• 대한임상독성학회지
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• 제4권1호
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• pp.32-43
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• 2006

Purpose: Toxic Exposure Surveillance System (TESS) is widely used for poisoning data collection and making a counterplan. But, there were few reports about poisoning data collection using TESS in Korea. The aim was to collect poisoning data using TESS report form and investigate the recognition of emergency physician about the necessity of TESS as preliminary survey. Methods: Retrospectively, we gathered data from hospital records about the patient who admitted hospital emergency room due to poisoning. Date were gathered by paper and/or web client system report form in patients recruited by ICD-10 codes Results: From Jun 2004 to May 2005,3,203 patients were enrolled in 30 hospitals and their mean age was $44.9{\pm}20.3years$ old(male: female = 1,565: 1,638). The most frequent site of exposure was their own residence (73.2%, 2,345/3,203) and most of reported patients were older than 20 years(89.7%, 2,871/3,203). Frequent substances involved in poisoning were medication(41.9%) and pesticide(33.3%). Intentional poisoning was 60.7%(1,954). In fatality, overall frequency was 5.1%(162/3,203) and the most frequent route of exposure was ingestion(96.3%, 156/162) and the most frequent substance was pesticide(85.2%, 138/ 162). Antidotes were administered in 202 patients(2-PAM, atropine, antivenin, N-acetylcystein, vitamin K, flumazenil, ethanol, methylene blue, naloxone, calcium compound). 19 of 20 emergency physicians agreed with necessity of TESS. Conclusion: Data collection using TESS report form showed preliminary poisoning events in Korea. Frequent poisoning substance were medication and pesticide. The fatality was mainly related with pesticide ingestion. Many doctors in emergency room recognized the necessity of TESS.

• 대한수의학회지
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• 제50권3호
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• pp.197-203
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• 2010

Pesticides are useful to eliminate harmful insects and grow crops however, misuse and abuse of pesticides may cause a death of wild birds, livestock, and companion animals. We analyzed residual pesticides in the ingesta and tissues from the dead wild birds, livestock, and companion animals which were suspected pesticide poisoning based on the diagnosis of the Animal Disease Diagnostic Center of National Veterinary Research and Quarantine Service (NVRQS). The samples were primarily brought to NVRQS from local communities and veterinary diagnostic laboratories. The 231 suspicious samples of pesticide poisoning based on the necropsy were analyzed by GC/NPD, GC/FPD, GC/ECD, or GC/MSD in 2008 and 2009. Pesticides were identified from the 55 samples of total 143 samples analyzed in 2008 and from the 34 samples of total 88 samples analyzed in 2009. The pesticide identification rates in 2008 were higher than the rates in 2009. It may have relevance to the increased samples with the outbreak of avian influenza in 2008 in Korea. The concentrations of pesticides found in the dead animals varied and exceeded the respective $LD_{50}$ of pesticides in many cases. Monochrotophos, phosphamidon, and methomyl were the most common pesticides found and those pesticides are high rank sales in Korea. The cause of pesticide poisoning in animal is assuming a misuse and an abuse of commonly used pesticides in Korea.

• 대한임상독성학회지
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• 제17권2호
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• pp.108-117
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• 2019

Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

• 대한임상독성학회지
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• 제20권1호
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• pp.25-30
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• 2022

In this study, we report the case of a 59-year-old male patient with organophosphate pesticide poisoning. He visited the local emergency medical center after ingesting 250 ml of organophosphate pesticide. The patient's symptoms improved after the initial intravenous infusion of pralidoxime 5 g and atropine 0.5 mg. However, 18 hours after admission, there was a worsening of the symptoms. A high dose of atropine was administered to improve muscarinic symptoms. A total dose of 5091.4 mg of atropine was used for 30 days, and fever and paralytic ileus appeared as side effects of atropine. Anticholinergic symptoms disappeared only after reducing the atropine dose, and the patient was discharged on the 35th day without any neurologic complications.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.29-37
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• 2003

