Dataset Information

Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015.

ABSTRACT: INTRODUCTION:Previous studies of scorpion envenomation in the United States (US) have focused on Arizona and the bark scorpion, Centruroides sculpturatus. Although many other scorpion species live in the US, information about envenomations in other states is lacking. METHODS:Nationwide scorpion exposures from 2005 to 2015 were analyzed using the National Poison Data System. RESULTS:Of the 185,402 total exposures, Arizona (68.2%), Texas (10.3%), and Nevada (4.2%) were the top contributors. However, six other southern states reported greater than 100 cases annually, primarily during the warmer months and evening hours. Envenomations occurred most often in a home (97.8%) and were typically managed on-site (90.1%). Pain was the most common effect nationwide (88.7%). Arizona had the highest frequencies of sensory, neuromuscular, and respiratory effects along with higher hospitalization and ICU admission rates, although the latter appeared to drop over the study period. In contrast, local skin effects such as erythema and edema were more common outside of Arizona. Children under 10 years of age in Arizona and Nevada had the highest rates of systemic effects, hospitalization, and ICU admission. CONCLUSIONS:Scorpion envenomations occurred throughout the southern US with similar seasonal and daily variations. Common clinical effects included pain, local edema, and erythema, except in Arizona and Nevada where severe systemic symptoms were more common. Systemic effects correlated with high rates of ICU admissions and intubations, especially in children under 10 years of age.

SUBMITTER: Kang AM

PROVIDER: S-EPMC5440315 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015.

Kang A Min AM Brooks Daniel E DE

Journal of medical toxicology : official journal of the American College of Medical Toxicology 20161205 2

<h4>Introduction</h4>Previous studies of scorpion envenomation in the United States (US) have focused on Arizona and the bark scorpion, Centruroides sculpturatus. Although many other scorpion species live in the US, information about envenomations in other states is lacking.<h4>Methods</h4>Nationwide scorpion exposures from 2005 to 2015 were analyzed using the National Poison Data System.<h4>Results</h4>Of the 185,402 total exposures, Arizona (68.2%), Texas (10.3%), and Nevada (4.2%) were the to ...[more]

PMID: 27921219

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Project description:BackgroundMethadone is a highly effective treatment for opioid use disorder. Its use in the United States is highly regulated at both the federal and state level. The regulations related to take-home doses were loosened because of the 2019 Novel Coronavirus public health emergency declaration. The aim was to assess the effect of loosened regulations on methadone-related exposures reported to poison control centers.MethodsRetrospective analysis of population-based intentional methadone exposures (in persons 18 years of age and older) reported to the American Association of Poison Control Centers' National Poison Data System. A quasi-experimental design looking at one year before and after the March 16, 2020 loosening of methadone take-home regulations. Severity of exposure was assessed by: disposition (discharged from emergency department, admitted to non-critical care versus critical care units), medical treatments received, and medical outcomes (no effect, minor effect, moderate effect, major effect, death). One tail Student t-test and Chi Square were used; p significance was <0.05.ResultsThe number of adult intentional exposures involving methadone increased by 5.3% in the year following the change in federal regulations (p<0.05). There was no statistically significant difference in distribution of age, gender, whether exposures involved methadone-only or methadone plus other substances, therapies administered or hospitalizations. There was no difference in overall distribution of medical outcomes, including deaths.ConclusionsAlthough the number of exposures involving methadone increased post-regulation change, the severity of exposures remained unchanged. Various additional factors (Medicare and Medicaid expansion; increased number of opioid treatment programs) may have also contributed to this increase. As federal officials consider possible permanent changes to the methadone regulations, it is important to evaluate potential related risks and benefits. This study lends support to the consideration that loosening of methadone regulations does not necessarily lead to a substantial increase in severity of exposures.

