Distinct dynamics in mountain watersheds: Exploring mercury and microplastic pollution-Unraveling the influence of atmospheric deposition, human activities, and hydrology.

The intensification of human activities all around the globe has led to the spread of micropollutants in high-mountain freshwater environments. We therefore aimed to assess the geospatial distribution and determine the potential sources of (total-) mercury (THg) and microplastics (MPs) in mountain freshwater ecosystems. To do so, we analyzed THg and MP concentrations in brown trout, biofilm, and sediments from lotic and lentic ecosystems in the Pyrenees - all subjected to different types of human pressure. Additionally, we assessed the potential impacts of these pollutants on fish, and explored the bioindication capacity of brown trout (Salmo trutta fario) and biofilm regarding THg and MP pollution. For the first time, we measured concentrations of MPs trapped in the matrix of freshwater biofilm. Our results suggest that THg in the Pyrenees might be explained by both legacy (regional) and distant sources, in combination with environmental characteristics such as the presence of peatlands or streamwater physicochemistry, while MPs in fish are linked to recent local pollution sources such as single-use plastics. In contrast, MPs in biofilm matrix and sediments indicate a combination of distant (i.e., atmospheric deposition) and recent local pollution sources. Moreover, hydrodynamics and plastic density likely control MP distribution in rivers. Based on Fulton's condition factor, we also found that higher THg concentrations caused a negative impact on fish health (K < 1), while no impact of MPs could be seen. Therefore, we suggest that brown trout and biofilm can serve as bioindicators of atmospheric deposition of THg in high-altitude lakes and that biofilm is a reliable bioindicator to assess MP pollution in remote environments. Brown trout may also act as a bioindicator of MP pollution, but only efficiently in more polluted areas.

Spider bites in France: Epidaemiology of cases occurring in 10 years in metropolitan France.

Spiders are often wrongly designated as responsible for cutaneous eruptions. We aim to describe spider bites and the spider species implicated in metropolitan France. A retrospective observational study was conducted for all reported cases of spider bites from 2007 to 2018 extracted from the French Poison Control Centers (PCCs) information system, after exclusion of non-native spiders. We described identification of the spider, level of certainty of the bite, symptoms and severity of cases. 1194 cases of spider bites met the inclusion criteria. The average age of the patients was 36.9 ± 19.8 years. Identification of the species or at least that a spider was implicated was only possible in 346 cases (29.0%). Loxosceles were involved in 53 cases (4.4%), Latrodectus in 46 cases (3.9%) and Cheiracanthium in 35 cases (2.9%). In one third of cases, the involved spider was not known to be present where the bite occurred. Where most of the patients (n = 1111, 93%) reported at least one cutaneous symptom, most of the symptoms were neurological. The bite was considered proven in only 242 cases (20%). Despite the efforts of arachnologists to educate the public, the fear of spiders is still alive in France, where spider bite is rare with low severity and often unproven.

Holocene Atmospheric Mercury Levels Reconstructed from Peat Bog Mercury Stable Isotopes.

Environmental regulations on mercury (Hg) emissions and associated ecosystem restoration are closely linked to what Hg levels we consider natural. It is widely accepted that atmospheric Hg deposition has increased by a factor 3 ± 1 since preindustrial times. However, no long-term historical records of actual atmospheric gaseous elemental Hg (GEM) concentrations exist. In this study we report Hg stable isotope signatures in Pyrenean peat records (southwestern Europe) that are used as tracers of Hg deposition pathway (Δ200Hg, wet vs dry Hg deposition) and atmospheric Hg sources and cycling (δ202Hg, Δ199Hg). By anchoring peat-derived GEM dry deposition to modern atmospheric GEM levels we are able to reconstruct the first millennial-scale atmospheric GEM concentration record. Reconstructed GEM levels from 1970 to 2010 agree with monitoring data, and maximum 20th century GEM levels of 3.9 ± 0.5 ng m-3 were 15 ± 4 times the natural Holocene background of 0.27 ± 0.11 ng m-3. We suggest that a -0.7‰ shift in δ202Hg during the medieval and Renaissance periods is caused by deforestation and associated biomass burning Hg emissions. Our findings suggest therefore that human impacts on the global mercury cycle are subtler and substantially larger than currently thought.

