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Original Research

Open Access

The epidemiology of poisoning and overdose in Saudi Arabia: exposures, risks, management and outcomes

  • Bader Alyahya1,*,
  • Musa Alfaifi2
  • Abdulaziz Alalshaikh1
  • Mohammed Arafat3
  • Abdulrahman Aldhabib3
  • Abdulaziz Al Hosaini3
  • Ali Alsultan3
  • Amash Al Harbi4
  • Reem Alwaibah5
  • Ghada Alajmi6
  • Muath Alhumud7
  • Mohammed Alswoaiegh7
  • Abdulrahman Altalasi7
  • Saad Alhaddab7
  • Ghaida Almutairi8
  • Maria Zadah9
  • Nawfal Aljerian3,10

1Department of Emergency Medicine, College of Medicine, King Saud University, 11472 Riyadh, Saudi Arabia

2Department of Emergency Medicine, Armed Forces Hospital, 62413 Khamis Mushait, Saudi Arabia

3Saudi Medical Appointments and Referral Center, Ministry of Health, 13717 Riyadh, Saudi Arabia

4Saudi Ministry of Health-Assistant Agency for Hospital Affairs-National Health Command Center, 14235 Riyadh, Saudi Arabia

5Prince Sultan Military Medical City, 12233 Riyadh, Saudi Arabia

6Department of Pharmacy Services, King Saud University Medical City, 11472 Riyadh, Saudi Arabia

7College of Medicine, King Saud University, 11472 Riyadh, Saudi Arabia

8College of Medicine, King Saud bin Abdulaziz University for Health Science, 11481 Riyadh, Saudi Arabia

9College of Medicine, Princess Nourah Bint Abdulrahman University, 11564 Riyadh, Saudi Arabia

10King Saud bin Abdulaziz University for Health Sciences, 11481 Riyadh, Saudi Arabia

DOI: 10.22514/sv.2024.035

Submitted: 11 October 2023 Accepted: 06 December 2023

Online publish date: 28 March 2024

*Corresponding Author(s): Bader Alyahya E-mail: balyahya@ksu.edu.sa

Abstract

Poisoning is a major public health concern. In Saudi Arabia, information related to poisoning is limited. Herein, we report a large number of poisoning cases from across The Kingdom of Saudi Arabia. We reviewed cases of poisoning received by the Poison Control Center (PCC) at the Saudi Medical Appointments and referral Center. This was a retrospective review of all documented calls to the PCC between September 2020 and September 2021. A total of 39,439 cases were reported to the PCC during the study period. The mean patient age was 7.1 ± 12.6 years, 52.8% were men, and 36.9% were women; 10.3% of the study population did not specify their gender. More than half of the cases (61.7%) were children ≤5 years-of-age. Public calls accounted for 76.1% of the cases, of which 76.4% were managed at home. Exposures to poisons were mostly acute (84.9%) and unintentional (69.1%). Medications were implicated in 34.7% of cases, the most common medications were analgesics (9.3%). Moderate or major effects were reported by 18.4% of the study population. The vast majority of toxicology consultations received by the PCC involved the accidental exposure of poisons to children less than five years-of-age. Therefore, there is an urgent need to develop educational campaigns targeting the safe use and storage of medications and chemicals in the household. Our findings also demonstrate that PCCs play a major role in reducing visits to the emergency department and will also reduce healthcare cost related to poisoning and overdose.


Keywords

Poisoning; Epidemiology; Exposure; Overdose; Saudi Arabia


Cite and Share

Bader Alyahya,Musa Alfaifi,Abdulaziz Alalshaikh,Mohammed Arafat,Abdulrahman Aldhabib,Abdulaziz Al Hosaini,Ali Alsultan,Amash Al Harbi,Reem Alwaibah,Ghada Alajmi,Muath Alhumud,Mohammed Alswoaiegh,Abdulrahman Altalasi,Saad Alhaddab,Ghaida Almutairi,Maria Zadah,Nawfal Aljerian. The epidemiology of poisoning and overdose in Saudi Arabia: exposures, risks, management and outcomes. Signa Vitae. 2024.doi:10.22514/sv.2024.035.

