National Poisons Information Service

A service commissioned by Public Health England

 

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Members of the public

seeking specific

information on poisons

should contact:

 

In England and Wales:

NHS 111 - dial 111

 

In Scotland:

NHS 24 - dial 111

 

In N Ireland:

Contact your local GP or

pharmacist during

normal hours; click here

(www.gpoutofhours

.hscni.net/) for GP

services Out-of-Hours.

 

In Republic of Ireland:

01 809 2166

 

Healthcare

professionals seeking

poisons information

should consult:

www.toxbase.org

Pesticides

The NPIS pesticide surveillance system was established in 2004 under approval of the Pesticides Safety Directorate and funded by the UK Department for Environment, Food and Rural Affairs. The work was implemented to better describe the incidence and character of pesticide exposures in the UK that result in contact with health professionals (thereby selecting for more serious exposures). Surveillance data are collated and both quarterly and annual reports are submitted to the government’s Advisory Committee on Pesticides (ACP) via the Health and Safety Executive’s Chemicals Regulation Directorate (CRD).


Currently, 1,563 TOXBASE entries for pesticides and biocides are being tracked, a decrease from the 1,706 tracked during 2016/17. Incident information is obtained in two ways, from follow-up of TOXBASE enquiries by an online or postal questionnaire or from data collected during NPIS telephone enquiries.


During the year, there were 4,005 accesses to TOXBASE about pesticides of interest and information on 569 potential exposures was collected via the NPIS telephone enquiry service. From the TOXBASE accesses, 325 follow-up postal or email questionnaires were completed and returned. Cases involving animals or head lice treatment products, enquiry sessions from locations in the Republic of Ireland, identifiable duplicate sessions involving the same patient, and sessions that were later reported not to have involved a pesticide, were excluded from the analysis. Of note, an unknown number of TOXBASE accesses were for educational purposes rather than care of patients, reducing the response rate denominator.


Overall, information was gathered on 975 potential exposures involving pesticides during 2017/18, an overall return rate of 20.6%. Four exposures involved multiple patients. This number is similar to the number of cases identified in 2016/17 (1,000). Of the 975 potential exposures available for analysis, there were 21 cases where symptoms were not thought to be related to the pesticide exposure, e.g. where a pre-existing illness or concomitant infection was the likely cause of symptoms. These cases were excluded, leaving 954 exposures for further analysis. The results presented below include both unintentional acute (825 cases; 86.5%) and chronic (34; 3.7%) exposures and deliberate self-harm exposures (76; 8.0%). The circumstances of exposure in 19 (2.0%) cases were unknown. Most exposures were graded as PSS 0 (469 cases; 59.1%) or PSS 1 (301; 31.2%). Smaller proportions were graded moderate (PSS 2; 14; 1.5%), severe (PSS 3; 2; 0.2%) or of uncertain severity (39; 3.9%) (PSS - see page 11). Three fatalities were reported (compared with none in 2016/17). All three involved acts of deliberate self-harm. One fatality involved a large ingestion of Roundup (glyphosate). The other two cases involved exposure to products containing aluminium phosphide.

 


Agents of interest
The agents most commonly involved in exposures are shown in Table 1. In addition, there were 126 cases involving unknown rodenticides, 37 involving unknown insecticides, 24 unknown herbicides, nine unknown pesticides, six unknown ant killers, and one unknown wood preservative.

 

Table 1. Pesticides most frequently reported by respondents in suspected pesticide exposures during 2017/18 compared with 2016/17, ordered by rank in 2017/18

 

 

In 2017/18, patients potentially exposed to pesticide products comprised 503 adults (13 years or older, 52.7%) and 427 children (12 years or younger, 44.7%), with 24 of unknown age (2.5%). There were 513 (53.8%) male patients and 418 (43.8%) female patients and 23 cases (2.4%) where the gender was not specified.


The classes of product most commonly involved in exposures are shown in Figure 1. Multiple/combination products were involved in some incidents.

 

There were 15 enquiries involving pregnant patients reported in 2017/18 (10 in 2016/17). All 15 exposures were unintentional and acute. None were severe.

 

Figure 1. Class of products (as reported by respondent) involved in enquiries in 2017/18 (1,053 agents)

 


Information from the NPIS Annual Report 2017/18.

 

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