Baclofen Self-Poisoning in the Era of Changing Indication: Multicentric Reports to a French Poison Control Centre.

AIMS: Baclofen has gained interest in treating alcohol use disorder patients. These patients are at risk of voluntary drug intoxications. Understanding the context of baclofen's widespread use for alcohol use disorder, a recent evaluation of the epidemiology, morbidity and mortality of baclofen self-poisoning episodes is necessary. METHODS: All baclofen self-poisoning reported to the Western France Poison Control Centre between January 2008 and December 2015 were included for analysis in this retrospective study. Baclofen poisoning cases were compared to the 31,859 non-baclofen voluntary poisoning cases declared over the same period. RESULTS: Number of baclofen poisoning grew from 8 cases in 2008 to 91 cases in 2015, attributable to patients purposely treated for alcohol use disorder. Overall, 190 cases were considered: 111 patients (59%) had Glasgow coma score (GCS) ≤12 at hospital admission and 77 had GCS > 12 (41%). Eighty patients required mechanical ventilation (42.6%). Neurological severity (GCS ≤ 12) was associated with seizures (n = 24, 22% vs. n = 2, 3%, P < 0.001). Two patients were deceased at first medical evaluation and three died in the hospital (mortality rate 2.6%). Non-baclofen cases had lower rate of endotracheal intubation (n = 1833, 6%, P < 0.001) and mortality rate (n = 299, 0.1%, P = 0.02). CONCLUSIONS: Baclofen self-poisoning cases has risen in recent years due to baclofen intake for alcohol use disorder therapies. The risk-benefit ratio may be evaluated before baclofen is safely prescribed.

Routine biological tests in self-poisoning patients: results from an observational prospective multicenter study.

CONTEXT: Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied. MATERIALS AND METHODS: This is a prospective multicentric observational study conducted in the emergency departments and intensive care units of 5 university and nonuniversity French hospitals. Adult self-poisoning patients without severely altered vital status on admission were prospectively included. RESULTS: Routine biological test (serum electrolytes and creatinine, liver enzymes, bilirubin, blood cell count, prothrombin time) ordering and results were analyzed. A total of 1027 patients were enrolled (age, 40.2 ± 14 years; women, 61.5%); no patient died during the hospital stay. Benzodiazepine was suspected in more than 70% of cases; 65% (range, 48%-80%) of patients had at least 1 routine biological test performed. At least 1 abnormal test was registered in 23% of these patients. Three factors were associated with abnormal test results: age older than 40 years, male sex, and poisoning with a drug known to alter routine tests (ie, acetaminophen, NSAIDs, metformine, lithium). Depending on these factors, abnormal results ranged from 14% to 48%. Unexpected severe life-threatening conditions were recorded in 6 patients. Only 3 patients were referred to the intensive care unit solely because of abnormal test results. CONCLUSION: Routine biological tests are commonly prescribed in nonsevere self-poisoning patients. Abnormal results are frequent but their relevance at bedside remains limited.

Chlorophyllum molybdites poisoning on Reunion Island.

