Introduction The main objectives of this study were: 1) to examine the prevalence and characteristics of opioid exposures, 2) to estimate the economic costs associated with opioid poisonings, and 3) to examine the characteristics associated with opioid poisoning-related health care resource use (HCRU) and costs in children. Methods Data from the National Poison Data System from January 1, 2010 to December 31, 2014 were utilized to examine the prevalence and characteristics of opioid exposures and poisonings in children <18 years. Economic costs were estimated using the 2012 Nationwide Emergency Department Sample, Kids’ Inpatient Database, Multiple Cause-of-Death file and other published sources, applying a societal perspective. Direct costs included costs associated with ED visits, hospitalizations and ambulance transports. Indirect cost included productivity costs due to caregivers’ absenteeism and premature mortality among children. Results There were a total of 83,418 pediatric opioid exposures and nearly half of them resulted in poisoning. The epidemiology of opioid exposures differed considerably by age. Opioid exposures were more prevalent and mainly accidental in young children. Exposures in adolescents were more likely to be intentional and severe. The total economic costs of pediatric opioid poisonings in the United States were calculated at $230.8 million in 2012. Total direct costs were estimated to be over $21.1 million. Total productivity costs were calculated at $209.7 million, and 98.6% of these costs were attributed to opioid poisoning-related mortality. Conclusions Opioid exposures and poisonings in children continue to occur and impose an economic burden on the society.

Objetivo: A Lei 7802/89 (Lei dos Agrotóxicos) foi considerada importante avanço para enfrentar problemas ambientais e de saúde provocados por agrotóxicos. Este estudo buscou avaliar o impacto da Lei e respectiva regulamentação na classificação toxicológica, na classificação de potencial de periculosidade ambiental dos agrotóxicos e nas intoxicações registradas. Métodos: Analisou-se a correlação entre vendas de agrotóxicos e registros de intoxicações no Brasil, de 1985 a 1999, utilizando Coeficiente de Correlação Linear de Pearson e Análise de Regressão. Os testes Qui-Quadrado de Tendência em Dados Ordenáveis e Coeficiente de Kappa foram utilizados para comparar o conjunto de substâncias que estava registrado em 1990 com o que estava registrado em 2000, segundo a classificação de periculosidade da Organização Mundial da Saúde. Analisaram-se as culturas/produtos de destinação permitidas, a classificação toxicológica e a de periculosidade ambiental dos produtos registrados após a Lei. Resultados: A correlação entre vendas e intoxicações foi positiva (r=0,82 ; p<0,0001). Obteve-se equação intox = 0,00236 x vendas (US$ 1,000.00) que permite estimar intoxicações registradas segundo vendas de agrotóxicos (R2=0,95; F=253,48; p<0,0001). Não houve diferenças significativas na classificação toxicológica e ambiental dos conjuntos de substâncias registradas antes-depois da Lei. Os registros posteriores à Lei continuaram privilegiando culturas de maior expressão econômica e agrotóxicos derivados de substâncias registradas antes da Lei. Produtos mais tóxicos foram registrados para finalidade que contava com outros menos tóxicos. Conclusões: Após dez anos não se consolidaram avanços esperados com a Lei. Recomendou-se: aplicar legislação com maior eficácia, priorizar registros de menor impacto, restringir produtos de maior periculosidade / Objective. The 1989 Brazilian\'s pesticide legislation (Law n° 7802/89) was considered an important improvement to control environmental and health problems. This study aimed to evaluate the impact of the law and it\'s regulations to the toxicological and environmental classifications of pesticides by hazard and to the notified poisonings. Methods. Pearson Correlation and Regression Analysis were used to evaluate the correlation between pesticide sales and notified intoxications in Brazil, from 1985 to 1999. Kappa Coefficient and Ridit Analysis (Relative Identified Distribution Analysis) were used to compare the WHO (World Health Organization) classification of pesticides by hazard of the group of chemicals that was registered in 1990 and the group registered in 2000. The toxicological and environmental classifications and the allowed destinations of the pesticides that were registered after the law were also analyzed. Results. The correlation among sales of pesticides and poisonings was positive (r=0,82 ; p<0,0001). The equation obtained make possible to estimate poisonings notifications using values of pesticides sales (R =0,95; F=253,48; p<0,0001): intox = 0,00236 x sales (US$ l,000.00) . No significant toxicological and environmental classifications differences were identified between the groups of pesticides that were registered in 1990 and 2000. The most economical expressive crops received the majority of the registers. More toxic pesticides were registered to destinations that had less toxic ones. Conclusions. After ten years of Law it was not possible to consolidate the expected improvements. Recommendations included: enforcement of the law, priority to less risky pesticides, restriction to more toxic ones

