No abstract

A retrospective analysis of poisoning calls received by the National Poisons Information Centre showed a total of 2719 calls over a period of three years (April 1999-March 2002). The queries were made on poisoning management (92%) and information (8%) about various products and functioning of the centre. The data were analysed with respect to age, sex, mode and type of poisoning. The agents belonged to various groups: household products, agricultural pesticides, industrial chemicals, drugs, plants, animal bites and stings, miscellaneous and unknown groups respectively. The age ranged from less than 1 to 70 years, with the highest incidence in the range of 14-40 years, with males (57%) outnumbering females (43%). The most common mode of poisoning was suicidal (53%), followed by accidental (47%). The route of exposure was mainly oral (88%). Dermal (5%), inhalation and ocular exposure contributed 7% to the total. The highest incidence of poisoning was due to household agents (44.1%) followed by drugs (18.8%), agricultural pesticides (12.8%), industrial chemicals (8.9%), animals bites and stings (4.7%), plants (1.7%), unknown (2.9%) and miscellaneous groups (5.6%). Household products mainly comprised of pyrethroids, rodenticides, carbamates, phenyl, detergents, corrosives etc. Drugs implicated included benzodiazepines, anticonvulsants, analgesics, antihistamines, tricyclic antidepressants, thyroid hormones and oral contraceptives. Among the agricultural pesticides, aluminium phosphide was the most commonly consumed followed by organochlorines, organophosphates, ethylene dibromide, herbicides and fungicides. Copper sulphate and nitrobenzene were common among industrial chemicals. The bites and stings group comprised of snake bites, scorpion, wasp and bee stings. Poisoning due to plants was low, but datura was the most commonly ingested. An alarming feature of the study was the high incidence of poisoning in children (36.5%). The age ranged from less than 1 to 18 years and the most vulnerable age group included children from less than 1 year to 6 years. Accidental mode was the most common (79.7%). Intentional attempts were also noticed (20.2%) in the age group above 12 years. The present data may not give an exact picture of the incidence of poisoning in India, but represents a trend in our country. The Poisons Information Centre plays a vital role in providing timely management guidelines including the supply of necessary antidotes from the recently established National Antidote Bank, thereby helping to save precious lives.

Although these data may not give an exact picture of the incidence rate in our country, due to underreporting of calls to the Centre and because the actual incidence might be higher or even variable, but they do give the trend in India, indicating that a strong emphasis should be placed on a prevention campaign which can at least reduce the occurrence of accidental pediatric poisoning. (J Occup Health 2003; 45: 191-196) Key words: Childhood Poisoning, Telephone queries, Poisons Centre, Household Products, Drugs Acute poisoning, a common pediatric emergency is one of the important causes of morbidity and mortality in children especially in developing countries. Thousands of innocent children under the age of five years are poisoned accidentally every year throughout the world, mainly due to their innovative and exploratory nature and mouthing tendencies [1][2][3] . Furthermore, the introduction of a whole range of new and complex chemicals in the form of pesticides, household cleaners, medicines, etc. has widened the spectrum of toxic products to which children may get exposed. There are a number of hospital based epidemiological studies on childhood poisoning in India implicating different agents and all emphasize the implementation and improvement of prevention programmes, which can be aided to a large extent by the identification of high risk circumstances, susceptible age groups, chemical substances and commercial products involved in pediatric poisoning cases [4][5][6][7][8][9] . Furthermore, occupational accidents are grossly underreported in India because the workforce though abundant, is not organized. Although the national policy aims to protect the health of all workers and prohibits the employment of children below 14 yr of age, a major problem is poor enforcement of the laws. So there has to be a broad framework under which the policies for occupational health and safety can be established.The Poisons Information Centre which forms an important component of the Poisons Control Programme Occupational Health / Safety in the WorldReceived Sep 30, 2002; Accepted April 4, 2003 Correspondence to: S. K. Gupta, Department of Pharmacology, National Poisons Information Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029 Abstract: A Study of Childhood Poisoning at

Early post-lung transplantation, dnDSA occurred in 1/4 of recipients, was associated with peri-transplant risk factors and resulted in decreased survival. Spontaneous clearance of dnDSA, seen in one-third of recipients, was associated with a lower risk of acute rejection.

Screening for corticosteroids carried out on 120 samples of alternative medicines which were dispensed to patients suffering mainly from asthma, arthritis, etc., showed that 38.32% of them were adulterated with steroids. Most of these samples were submitted for screening by either a medical practitioner or the patients themselves, who suspected effects of steroids from these drugs. The percentage of steroid positivity was determined in ayurvedic drugs, homeopathic drugs, and unknown or other category of drugs. The presence of steroids in these drugs given for different ailments such as asthma, arthritis, and unknown/other ailments was also tabulated. The results show that a high percentage of these samples contained corticosteroids, however, the distribution of positivity amongst groups was not statistically significant. The lack of proper quality control mechanisms to verify ingredients or efficacy of 'alternative medicines' has led to the proliferation of the practice of dispensing spurious drugs containing corticosteroids as alternative medicines. This study aims to highlight the existence of 'quick fix' remedies dispensed as 'alternative medicines' which not only cause extensive adverse health effects to the patients but also bring alternative systems of medicines into disrepute. The deliberate contamination of corticosteroids with alternative systems of medicine by some practitioners is a cause of great concern. Such practices may not only disgrace alternative systems of medicine but may also lead to adverse side-effects on chronic exposure.