Ali M. Al-Rawaq (1)
Poisoning remains a major global public health concern, accounting for significant morbidity and mortality, particularly in developing countries where access to toxic agents is common. In Iraq, especially in Basra, cases of acute poisoning are frequent, yet epidemiological data remain limited, hampering effective prevention and management strategies. Despite regional studies, there is insufficient systematic analysis of poisoning trends, types of agents, and demographic risk factors in Basra over recent years. This study aimed to evaluate the prevalence, types, and outcomes of chemical and pharmaceutical poisoning cases reported to the Basra Poison Control Centre over a three-year period (2020–2022). A total of 244 cases were analyzed, with nearly half occurring in children under seven years old, indicating their high vulnerability. Males predominated in 2020 and 2021, while females were more frequently affected in 2022. Drugs were the leading cause of poisoning (171 cases), particularly benzodiazepines (18–29.5%) and paracetamol (15–18.5%). Pesticides, especially organophosphorus compounds and zinc phosphide, were the most common non-pharmaceutical agents in 2020 and 2021, whereas sulfur dioxide gas accounted for 30% of chemical cases in 2022. This is the first comprehensive epidemiological study documenting temporal and demographic variations in poisoning cases in Basra, integrating both pharmaceutical and chemical exposures. The findings highlight the urgent need for stricter drug dispensing regulations, enhanced public awareness, and improved poison control strategies, including antidote availability and healthcare worker training, to reduce the burden of poisoning.
Highlights:
1. KV R, HD NK. Study the assessment of poisoning cases in a rural tertiary care teaching hospital by a clinical pharmacist. Asian J Pharm Clin Res. 2012;5(2):138-41. https://www.researchgate.net/publication/288456125
2. Abo El-Noor M. Pattern of acute poisoning among patients admitted to Tanta Poison Control Center during 2012. Ain Shams Journal of Forensic Medicine and Clinical Toxicology. 2013 Jan 1;20(1):158-69. https://doi.org/10.21608/ajfm.2013.19402
3. Roberts DM, Karunarathna A, Buckley NA, Manuweera G, Sheriff MR, Eddleston M. Influence of pesticide regulation on acute poisoning deaths in Sri Lanka. Bulletin of the World Health Organization. 2003 Nov;81(11):789-98. https://pmc.ncbi.nlm.nih.gov/articles/PMC1693668/
4. Alghafees MA, Abdulmomen A, Eid M, Alhussin GI, Alosaimi MQ, Alduhaimi GS, Albogami MT, Alhelail M. Poisoning-related emergency department visits: the experience of a Saudi high-volume toxicology center. Annals of Saudi medicine. 2022 Jan;42(1):36-44. https://doi.org/10.5144/0256-4947.2022.36
5. Thundiyil JG, Stober J, Besbelli N, Pronczuk J. Acute pesticide poisoning: a proposed classification tool. Bulletin of the World Health Organization. 2008;86:205-9. https://doi.org/10.2471/blt.08.041814
6. Ahmadi A, Pakravan N, Ghazizadeh Z. Pattern of acute food, drug, and chemical poisoning in Sari City, Northern Iran. Human & experimental toxicology. 2010;29(9):731-8. https://doi.org/10.1177/0960327110361501
7. Abdelhamid W. Evaluation of the severity of poisoning exposures among patients presented to Poison Control Center, Ain Shams University Hospitals, Egypt in 2019. Ain Shams Journal of forensic medicine and clinical toxicology. 2021;36(1):106-22. http://dx.doi.org/10.21608/ajfm.2021.139281
8. Lam LT. Childhood and adolescence poisoning in NSW, Australia: an analysis of age, sex, geographic, and poison types. Injury Prevention. 2003;9(4):338-42. https://doi.org/10.1136/ip.9.4.338
9. Yehya A, Albals D, Issa R, Fawadleh A. Retrospective assessment of acute poisoning incidents by pharmaceutical agents in Jordan: Data from Pharmacy One™ Poison Call Center, 2014 to 2018—Part II. Pharmacology Research & Perspectives. 2020;8(2):e00583. https://doi.org/10.1002/prp2.582
10. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Hassanian-Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Human & experimental toxicology. 2007;26(9):753-6. https://doi.org/10.1177/0960327107083017
11. Ramesha K, Rao KB, Kumar GS. Pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka, India. Indian Journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2009;13(3):152. https://doi.org/10.4103/0972-5229.58541
12. Jesslin J, Adepu R, Churi S. Assessment of prevalence and mortality incidences due to poisoning in a South Indian tertiary care teaching hospital. Indian Journal of pharmaceutical sciences. 2010;72(5):587. https://doi.org/10.4103/0250-474x.78525
13. Zhang Y, Yu B, Wang N, Li T. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ open. 2018;8(8):e021881. https://doi.org/10.1136/bmjopen-2018-021881
14. Tawfik H, Khalifa E. Evaluation of poisoning and drug overdose among cases presented to poison control centre, Ain Shams University Hospital during the year 2015. Ain Shams Journal of Forensic Medicine and Clinical Toxicology. 2017;29(2):100-12. https://doi.org/10.21608/ajfm.2017.41227
15. Resiere D, Kallel H, Oxybel O, Chabartier C, Florentin J, Brouste Y, et al. Clinical and epidemiological characteristics of severe acute adult poisoning cases in Martinique: implicated toxic exposures and their outcomes. Toxics. 2020;8(2):28. https://doi.org/10.3390/toxics8020028
16. Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iranian journal of pediatrics. 2011;21(4):479. https://pmc.ncbi.nlm.nih.gov/articles/PMC3446134/
17. Michael JB, Sztajnkrycer MD. Deadly pediatric poisons: nine common agents that kill at low doses. Emergency Medicine Clinics. 2004;22(4):1019-50. https://doi.org/10.1016/j.emc.2004.05.004
18. Parris MA, Calello DP. Found down: approach to the patient with an unknown poisoning. Emergency Medicine Clinics. 2022;40(2):193-222. https://doi.org/10.1016/j.emc.2022.01.011
19. Akgür SA, Dağlıoğlu N, editors. Temel Adli Toksikoloji. Akademisyen Kitabevi; 2018 Jul 26. http://dx.doi.org/10.51982/bagimli.1071269
20. Cope WG. Exposure classes, toxicants in air, water, soil, domestic and occupational settings. A textbook of modern toxicology. 2004:31-48. https://repository.stikesbcm.ac.id/id/eprint