Poisoning

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Visible symptoms of arsenic poisoning following exposure. Arsenic Poisoning.jpg
Visible symptoms of arsenic poisoning following exposure.

Poisoning is the harmful effect which occurs when toxic substances are introduced into the body. [1] The term "poisoning" is a derivative of poison, a term describing any chemical substance that may harm or kill a living organism upon ingestion. [2] Poisoning can be brought on by swallowing, inhaling, injecting or absorbing toxins through the skin. Toxicology is the practice and study of symptoms, mechanisms, diagnoses, and treatments correlated to poisoning. [3]

Contents

Levels of Exposure

When a living organism is introduced to a poison, the symptoms that follow successful contact develop in close relation to the degree of exposure. [4]

Acute exposure

Acute toxicity/poisoning consists of a living organism being harmfully exposed to poison once or more times during a brief period, with symptoms manifesting within 14 days since administration. [5]

Chronic exposure

Chronic toxicity/poisoning involves a living organism being exposed to a toxin on multiple instances over an extended period of time, whereas the symptoms either develop gradually or after a protracted latent period. [6] Chronic poisoning most commonly occurs following exposure to poisons that bioaccumulate, or are biomagnified, such as mercury, gadolinium, and lead. [7]

Methods of Poisoning

Accidental poisoning

Death rate from unintentional poisoning in 2017. Death rate from unintentional poisoning, OWID.svg
Death rate from unintentional poisoning in 2017.

In 2020, America's Poison Centers' NPDS (National Poison Data System) report determined that 76.9% of recorded toxin exposures were accidental, with the rest of the statistics either being deliberate or unexpected. [9] A large portion of these accidental incidents occurred due to mistakingly taking the incorrect medicine, or doubling one's dose by mistake. [9]

Industry and Warfare

Arsenic trioxide is a white, crystalline powder that closely resembles sugar. The 1858 Bradford sweets poisoning incident happened because it was mistaken for a sugar substitute ("daff"). Arsenic trioxide.jpg
Arsenic trioxide is a white, crystalline powder that closely resembles sugar. The 1858 Bradford sweets poisoning incident happened because it was mistaken for a sugar substitute ("daff").

Nerve gases are synthetic substances used in industry or warfare that are specifically engineered to bring harm to living organisms. [10] They may paralyze a person in a matter of seconds or cease organ function, quickly resulting in death.They're considered to be biologically derived neurotoxins, which are a genre of toxic agents that act specifically against the nervous system. Inhaled or ingested cyanide (or Zyklon B) was used as a method of execution in gas chambers. [11] This method of poisoning instantly starved the body of energy by inhibiting the enzymes in mitochondria that produce ATP. [12] Intravenous injection of an unnaturally high concentration of potassium chloride, such as in the execution of prisoners in parts of the United States, quickly stops the heart by eliminating the cell potential necessary for muscle contraction. [13]

Pesticide exposure

Most biocides, including pesticides, are created to act as poisons to target organisms. Although acute or less observable chronic poisoning can also occur in non-target organisms (secondary poisoning), including the humans who apply the biocides and other beneficial organisms. [14] For example, the herbicide 2,4-D imitates the action of a plant hormone, which makes its lethal toxicity specific to plants. Indeed, 2,4-D is not a poison, but is classified as harmful. [15]

Toxication

Many substances regarded as poisons are toxic only indirectly through toxication. An example is "wood alcohol" or methanol, which is not poisonous itself but is chemically converted to toxic formaldehyde and formic acid once it's reached the liver. [16] Many drug molecules are made toxic in the liver, and the genetic variability of certain liver enzymes makes the toxicity of many compounds differ between people.

Precautionary Measures

Poisoning
GHS-pictogram-skull.svg
Hazard Symbol (Pictogram) for Poisonning
Specialty Toxicology

As mandated in GHS, various safety-orientated government agencies from around the globe have put into place the usage of pictograms when labelling toxic substances. [17] [18] The hazard symbol which labels a substance as capable of poisoning depicts the imagery of a human skull in front of two bones crossing one another. [19]

GHS precautionary statements, which advise users to exercise caution or be aware of the substance's potentially dangerous features, are added to a legal toxins' labelling. [20] Toxic substances can also come with instructions on how to handle the product, what compounds to avoid mixing the product with, and how to treat a victim at risk of poisoning who has come in contact with the product. [21]

Various poison control centers are also available to assist in diagnosing, managing, and preventing possible incidents of poisoning. [22] Many are accessible through phone calls or official websites.

