Trends and Characteristics of Manufactured Cannabis Product and Cannabis Plant Product Exposures Reported to US Poison Control Centers, 2017-2019.
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SUBMITTER: Dilley JA
PROVIDER: S-EPMC8144922 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionPrevious 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.MethodsNationwide scorpion exposures from 2005 to 2015 were analyzed using the National Poison Data System.ResultsOf 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.ConclusionsScorpion 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.
| S-EPMC5440315 | biostudies-literature
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.
| S-EPMC7438241 | biostudies-literature
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.
| S-EPMC8769878 | biostudies-literature
Project description:OBJECTIVE:The aim of this analysis was to contrast trends in exposure-report calls and informational queries (a measure of public interest) about mercury to the Florida Poison Control Centers over 2003-2013. MATERIALS AND METHODS:Poison-control specialists coded calls to Florida Poison Control Centers by substance of concern, caller demographics, and whether the call pertained to an exposure event or was an informational query. For the present study, call records regarding mercury were de-identified and provided along with daily total number of calls for statistical analysis. We fit Poisson models using generalized estimating equations to summarize changes across years in counts of daily calls to Florida Poison Control Centers, adjusting for month. In a second stage of analysis, we further adjusted for the total number of calls each day. We also conducted analyses stratified by age of the exposed. RESULTS:There was an overall decrease over 2003-2013 in the number of total calls about mercury [Ratio per year: 0.89, 95% CI: (0.88, 0.90)], and calls about mercury exposure [Ratio per year: 0.84, 95% CI: (0.83, 0.85)], but the number of informational queries about mercury increased over this time [Ratio per year: 1.15 (95% CI: 1.12, 1.18)]. After adjusting for the number of calls of that type each day (e.g., call volume), the associations remained similar: a ratio of 0.88 (95% CI: 0.87, 0.89) per year for total calls, 0.85 (0.83, 0.86) for exposure-related calls, and 1.17 (1.14, 1.21) for informational queries. CONCLUSION:Although, the number of exposure-related calls decreased, informational queries increased over 2003-2013. This might suggest an increased public interest in mercury health risks despite a decrease in reported exposures over this time period.
| S-EPMC5623635 | biostudies-literature
Project description:BACKGROUND:There is little published data about human plant exposures reported to US poison control centers (PCCs). METHODS:A retrospective chart review of all reported plant exposures to a single regional PCC between January 1, 2003 and December 31, 2010 was done to understand better the characteristics of plant exposure cases. Specific generic plant codes were used to identify cases. Recorded variables included patient demographics, plant involved, exposure variables, symptoms, management site, treatments, and outcome. Univariate and multivariate regression was used to identify outcome predictors. RESULTS:A total of 6492 charts met inclusion criteria. The average age was 16.6 years (2 months-94 years); 52.4% were male. The most common exposure reason was unintentional (98%), and the majority (92.4%) occurred at the patient's home. Ingestions (58.3%) and dermal exposures (34.3%) accounted for most cases. Cactus (27.5%), oleander (12.5%), Lantana (5.7%), and Bougainvillea (3.8%) were most commonly involved. Symptoms developed in 47.1% of patients, and were more likely to occur following Datura (66.7%), and Morning Glory or Milkweed (25% each) exposures. Almost 94% of patients were managed onsite (home) and only 5.2% involved evaluation in a health care facility (HCF). Only 37 (0.6%) patients required hospital admission, and 2.9% of cases resulted in more than minimal effects. Exposures resulting in more than minimal clinical effects were predicted by several variables: abnormal vital signs (OR?=?35.62), abnormal labs (OR?=?14.87), and management at a HCF (OR?=?7.37). Hospital admissions were increased for patients already at a HCF (OR?=?54.01), abnormal vital signs (OR?=?23.28), and intentional exposures (OR?=?14.7). CONCLUSION:Plant exposures reported to our poison control center were typically unintentional ingestions occurring at home. Most patients were managed onsite and few developed significant symptoms.