본 연구는 강원도 일부 고랭지 농업 농민을 대상으로 농약 노출 실태와 농약 노출로 인한 급성 중독 증상 경험을 비교하기 위하여 농약 노출력과 급성 중독증상에 대한 설문을 강원도 강릉시 왕산면 대기리의 고랭지 농업지역 농민을 대상으로 면접식 설문을 실시하였다. 연구결과 농약 노출과 농약 사용 기간은 두 집단간에 차이가 없었으나 연간 살충제 사용 일수는 고랭지 농업 농민이 1년에 평균 35.9일로 일반 농업 농민의 14.4일보다 더 많이 사용하였다. 일일 살충제 사용 시간도 고랭지 농업 농민이 하루 6.7시간으로 일반 농업 농민의 2.8시간 보다 길었다. 농약 노출에 의한 급성 중독 점수도 고랭지 농업 농민에서 유의하게 높았다. 회귀분석 결과 급성 중독 증상은 제초제 노출과는 통계적으로 유의한 상관성이 없었으며 살충제 노출과는 밀접한 연관관계가 있었다. 또한 중독 증상으로는 '피부가 따갑고 가렵다', '머리가 어지럽거나 아프다', '온 몸에 힘이 빠진다', '눈이 따갑다', '구역질이 난다' 의 5개 문항에 있어서 고랭지 농업 농민이 더 많이 경험을 하였으며 '눈 앞이 흐려졌다', '의식을 잃고 쓰러진다', '전신이 마비되었다'. '말이 나오지 않았다'의 4개 문항은 양 군간에 차이를 보이지 않았다. 증상의 경험률은 전체적으로 52.9%였으며 농업 형태별로 보면 일반 농업지역은 51.1%, 67.9%로 매우 높은 편이었다. 증상별로 보면 두통의 경우 전체적으로는 40.7%였으나 고랭지 농업의 경우는 73.7%, 일반 농업의 경우는 35.3%였으며 피부증상의 경우에는 전체적으로 22.9%, 고랭지 농업 농민은 57.9%, 일반 농업 농민은 17.2%였다. 이상의 연구결과를 볼 때, 고랭지 농업 농민은 일반 농업 농민보다 농약 노출이 많은 것을 알 수 있으며 추후 고랭지 농업 농민들의 농약 노출에 대한 건강영향 평가 및 농약 노출을 감소시켜 건강장해를 예방하기 위한 다양한 연구 및 행정적 노력이 필요할 것으로 사료된다.

• 대한임상독성학회지
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• 제17권2호
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• pp.94-101
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• 2019

Purpose: This study examined the clinical characteristics of severe elderly poisoning patients to determine the factors that can prevent them. Methods: Data were collected from patients over 65 years of age presenting to the emergency center with poisoning from 2013 to 2018. Their medical records were analyzed retrospectively, and patients with a poisoning severity score of three or more were defined as the severe poisoning group. The risk factors were evaluated by univariate and multivariate analysis. Results: This study analyzed 292 patients, of whom 37 (12.7%) belonged to the severe poisoning group. The severe poisoning group showed a significantly higher association with pesticide poisoning and intentional suicide attempts. Loneliness and somatization were the cause of the suicidal ideas. No significant differences in age, sex, drinking, ingestion time, poisonous materials other than pesticides, and neuropsychological consultation were observed between the two groups. Conclusion: The severe elderly poisoning patients were the result of intentional poisoning for suicide. Loneliness and somatization were the most influential causes of suicidal poisoning. Therefore, psychiatric screening and frequent medical treatment for elderly people are required to prevent severe poisoning in elderly patients.

• 대한임상독성학회지
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• 제9권2호
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• pp.56-60
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• 2011

Purpose: The optimal dose of oximes for use in the treatment of organophosphorus pesticide poisoning has not been conclusively established. In this retrospective study, we assessed the effectiveness of the use of high-dose pralidoxime infusion in treating organophosphorus pesticide poisoning. Methods: From January 1998 to December 2009, 71 patients visited the hospital Emergency Department (ED) as a result of organophosphate pesticide intoxication. All of these patients received an initial bolus of 2 g of pralidoxime as the first step of treatment. Patients who then received continuous infusion of pralidoxime at a dose of 500 mg/hr were entered into study group 1 (low dose), and those treated by continuous infusion of pralidoxime at a dose of 1000 mg/hr were entered into study group 2 (high-dose). Plasma cholinesterase activities for each patient were evaluated at ED arrival and re-evaluated 24 hours after pralidoxime infusion. The effectiveness of the two treatment modalities was gauged by comparing the required duration of mechanical ventilation, time spent in the intensive care unit (ICU) and total time spent in the hospital. Results: The mean duration of mechanical ventilation was $9.98{\pm}6.47$ days for group 1 and $4.39{\pm}6.44$ days for group 2. The respective mean duration of time spent in ICU and the total number of days in the hospital were $16.38{\pm}18.84$ days and $21.87{\pm}20.16$ days for group 1, and $7.83{\pm}9.99$ days and $11.71{\pm}13.53$ days for group 2. Highdose pralidoxime treatment was associated with shorter required durations for mechanical ventilation, ICU and hospital stay. In addition, plasma cholinesterase reactivation rates were higher for those patients receiving high-dose pralidoxime treatment. Conclusion: The results suggest that high-dose pralidoxime treatment has greater efficacy for patients suffering from organophosphorus pesticide poisoning.