In France, mushroom picking is part of the culture. The practice is not without risk, as around 1300 people are poisoned each year by eating wild mushrooms on the French mainland. However, this practice is not part of local culture on Reunion Island, a French territory located in the Indian Ocean. Indeed, there are practically no reports of mushroom poisoning on Reunion Island. Here we describe, through a retrospective study, cases of mushroom poisoning recorded in the Indian Ocean toxicosurveillance system database from 2020 to 2021. Overall, 19 people were poisoned following wild mushroom ingestion on Reunion Island: 15 in 2020 and 4 in 2021. Six events were recorded: the majority of poisonings involved clusters (n = 5) during a shared meal (pan-fried), only one case was single mushroom poisoning by ingesting a raw mushroom. Of all patients, 15 cases presented a gastrointestinal irritant syndrome (latency between 30 min and 3 h). Chlorophyllum molybdites was positively identified by mycologists in 4 cases, suspected by emergency doctor in 1 case and in one self-declared case, Volvariella volvacea was consumed. Poisoning following ingestion of wild mushrooms does occur on Reunion Island, and Chlorophyllum molybdites is the main culprit.

Paraspecificity of Mexican Antivipmyn TRI antivenom in envenomation by Chinese Protobothrops mangshanensis (Mangshan pit viper) in France: a case report and experimental neutralization of venom procoagulant effect.

This case report presents an exotic envenomation by a Chinese snake, Protobothrops mangshanensis. Its venom exhibited potent activity against plasma and fibrinogen, among other enzymatic activities. The patient initially presented with edema of the right upper limb, without tissue necrosis. There were no signs of bleeding; however, severe hypofibrinogenemia was observed (nadir value at 0.4 g/L), with a marked increase in fibrinogen degradation products and D-dimers, without any other coagulation disturbances. In the absence of a specific antivenom available against Asian Crotalinae venoms, the patient was treated at the 29th hour after bite with six vials of Antivipmyn™ TRI (Instituto Bioclon, Mexico, Mexico), a Mexican antivenom initially intended for American Crotalinae venoms, i.e., Bothrops asper, Lachesis muta and Crotalus durissus. Fibrinogen began to rise 6 hours after the antivenom infusion and was within the normal range 38 hours later. The report also underscores the utility of ClotPro® (Haemonetics ®USA), a viscoelastic test, for real-time monitoring of the snakebite-related coagulopathy. The clotting time was extended to 188 seconds on the EX-test while the MCF was decreased to 31 mm on the EX-test and the AP-test and was not measurable on the FIB-test, confirming severe hypofibrinogenemia. In order to confirm the paraspecificity of antivenom on the venom of P. mangshanensis, we studied the experimental neutralization of the venom procoagulant effect by Antivipmyn TRI and Green Pit Viper antivenom, which has been used in previous published clinical cases of P. mangshanensis envenomation. Both Antivipmyn™ TRI and Green Pit Viper antivenom corrected the procoagulant effect induced by P. mangshanensis venom. These findings suggest that Antivipmyn™ TRI cross-reacts with Protobothrops mangshanensis venom. In the absence of antivenom covering Asian Crotalinae, Antivipmyn TRI should be considered to treat an envenomation by Protobothrops spp.

Environmental exposure to metallic pollution impairs honey bee brain development and cognition.

Laboratory studies show detrimental effects of metallic pollutants on invertebrate behaviour and cognition, even at low levels. Here we report a field study on Western honey bees exposed to metal and metalloid pollution through dusts, food and water at a historic mining site. We analysed more than 1000 bees from five apiaries along a gradient of contamination within 11 km of a former gold mine in Southern France. Bees collected close to the mine exhibited olfactory learning performances lower by 36% and heads smaller by 4%. Three-dimensional scans of bee brains showed that the olfactory centres of insects sampled close to the mine were also 4% smaller, indicating neurodevelopmental issues. Our study raises serious concerns about the health of honey bee populations in areas polluted with potentially harmful elements, particularly with arsenic, and illustrates how standard cognitive tests can be used for risk assessment.

What drives the risk of being bitten by a viper? A fine spatial scale study in western France.

