National Poisons Information Service

A service commissioned by Public Health England

 

Loading...

 


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 with the 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 characteristics of pesticide exposures in the UK that result in contact with health professionals (thereby selecting for more serious exposures). Surveillance data is 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 1,706 TOXBASE entries for pesticides and biocides are being tracked, a decrease from the 1,897 tracked during 2015/16. 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 3,999 accesses to TOXBASE about pesticides of interest and information on 663 potential exposures was available from the NPIS telephone enquiry service. From TOXBASE sessions, 345 follow up post or email questionnaires were 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 the TOXBASE accesses were for educational purposes rather than care of patients, reducing the response rate denominator.

 

Overall, information was gathered on 1,011 potential exposures involving pesticides during 2016/17, an overall return rate of 25.3%. No exposures involved multiple patients. This number is similar to the number of cases identified in 2015/16 (1,138).

 

Of the 1,011 potential exposures available for analysis, there were 11 cases where symptoms were not thought on the balance of probabilities to be related to the pesticide exposure, either by the respondent or by NPIS Edinburgh, because of, for example, there was a pre-existing illness or reasonable grounds to link symptoms to a concomitant infection. These cases were excluded, leaving 1,000 exposures for further analysis. The results presented below include both unintentional acute (845 cases; 84.5%) or chronic (40; 4.0%) exposures and self-harm exposures (SH) (79; 7.9%). The circumstances of exposure in 36 (3.6%) cases were unknown. Most exposures were graded as poisoning severity scrore (PSS, see Section 2) 0 (564 cases; 56.4%) or PSS 1 (369; 36.9%) by the NPIS. Smaller proportions were graded as moderate (PSS 2; 24; 2.4%), severe (PSS 3; 4; 0.4%) or of uncertain severity (39; 3.9%).1 No fatalities were reported (compared with one in 2015/16).

 


Agents of interest
The agents most commonly involved in exposures are shown in Table 1. In addition, there were 125 cases involving unknown rodenticides, 39 cases of unknown herbicides, 27 of unknown insecticides, 22 of unknown pesticides, 15 of unknown ant killers, and three of unknown wood preservatives.

 

 

Table 1. Pesticides most frequently reported by respondents in suspected pesticide exposures during 2016/17 compared with 2015/16, ordered by rank in 2016/17

 

 

In 2016/17, the patients potentially exposed to pesticide products comprised 550 adults (13 years or older – 55.0%) and 423 children (12 years or younger – 42.3%), with 27 of unknown age (2.7%). There were 545 (54.5%) male patients and 444 (44.4%) female patients and 11 cases (1.1%) where sex 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 ten enquiries involving pregnant patients reported in 2016/17 (8 in 2014/15). All ten exposures were unintentional and acute. None were severe.

 

Figure 1. Pesticide exposures by class of product (as reported by respondent) in 2016/17 (1,021 agents)

 

 


Information from the NPIS Annual Report 2016/17.

 

| Reserach we undertake | Antidotes | Button batteries | Carbon monoxide | Cyanide | 2,4-dinitrophenol | Drugs of misuse | Electronic cigarettes | Glycols and methanol |Household products | Iron poisoning | Lead exposure | NSAIDs | Oral anticoagulants | Pesticides | Snake bite |