Scheme for Investigating Cases of Death due to Poisoning
Paul T. Jayaprakash in Crime Scene Investigation and Reconstruction, 2023
Major indications in the scene supporting accidental poisoning are evidence of lack of deliberation and willfulness on the part of the victim in exposure to the poison. Examples include carbon-monoxide-related fatalities involving family members sleeping in closed rooms that are connected to defective heating systems or fatalities of individuals relaxing inside cars parked in closed garages with engine and air conditioner turned on. Toxic-gas-related accidental poisoning occurs when individuals get into sewage tanks or into unused wells for cleaning them. In such instances, the SOCOs can tie a live chicken in a rope by its legs and let it go into the depth of the tank or well to verify if it becomes unconscious due to the noxious gases. Accidental poisoning may also be reported during drug and alcohol abuse. Mixing of methyl alcohol with other intoxicating liquors has been the cause for mass fatalities in some parts of India. This author examined a case wherein three friends consuming alcoholic drinks mistakenly mixed cyanide considering it to be chloral hydrate, and all of them died of cyanide poisoning.
Introduction
Jim Ford, Gordon Parker, Fiona Ford, Diana Kloss, Simon Pickvance, Philip Sawney, Dame Carol Black in Rehabilitation for Work Matters, 2018
Poisoning is due to the ingestion, inhalation or absorption of noxious substances. Traditional workplace hazards include lead, asbestos and ionising radiation. However, occasionally some substances have been quite unexpectedly found to be toxic. For example, vinyl chloride monomer (VCM) – a gas used in the polymerisation of PVC (polyvinylchloride) – was initially considered to be benign enough to be used as an anaesthetic agent. However, it has subsequently been shown to be associated with two types of malignant liver cancer, as well as being toxic to the bones and circulation of the fingers, thus preventing affected individuals from doing some of their work tasks, as well as their hobbies, that require fine motor skills – and domestic chores such as washing dishes! Naturally, those affected will be inquisitive as to the causation, and such concerns may result in a claim against the company’s insurer. The processing of such claims can take an eternity – and may stand in the way of the patient adjusting to their disability and moving on. Again, a sympathetic ear or, at other times, a measured but challenging approach from a familiar practitioner can result in the patient not allowing their unresolved concerns to prevent them from returning to their usual work, and possibly becoming unemployable.
Agrochemicals: A Brief Overview
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Tobacco extracts had been used to repel and kill insects for several centuries, and tobacco smoke was also used for fumigation (88). Nicotine, an alkaloid extracted from the leaves of tobacco plants, was extensively used as an insecticide (as a free base or as the sulfate salt) until the middle of the last century. Nicotine exerts its toxic effects in insects and mammals by activating nicotinic acetylcholine receptors (nAChRs). Interaction of nicotine with nAChRs produces initial stimulation followed by protracted depolarization, which results in receptor paralysis. Nicotine has a high acute toxicity in vertebrates, with LD50 usually below 50 mg/kg (88). Signs and symptoms of poisoning include nausea, vomiting, muscle weakness, respiratory effects, headache, lethargy, and tachycardia. Starting in the late 1970s, a new class of insecticides, the neonicotinoids, has been developed through various chemical modifications of nicotine and other nAChRs agonists. As for nicotine, the insecticidal activity of neonicotinoids is due to activation of nAChRs, which in insects are located exclusively in the CNS. In contrast to nicotine, however, acute oral toxicity of neonicotinoids is low (LD50 in rats ranges from 180 to >2000 mg/kg) (89). Signs and symptoms of toxicity in mammals are attributable to stimulation of nAChRs, particularly in the peripheral nervous system, given their poor penetration of the blood-brain barrier (90). However, some initial evidence suggests that neonicotinoids may affect the developing nervous system (91).
Using the power card strategy to teach poison-prevention skills to children with developmental disabilities
Published in International Journal of Developmental Disabilities, 2023
Metehan Kutlu, Savas Berk
Unintentional injury is defined as ‘events in which the injury occurs in a short period of time – seconds or minutes, the harmful outcome was not sought, or the outcome was the result of one of the forms of physical energy in the environment or normal body functions being blocked by external means, e.g. drowning’ (Maine Center for Disease Control and Prevention 2023). More than 2000 children around the world die every day as a result of unintentional injuries (World Health Organization 2022). Leading causes of unintentional injury in children include motor vehicle crashes, suffocation, drowning, fires, falls, and poisoning (Center for Disease Control and Prevention (CDC) 2022). The leading cause of poisoning is the exposure of children to household cleaning chemicals (Presgrave et al.2008). In the United States, two children aged 0–19 die every day, and 374 children are treated in the emergency department as a result of being poisoned by household cleaning chemicals (CDC 2023).
Epidemiology of poisoning in Syria (1999 through 2020)
Published in Clinical Toxicology, 2023
Moudar Kouli, Hasan Nabil Al Houri, Sami Jomaa, Abdulmoez Issa, Douaa Mohammad Nazir Arrouk, Abdullah Alhouri, Ghaith Almhanni, Ahmad Nabil Alhouri, Rahaf Wardeh, Maher Kouli
Acute poisoning is a significant international public health issue [1,2] and one of the leading causes of death in the Emergency Department (ED) [3,4]. Although toxic substances, gases, and vapors are common causes of poisoning, drug poisoning is the foremost cause worldwide, and the majority of deaths were after an unintentional or intentional drug overdose, given the wrong drug, taking the wrong drug by mistake, or taking a drug inadvertently [5]. However, the most common poisoning agents differ between developing and developed countries, with pesticides being the most common cause of poisoning in developing countries and pharmaceuticals being the leading cause in developed countries [6,7]. These results were secondary to the discrepancies in the socioeconomic status, cultural habits, and agricultural and industrial activities between the countries [7,8]. In addition, the rates of food poisoning also increased globally due to the increase in transporting food products in parallel to the increase in travel [9].
Poisoning in older adults: characterization of exposures reported to the Dutch Poisons Information Center
Published in Clinical Toxicology, 2022
Saskia J. Rietjens, Joyce E. M. van der Heijden, Dylan W. de Lange
Older people are a high-risk group, because of the high prevalence of comorbidities and polypharmacy, and potential cognitive dysfunction. Poisoning prevention strategies need to be tailored to target individuals residing at home and in aged care facilities. In our study, the majority of intoxications in older adults involved medication errors. Most common scenarios were inadvertently taken or given a (more than) double dose or the wrong medication. Simplified drug regimens and the use of innovative technologies, such as automatic medication dispensers could reduce these type of medication errors. In addition, if patients are cognitively impaired, potentially harmful substances should be kept out of their reach and medication should only be administered under direct supervision. Furthermore, manufacturers of pharmaceuticals and consumer products should be encouraged to design labels which can be easily read and understood by older people to avoid mistakes. A multidisciplinary approach involving instruction and monitoring by general practitioners, geriatric physicians, pharmacists, nursing home staff, and home care providers may prevent future poisonings in older individuals.
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