Project description:ContextOn October 6, 2014, the United States Drug Enforcement Administration (DEA) implemented a regulatory change for hydrocodone combination products (HCPs), moving them from Schedule III to II, in an effort to decrease drug overdoses. Existing research suggests this regulatory action reduced HCP prescribing and dispensing; however, there is limited research assessing its possible effects on overdoses and accidental exposures.ObjectiveTo analyze the changes in opioid exposures reported to the California Poison Control System (CPCS) before and after DEA rescheduling of HCPs.MethodsWe collected monthly exposure data reported to CPCS from 2012 to 2019 and conducted interrupted time series analyses to assess changes in exposures after rescheduling for HCPs, tramadol, oxycodone, morphine, codeine, fentanyl, and heroin. Additional analyses were done to assess any changes in exposures resulting in severe outcomes (moderate or major health effects). For HCPs, we also conducted logistic regressions to identify characteristics of exposures resulting in severe outcomes before and after rescheduling.ResultsOverall monthly opioid exposures reported to CPCS decreased after DEA rescheduling of HCPs. These decreases were significant for HCP, tramadol, and morphine (p < 0.001). Exposures significantly increased for heroin and fentanyl (p < 0.001). There were no significant changes in the share of severe outcomes attributed to HCP exposures after rescheduling.DiscussionThe DEA rescheduling of HCPs was associated with a significant decrease in HCP exposures and prescription opioid exposures overall, but was associated with increased fentanyl and heroin exposures. While other initiatives may have contributed to this decrease, our findings suggest that rescheduling may be a useful regulatory strategy to reduce drug exposures.ConclusionDEA rescheduling of HCPs was associated with a significant reduction in prescription opioid exposures, suggesting that rescheduling high-risk drugs may be an effective strategy to improve public health.

Project description:Rodent control is necessary to prevent damage and spread of disease, and the most common pesticides used for urban and rural rodent control are anticoagulant rodenticides. The aim of this present study was to present data on suspected exposure to rodenticides in humans and domestic animals in Norway based on inquiries to the Norwegian Poison Information Centre in the 16-year period from 2005 through 2020. A total of 4235 inquiries regarding suspected exposures to rodenticides were registered in the study period. Of these, 1486 inquiries involved humans and 2749 animals. Second generation anticoagulants were involved in 68% of human exposures and 79% of animal exposures. Dogs were the most frequent species involved in the animal exposures with 93% of the inquiries, while cats were second most frequent involved. Around 50% of the human inquiries concerned children at the age of 0-4 years. Only 2% of the cases were in the age group 10-19 years, while adults comprised 35% of the inquiries. Acute poisonings accounted for almost 100% of the inquiries among both humans and animals. The exposure was accidental in 99% of the animal exposures and in 85% of the human exposures. In humans, only 14 inquiries were regarding occupational related accidents. Misdeed or self-inflicted injury accounted for 15% of the human inquiries and were the cause of 79% of the severe poisonings. Severe poisoning was only assessed in 1% of the cases involving children under 5 years. In contrast, 17% of the inquiries concerning adults (≥20 years) were assessed as severe. Subsequently, to prevent human and animal rodenticide exposure, we urge the use of non-chemical methods such as sanitation, rodent proofing (a form of construction which will impede or prevent rodents access to or from a given space or building) and mechanical traps. Restricting the use of rodenticides to professional pest controllers (or other persons with authorisation), reinforcing high quality education of these persons, and securing compliance of the best codes of practice could be advocated to reduce accidental exposure to rodenticides in humans and animals.

Project description:Background and aimsRecreational cannabis has been legalized in 11 states and District of Columbia (DC) in the United States. Among these, 10 states further permitted retail sale to provide a legal supply to adults. This study examined the associations of cannabis exposures with recreational cannabis legalization and commercialization.DesignSecondary data analysis of state-quarter level cannabis exposures during 2010-17 in the United States. Linear regressions with a difference-in-differences design were used to compare pre- and post-legalization trends in states that legalized recreational cannabis to contemporaneous trends in states that did not legalize recreational cannabis.SettingUnited States, including all 50 states and DC.CasesCannabis exposures reported to the US National Poison Data System.MeasurementsThe primary outcome was state age-adjusted cannabis exposures reported to the US National Poison Data System per 1 000 000 population per quarter. The two policy variables of interest included (1) the enactment of recreational cannabis legalization (i.e. removing penalties for adults' possession of cannabis in a small amount for recreational use) and (2) the initiation of recreational cannabis commercialization (i.e. providing a legal supply of cannabis to adults through licensed dispensaries).FindingsThe association between a state's enactment of recreational cannabis legalization and its changes in cannabis exposures was statistically non-significant overall. After controlling for recreational cannabis legalization, however, the initiation of recreational cannabis commercialization was associated with 5.06-5.80 more exposures per 1 000 000 population per quarter (67-77% increase relative to the pre-legalization average), depending on the composition of comparison states. The increase associated with commercialization was higher among minors than adults (7.97-9.53 versus 3.83-4.21 more exposures), higher among males than females (6.16-7.56 versus 3.76-3.91 more exposures) and higher among exposures with medical consequences than those without medical consequences (4.09-4.79 versus 0.97-1.01 more exposures).ConclusionAn increase in cannabis exposures reported to the US National Poison Data System was observed following recreational cannabis commercialization in the United States.

Dataset Information

Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015.

Publications

Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015.

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