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From 2000 to 2010, the Poison Control Centre of Milan (CAV), in collaboration with the University of Milan, Faculty of Veterinary Medicine, Department of Veterinary Sciences and Technologies for Food Safety, Toxicology Section, collected epidemiological information related to animal poisoning and classified it in an organised and computerised data bank. Data recorded were predominantly related to small animals and to some extent to horses, ruminants and other food-production animals. Few calls were registered involving exotics and no information was recorded on wildlife. The dog was reported to be the most common species involved in animal poisoning, and pesticides constituted the primary group of toxicants. In the case of pets, 'drugs' including veterinary parasiticide and drugs for human use constituted the second class of toxicants responsible for poisoning followed by household products, plants, zootoxins and metals. With regard to horses and farm animals, the second group consisted of phytotoxins, even if only episodically. In Italy, published data on this subject are scarce but this information is crucial for better management of the poisoning of domestic animals in an effort to reduce mortality.

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A retrospective study was conducted on the exposure of dogs and cats to drugs, reported to the Poison Control Centre of Milan (Centro Antiveleni di Milano (CAV)) between January 2006 and December 2012. Calls related to drugs for human use and veterinary drugs accounted for 23.7 per cent of total inquiries (1415) received by CAV and mostly involved dogs (70 per cent of enquiries). Exposure to drugs for human use accounted for 79 per cent of cases involving dogs, whereas veterinary drugs were the main culprit (77 per cent) in the case of cats. The most common class of drugs for human use proved to be CNS drugs (26.8 per cent), followed by NSAIDs (19.6 per cent) and cardiovascular and endocrine drugs (12.9 per cent each). The majority of calls (95.2 per cent) related to veterinary drugs involved dogs and cats exposed to parasiticides. The outcome was reported in only 58.2 per cent of cases, and fatal poisoning accounted for 8.7 per cent of these cases. Epidemiological data from this Italian survey provide useful information on animal exposure to drugs. The knowledge of agents involved in poisoning episodes can help veterinarians make the correct diagnosis and institute preventive measures to possibly reduce animal exposure to drugs.

ObjectiveTo analyse paediatric exposures to pod and traditional laundry detergents in Italy and changes in exposure trends.MethodsAnalyses of a series of patients aged <5 years and exposed to laundry detergents between September 2010 and June 2015, identified by the National Poison Control in Milan.ResultsIn comparison with patients exposed to traditional laundry detergents (n=1150), a higher proportion of those exposed to pods (n=1649) were managed in hospital (68% vs 42%), had clinical effects (75% vs 22%) and moderate/high severity outcomes (13% vs <1%). Exposure rates were stable over time for traditional detergents (average 0.65 cases/day), but an abrupt decline in major company pods was seen in December 2012, 4 months after the introduction of opaque outer packaging (from 1.03 to 0.36 cases/day and from 1.88 to 0.86 cases/million units sold). The odds of clinical effects was higher for exposure to pods than for traditional detergents (OR=10.8; 95% CI 9.0 to 12.9). Among patients exposed to pods, the odds of moderate/high severity outcomes was four times higher for children aged <1 years than for the other age groups (OR=3.9; 95% CI 2.2 to 7.0). Ten children exposed to laundry detergent pods had high severity outcomes while no children exposed to traditional laundry detergents developed high severity effects.ConclusionsThe study confirms that exposure to laundry detergent pods is more dangerous than exposure to traditional detergents. In Italy, 4 months after the introduction of opaque outer packaging by a major company, product-specific exposure rates decreased sharply, suggesting that reducing visibility of laundry detergent pods may be an effective preventive measure. Further efforts are needed to improve safety.

An Italian epidemiological study based on the human Poison Control Centre of Milan (Centro Antiveleni di Milano (CAV)) data related to domestic animal poisoning by exposure to plants, was carried out in collaboration with the Veterinary Toxicology Section of the University of Milan. It encompasses a 12-year period, from the beginning of 2000 to the end of 2011. Calls related to toxic plants accounted for 5.7 per cent of total inquiries (2150) received by CAV. The dog was the most commonly poisoned species (61.8 per cent of calls) followed by the cat (26 per cent). Little information was recorded for other species. Most exposures (73.8 per cent) resulted in mild to moderate clinical signs. The outcome was reported in only 53.7 per cent of cases, and fatal poisoning accounted for 10.6 per cent of these cases. Glycoside, alkaloid, oxalate, toxalbumin, saponin, terpene and terpenoid-containing plants were recorded and found to be responsible for intoxication. Cycas revoluta, Euphorbia pulcherrima, Hydrangea macrophylla, Nerium oleander, Rhododendron species and Prunus species were the plants most frequently involved. Epidemiological data from this Italian survey provide useful information on animal exposure to plants and confirm the importance of plants as causative agents of animal poisoning.

ObjectiveTo evaluate the impact of a television advertising campaign on the risk of oral ingestion of a topical non-prescription gynaecological preparation containing benzydamine hydrochloride.DesignAn interrupted time series design with data routinely collected.SettingA National Poison Control Centre.Participants215 cases of hazardous exposure to the preparation under study occurred in Italy from January 2005 to December 2010.Primary and secondary outcome measuresMean daily rate of cases of exposure by gender in three different periods, that is, pre-advertisement period, before the advertisement was broadcast (from 1 January 2005 to 19 December 2009), advertisement period, when the advertisement was repeatedly launched (from 20 December 2009 to 27 February 2010), post-advertisement period (from 28 February 2010 to 6 March 2010); observed/expected ratios of cases, with expected cases based on data from the pre-advertisement period, adjusted for estimated variations in the number of users. Comparison of the distribution of the main characteristics of cases in the three different periods by means of Pearson's χ2 test or Fisher's exact test.ResultsThe adjusted observed/expected ratio of cases in women was 7.48 (95% CI 5.76 to 9.56) in the advertisement period and 2.97 (95% CI 2.24 to 3.85) in the post-advertisement period. Regarding the characteristics of cases, there was an increased proportion of cases of exposure due to confusion about the correct administration route in the advertisement and post-advertisement periods (81% and 55%, respectively, compared to 16% for the pre-advertisement period.) and of individuals with clinical effects (55%, 52% and 27%, respectively).ConclusionsIn Italy, an advertisement for a non-prescription medicine seems to have confused consumers regarding the administration route. This effect was observed even after the advertisement had stopped being broadcast. These results highlight the need for the monitoring of medication errors and adverse effects before, during and after advertising.