References

[1] National Safety Council. Top 10 preventable injuries of 2021, injury facts. 2021. Available at: https://injuryfacts.nsc.org/all-injuries/deaths-by-demographics/top-10-preventable-injuries/#:~:text=The%20top%20three%20leading%20causes,86%25%20of%20all%20pr eventable%20deaths (Accessed: 15 April 2023).

[2] Centers for Disease Control and Prevention. DOSE dashboard: nonfatal overdose syndromic surveillance data. 2023. Available at: https://www.cdc.gov/drugoverdose/nonfatal/dashboard/index.html (Accessed: 15 April 2023).

[3] World Health Organization (WHO). WHO guidelines for establishing a poison center. 2021. Available at: https://www.who.int/news/item/18-01-2021-who-guidelines-for-establishing-a-poison-centre#:~:text=Poisoning%20is%20a%20significant%20global,of%20emergency%20attendance%20at%20hospitals (Accessed: 15 April 2023).

[4] Mowry J, Spyker DA, Cantilena LR, Bailey JE, Ford M. Annual report of the American Association of poison control centers toxic exposure and surveillance system. Clinical Toxicology. 2012; 51: 949–1229.

[5] World Health Organization (WHO). Poison control and unintentional poisoning. 2023. Available at: https://www.who.int/data/gho/data/themes/topics/indicator-groups/poison-control-and-unintentional-poisoning (Accessed: 15 April 2023).

[6] Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, et al. 2020 annual report of the American Association of poison control centers’ national poison data system (NPDS): 38th annual report. Clinical Toxicology. 2021; 59: 1282–1501.

[7] Warner M, Chen LH, Makuc DM, Anderson RN, Minino AM. Drug poisoning deaths in the United States, 1980–2008. NCHS Data Brief. 2011; 81: 1–8.

[8] Chen LH, Hedegaard H, Warner M. Drug-poisoning deaths involving opioid analgesics: United States, 1999–2011. NCHS data brief, no 166. Hyattsville, MD: National Center for Health Statistics. 2014.

[9] Abd-Elhaleem ZA, Al Muqhem BA. Pattern of acute poisoning in Al Majmaah region, Saudi Arabia. American Journal of Clinical and Experimental Medicine. 2014; 2: 79–85.

[10] Almutairi SA, Alsaleem JH, Alrashed MA, Alsalim MJ, Al-Qadhi AA, Menezes RG. Pediatric poisoning deaths in Saudi Arabia: a systematic review. Legal Medicine. 2023; 60: 102173.

[11] Al-Barraq A, Farahat F. Pattern and determinants of poisoning in a teaching hospital in Riyadh, Saudi Arabia. Saudi Pharmaceutical Journal. 2011; 19: 57–63.

[12] Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, et al. 2019 Annual report of the American association of poison control centers’ national poison data system (NPDS): 37th annual report. Clinical Toxicology. 2020; 58: 1360–1541.

[13] Alghafees MA, Abdulmomen A, Eid M, Alhussin GI, Alosaimi MQ, Alduhaimi GS, et al. Poisoning-related emergency department visits: the experience of a Saudi high-volume toxicology center. Annals of Saudi Medicine. 2022; 42: 36–44.

[14] Al-Mousa FA, Gado AM, Attia AM, Tammam HG. Medical toxicology experience: Poisoning consultations cases registry in Saudi Ministry of Health—2020 annual report. Toxicology Reports. 2021; 8: 1558–1564.

[15] Alshahrani MM, Albogami HA, Asiri AA, Al Haydhah KS, Aldeailej IM, Aldehaim MA, et al. Epidemiological trends of acute chemical poisoning among children over a recent three-year period in Saudi Arabia. Children. 2023; 10: 295.

[16] Alzahrani SH, Alqahtani AH, Farahat FM, Elnour MA, Bashawri J. Drug poisoning and associated factors in Western Saudi Arabia: a five-year retrospective chart review (2011–2016). Pakistan Journal of Medical Sciences. 2017; 33: 1188–1193.

[17] Cairns R, Buckley NA. The Poisoning Severity Score: If It Did Not Exist, We Would Have To Invent It. Journal of medical toxicology. 2017; 13: 131–134.