| S-EPMC6013727 | biostudies-literature
Project description:BackgroundElectronic nicotine delivery systems (ENDSs), including electronic cigarettes (e-cigarettes), are rapidly gaining popularity. The aim of this study was to use poison centre data to describe epidemiological trends in ENDS-related exposures.MethodsWe conducted an observational case series study using records containing both coded fields and free-text narratives from the British Columbia Drug and Poison Information Centre for all calls involving exposure to ENDS received from 2012 to 2017. We described trends in exposures and exposed people, as well as clinical effects.ResultsA total of 243 calls were recorded for 186 unique exposures to ENDS devices, e-juice, e-cigarette cartridges and other associated paraphernalia over the study period. Calls related to ENDS exposures increased nearly sixfold between 2013 and 2014 and did not decline subsequently. Exposures were most frequently documented in children aged 4 years or less (81 [43.5%]), with 58 (31.0%) in 1- and 2-year-olds. Seventy-two exposures (89%) in children aged 4 years or less were due to accidental ingestion, whereas adults aged 25 years or more called the poison centre following ENDS malfunctions (7 [23%], spills (4 [13%]) and exposure to e-juice mistaken for other substances (4 [13%]). Of the 186 exposed people, 87 (46.8%) reported symptoms.InterpretationBritish Columbia experienced a sixfold increase in ENDS-related calls to the provincial poison centre between 2012 and 2017, driven by ingestions in young children. Regulatory approaches aimed at minimizing children's access to ENDS, clear labelling of nicotine concentration, and packaging that reduces the likelihood of spills, product confusion and malfunction should be considered.
| S-EPMC6639097 | biostudies-literature
Project description:The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whether intentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposures across European Union Member States (EU MS).A retrospective analysis of exposures associated with e-cigarettes reported to national poison centers was performed covering incidents from 2012 to March 2015 from 10 EU MS. De-identified and anonymous raw data was acquired.In total, 277 incidents were reported. Unintentional exposure was the most frequently cited type of exposure (71.3%), while e-cigarette refill vials were responsible for the majority of the reported incidents (87.3%). Two-thirds of all exposures (67.5%) occurred as ingestion of e-liquids, which was more frequent among children (≤ 5 years, 6-18 years) compared to adults (87.0% vs. 59.3% vs. 57.6%, p < 0.001 respectively), exposure via the respiratory (5.4% vs. 22.2% vs. 22.2%, p < 0.001) were more frequent among paediatric patients while ocular routes (2.2% vs. 3.7% vs. 11.4%, p = 0.021) were more frequent among adults. Logistic regression analyses indicated that paediatric incidents (≤ 5 years) were more likely to be through ingestion (adjusted Odds Ratio [aOR] = 4.36, 95% Confidence Interval [C.I.]: 1.87-10.18), but less likely to have a reported clinical effect (aOR = 0.41, 95% C.I.: 0.21-0.82).Our study highlighted parameters related to e-cigarette exposure incidents in 10 EU MS, the results of which indicate that consideration should be given to the design features which may mitigate risks, thereby protecting users, non-users and especially children.