Objetivo: A Lei 7802/89 (Lei dos Agrotóxicos) foi considerada importante avanço para enfrentar problemas ambientais e de saúde provocados por agrotóxicos. Este estudo buscou avaliar o impacto da Lei e respectiva regulamentação na classificação toxicológica, na classificação de potencial de periculosidade ambiental dos agrotóxicos e nas intoxicações registradas. Métodos: Analisou-se a correlação entre vendas de agrotóxicos e registros de intoxicações no Brasil, de 1985 a 1999, utilizando Coeficiente de Correlação Linear de Pearson e Análise de Regressão. Os testes Qui-Quadrado de Tendência em Dados Ordenáveis e Coeficiente de Kappa foram utilizados para comparar o conjunto de substâncias que estava registrado em 1990 com o que estava registrado em 2000, segundo a classificação de periculosidade da Organização Mundial da Saúde. Analisaram-se as culturas/produtos de destinação permitidas, a classificação toxicológica e a de periculosidade ambiental dos produtos registrados após a Lei. Resultados: A correlação entre vendas e intoxicações foi positiva (r=0,82 ; p<0,0001). Obteve-se equação intox = 0,00236 x vendas (US$ 1,000.00) que permite estimar intoxicações registradas segundo vendas de agrotóxicos (R2=0,95; F=253,48; p<0,0001). Não houve diferenças significativas na classificação toxicológica e ambiental dos conjuntos de substâncias registradas antes-depois da Lei. Os registros posteriores à Lei continuaram privilegiando culturas de maior expressão econômica e agrotóxicos derivados de substâncias registradas antes da Lei. Produtos mais tóxicos foram registrados para finalidade que contava com outros menos tóxicos. Conclusões: Após dez anos não se consolidaram avanços esperados com a Lei. Recomendou-se: aplicar legislação com maior eficácia, priorizar registros de menor impacto, restringir produtos de maior periculosidade / Objective. The 1989 Brazilian\'s pesticide legislation (Law n° 7802/89) was considered an important improvement to control environmental and health problems. This study aimed to evaluate the impact of the law and it\'s regulations to the toxicological and environmental classifications of pesticides by hazard and to the notified poisonings. Methods. Pearson Correlation and Regression Analysis were used to evaluate the correlation between pesticide sales and notified intoxications in Brazil, from 1985 to 1999. Kappa Coefficient and Ridit Analysis (Relative Identified Distribution Analysis) were used to compare the WHO (World Health Organization) classification of pesticides by hazard of the group of chemicals that was registered in 1990 and the group registered in 2000. The toxicological and environmental classifications and the allowed destinations of the pesticides that were registered after the law were also analyzed. Results. The correlation among sales of pesticides and poisonings was positive (r=0,82 ; p<0,0001). The equation obtained make possible to estimate poisonings notifications using values of pesticides sales (R =0,95; F=253,48; p<0,0001): intox = 0,00236 x sales (US$ l,000.00) . No significant toxicological and environmental classifications differences were identified between the groups of pesticides that were registered in 1990 and 2000. The most economical expressive crops received the majority of the registers. More toxic pesticides were registered to destinations that had less toxic ones. Conclusions. After ten years of Law it was not possible to consolidate the expected improvements. Recommendations included: enforcement of the law, priority to less risky pesticides, restriction to more toxic ones

