The pattern of poisonings with substance of abuse in Poland (1997-1998).

Substances of abuse have been known in many cultures and geographic zones, and they were used for different reasons, from religions up to hedonistic ones. Central Europe, a region of Poland has never been an area of religious use of narcotics, but lately a number of drug abusers is still growing up. The extent of the drug abuse problem in Poland is difficult to assess, because there is no monitoring system, which registers drug abusers. In this study, authors retrospectively analyzed the files of all drug abuse poisoned patients treated in 10 Polish Poison Centres; as well as the files of patients treated in other hospitals, but who were consulted by toxicologists from these units. During the last 10 years the number of patients treated for drug abuse intoxication has grown 10 times. The structure of used substance of abuse has also changed. In the early 90's opiates dominated. In 1997 all groups of drug abuses were noted, from natural or synthetic opiates, cocaine, LSD, amphetamine, up to Cannabis sativa derivatives (THC). We also revealed intoxications with hallucinogenic mushrooms and plant--Datura stramonium. The most common drugs used were opiates and amphetamine. THC were the third. Amphetamine and THC derivatives were the most often sources of intoxication in young people 15-25 years of age. The opiate poisonings were the commonest in young males, 20-40 years old.

Poison Information Service of the Nofer Institute of Occupational Medicine in Lódz. Types of toxicological inquiries 1991-1994.

The National Poison Information Centre and the physicians of the Clinic of Acute Poisonings, the Nofer Institute of Occupational Medicine in Lódz, provide telephone toxicological information to the medical professions and the general public. The most frequently offered advice was for drugs, pesticides, solvents, corrosives and mixtures. The most frequent drug inquiries concerned tranquillizers, hypnotic and psychotropic drugs. Advice to the public most frequently involved the toxic action and composition of various agents. At present, much effort is devoted at the National Poison Information Centre to develop a system of toxicologic information for the general public.

Sources of poisoning exposures in children during 1990-1995. An analysis of the National Poison Information Centre files.

Information protocols on the causes of acute poisoning exposures with chemicals in children up to 14 years old collected during 1990-95 at the National Poison Information Centre have been analyzed. Approximately 96% of intoxication were accidental, 44% of patients were poisoned with drugs, 22% with household products and 14% with pesticides. Almost 25% of drug poisonings were due to sedative and to psychotropic drugs, and 17% to drug mixtures. The frequency of mushrooms and plants poisonings were low - 6%. In Poland there are practically no acute poisoning departments which treat children (actually, there is only one Poison Unit in Kraków at Polish-American Children's Hospital), and thus these patients are treated in paediatric wards and paediatric hospitals, so complete data on the poisonings in children from over the whole territory of Poland are not available. However, we believe that the frequency of causes of children's intoxication in our country is properly reflected in our material. This allows us to draw conclusions of the prevention of poisoning in this age group.

[Poisoning with narcotics and hallucinogens in material from the Clinic of Acute Poisoning in Lodz (1993-1996)]. / Zatrucia srodkami narkotycznymi i halucynogennymi w materiale Kliniki Ostrych Zatruc Instytutu Medycyny Pracy w Lodzi (lata 1993-1996).

Our material consists of the patients treated for poisonings with street-drugs in Clinic of Acute Poisonings, Lódz, Poland during the period 1993-1996. During the time of 4 years, the number of hospitalised patients have grown up 4.5 times. The structure of used drugs has also changed. Up to 1993 the most popular were opiates derivatives and narcotic analgetics-morphine derivatives. In 1996 almost all narcotics are common, opiates (both natural and synthetic), cocaine, LSD, amphetamine and commonly used (by youngsters especially) Cannabis sativa (marihuana etc). The most common sources of poisoning in our material were opiates and amphetamine, followed by tetrahydrocannabinol derivatives-marijuana.

The pattern of acute poisonings with pesticides in Poland during the periods 1989-1990 and 1994-1995.

Pesticide constitute a large group of commonly used chemicals with diverse chemical structure and toxicity. They are intended mostly to protect plants and plant products from the activity of various harmful organisms but they can also be used as biocides. Pesticide poisonings may be due to suicidal attempts or accidental ingestion associated with improper storage in unlabelled containers. Severe cases are treated at the regional poison units while others in the in-patient and out-patient clinics all over the country. The study made us draw the conclusion that poisonings with organophosphates and dipyridyl derivatives pose an essential toxicological problem. They are usually severe and require long hospitalisation. The highest morality rate was noted also for the poisonings with organophosphates and dipyridyl derivatives. Suicidal attempts constitute the most frequent cause of the poisonings. The results of the analysis imply a necessity to replace the most harmful organophosphate and dipyridyl pesticides with others of a lower toxicity class. It should be underlined that in order to avoid an accidental misuse, pesticides should be stored in the original, labelled containers.

