[Poisonings in Germany : Poisons Centres, Medical Management and National Monitoring]. / Vergiftungen in Deutschland : Giftinformationszentren, medizinische Versorgung und nationales Monitoring.

BACKGROUND: Illnesses caused by exposure to extracorporeal artificial substances play a major role in emergency medicine, family medicine, and environmental medicine. OBJECTIVE: The current situation of medical poisoning management and national reporting of poisonings in Germany are described. MATERIALS UND METHODS: The information and data presented here are derived from a literature review and from stakeholder interviews. RESULTS AND CONCLUSION: Eight poison centres (PCs) offer consultation supporting the diagnosis and treatment of poisoning cases in Germany today. Furthermore, those affected, their relatives and first aiders contact these German PCs, mainly because of a suspected poisoning. German PCs are also contacted by those affected and by institutions in other situations when expert toxicological judgement is needed, especially in cases with an environmental background. Often, interpretation of analytical laboratory results of body fluid samples or environmental samples are requested, or reference to environmental medicine treatment facilities is made. The PCs and the German Federal Institute for Risk Assessment (BfR) cooperate on the national reporting of the risks of poisoning for the population. In addition, the BfR collects and evaluates poisoning reports from German medical doctors that have been directly submitted. A pilot project on a national monitoring of poisonings should collate future case reports. An extensive and current overview of poisonings in Germany is a prerequisite for the identification of unsafe products and to fully comply with the international reporting needs of the German Federal Government in the case of chemical outbreaks and the resulting suspected cases.

Plant exposures reported to the Poisons Information Centre Erfurt from 2001-2010.

At the moment, no recent study about plant exposures in Germany and in the federal states the Poisons Information Centre (PIC) Erfurt is serving is available. To get new information about important characteristics of plant exposures like the development of frequency, plants, age groups involved, circumstances of exposure, and symptom severity, we conducted a retrospective study including all human plant exposures reported to the PIC Erfurt over a 10-year period from the beginning of 2001 to the end of 2010. In total, 13 001 plant exposures were registered. While the absolute number of plant exposures discontinuously increased from 1110 in 2001 to 1467 in 2009, and decreased to 1157 in 2010, their relative frequency to all human exposures fell from 9.2 % in 2001 to 5.9 % in 2010. Age groups: children 87.5 % (toddler 60.0 %); adults 11.3 % (middle-aged adults 5.2 %). Gender: female 39.0 % and male 41.2 %. Circumstances: accidental 91.6 %, unknown 4.6 %, abuse 2.9 %, suicide 0.9 %. Severity of symptoms: none to slight 85.5 %, moderate 1.7 %, unknown 12.7 %, severe 0.1 % (in total 9, one 4-year-old girl, involved plant genera: Aconitum, Arum, Chelidonium, Datura, brugmansia, Dieffenbachia, Ricinus, 2 Taxus), fatal 0.03 % (in total 4, involved plant genera: 2 Aconitum, 2 Taxus). In comparison to all human exposures, the relative frequency of severe symptoms in accidental and intentional plant exposures by abuse was significantly lower but as high by suicide. The significant higher involvement of children resulted mainly in none or mild symptoms. Severe symptoms could mostly be observed in adults in intentional plant exposures or when poisonous plants were mistaken for eatable. Because some plant exposures resulted in severe symptoms and even death, their dangerousness should not be trivialised.