Previous studies on viper bites in France have focused on clinical consequences of envenomation, efficacy of antivenom and epidemiology of bites. Herein, we wanted to clarify temporal and spatial patterns in bite incidence using a fine spatial scale (municipality level). We focused on viper bites recorded over the last 10 years in 4 regions of western France. We addressed the determinants of bite occurrence and number of bites considering the following variables: predicted probability of viper presence, species (V. aspis or V. berus), climatic data, tourism function rate, soil transformation and landscape use. 703 bite cases were retained with significant disparities between areas. Bites occurred either during a garden-related activity (339 cases, 51.2%) or during an activity in the countryside (300 cases, 45.3%). The probability of presence of a viper at the municipality level positively influenced the risk of being bitten (multiplied by 3 for a variation in probability of 0.25 from 0.5) but varied between species (lower in V. berus than V. aspis). Artificial land development had a positive effect on bite risks. Finally, a tourism function rate above 50 beds/100 inhabitants was strongly associated with an increase in the risk of occurrence and frequency of bites. Overall, viper bites recorded in our study were concentrated on the south coastline of Pays de la Loire region. The coastal towns are significant areas of tourist attraction and are located close to preserved semi-natural landscapes that provide favorable habitats for vipers. This convergence may favor human/wildlife encounters.

Cyclopeptide mushroom poisoning: A retrospective series of 204 patients.

Cyclopeptide mushroom poisoning is responsible for 90%-95% of deaths from macrofungi ingestion. The main objectives of this study are to describe cases of cyclopeptide mushroom poisoning and to determine risk factors that may influence the severity/mortality of poisoned patients. We included all cases of amatoxin toxicity reported to two French Poison Centers from 2013 through 2019. We compared the severity with the Poison Severity Score (PSS) and the outcomes of patients using simple logistic regression and multinomial logistic regression. We included 204 cases of amatoxin toxicity. More than three-quarters developed an increase in AST and/or ALT (78.1%), and over half developed a decrease in prothrombin ratio (<70%: 53%) and/or Factor V (<70%: 54%). One-third developed an acute renal injury (AKI). Twelve patients (5.9%) developed post-poisoning sequelae (persistent kidney injury more than 1 month after ingestion and liver transplant). Five patients (2.5%) received a liver transplant, and nine died (4.4%). The mean time to onset of digestive disorders was shorter in PSS2 and PSS3-4 patients (10.9 ± 3.9/11.3 ± 6.3 h) than in PSS1 patients (14 ± 6.5 h; p < 0.05). Patients who died or developed post-poisoning sequelae had more frequent cardiovascular comorbidities compared with recovered patients (60.0% versus 29.5%; p < 0.01).

Geochemical landscapes as drivers of wildlife reproductive success: Insights from a high-Arctic ecosystem.

The bioavailability of essential and non-essential elements in vegetation is expected to influence the performance of free-ranging terrestrial herbivores. However, attempts to relate the use of geochemical landscapes by animal populations directly to reproductive output are currently lacking. Here we measured concentrations of 14 essential and non-essential elements in soil and vegetation samples collected in the Zackenberg valley, northeast Greenland, and linked these to environmental conditions to spatially predict and map geochemical landscapes. We then used long-term (1996-2021) survey data of muskoxen (Ovibos moschatus) to quantify annual variation in the relative use of essential and non-essential elements in vegetated sites and their relationship to calf recruitment the following year. Results showed that the relative use of the geochemical landscape by muskoxen varied substantially between years and differed among elements. Selection for vegetated sites with higher levels of the essential elements N, Cu, Se, and Mo was positively linked to annual calf recruitment. In contrast, selection for vegetated sites with higher concentrations of the non-essential elements As and Pb was negatively correlated to annual calf recruitment. Based on the concentrations measured in our study, we found no apparent associations between annual calf recruitment and levels of C, Mn, Co, Zn, Cd, Ba, Hg, and C:N ratio in the vegetation. We conclude that the spatial distribution and access to essential and non-essential elements are important drivers of reproductive output in muskoxen, which may also apply to other wildlife populations. The value of geochemical landscapes to assess habitat-performance relationships is likely to increase under future environmental change.