Telephone toxicological information service on pesticide poisonings.

The problem of pesticide poisonings has been discussed with reference to the records of the toxicological information provided in 1993-1995 by the staff of the National Poison Information Centre and the physicians of the Clinic of Acute Poisonings in Lódz. Based on those data, pesticide poisonings occupy second place among the categories of chemical most frequently responsible for acute poisonings, while the first place is occupied by drugs. In the pesticide category, most of the information related to poisonings with pyrethroids, followed by organophosphorous compounds, coumarine derivatives, carbamates. Pesticide poisonings in children continue to be a serious problem. Coumarine derivatives and zinc phosphide found in rodenticides constitute the most frequent source of pesticide poisoning among children. Considering the circumstances of pesticide poisoning, accidental poisonings are the most frequent. The high incidence of pesticide poisoning shows that it is a serious problem and the steps should be taken to prevent poisonings with pesticides.

Acute poisonings with drugs. A review of the data collected at the National Poison Information Centre during the period 1991-1995.

An analysis of the files collected in the National Poison Information Centre reveals that drugs are the most frequent causes of acute poisonings (followed by pesticides and other chemical substances) not only in big cities but also in rural areas. Within the drug poisoning category, about 59% of the toxicological advice related to poisonings in children up to 14 years of age. The most frequent poisonings with drugs related to poisonings with sedative and psychotropic drugs, particularly those containing benzodiazepines, phenothiazine derivatives and tricyclic antidepressants. There were frequent inquiries relating to poisonings with drug mixtures. Self-poisonings were the most frequent cause of poisonings among the adults (87.3%), in children below 14 years of age dominated accidental poisonings (96% of all drug poisonings in children).

[Analysis of toxicological information rendered by the staff of the National Poison Information Center and physicians at the Clinic of Acute Poisoning of the Institute of Occupational Medicine in Lódz]. / Analiza informacji toksykologicznych udzielanych przez Krajowe Centrum Informacji Toksykologicznej i Klinike Ostrych Zatruc Instytutu Medycyny Pracy w Lodzi.

The article presents structure of toxicological information given by phone to the physicians involved in treatment of acute poisonings, private persons the services monitoring the working environment. The information comprises data on toxic effect on human organism, chemical composition, therapeutic procedure in acute poisonings as well as the data on hazards occurring in every day life. The consultations chiefly regarded poisonings with drugs, pesticides, alcohols, organic solvents and corrosive substances. The analysis has shown that poisonings of children aged below 14 years pose a significant problem. Moreover, it has been noted that there is a growing demand for toxicological consultations among the general population. They play a significant role in education of the society, making them aware of the hazards created by various chemicals used in the households and occurring in the working environment which contributes to promotion of the poisonings prevention.

The National Poison Information Center in Poland.

OBJECTIVE: To describe the national poison information program in Poland. RESULTS: There are nine regional poison information centers in Poland associated with acute poisoning wards or diagnostic laboratories. The National Poison Information Center in Lodz prepares information materials (ITOX database, books, periodicals, leaflets, posters) on treatment and prevention to regional and other health care units treating acute poisoning cases and to the general public. The staff of the National Poison Information Center together with the physicians of the Clinic of Acute Poisonings provide a 24 h poison information service accessible to health care units, work safety services, and the general public.

Causes of poisoning in children during the period 1990-1993.

We retrospectively analysed the files from our Centre concerning intoxication in children younger than 14 years. About 96% of intoxication were accidental, 43% of patients were poisoned with drugs, 22% with house-hold products and 15% with pesticides. Almost 25% of drug poisonings were due to sedative and to psychotropic drugs, the 20% to drug mixtures. The frequency of mushrooms and plants poisonings were low-7%. In Poland there are no acute poisoning departments which treat children, and thus these patients are treated in paediatric wards and paediatric hospitals, so complete data on the poisonings in children from over the whole territory of Poland are not available (due to the great number of paediatric wards in Poland and to the lack of a computer network, collection of such complete data is practically impossible). However, we believe that the frequency of causes of children's intoxication in our country is properly mirrored in our material. This allows conclusions to be drawn the prophylaxis of poisoning in this age group.