Poisonings

What is poisoning/intoxication? 

Intoxication is the disruption of normal body functions due to a toxic substance that enters the body by any means or a non-toxic but ingested substance in excessive amounts. Sometimes it can be fatal.

Intoxication can be seen in different intensities depending on the type of substance taken, the way it is taken, the amount, the age of the person, and the general characteristics.

More than half (60%) of poisoning cases occur in children under the age of five. In addition, almost all of the cases (90%) develop in the home environment.

According to WHO data, 1-2 people in every 100 thousand people worldwide are poisoned for various reasons. While this rate is highest in Africa region, it is lowest in South Asia and America region.

What are the ways of poisoning? 

Toxic substances can be taken into the human body in various ways. The route of entry of the toxic substance into the body is also effective on the severity of the poisoning. Poisoning may occur as a result of accident, or it may occur for suicidal purposes.

Common entry routes are:

1. Ingestion: These are poisonings that occur as a result of ingestion of chemicals, fungi, spoiled foods, drugs, alcohol or addictive substances by mouth and ingestion in the gastrointestinal tract. It is the most common way of poisoning.
2. Inhalation: These are poisonings caused by toxic chemical gases such as carbon monoxide and chlorine entering the body by inhalation through stoves, water heaters, pipes, sewer pits, pools, and house cleaning. The toxic chemical inhaled reaches the lungs and shows its toxic effects.
3. Through the skin: It is the poisoning that occurs as a result of toxic chemicals such as insect, snake, scorpion bites or stings, drug injections, hair dyes, pesticides entering the body through the skin or veins. Symptoms occur most rapidly in poisoning in the form of intravenous injection.

What are the types of poison? 

Some common poisoning agents are:

• Medicines,
• Cleaning materials (bleach etc.),
• Cosmetic products (nail polish etc.),
• Some types of fungi and plants,
• Fly and insecticides,
• Household chemicals,
• Carbon monoxide,
• Spoiled foods,
• Alcohol,
• Drugs,
• Bee, insect, snake, scorpion stings and bites.

What are the factors affecting poisoning? 

Although it depends on the characteristics of the poisoned person, it is the characteristics of the toxin that mainly affects the poisoning. These:

Duration and frequency of contact with the toxin 

Poisoning due to exposure to the toxin once or more than once in 24 hours is called “acute poisoning”. Intoxications due to exposure to chemicals such as pesticides more than once in a month or less are considered “subacute poisonings”.

Intoxications that occur when exposed to a toxic substance more than once for 3 months or longer are “chronic poisonings”. These chemicals show their effects depending on their ability to accumulate in the body. They are especially seen in occupational exposures.

dose of toxin 

The dose of the toxin taken into the body also affects the poisoning. For this, the LD50 and LC50 values of the toxin are checked.

LD50 

It is the dose in mg/kg that, once given, kills 50% of the experimental animals. It is used for toxins that enter the body by means other than the respiratory tract.

LC50 

It expresses the concentration in ppm or mg/mm3 of toxins that enter the body through the respiratory system, which, once administered, kills 50% of the experimental animals.

Metabolic properties of the toxin 

The absorption of the toxin that enters the body, its distribution in the body, its destruction and excretion from the body also affect the level of poisoning.

Absorption 

Features such as the level of blood supply at the entry site of the toxin, the size of the toxin, its ability to bind to the adipose tissue, the residence time in the stomach after oral intake, and the place of absorption from the intestines affect the rate of passage through the membranes and thus the poisoning process.

Distribution 

Depending on the type, the absorbed toxin tends to be more distributed to some tissues through plasma proteins in the body. For example, for distribution, carbon monoxide hemoglobin; arsenic hair, hair and nails; pesticides fat tissue; Cadmium prefers kidney and liver more. Some toxins, such as methyl, mercury, and lead, pass through the blood-brain barrier and disperse in the brain. Some vitamins, rubella virus, etc. can cross the placenta and reach the baby (fetus) in the womb.