Bites by Non-Native Reptiles in France: Species, Circumstances and Outcome.

We aimed to make an exhaustive assessment of circumstances of bites by exotic reptiles bred in France. A retrospective observational study was conducted in all the reported cases from 2000 to 2020 in French poison control centers (PCCs). Two hundred and eighteen cases of bites were recorded. The sex ratio (M/F) of the patients was 1.79 and the mean age of the patients was 29.0 ± 15.8 years. Twenty-two cases (10.1%) occurred during the deep night. One hundred and eighty-six bites (85.7%) occurred in a private context; however, there were more cases of high severity when it occurred in a professional setting (60.0% vs. 11.2%, p < 0.01). The feeding/nursing activity accounted for 54.7% cases. Forty-three species of snake were identified; 28 were considered venomous. There were no deaths among the patients in the study. Most of the cases (85.8%) were of mild severity. All of the patients bitten by a venomous reptile were hospitalized: 10 patients received an antivenom; and 2 required surgery. Bites occurred at home and by a small number of popular non-venomous reptile species (pythons and boas, colubrids). These occurred mainly when handling the animals. The rare envenomations were mainly by Asian and American crotalids, followed by elapids. One-third of them were treated with antivenom when available.

The role of abiotic variables in an emerging global amphibian fungal disease in mountains.

The emergence of the chytridiomycete fungal pathogen Batrachochytrium dendrobatidis (Bd), causing the disease chytridiomycosis, has caused collapse of amphibian communities in numerous mountain systems. The health of amphibians and of mountain freshwater habitats they inhabit is also threatened by ongoing changes in environmental and anthropogenic factors such as climate, hydrology, and pollution. Climate change is causing more extreme climatic events, shifts in ice occurrence, and changes in the timing of snowmelt and pollutant deposition cycles. All of these factors impact both pathogen and host, and disease dynamics. Here we review abiotic variables, known to control Bd occurrence and chytridiomycosis severity, and discuss how climate change may modify them. We propose two main categories of abiotic variables that may alter Bd distribution, persistence, and physiology: 1) climate and hydrology (temperature, precipitation, hydrology, ultraviolet radiation (UVR); and, 2) water chemistry (pH, salinity, pollution). For both categories, we identify topics for further research. More studies on the relationship between global change, pollution and pathogens in complex landscapes, such as mountains, are needed to allow for accurate risk assessments for freshwater ecosystems and resulting impacts on wildlife and human health. Our review emphasizes the importance of using data of higher spatiotemporal resolution and uniform abiotic metrics in order to better compare study outcomes. Fine-scale temperature variability, especially of water temperature, variability of moisture conditions and water levels, snow, ice and runoff dynamics should be assessed as abiotic variables shaping the mountain habitat of pathogen and host. A better understanding of hydroclimate and water chemistry variables, as co-factors in disease, will increase our understanding of chytridiomycosis dynamics.

Human poisonings by neurotoxic phycotoxins related to the consumption of shellfish: study of cases registered by the French Poison Control Centres from 2012 to 2019.