[18] Ministry of Health, Saudi Arabia. Health Minister inaugurates Poison Control E-system. 2018. Available at: https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2018-12-09-002.aspx (Accessed: 15 April 2023).

[19] Ministry of Health. The 12th Middle East and North Africa Clinical Toxicology Association Congress (MENATox2022) concluded yesterday at Crowne Plaza Hotel. 2022. Available at: https://www.moh.gov.om/en/-/--1748 (Accessed: 15 April 2023).

[20] Arnold JK, Borger J, Nappe TM. Poison control in the United States. StatPearls Publishing: Treasure Island (FL). 2024.

[21] Benabdellah FZ, Soulaymani A, Mokhtari A, Soulaymani-Bencheikh R, Khadmaoui A, Hami H. Economic evaluation of the direct cost resulting from childhood poisoning in Morocco: micro-costing analysis. Archives of Public Health. 2020; 78: 59.

[22] Munema Khan MK, Raza S. Gender based differences in patients of poisoning managed at a Medical Unit. JPMA. 2019; 69: 1025–1028.

[23] Tarvadi PV, Bakkannavar SM, Palimar V, Kumar GP, Shetty M, Badiger S. Gender differences in childhood poisoning. Journal of Health and Allied Sciences NU. 2013; 3: 69–72.

[24] Tobaiqy M, Asiri BA, Sholan AH, Alzahrani YA, Alkatheeri AA, Mahha AM, et al. Frequency and management of acute poisoning among children attending an emergency department in Saudi Arabia. Pharmacy. 2020; 8: 189.

[25] Sharma R, Saikia D, Janardhan K. Clinical profile of poisoning due to various poisons in children of age 0–12 years. Journal of Family Medicine and Primary Care. 2020; 9: 2291–2296.

[26] Gaw CE, Curry AE, Osterhoudt KC, Wood JN, Corwin DJ. Characteristics of fatal poisonings among infants and young children in the United States. Pediatrics. 2023; 151: e2022059016.

[27] Soave PM, Curatola A, Ferretti S, Raitano V, Conti G, Gatto A, et al. Acute poisoning in children admitted to pediatric emergency department: a five-years retrospective analysis. Acta Bio Medica: Atenei Parmensis. 2022; 93: e2022004.

[28] Alwan IA, Brhaish AS, Awadh AI, Misnan A, Rahim NA, Tangiisuran B, et al. Poisoning among children in Malaysia: a 10-years retrospective study. PLOS ONE. 2022; 17: e0266767.

[29] Grabska K, Pilarska I. Acute poisoning among children and adolescents: a narrative review. Medical Science Pulse. 2022; 16: 33–39.

[30] Thapa S, Dawadi BR, Upreti AR. Acute poisoning among patients presenting to the emergency department of a tertiary care center: a descriptive cross-sectional study. Journal of Nepal Medical Association. 2020; 58: 470–473.

[31] Khan LA, Khan SA, AI-Hateeti HS, Bhat AR, Bhat KS, Sheikh FS. Clinical profile and outcome of poisoning in Najran. Annals of Saudi Medicine. 2003; 23: 205–207.

[32] Zhang Y, Yu B, Wang N, Li T. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ Open. 2018; 8: e021881.

[33] Dayasiri MBKC, Jayamanne SF, Jayasinghe CY. Patterns and outcome of acute poisoning among children in rural Sri Lanka. BMC Pediatr. 2018; 18: 274.

[34] Firozian F, Karami S, Ranjbar A, Azandaryani MT, Nili-Ahmadabadi A. Improvement of therapeutic potential N-acetylcysteine in acetaminophen hepatotoxicity by encapsulation in PEGylated nano-niosomes. Life Sciences. 2020; 255: 117832.

[35] Zaloshnja E, Miller T, Jones P, Litovitz T, Coben J, Steiner C, et al. The potential impact of poison control centers on rural hospitalization rates for poisoning. Pediatrics. 2006; 118: 2094–2100.

[36] Bunn TL, Slavova S, Spiller HA, Colvin J, Bathke A, Nicholson VJ. The effect of poison control center consultation on accidental poisoning inpatient hospitalizations with preexisting medical conditions. Journal of Toxicology and Environmental Health, Part A. 2008; 71: 283–288.


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