Treatment

Seeking medical attention is strongly advised if someone is thought to have been exposed to or consumed a poison, mainly from a nearby poison control centre. [23] [24] It is advised to provide medical personnel with information regarding the poisoning, the patient's age, weight, and any other drugs they may be taking in addition to the symptoms of the illness. Try to determine what was ingested, the amount and how long since the person was exposed to it. If possible, have on hand the pill bottle, medication package or other suspect container. [25]

The treatment will depend on the substance to which the patient is exposed. Depending on the type of poisoning, some first aid measures may help. Treatments include activated charcoal, induction of vomiting and dilution or neutralizing of the poison. [26]

See also

Related Research Articles

In toxicology, the median lethal dose, LD50 (abbreviation for "lethal dose, 50%"), LC50 (lethal concentration, 50%) or LCt50 is a toxic unit that measures the lethal dose of a given substance. The value of LD50 for a substance is the dose required to kill half the members of a tested population after a specified test duration. LD50 figures are frequently used as a general indicator of a substance's acute toxicity. A lower LD50 is indicative of higher toxicity.

<span class="mw-page-title-main">Toxin</span> Naturally occurring organic poison

A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. They occur especially as proteins, often conjugated. The term was first used by organic chemist Ludwig Brieger (1849–1919) and is derived from the word "toxic".

<span class="mw-page-title-main">Toxicology</span> Study of substances harmful to living organisms

Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposures to toxins and toxicants. The relationship between dose and its effects on the exposed organism is of high significance in toxicology. Factors that influence chemical toxicity include the dosage, duration of exposure, route of exposure, species, age, sex, and environment. Toxicologists are experts on poisons and poisoning. There is a movement for evidence-based toxicology as part of the larger movement towards evidence-based practices. Toxicology is currently contributing to the field of cancer research, since some toxins can be used as drugs for killing tumor cells. One prime example of this is ribosome-inactivating proteins, tested in the treatment of leukemia.

<span class="mw-page-title-main">Poison</span> Substance that causes death, injury or harm to organs

A poison is any chemical substance that is harmful or lethal to living organisms. The term is used in a wide range of scientific fields and industries, where it is often specifically defined. It may also be applied colloquially or figuratively, with a broad sense.

Bioaccumulation is the gradual accumulation of substances, such as pesticides or other chemicals, in an organism. Bioaccumulation occurs when an organism absorbs a substance faster than it can be lost or eliminated by catabolism and excretion. Thus, the longer the biological half-life of a toxic substance, the greater the risk of chronic poisoning, even if environmental levels of the toxin are not very high. Bioaccumulation, for example in fish, can be predicted by models. Hypothesis for molecular size cutoff criteria for use as bioaccumulation potential indicators are not supported by data. Biotransformation can strongly modify bioaccumulation of chemicals in an organism.

<span class="mw-page-title-main">Toxicity</span> Degree of harmfulness of substances

Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacterium, or plant, as well as the effect on a substructure of the organism, such as a cell (cytotoxicity) or an organ such as the liver (hepatotoxicity). Sometimes the word is more or less synonymous with poisoning in everyday usage.

<span class="mw-page-title-main">Safety data sheet</span> Sheet listing work-related hazards

A safety data sheet (SDS), material safety data sheet (MSDS), or product safety data sheet (PSDS) is a document that lists information relating to occupational safety and health for the use of various substances and products. SDSs are a widely used system for cataloguing information on chemical species including chemical compounds and chemical mixtures. SDS information may include instructions for the safe use and potential hazards associated with a particular material or product, along with spill-handling procedures. The older MSDS formats could vary from source to source within a country depending on national requirements; however, the newer SDS format is internationally standardized.