SUMMARY Aim of the study. To evaluate the information on admissions due to injuries, accidents and poisonings to health care institutions in the major health databases. Methods. The information about injuries, accidents and poisonings has been evaluated in the certified registration forms and reports, which are filled in at the health care institutions, emergency services, medico-social expertise commission. Comparison of the records on admissions due to injuries in 2003 of the adults (16 years old and over) in the database of Lithuanian Health Information Centre and in the database of State Sickness Fund „SVEIDRA” was performed. The continuity of the data from inpatient to outpatient health care institutions was analyzed. The more detailed analysis was carried out analyzing two largest groups of traumas: head injuries (S00-S09) and arm and shoulder injuries (S40-S69) in the database of State Sickness Fund „SVEIDRA“. Morbidity rates per 1000 population were calculated. Statistical analysis was carried out using SPSS 11.00 for Windows. The associations between the variables were measured using the Chi-squared and the Student test. The results were considered statistically significant, when p<0.05. Results. Injuries, accidents and poisonings in most forms of the registration were coded according to the medical consequences, and only in few medical registration forms were coded according to external causes. Some forms used different codes for coding external causes, and some... [to full text]

1 ABSTRACT Background The annual drug overdose rates have been increasing exponentially since the 90's worldwide. Toxicological information centre (TIC) represents a valuable source of information for evaluating the trends in the drug poisonings in Czech Republic. Aim of the study The purpose was to analyze the number and trends in the calls concerning poisonings due to central nervous system (CNS) affecting drugs, identify the reasons of medication errors caused by laymen, frequency and consequences of these errors across all age groups and also to analyze the numbers, causes, symptoms and severity of the paracetamol intoxications. Methods During the reference period the data from the enquiries were extracted from the TIC electronic database, discharge reports from the hospital were studied or phone call follow-ups with the patients were carried out to be able to evaluate the outcome of the poisonings. Results In the years 1997-2002 the number of calls caused by poisoning with tricyclic antidepressants and barbiturates decreased (by 366.7 % and 340,0 %, respectively) whereas the calls due to selective serotonin reuptake inhibitors and benzodiazepines overdose increased (by 1347.4 % and 359.8 %). The 0-5 years old children are at the highest risk of experiencing medication errors or accidental poisonings...

Orientador: Herling Gregorio Aguilar Alonzo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T19:45:31Z (GMT). No. of bitstreams: 1 Germano_LucasCoraca_M.pdf: 2927353 bytes, checksum: 0acf11b60ff7d23a33ff0ac8280c2046 (MD5) Previous issue date: 2015 / Resumo: As intoxicações constituem um problema de saúde pública global, com crescente número de ocorrências e óbitos. No Brasil, os dados deste agravo decorrem principalmente dos atendimentos de hospitais, que notificam ao Sistema de Informação de Agravos de Notificação (SINAN) ou solicitam auxílio dos Centros de Informação e Assistência Toxicológica (CIAT) no tratamento. Estes centros, por sua vez, enviam dados de seus atendimentos ao Sistema Nacional de Informações Tóxico-farmacológicas (SINITOX), entretanto, mesmo com ambos os sistemas de informação, grande parcela das ocorrências é ainda desconhecida. O objetivo do trabalho foi analisar os atendimentos por exposição, intoxicação ou envenenamento em um município do Estado de São Paulo, no período entre um de janeiro e 31 de dezembro de 2012, quanto às características de exposição, assistência, desfecho e de notificação. Foram revisadas as fichas de todos os atendimentos ocorridos na Unidade de Urgência e Emergência (UUE) e selecionados os decorrentes de exposição, intoxicação ou envenenamento, das quais foram coletadas variáveis de ocorrência e assistência, e analisadas com auxílio de software estatístico. Dos 95.923 atendimentos ocorridos, 3.184 (3,3%) decorreram dos eventos toxicológicos, destes, 68,6% eram do gênero masculino com mediana de idade de 38 anos, ao feminino corresponderam 31,4% e mediana de 30 anos, ambos com predomínio das faixas etárias entre 20 e 59 anos (74,5%). A taxa da prevalência foi de 46,4 atendimentos/mil habitantes. Predominaram as exposições agudas (48,5%) e crônicas (31,9%), e os principais agentes foram as drogas de abuso (58,1%), animais peçonhentos (15,8%) e medicamentos (10,0%). Em 71,0% dos atendimentos foram adotadas medidas de suporte. Foram notificados ao SINAN apenas acidentes por animais peçonhentos e o contato ao CIAT ocorreu em 10 atendimentos (0,3%), o que correspondeu a 3,1 notificações a CIATs para cada mil ocorrências toxicológicas atendidas. Em 1,7% a internação foi necessária e 4,8% receberam