalence of poisoning due to corrosives, venom, drugs and miscellaneous agents, along with subgroup analysis based on age and region, was also determined. The percentage of persons with poisoning along with 95% CI was analysed.ResultsPooled analysis of studies revealed that pesticides were the main cause of poisoning in adults, with an incidence of 63% (95% CI 63% to 64%), while miscellaneous agents were the main cause of poisoning in children, with an incidence of 45.0% (95% CI 43.1% to 46.9%), among those presenting to hospitals. Pesticide poisoning was the most prevalent in North India (79.1%, 95% CI 78.4% to 79.9%), followed by South (65.9%, 95% CI 65.3% to 66.6%), Central (59.2%, 95% CI 57.9% to 60.4%), West (53.1%, 95% CI 51.9% to 54.2%), North East (46.9%, 95% CI 41.5% to 52.4%) and East (38.5%, 95% CI 37.3% to 39.7%). The second most common cause of poisoning was miscellaneous agents (18%, 95% CI 18% to 19%), followed by drugs (10%, 95% CI 10% to 10%), venoms (6%, 95% CI 6% to 6%) and corrosives (2%, 95% CI 1% to 2%).ConclusionsPesticide poisoning is the most common type of poisoning in adults, while miscellaneous agents remain the main cause of poisoning in children.PROSPERO registration numberCRD42020199427.

Case report: Airway management in post corrosive poisoning

“…Pooled prevalence of corrosive poisoning in the whole population of india was found to be around 2% of the total cases of poisoning [1] . Ingestion of corrosive solutions may cause severe injury to aerodigestive tract and morbidity and mortality rates estimated at 50% and 13% respectively.…”

A Review on Household Poisoning and its Management

“…1 The larger number of poisonings that is about79% occur in low-and middle-income nations like India, with oral intake of dangerous substances being the most common mode of poisoning. 2 WHO appraised that, in 2016, unintentional poisoning caused 106 683 deaths and a loss of about 6.3 million years of healthy life (disability-adjusted life year) 3 . The worldwide occurrence of poisoning is unknown.…”

Changing spectrum of acute poisoning in North India

“…[ 3 4 5 ] In India, organophosphate and aluminum phosphide are the most common pesticides that cause acute poisoning. [ 5 6 7 8 9 10 11 ] Household products such as disinfectants or cleaners remain the continuous source of intentional or unintentional exposures. [ 9 10 11 12 ] In recent years, worldwide reports have established an increasing incidence of a drug overdose, including pharmaceutical agents (e.g., antidepressants) or illicit drugs (e.g., opioids).…”

“…[ 9 10 11 12 ] In recent years, worldwide reports have established an increasing incidence of a drug overdose, including pharmaceutical agents (e.g., antidepressants) or illicit drugs (e.g., opioids). [ 2 6 13 14 ]…”

“…Although acute poisoning is a universal phenomenon, the spectrum varies in different parts of the world and even within a country. [ 2 5 6 7 8 9 10 11 12 ] Socioeconomics, cultural environment, and toxicant availability are the essential factors influencing the poisoning spectrum and trends. Evaluating local trends and continued monitoring of poisoning patterns is critical for prompt recognition of the toxidromes, establishing immediate treatment facilities at the primary health centers (e.g., antidote availability), and effective preventive strategies (e.g., awareness campaigns, governmental restrictions on hazardous substances marketing).…”