CONTEXT: In June 2019, a paralytic shellfish poisoning (PSP) case related to the consumption of mussels contaminated by saxitoxins at a concentration below the regulatory threshold came to the attention of the French Agency for Food, Environmental and Occupational Health and Safety (ANSES). This pointed to probable undetected human cases of poisoning by neurotoxic phycotoxins. METHODS: We conducted a retrospective study of poisoning cases by bivalve shellfish (oysters, mussels and scallops) recorded by the French Poison Control Centres (PCC) from 2012 to 2019. All medical records were reviewed by a toxicologist.Cases that could be related to neurotoxic phycotoxins were selected and described. Diagnosis was based on symptoms compatible with ingestion of contaminated shellfish and on contamination data for the shellfish production area (analysed by the French Research Institute for Exploitation of the Sea, Ifremer), or notifications to the European Rapid Alert System for Food and Feed when the origin of the shellfish was known. RESULTS: Among the 619 shellfish poisoning cases recorded by the PCCs from 2012 to 2019, 22% (n = 134) had reported at least one neurological symptom (headache, dizziness or paraesthesia). Review of medical records for the 134 patients led to suspicion of 14 cases of PSP and one case of amnesic shellfish poisoning. Five patients experienced persistent neurological symptoms. Marine toxins were not tested for in the blood or urine of these patients. CONCLUSION: This retrospective identification of cases strongly suspected of being related to neurotoxic phycotoxins led ANSES, PCCs and Ifremer to develop a specific questionnaire and to recommend actions to take when neurological symptoms related to shellfish consumption are reported to a PCC. Daily monitoring of shellfish poisoning cases registered in the national PCCs database was also implemented in order to rapidly detect any suspicious cases, alert the competent authorities, and warn the general population.

Shiitake dermatitis: experience of the Poison Control Centre Network in France from 2014 to 2019.

OBJECTIVE: Shiitake mushrooms (Lentinus edodes) are an edible fungus, initially grown in Japan and China that are increasingly marketed in Europe. We previously presented 15 shiitake dermatitis cases reported to Poison Control Centres (PCCs) in France from January 2000 to December 2013. The aim of this study was to describe changes in the number of shiitake dermatitis cases since 2014, and to better describe the clinical characteristics and risk factors of this reaction. CASE SERIES: This observational study is a retrospective review of cases in the French PCCs database between 1 January 2014 and 31 December 2019. Out of 125 shiitake exposures, we identified 59 cases of dermatitis: sex ratio of 1.80 M/F; ages ranging from 19 to 69 years (median: 39 years). Dermatitis occurred after raw or undercooked shiitake consumption (e.g., from the wok, in soup, or on pizza). The rash appeared 1-168 h (median: 48 h) after shiitake ingestion. Linear, erythematous, urticarial papules and plaques developed across the trunk, arms, and legs within a few hours and persisted for 1-40 d (median 10 d). The amount of shiitake eaten (low vs. medium vs. high) significantly increased the duration of dermatitis (median days 4 vs. 7 vs. 15, respectively; p = .007). In all, 38 patients received corticosteroids, antihistamine drugs, or both without demonstrated benefit. All patients made a complete recovery. CONCLUSIONS: The mechanism of shiitake dermatitis is thought to involve lentinan, a heat-labile polysaccharide component. Inadequate cooking clearly seems to be a driver of the occurrence of shiitake dermatitis. This study highlighted a dose-dependent response, suggesting a partial toxic mechanism or a th1-type hypersensitivity mechanism. Treatment is focused on symptom management. Health professionals and the general population should be aware of both the risk associated with inadequately cooked shiitake consumption and the favourable prognosis of this still poorly known toxic dermatitis.

Honey bees cannot sense harmful concentrations of metal pollutants in food.

Whether animals can actively avoid food contaminated with harmful compounds through taste is key to assess their ecotoxicological risks. Here, we investigated the ability of honey bees to perceive and avoid food resources contaminated with common metal pollutants known to impair behaviour at low concentrations. In laboratory assays, bees did not discriminate food contaminated with arsenic, lead or zinc and ingested it readily, up to estimated doses of 929.1 µg g-1 As, 6.45 mg g-1 Pb and 72.46 mg g-1 Zn. A decrease of intake and appetitive responses indicating metal detection was only observed at the highest concentrations of lead (3.6 mM) and zinc (122.3 mM) through contact with the antennae and the proboscis. Electrophysiological analyses confirmed that only high concentrations of the three metals in a sucrose solution induced a consistently reduced neural response to sucrose in antennal taste receptors (As: >0.1 µM, Pb: >1 mM; Zn: >100 mM). Overall, cellular and behavioural responses did not provide evidence for specific mechanisms that would support selective detection of toxic metals (arsenic, lead), as compared to zinc, which has important biological functions. Our results thus show that honey bees can avoid metal pollutants in their food only at high concentrations unlikely to be encountered in the environment. By contrast, they appear to be unable to detect low, yet harmful, concentrations found in flowers. Metal pollution at trace levels is therefore a major threat for pollinators.