alta com orientação de acompanhamento em outros serviços. Em 30,8% dos expostos a drogas de abuso foram solicitadas internações em instituição de tratamento para dependência química. Em 16,7% foram identificados agravos/doenças com ou sem associação a exposição química. Ocorreram oito (0,2%) óbitos, a maioria associados a outros agravos ou doenças. O perfil apresentado dos atendimentos foi parcialmente semelhante ao apresentado em outros estudos, porém, é grande a variação entre diferentes países e regiões do mundo, inclusive no Brasil. Foi elevada a proporção de atendimentos dentre o total de urgências médicas e isso se deu ao ampliado critério de inclusão adotado, o que proporcionou uma alta representatividade das ocorrências em uma UUE. A alta subnotificação ao SINAN e SINITOX, bem como as diferenças observadas quanto aos dados destes sistemas, apontam para a necessidade de reformulação/qualificação dos dados sobre intoxicações no País, uma vez que sua representatividade pode estar comprometida. Discussões e ações devem ser tomadas para estruturação e qualificação da atenção ao exposto/intoxicado no SUS, com vistas ao conhecimento, redução e resolutividade das ocorrências / Abstract: Poisoning is a global public health problem, with an increasing number of cases and deaths. In Brazil, the data of this problem stem mainly from hospital care, which notify the National Information System of Diseases Notification (NISDN) or request assistance of Information and Toxicological Care Centers (ITCC) in the treatment. These centers, send data from your calls to the National System of Toxic-Pharmacological Information (NSTI), however, even with both information systems, large portion of cases is still unknown. The objective of this study was to analyze consultations for chemical exposures and poisonings in a municipality of San Paul State, Brazil, in the period between January 1 and December 31, 2012, for the chemical exposure characteristics, received medical care, and outcomes reporting to national systems of health information. All chart records of medical assistances occurred in Emergency Department (ED) were reviewed and selected those arising from chemical exposures and poisonings, in addition the occurrence characteristics and support variables were collected and analyzed with the statistical software. Of the 95,923 visits to ED, 3,184 (3.3%) arose from chemical exposures and poisonings, of these, 68.6% were male with a median age of 38 years, and 31.4% were female with median age of 30 years, both with predominance of age groups between 20 and 59 years (74.5%). The rate of prevalence was 46.4 ED visits / thousand inhabitants. The acute (48.5%) and chronic (31.9%) were the predominant exposures, and major toxic agents were drugs of abuse (including tobacco and alcohol) (58.1%), venomous animals (15.8%) and drugs (10.0%). Support measures were adopted in 71.0% of cases and were reported to NISDN only envenomations by venomous animals contact. ITCC consultations occurred in 10 ED visits (0.3%) corresponding to 3.1 notifications to ITCC per thousand toxicological occurrences met. 1.7% hospitalization was required and 4.8% were discharged with accompanying guidance in other services. In 30.8% of exposed to drug abuse were requested admission to the institution of treatment for chemical dependency. In 16.7% cases were identified diseases / disorders with or without associated chemical exposure. There were eight (0.2%) deaths, most associated with other health problems or diseases. The presented profile of the visits was partially similar to that shown in other studies and there is great variation between different countries and regions worldwide, including others Brazilian municipalities. The proportion of visits among the total number of medical emergencies and it took the extended inclusion criteria, which proportional representation of high occurrences in a UUE. The high underreporting to NISDN and NSTI as well as the differences on the data from these systems point to the need to reformulate / qualification of data on poisoning in the country, since their representation may be compromised. Discussion and action must be taken to structure and improve care of the intoxicated in Brazilian Universal Health System, with the objective to know, prevent, reduce and resolve all toxicologic events / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Thesis (Ph.D.) - James Cook University, 2004. / Thesis submitted by Sally Marie Babidge, BA (Hons) UWA June 2004, for the Degree of Doctor of Philosophy in the School of Anthropology, Archaeology and Sociology, James Cook University. Bibliography: leaves 283-303.