J Med Assoc Thai 2010; 93 (12):41

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Acute Poison Exposure in the Emergency Department: a 2-Year Study in a University Hospital
Limjindaporn C Mail

Background: Pattern of acute poison exposure varies in the different areas. The information will be useful for prevention.
Objective: To evaluate pattern, severity and clinical outcome of acute poison exposure in the Emergency Department of a
University Hospital in Thailand.

Material and Method: Medical records of all acute poison exposure cases, presented the Emergency Department of Thammasat
University Hospital between October 1, 2006 and September 30, 2008 were reviewed retrospectively. Demographic
characteristics, exposure time, agents, route and cause of exposure, clinical course and outcome were analyzed.

Results: Of the total 76,805 Emergency Department visits, 1,112 cases were related to acute poison exposures, which were
accounted for 1.4%. Sixty-five percents were female. Patients whom their ages ranging from 21 to 40 years old showed the
highest rate of acute poison exposures. Intentional and unintentional exposures accounted for 52.7% and 44.9%, respectively.
Intentional exposure was the major cause of exposure in the age group of 11-40 years, while unintentional exposure was the
major cause of exposure in children. Pharmaceutical products (38.1%) were the most common category of substances
involved in acute poison exposure followed by bites and stings (31.7%) and household products (17.6%). The substances
most frequently involved were acetaminophen (17.7%) and toilet cleaning agents (12.3%). Fifty-six (5%) cases developed
severe clinical course and three (0.27%) patients died. Pesticide and toilet cleaning agents were responsible for all these
fatalities.

Conclusion: Acetaminophen and toilet cleaning agents were commonly involved in acute poison exposure. Pesticide and
toilet cleaning agents caused severe morbidity and mortality. Unintentional exposure was the major cause of exposure in
children. Public education regarding the danger of these agents and prevention of the poison exposure in children should be
emphasized.

Keywords: Acute poison exposure, Poisoning, Emergency Department, Thailand

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