Patients with Toxicological Exposures Consulted to Siriraj Poison Control Center: The Analysis of Different Age Groups
Kriengsoontornkij W, MD1,2, Jiranantakan T, MD, MPH3,4,5, Ruenglerdpong S, MD6, Mitsungnern T, MD7, Phannarus H, MD3
Affiliation : 1 Siriraj Poison Control Center, Siriraj Hospital, Bangkok, Thailand 2 Department of Pediatric, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 3 Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 4 New South Wales Poisons Information Centre, Sydney Children’s Hospitals Network, Sydney, Australia 5 Drug Health Clinical Services, Royal Prince Alfred Hospital, Sydney, Australia 6 Prachupkhirikhan Hospital, Prachupkhirikhan, Thailand 7 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Human poisoning is not a common cause of death, but it secondarily leads to mortality by introducing injuries or
cancers. The last update of human toxicological exposure in Thailand was published by Ramathibodi Poison Center (RPC) between
2001 and 2004. The authors want to update the toxicological exposure and focus on the differences between age groups to establish
a prevention program for each group.
Objective : To explore toxicological exposure in humans, types of xenobiotics, clinical patterns, treatment and outcomes of intoxicated
patients that were referred to the Siriraj Poison Control Center (SiPCC).
Materials and Methods : This is a retrospective study that included all cases that were referred to SiPCC from 2010 to 2012. Data
were recorded into a paper-based form by pharmacists who were trained as the specialist in poison information, abstracted
variables by two physicians, and validated data by three toxicologists. Data were analyzed by descriptive statistical method using
SPSS version 18.0.
Results : The authors included 4,591 cases from 4,509 events. The incidences of human exposure were 1.89, 2.22, and 2.69 per
100,000 population in 2010, 2011, and 2012, respectively. The most common route of exposure was ingestion and a half of cases
were suicidal gesture. The common agents that contributed to exposures were medications (35%), pesticides (29%), and household
products (12.4%). The overall mortality ratio was 4.4 percent. Common xenobiotics that led to death were paraquat, carbamate,
psychoactive medications, and acidic corrosive. The accidental ingestion occurred in all age-groups: children (4.9%), adult (5.6%)
and elderly (15.4%).
Conclusion : The authors report significant aspects of patients with toxicological exposure in children, adults, and the elderly age
groups and recommend a prevention program on mental health, pesticide handling (paraquat, carbamates), medication safety
(psychoactive medications), and corrosives handling. Whereas, accidental ingestion from non-original containers occurred among
all age groups, not only children as previous understood.
Keywords : Human intoxication, Age group, Clinical patterns, Mortality, Poisoning prevention