<span class="mw-page-title-main">Chlorfenvinphos</span> Chemical compound

Chlorfenvinphos is an organophosphorus compound that was widely used as an insecticide and an acaricide. The molecule itself can be described as an enol ester derived from dichloroacetophenone and diethylphosphonic acid. Chlorfenvinphos has been included in many products since its first use in 1963. However, because of its toxic effect as a cholinesterase inhibitor it has been banned in several countries, including the United States and the European Union. Its use in the United States was cancelled in 1991.

Demeton-S-methyl is an organic compound with the molecular formula C6H15O3PS2. It was used as an organothiophosphate acaricide and organothiophosphate insecticide. It is flammable. With prolonged storage, Demeton-S-methyl becomes more toxic due to formation of a sulfonium derivative which has greater affinity to the human form of the acetylcholinesterase enzyme, and this may present a hazard in agricultural use.

<span class="mw-page-title-main">Palytoxin</span> Chemical compound

Palytoxin, PTX or PLTX is an intense vasoconstrictor, and is considered to be one of the most poisonous non-protein substances known, second only to maitotoxin in terms of toxicity in mice.

<span class="mw-page-title-main">Environmental hazard</span> Harmful substance, a condition or an event

Environmental hazards are those hazards that affect biomes or ecosystems. Well known examples include oil spills, water pollution, slash and burn deforestation, air pollution, ground fissures, and build-up of atmospheric carbon dioxide. Physical exposure to environmental hazards is usually involuntary

Toxic encephalopathy is a neurologic disorder caused by exposure to neurotoxic organic solvents such as toluene, following exposure to heavy metals such as manganese, as a side effect of melarsoprol treatment for African trypanosomiasis, adverse effects to prescription drugs, or exposure to extreme concentrations of any natural toxin such as cyanotoxins found in shellfish or freshwater cyanobacteria crusts. Toxic encephalopathy can occur following acute or chronic exposure to neurotoxicants, which includes all natural toxins. Exposure to toxic substances can lead to a variety of symptoms, characterized by an altered mental status, memory loss, and visual problems. Toxic encephalopathy can be caused by various chemicals, some of which are commonly used in everyday life, or cyanotoxins which are bio-accumulated from harmful algal blooms (HABs) which have settled on the benthic layer of a waterbody. Toxic encephalopathy can permanently damage the brain and currently treatment is mainly just for the symptoms.

<span class="mw-page-title-main">Globally Harmonized System of Classification and Labelling of Chemicals</span> International standard managed by the United Nations

The Globally Harmonized System of Classification and Labelling of Chemicals (GHS) is an internationally agreed-upon standard managed by the United Nations that was set up to replace the assortment of hazardous material classification and labelling schemes previously used around the world. Core elements of the GHS include standardized hazard testing criteria, universal warning pictograms, and safety data sheets which provide users of dangerous goods relevant information with consistent organization. The system acts as a complement to the UN numbered system of regulated hazardous material transport. Implementation is managed through the UN Secretariat. Although adoption has taken time, as of 2017, the system has been enacted to significant extents in most major countries of the world. This includes the European Union, which has implemented the United Nations' GHS into EU law as the CLP Regulation, and United States Occupational Safety and Health Administration standards.

<span class="mw-page-title-main">Environmental toxicology</span>

Environmental toxicology is a multidisciplinary field of science concerned with the study of the harmful effects of various chemical, biological and physical agents on living organisms. Ecotoxicology is a subdiscipline of environmental toxicology concerned with studying the harmful effects of toxicants at the population and ecosystem levels.

Precautionary statements form part of the Globally Harmonized System of Classification and Labelling of Chemicals (GHS). They are intended to form a set of standardized phrases giving advice about the correct handling of chemical substances and mixtures, which can be translated into different languages. As such, they serve the same purpose as the well-known S-phrases, which they are intended to replace.

The Hazard Communication Standard (HCS) requires employers to disclose toxic and hazardous substances in workplaces. This is related to the Worker Protection Standard.

Occupational toxicology is the application of toxicology to chemical hazards in the workplace. It focuses on substances and conditions that people may be exposed to in workplaces, including inhalation and dermal exposures, which are most prevalent when discussing occupational toxicology. These environmental and individual exposures can impact health, and there is a focus on identifying early adverse affects that are more subtle than those presented in clinical medicine.