Breakdown (metabolism) 

Toxins are mostly broken down in the body and new products are formed. These new products can sometimes be more harmful than the original toxin. For example, formaldehyde is formed when methyl alcohol breaks down. Formaldehyde causes retinal damage.

Leap 

Toxins are eliminated from the body in different ways. They are mostly excreted via the kidneys. Some are through bile, respiratory tract (anesthetic gases, ethylene, benzene etc.), saliva (iodine, bromine, lithium etc.), sweat (arsenic, iodine etc.), breast milk (alcohol, ether, diazepam, barbiturate etc.), hair/ can be excreted through nails (arsenic, mercury, etc.).

What is the mechanism of action of toxins? 

Toxins can show their effects by killing the cell, causing organ damage, and disrupting the biochemical or physiological balance of the body. While these effects are sometimes reversible, sometimes they are irreversible.

Toxins act by binding to receptors (muscarine, etc.), disrupting cell membrane integrity (general anesthetics, mercury, cadmium, etc.), reducing cellular energy production (carbon monoxide, cyanide, etc.), binding to biomolecules (mercury, arsenic, lead, copper, etc.), disrupting blood circulation. can show.

What are the general symptoms of poisoning? 

• Circulatory system symptoms: Headache, sweating, arrhythmia, absence of pulse, bradycardia etc.
• Respiratory system symptoms : Respiratory problems, arrest, dizziness, tinnitus, etc.
• Nervous system symptoms: muscle aches, drowsiness, confusion, coma, etc.
• Digestive system symptoms: Nausea, vomiting, abdominal pain, gas, diarrhea etc.

What to do in case of poisoning? 

Poisoning is suspected in a person who has redness around the mouth, a mouth that smells of gasoline or thinner, nausea, vomiting, breathing problems, and mental confusion. In this case, get information from the Poison Information Line of your region and act in accordance with their directions. If you do not know or cannot reach the Poison Information Line, call the emergency services and ask for an ambulance.

If you suspect poisoning, collect empty pill bottles or packs, pills scattered around, and clues on the person or nearby objects. Consider the possibility of swallowing drugs, buttons, batteries, especially in children.

Do not try to make the patient vomit, if there is contact with toxic substances, wash with soapy water, if there is contact with the mouth, have the mouth rinsed. Seek medical assistance. Assess the patient’s vital signs until medical assistance arrives, administer first aid if needed and if you have received first aid training. First, ensure that the airways are open.

If the patient has inhaled toxin, immediately remove it to the open air and provide fresh air. Seek medical assistance. Assess the patient’s vital signs until medical assistance arrives, administer first aid if needed and if you have received first aid training. First, ensure that the airways are open.

If the patient has come into contact with the toxin through the skin, first prevent contact with the toxin. Take off your clothes. Wash hands or contacted skin areas with soapy water. Wash skin with plenty of water for 15-20 minutes. Seek medical assistance. Assess the patient’s vital signs until medical assistance arrives, administer first aid if needed and if you have received first aid training. First, ensure that the airways are open.

Poison Counseling Centers 

Poison Counseling Centers are public institutions that provide consultancy services to the public and health professionals regarding diagnosis and intervention methods in case of poisoning.

WHO states that just over half of the countries around the world have Poison Counseling Centers.

These centers also keep statistics on poisoning cases in their countries and make their analysis. In this way, the most common types of poisoning are determined. To this end, they support the training of the public and health professionals, the determination of country policies, and the supply of first aid materials and medicines. They can also organize the distribution of drugs that should be used in cases of poisoning, such as antidotes.

Poison Counseling Centers, which are mostly available 24 hours a day, share their contact information with health professionals and the public. They are easily accessible and often coordinate with the country’s emergency services.

Knowing the Poison Control Center number serving in your area can be life-saving for yourself, your child or a loved one.