Scientists' warning of threats to mountains.

Mountains are an essential component of the global life-support system. They are characterized by a rugged, heterogenous landscape with rapidly changing environmental conditions providing myriad ecological niches over relatively small spatial scales. Although montane species are well adapted to life at extremes, they are highly vulnerable to human derived ecosystem threats. Here we build on the manifesto 'World Scientists' Warning to Humanity', issued by the Alliance of World Scientists, to outline the major threats to mountain ecosystems. We highlight climate change as the greatest threat to mountain ecosystems, which are more impacted than their lowland counterparts. We further discuss the cascade of "knock-on" effects of climate change such as increased UV radiation, altered hydrological cycles, and altered pollution profiles; highlighting the biological and socio-economic consequences. Finally, we present how intensified use of mountains leads to overexploitation and abstraction of water, driving changes in carbon stock, reducing biodiversity, and impacting ecosystem functioning. These perturbations can provide opportunities for invasive species, parasites and pathogens to colonize these fragile habitats, driving further changes and losses of micro- and macro-biodiversity, as well further impacting ecosystem services. Ultimately, imbalances in the normal functioning of mountain ecosystems will lead to changes in vital biological, biochemical, and chemical processes, critically reducing ecosystem health with widespread repercussions for animal and human wellbeing. Developing tools in species/habitat conservation and future restoration is therefore essential if we are to effectively mitigate against the declining health of mountains.

Pediatric Eye Injuries by Hydroalcoholic Gel in the Context of the Coronavirus Disease 2019 Pandemic.

Importance: The coronavirus disease 2019 (COVID-19) pandemic has made alcohol-based hand sanitizers (ABHS) widely available in public places. This may warrant determining whether cases of unintentional ocular exposure are increasing, especially in children. Objective: To describe the epidemiologic trend of pediatric eye exposures to ABHS and to report the severity of the ocular lesions. Design, Setting, and Participants: Retrospective case series conducted from April 1, 2020, to August 24, 2020. Cases were retrieved from the national database of the French Poison Control Centers (PCC) and from a pediatric ophthalmology referral hospital in Paris, France. Cases of ocular exposure to chemical agents in children younger than 18 years during the study period were reviewed. Cases of ABHS exposure were included. Exposures: The following data were collected: age, sex, circumstances of exposure, symptoms, size of the epithelial defect at first examination, time between the incident and re-epithelialization, and medical and/or surgical management. Main Outcomes and Measures: Comparison of the number of eye exposures to ABHS in children between April to August 2020 and April to August 2019. Results: Between April 1 and August 24, 2020, there were 7 times more pediatric cases of ABHS eye exposures reported in the PCC database compared with the same period in 2019 (9.9% of pediatric eye exposures in 2020 vs 1.3% in 2019; difference, 8.6%; 95% CI, 7.4-9.9; P < .001). The number of cases occurring in public places increased in 2020 (from 16.4% in May to 52.4% in August). Similarly, admissions to the eye hospital for ABHS exposure increased at the same period (16 children in 2020 including 10 boys; mean [SD] age, 3.5 [1.4] years vs 1 boy aged 16 months in 2019). Eight of them presented with a corneal and/or conjunctival ulcer, involving more than 50% of the corneal surface for 6 of them. Two cases required amniotic membrane transplant. Conclusions and Relevance: These data support the likelihood of an increasing number of unintentional ocular exposures to ABHS in the pediatric population. To maintain good public compliance with hand disinfection, these findings support that health authorities should ensure the safe use of these devices and warn the parents and caregivers about their potential danger for children.