Phoratoxins are a group of peptide toxins that belong to the family of thionins, a subdivision of small plant toxins. Phoratoxins are proteins present in the leaves and branches of the Phoradendron, commonly known as the American variant of the mistletoe, a plant commonly used as decoration during the festive season. The berries of the mistletoe do not contain phoratoxins, making them less toxic compared to other parts of the plant. The toxicity of the mistletoe is dependent on the host tree, since mistletoe is known to be a semi-parasite. The host tree provides fixed inorganic nitrogen compounds necessary for the mistletoe to synthesize phoratoxins.

Threshold dose is the minimum dose of drug that triggers minimal detectable biological effect in an animal. At extremely low doses, biological responses are absent for some of the drugs. The increase in dose above threshold dose induces an increase in the percentage of biological responses. Several benchmarks have been established to describe the effects of a particular dose of drug in a particular species, such as NOEL(no-observed-effect-level), NOAEL(no-observed-adverse-effect-level) and LOAEL(lowest-observed-adverse-effect-level). They are established by reviewing the available studies and animal studies. The application of threshold dose in risk assessment safeguards the participants in human clinical trials and evaluates the risks of chronic exposure to certain substances. However, the nature of animal studies also limits the applicability of experimental results in the human population and its significance in evaluating potential risk of certain substances. In toxicology, there are some other safety factors including LD50, LC50 and EC50.