• 한국지역사회생활과학회지
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• 제16권1호
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• pp.149-163
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• 2005

Family has emerged as a key concept for health, and it has been identified as one of the most important conditions. The relationship between health habit and its management is different depending on family. The odd pair family, mostly rural lower income class, worry to have poor health because of no spouse and small family size. One thousand eight hundred and seventy(1870) subjects were collected in 9 provinces through the sampling of Probability Proportional to Size (PPS). Questionnaire method was conducted on health checking, bath states, alcohol consumption, cigarette smoking, and the prevalence of farmer's health related problems. The main results were as follows: 1) The characteristics of odd pair families are that the head of household is female(77% ), the size of family is small(1.76 persons), the education level is low(7.5 years for male, 3.1 years for female) and the age group is old (male: 89.78 year old, female: 73.69 year old). 2) For the odd pair family, the frequency of health checking is quite low with one or two times per year(l0.2%) and the rate of no-health checking is much higher(35.8%) .3) Bathing utility is not available 29.6% of the odd pair family and only cold water is supplied at home for the 11.5 % of them. However, for the paired family, 9.8 % of them has no bathing utility and the rate of the family supplied with only cold water is just 7.9%. 4) The bathing frequency score of odd pair family is l.74points for male and 1.25 points for female. 5) The rate of smoking habits for odd pair family is 68.5 % and specially it is 7.6% for female, which is higher comparing with that of pair family. 6) The smoking frequency score of odd pair family is 1.57 points. 7) Alcohol drinking frequency score of odd pair family is 1.79 points for male, and 3.24points for female. 8) Farmers' syndrome(FS) revealed 38.7% of odd pair family and it is lower than that of pair family(57.3%). Special pain of FS was huckle bone and muscle(28.4%) and articular pain(24.l %). The pain rate of huckle bone and muscle(43.l %) and articular pain(33.5%) were higher in a year in odd pair family were lower than those of pair family: farming machine caused accidents(6.5%) and pesticide poisoning(5.7%). l0) The odd pair family use more frequently medical clinic or public health center for the treatment of FS(74.7%) and pesticide poisoning(62.5%) than the pair family for FS(69.0%) and for pesticide poisoning(.53.6%). The score of FS treatment is 5.70 points for odd pair family and it is not significantly different from 5.62 points of the paired family. The result of pesticide poisoning treatment score is as same as that of FS.

• 대한임상독성학회지
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• 제15권2호
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• pp.131-139
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• 2017

Purpose: The purpose of this study was to investigate the epidemiologic characteristics of patients who visited emergency departments (EDs) after intentional poisoning in Korea. Methods: This study retrospectively analyzed the data of of 23 hospitals during a five-year period, between 2011 and 2015. We included patients who inflicted injury to themselves - attempt of suicide - by means of poisoning. Results: A total of 18,121 patients visited an ED after intentional poisoning. Among them, 58.3% were females; however, there were more males among those aged 60 years or older. The mortality rate for males was 8.6%, which was 3.1 times higher than that for females with 2.8%. The most common poison was pesticides (35.4%) in males and sedative-hypnotics (44.0%) in females. The most common causative agent of death was pesticide in both sexes (75.2% and 65.3%, respectively). Since the production of paraquat was discontinued in 2011, the number of deaths from pesticide poisoning has decreased. The mortality rate declined in both males and females, from 12.6% and 4.5% in 2011 to 7.1% and 2.1% in 2015, respectively. Conclusion: In this study, we analyzed the epidemiologic characteristics of intentional poisoning, especially the frequency of suicide attempts by gender and age group, the cause of suicide, and the causative agent. This can be used as basic data for establishing policies to reduce and prevent suicide attempts by poisoning.

• 대한임상독성학회지
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• 제15권1호
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• pp.56-59
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• 2017

Pneumatosis cystoides intestinalis and portomesenteric venous gas are uncommon radiological findings, but are found commonly in cases of bowel ischemia, or as a result of various non-ischemic conditions. A 72-year-old man visited an emergency center with altered mental status 2 hours after ingestion of an unknown pesticide. On physical examination, he showed the characteristic hydrocarbon or garlic-like odor, miotic pupils with no response to light, rhinorrhea, shallow respiration, bronchorrhea, and sweating over his face, chest and abdomen. Laboratory results revealed decreased serum cholinesterase, as well as elevated amylase and lipase level. We made the clinical diagnosis of organophosphate poisoning in this patient based on the clinical features, duration of symptoms and signs, and level of serum cholinesterase. Activated charcoal, fluid, and antidotes were administered after gastric lavage. A computerized tomography scan of the abdomen with intravenous contrast showed acute pancreatitis, poor enhancement of the small bowel, pneumatosis cystoides intestinalis, portomesenteric venous gas and ascites. Emergent laparotomy could not be performed because of his poor physical condition and refusal of treatment by his family. The possible mechanisms were believed to be direct intestinal mucosal damage by pancreatic enzymes and secondary mucosal disruption due to bowel ischemia caused by shock and the use of inotropics. Physicians should be warned about the possibility of pneumatosis cystoides intestinalis and portomesenteric venous gas as a complication of pancreatitis following anticholinesterase poisoning.