Prevalence and characteristics of inhalational and dermal palytoxin exposures reported to the National Poison Data System in the U.S.

INTRODUCTION: Palytoxin, produced by unicellular microalgae, is one of the most potent toxins known. Human exposure results most prominently through oral, dermal, and inhalational contact. There is no current data on the prevalence of cases in the United States. METHODS: This study reviewed human inhalational and dermal exposures to palytoxin via records from the National Poison Data System from 2000 to 2014. RESULTS: There were 171 cases reported, the majority occurred at a residence and experienced minor respiratory or dermal symptoms and recovered without any major sequelae or fatalities. Ten patients required admission to an intensive care unit. CONCLUSION: The incidence of palytoxin exposure is low but significant symptoms can occur.

The toxicity of picaridin containing insect repellent reported to the National Poison Data System.

CONTEXT: While low toxicity is reported, there are sparse data on the safety of acute picaridin (icaridin) exposures in humans. OBJECTIVE: The purpose of this study was to review National Poison Data System (NPDS) data regarding ingestion of insect repellents containing picaridin and compare those to insect repellents containing DEET and other insect repellents not containing DEET. METHODS: NPDS was queried for single agent human insect repellent ingestions reported between 1 January 2000 and 31 May 2015 using the American Association of Poison Control Center generic categories 201048 (Insect Repellents with DEET) and 201049 (Insect Repellents without DEET). Picaridin-containing product exposures were assessed using Poisindex(®) product ID 6744589. Insect repellents of unknown type were not included. RESULTS: 68,429 exposures occurred; 24% were non-DEET-containing products, of which 2% were picaridin-containing products. Among picaridin exposures, 92.9% were managed outside of a health-care facility; there were no reported cases of major effect or death, and only one case of moderate effect. Primary symptoms across all insect repellent exposures included ocular irritation/pain, vomiting, red eye/conjunctivitis, and oral irritation. Treatment primarily included dilution/irrigation/wash. CONCLUSION: Unintentional ingestion of picaridin-containing and other insect repellents was associated only with minor toxicity and was generally managed outside of a health-care facility.