References

  1. ↑ "Poisoning". medlineplus.gov. Retrieved 2021-10-26.
  2. ↑ Cammack, Richard; Atwood, Teresa; Campbell, Peter; Parish, Howard; Smith, Anthony; Vella, Frank; Stirling, John, eds. (2006-01-01). Oxford Dictionary of Biochemistry and Molecular Biology (2 ed.). Oxford University Press. doi:10.1093/acref/9780198529170.001.0001. ISBN   978-0-19-852917-0.
  3. ↑ "Toxicology". National Institute of Environmental Health Sciences. Retrieved 2022-12-05.
  4. ↑ Calabrese, E.J. (2014), "Dose–Response Relationship", Encyclopedia of Toxicology, Elsevier, pp. 224–226, doi:10.1016/b978-0-12-386454-3.00991-x, ISBN   978-0-12-386455-0 , retrieved 2024-04-09
  5. ↑ Gold, Victor, ed. (2019). The IUPAC Compendium of Chemical Terminology: The Gold Book (4 ed.). Research Triangle Park, NC: International Union of Pure and Applied Chemistry (IUPAC). doi:10.1351/goldbook.at06800.
  6. ↑ Elhag, Ibtihag Yahya (2023), "Role of AI in ADME/Tox toward formulation optimization and delivery", A Handbook of Artificial Intelligence in Drug Delivery, Elsevier, pp. 301–345, doi:10.1016/b978-0-323-89925-3.00011-3, ISBN   978-0-323-89925-3 , retrieved 2024-04-15
  7. ↑ Chojnacka, K.; Mikulewicz, M. (2014), "Bioaccumulation", Encyclopedia of Toxicology, Elsevier, pp. 456–460, doi:10.1016/b978-0-12-386454-3.01039-3, ISBN   978-0-12-386455-0 , retrieved 2024-04-15
  8. ↑ "Death rate from unintentional poisoning". Our World in Data. Retrieved 5 March 2020.
  9. 1 2 Gummin, David D.; Mowry, James B.; Beuhler, Michael C.; Spyker, Daniel A.; Bronstein, Alvin C.; Rivers, Laura J.; Pham, Nathaniel P. T.; Weber, Julie (2021-12-02). "2020 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th Annual Report". Clinical Toxicology. 59 (12): 1282–1501. doi:10.1080/15563650.2021.1989785. ISSN   1556-3650.
  10. ↑ Patton, James. "Gas in The Great War". www.kumc.edu. Mail Stop 1025 3901 Rainbow Blvd. Kansas City, KS 66160: History and Philosophy of Medicine. Retrieved 2024-04-15.{{cite web}}: CS1 maint: location (link)
  11. ↑ Stewart, Ken. "Zyklon-B | Description, Manufacturer, & Facts | Britannica". www.britannica.com. Retrieved 2024-04-15.
  12. ↑ Jethava, Durga; Gupta, Priyamvada; Kothari, Sandeep; Rijhwani, Puneet; Kumar, Ankit (2014). "Acute cyanide Intoxication: A rare case of survival". Indian Journal of Anaesthesia. 58 (3): 312–314. doi: 10.4103/0019-5049.135045 . ISSN   0019-5049. PMC   4090999 . PMID   25024476.
  13. ↑ Simon, Gábor (2023-04-04). "Detection of Fatal Potassium Overdose: A Case Report and Review of the Literature". Diagnostics. 13 (7): 1339. doi: 10.3390/diagnostics13071339 . ISSN   2075-4418. PMC   10093193 . PMID   37046560.
  14. ↑ Kapeleka, Jones A.; Sauli, Elingarami; Ndakidemi, Patrick A. (2021-10-03). "Pesticide exposure and genotoxic effects as measured by DNA damage and human monitoring biomarkers". International Journal of Environmental Health Research. 31 (7): 805–822. Bibcode:2021IJEHR..31..805K. doi:10.1080/09603123.2019.1690132. ISSN   0960-3123. PMID   31736325.
  15. ↑ Carvalho, Laíse M.; Soares-Filho, Antônio F.; Lima, Maciel S.; Cruz-Filho, João F.; Dantas, Taisa C. M.; Luz, Geraldo E. (February 2021). "2,4-Dichlorophenoxyacetic acid (2,4-D) photodegradation on WO3-TiO2-SBA-15 nanostructured composite". Environmental Science and Pollution Research. 28 (7): 7774–7785. Bibcode:2021ESPR...28.7774C. doi:10.1007/s11356-020-11085-4. ISSN   0944-1344.
  16. ↑ Jones, A W. "Clinical and forensic toxicology of methanol". Forensic Sci Rev . Central Police University. PMID   34247144.
  17. ↑ Boelhouwer, Eric; Davis, Jerry; Franco-Watkins, Ana; Dorris, Nathan; Lungu, Claudiu (September 2013). "Comprehension of hazard communication: Effects of pictograms on safety data sheets and labels". Journal of Safety Research. 46: 145–155. doi:10.1016/j.jsr.2013.06.001. ISSN   0022-4375.
  18. ↑ "Globally Harmonized System of Classification and Labelling of Chemicals". www.canada.ca. 2023-03-21. Retrieved 2024-04-15.
  19. ↑ "Know Your Hazard Symbols (Pictograms)". Office of Environmental Health and Safety. Retrieved 2024-04-15.
  20. ↑ Vereinte Nationen, ed. (2007). Globally harmonized system of classification and labelling of chemicals: GHS (2nd revised ed.). New York: United Nations. ISBN   978-92-1-116957-7.
  21. ↑ Vereinte Nationen, ed. (2011). Globally harmonized system of classification and labelling of chemicals: GHS. United Nations (4th revised ed.). New York: United Nations. ISBN   978-92-1-117042-9.
  22. ↑ "Poison control center - PAHO/WHO | Pan American Health Organization". www.paho.org. 2021-01-14. Retrieved 2024-04-15.
  23. ↑ "Poisoning Prevention | Child Safety and Injury Prevention| CDC Injury Center". www.cdc.gov. 2020-07-02. Retrieved 2020-11-28.
  24. ↑ Yadav, Sharad; Shah, Gautam Kumar; Verma, Dharmesh; Yadav, Prakash Chand (2022-07-22). "Study of profile, pattern and outcomes of oral poisoning cases admitted in emergency department of Janakpur provincial hospital, Nepal". doi:10.5281/zenodo.6879818.{{cite journal}}: Cite journal requires |journal= (help)
  25. ↑ "Poisoning: First aid - Mayo Clinic". www.mayoclinic.org. Retrieved 2021-10-26.
  26. ↑ Avau, Bert; Borra, Vere; Vanhove, Anne-Catherine; Vandekerckhove, Philippe; De Paepe, Peter; De Buck, Emmy (December 2018). "First aid interventions by laypeople for acute oral poisoning". The Cochrane Database of Systematic Reviews. 12 (12): CD013230. doi:10.1002/14651858.CD013230. ISSN   1469-493X. PMC   6438817 . PMID   30565220.
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