Acute toxic gas poisoning cases treated from 2004 through 2007 at a regional hospital emergency department: an epidemiologic study

Macías Robles MD, Fernández Carreira JM, García Suárez I, Fernández Diéguez O, Redondo Torres G

Objective: To determine changes in agents causing cases of chemical poisoning treated

in the emergency department of Hospital San Agustín de Avilés in the period 2004

through 2007.

Methods: Descriptive observational study. The target population consisted of patients

suffering from chemical poisoning who required emergency care at our hospital from

2004 through 2007. Data were extracted from the records of the clinical toxicology

section of the Spanish Toxicology Association (AETOX).

Results: Two hundred four patients were treated for chemical poisoning during the

study period. The agents involved were irritant gases (32.8%), caustic substances (25%),

toxic gases (21.6%), solvents (11.3%), pesticides (4.4%), detergents (2.9%), and metals

(2%). Toxic gas poisoning accounted for 68.2% of cases in the first 2 years (2004-2005)

and 31.8% of cases in the second 2 years (2006-2007) (P < .001). Carbon monoxide (CO) was involved in 93.2% of the toxic gas cases. CO poisoning was mild-moderate in 78%, with carboxyhemoglobin levels between 11% and 30%. Most patients suffered from neurologic symptoms (95.%); the episode was resolved in the emergency department in 77.3% of the cases, usually by applying high-flow oxygen. The local media reported on the large number of poisonings treated in 2004 and 2005, at the same time publicizing measures for preventing CO poisoning. Conclusions: The number of cases of toxic gas poisoning has decreased significantly, mainly due to a lower incidence of CO poisoning in the last 2 years. Efforts made to record cases and publicize information about how to maintain household heaters and heating systems have had a positive influence.

Fernández Carreira JM, Fernández Diéguez O, García Suárez I, Macías Robles MD, Redondo Torres G