Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
권호 표지
DOI QR코드

DOI QR Code

The 2022 Annual Report on Toxicology Surveillance and Severe Poisoning Cases at Emergency Departments in Korea

2022년 질병관리청 응급실 기반 중독 심층 실태조사 및 사례분석 연구결과 보고

  • Eun Sun Lee (Seoul Poison Control Center, Korea University Anam Hospital) ;
  • Su Jin Kim (Department of Emergency Medicine, Korea University College of Medicine) ;
  • Gyu Chong Cho (Department of Emergency Medicine, Kangdong Sacred Heart Hospital) ;
  • Mi Jin Lee (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Byung Hak So (Department of Emergency Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kyung Su Kim (Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Juhyun Song (Department of Emergency Medicine, Korea University College of Medicine) ;
  • Sung Woo Lee (Seoul Poison Control Center, Korea University Anam Hospital)
  • 이은선 (고려대안암병원 서울시 독성물질 중독관리센터) ;
  • 김수진 (고려대학교 의과대학 응급의학교실) ;
  • 조규종 (강동성심병원 응급의학과) ;
  • 이미진 (경북대학교 의과대학 응급의학교실) ;
  • 소병학 (가톨릭대학교 의과대학 성빈센트병원 응급의학과) ;
  • 김경수 (서울대학교 의과대학 서울대학교병원 응급의학과) ;
  • 송주현 (고려대학교 의과대학 응급의학교실) ;
  • 이성우 (고려대안암병원 서울시 독성물질 중독관리센터)
  • Received : 2023.05.18
  • Accepted : 2023.06.15
  • Published : 2023.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study investigated the actual incidence of acute poisoning in Korea on a nationwide scale, with the aim of laying the groundwork for future initiatives in prevention, strategic antidote distribution, and the development of effective emergency treatment for acute poisoning. Methods: The study analyzed data from 3,038 patients who presented to emergency departments with poisoning-related conditions from June 1, 2022 to December 31, 2022 at 10 sites in nine cities across the country. We extracted data on general characteristics of the poisoning cases, including demographic characteristics (age and gender), place of exposure, reason for poisoning, route of exposure, and the substance involved in the poisoning incident. Age-related patterns in reasons for poisoning, medical outcomes, frequent and primary poisoning substances, and deaths were also analyzed. Results: The population analyzed in our study was predominantly female, with women constituting 54.74% of all cases. Among infants and children, non-intentional poisoning due to general accidents was the most common cause, accounting for 71.43% of cases. Conversely, suicidal poisoning was more prevalent among teenagers and adults over 20. Fifty-two patients died during the study period, with males comprising approximately two-thirds (67.31%) of these fatalities. Pesticides were the most common poisoning substance among those who died, accounting for 55.77% of such cases. Notably, a significant majority of the victims were elderly individuals aged 60 and above. Conclusion: This study holds substantial significance, since it represents the first comprehensive investigation and analysis of the symptoms, treatment, and causes of death due to poisoning in Korea on a national scale. By substantially expanding the range and types of poisonous substances examined, we were able to more precisely identify the characteristics and clinical patterns of poisoning cases nationwide.

Keywords

Acknowledgement

본 연구는 2022년도 질병관리청의 정책연구용역사업으로 수행되었다(질병관리청 2022-12-107, 고려대학교산학협력단 Q2212431). 본 연구의 원활한 수행을 도와주신 김상철(충북대학교병원), 김선휴(울산대학교병원), 김현(연세대학교 원주세브란스기독병원), 박정배(경북대학교병원), 이의중(고려대학교안암병원), 이재광(건양대학교병원), 전우찬(인제대학교 일산백병원), 정태오(전북대학교병원), 조용수(전남대학교병원) 교수님께 감사드린다.