| S-EPMC5559815 | biostudies-other
Project description:BackgroundPrevalence of cannabis use has been increasing among select subgroups in the US; however, trend analyses typically examine prevalence of use across years. We sought to determine whether there is seasonal variation in use.MethodsWe conducted a secondary analysis of the National Survey on Drug Use and Health, a repeated cross-sectional survey of nationally representative probability samples of noninstitutionalized populations age ≥12 in the US. Quarterly trends in any past-month cannabis use were estimated using data from 2015-2019 (N = 282,768).ResultsPrevalence of past-month cannabis use increased significantly from 2015 to 2019 from 8.3%-11.5%, a 38.2 % increase (P < 0.001). Prevalence increased across calendar quarters on average from 8.9 % in January-March to 10.1 % in October-December, a 13.0 % increase (P < 0.001). Controlling for survey year and participant demographics, each subsequent quarter was associated with a 6% increase in odds for use (aOR=1.06, 95 % CI: 1.04-1.07). There were significant increases by quarter among all subgroups of sex, race/ethnicity, education, and among most adult age groups (Ps<0.05), with a 52.7 % increase among those age ≥65. Prevalence also significantly increased among those without a medical cannabis prescription and those not proxy-diagnosed with cannabis use disorder (Ps<0.01), suggesting recreational use may be driving increases more than medical or more chronic use. Those reporting past-year LSD or blunt use in particular were more likely to report higher prevalence of use later in the year (a 4.9 % and 3.3 % absolute increase, respectively; Ps<0.05).ConclusionThe prevalence of cannabis use increases throughout the year, independently of annual increases.
| S-EPMC7855903 | biostudies-literature
Project description:BACKGROUND:Suicides have become headline news in most developing countries and often feature on front pages with accompanying graphic pictures on prominent news portals. There has been an increased reportage of suicides by the Ghanaian news media. This study aims to shed light on the trend of online news media reporting of suicides, and the epidemiology of media reported suicides in Ghana. METHODS:An online search was conducted for news media reports of suicides committed in Ghana. One hundred and forty-two (142) news media reported suicides spanning 1997 to 31st July 2019 were retrieved and included in the analyses. RESULTS:The victims of suicides were predominantly male (85.92%), young (mean age = 34.81 ± 15.71 years; range 10-86 years). Suicide by hanging (67.94%), the use of firearms (18.32%), and self-poisoning (8.93%) were the common methods used by the victims. There has been increased online news media reportage of suicides in Ghana in the last 3 years; 2017 witnessed the highest reportage of 30 (21%) cases. Marital or relationships and family problems were commonly cited as the reasons for the commission of suicides; mental disorders, and financial problems were also cited as immediate triggers of the suicides by close relations of the victims. CONCLUSION:There is an increased media reportage of suicides in Ghana, although this cannot be linked to a corresponding increase in suicide incidence. Interventions to decrease the risk of suicide among vulnerable populations (young adults) such as the identification of suicidal behavior, making mental healthcare services more accessible by integrating into the general healthcare service, public education, establishing a suicide hotline will be critical programs to help reduce suicide incidence in Ghana.
| S-EPMC6953180 | biostudies-literature
Project description:ImportanceSince the accidental introduction of the yellow-legged hornet (Vespa velutina nigrithorax) in France in 2004, there have been reports of this insect unexpectedly projecting a liquid toward the human face, but ocular morbidity associated with this is unknown, to our knowledge.ObjectiveTo describe a case series of ocular lesions after exposure to a liquid projection emitted by a hornet.Design, setting, and participantsThis was an analysis of all cases of ocular exposure to a projection by a yellow-legged hornet (excluding stings in the eye) collected by French poison control centers between January 1, 2004, and December 31, 2019.Main outcomes and measuresSymptoms were evaluated, and a fluorescein eye stain test was used.ResultsTwenty-nine cases were recorded (24 in male and 5 in female patients; median age, 40 [interquartile range, 11] years); the first occurred in 2009. Most cases (20 [80%]) were occupational exposure among professionals dealing with hornet nests (eg, firefighters, wasp exterminators). Symptoms consistent with conjunctivitis often resolved quickly after ocular decontamination, but 5 patients developed a periorbital edema, 2 experienced radiating neuropathic pain, and 2 experienced keratitis.Conclusions and relevanceThese findings suggest that the projection of a liquid into the eyes by the yellow-legged hornet presents a new risk to human health, but its precise nature remains to be determined. Ocular lesions had a favorable outcome. For professionals who deal with these insects, adaptation of the usual protections designed for native hymenopterans may be warranted.
| S-EPMC7662492 | biostudies-literature