References

  1. Kim A, Song H, Park N, Choi S, Cho J. Injury pyramid of unintentional injuries according to sex and age in South Korea. Clin Exp Emerg Med 2018;5:84-94. https://doi.org/10.15441/ceem.17.205
  2. Kim W, Kim KH, Shin DW, Park J, Kim H, Jeon W, et al. Characteristics of Korean poisoning patients: retrospective analysis by National Emergency Department Information System. J Korean Soc Clin Toxicol 2019;17:108-17. https://doi.org/10.22537/jksct.2019.17.2.108
  3. Lee H, Choa M, Han E, Ko DR, Ko J, Kong T, et al. Causative substance and time of mortality presented to emergency department following acute poisoning: 2014-2018 National Emergency Department Information System (NEDIS). J Korean Soc Clin Toxicol 2021;19:65-71. https://doi.org/10.22537/jksct.2021.19.2.65
  4. Chung SP, Lee MJ, Kang H, Oh BJ, Kim H, Kim YW, et al. Analysis of poisoning patients using 2016 ED based injury in-depth surveillance data. J Korean Soc Clin Toxicol 2017;15:86-93. https://doi.org/10.22537/jksct.2017.15.2.86
  5. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Rivers LJ, Feldman R, et al. 2021 Annual report of the National Poison Data System (NPDS) from America's Poison Centers: 39th annual report. Clin Toxicol (Phila) 2022;60:1381-643. https://doi.org/10.1080/15563650.2022.2132768
  6. Seoul Poison Control Center Official Website [Internet]. Seoul: Seoul Poison Control Center; c2023 [cited 2023 May 3]. Available from: https://seoulpcc.or.kr/index.do
  7. Koh J, Jeon W, Kang H, Kim YW, Kim H, Oh BJ, et al. Analysis of poisoning patients using 2017-18 ED based injury indepth surveillance data. J Korean Soc Clin Toxicol 2020;18:85-93. https://doi.org/10.22537/jksct.2020.18.2.85
  8. Kim DY, Kim JH, Paik JH, Han SB, Jung HM. Analysis of characteristics in children and adolescents with poisoning at emergency department. J Korean Soc Clin Toxicol 2017;15:140-7. https://doi.org/10.22537/jksct.2017.15.2.140
  9. Berk LE. Child development. 5th ed. Boston (MA): Allyn & Bacon; 2000.
  10. Ryu WS, Choi JY, Cho JS, Lim YS, Hyun SY, Yang HJ. Age group characteristics of children who visited the emergency department with acute poisoning by ingestion. Pediatr Emerg Med J 2018;5:5-12. https://doi.org/10.22470/pemj.2018.00206
  11. Shin JU, Kwak SJ, Yun SH. Impact of coronavirus disease 2019 pandemic on pediatric poisoning in a single emergency department in Korea. Pediatr Emerg Med J 2023 Apr 17 [Epub]. https://doi.org/10.22470/pemj.2022.00647
  12. Chon MW, Lee J, Chung S, Kim Y, Kim HW. Prescription pattern of antidepressants for children and adolescents in Korea based on nationwide data. J Korean Med Sci 2017;32:1694-701. https://doi.org/10.3346/jkms.2017.32.10.1694
  13. Kim CY, Lee EJ, Lee SW, Kim SJ, Han KS. Changes in toxicological characteristics after sales of nonprescription drugs in convenience stores. J Korean Soc Clin Toxicol 2018;16:42-8. https://doi.org/10.22537/jksct.2018.16.1.42
  14. Kong SK, Oh SH, Park KN, Kim HJ. Trends of intentional poisoning: a retrospective single center study during 15 years. J Korean Soc Clin Toxicol 2016;14:47-53.
  15. Lee H, Won S, Lee JH, Seo YR, Yun SY. Understanding the status of acute poisoning patients who visited the emergency room in 2018: using sample in-depth survey data. J Korean Soc Emerg Med 2021;32:636-46.
  16. Lee CA, Cho JP, Choi SC, Kim HH, Park JO. Patients who leave the emergency department against medical advice. Clin Exp Emerg Med 2016;3:88-94. https://doi.org/10.15441/ceem.15.015
  17. Vallersnes OM, Jacobsen D, Ekeberg O, Brekke M. Mortality and repeated poisoning after self-discharge during treatment for acute poisoning by substances of abuse: a prospective observational cohort study. BMC Emerg Med 2019;19:5. https://doi.org/10.1186/s12873-018-0219-9
  18. Shin SD, Suh GJ, Rhee JE, Sung J, Kim J. Epidemiologic characteristics of death by poisoning in 1991-2001 in Korea. J Korean Med Sci 2004;19:186-94. https://doi.org/10.3346/jkms.2004.19.2.186
  19. Jung W, Je S, Lee S, Lee J, Kim C, Bak H, et al. Comparison of epidemiological characteristics and outcomes for the in-hospital cardiac arrest between poisoned patients in Korea: a population study based on Korean Health Insurance Review and Assessment Service. J Korean Soc Emerg Med 2017;28:117-23. https://doi.org/10.0000/jksem.2017.28.1.117
  20. Pesticide and chemical fertilizer usage [Internet]. Sejong: Ministry of Agriculture, Food and Rural Affairs, Korea Crop Protection Association, Korea Fertilizer Association, Statistics Korea; 2022 [cited 2023 May 3]. Available from: https://www.index.go.kr/unity/potal/main/EachDtlPageDetail.do?idx_cd=2422
  21. Cho NJ, Park S, Lee EY, Gil HW. Risk factors to predict acute respiratory failure in patients with acute pesticide poisoning. J Korean Soc Clin Toxicol 2020;18:116-22. https://doi.org/10.22537/jksct.2020.18.2.116
  22. Park CY, Cha KM, So BH, Jeong WJ. Severity predictors of elderly poisoning patients admitted to an emergency medical center. J Korean Soc Clin Toxicol 2019;17:94-101. https://doi.org/10.22537/jksct.2019.17.2.94