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Danger: Poison!
Ossy M. J. Kasilo & Charles F. B. Nhachi
H
ow much harm is done to an individual through contact with a chemical depends on the route of exposure, that is, how the chemical gets into the body: the quantity of the chemical; the duration of exposure to the chemical; the age of the person, and his or her health status at the time.Children are at particular risk of poisoning as a result of swallowing chemicals that are commonly used around the home, and inhaling carbon monoxide in smoke. For example, a retrospective study of hospital admis- sions in Zimbabwe found that 90 (4%) of the 2236 children below 15 years of age admitted during 1980-89 were victims of carbon monoxide poison- ing. They were mostly very young children who had been ill; as a form of curing the illness and "sending bad spirits away" they were exposed to smoke, using traditional herbs which were added to the fire or hot stone according to a local cultural belief.
Unfortunately, some of these
"smoked" children were poisoned by a combination of smoke and toxic fumes from the herbs and fuel; they also suffered from carbon monoxide poisoning and hypoxia (lack of oxy- gen). Most of the children recovered, though some required treatment with pure oxygen.
Petroleum distillates such as kerosene or paraffm, if taken by mouth, may cause oedema (fluid) in the lung. A high prevalence of acci- dental paraffm poisoning of children has been reported among poor com- munities in countries as far apart as India, Turkey, Uganda and Zimba- bwe. A study in Zimbabwe focusing on poisoning admissions in six major hospitals found that household chemi- cals represented the second biggest
after traditional medicines (1378 cases). Some 12% were suicides or attempted suicides and 285 of the 1192 cases died. Paraffin alone ac- counted for about 20% of cases of poisoning in children involving house- hold chemicals; most of the victims were under five years of age. In coun- try areas without electricity, paraffin is the main source of fuel, and it is a commonly used cooking fuel in city slums. Obviously, shopkeepers should be discouraged from selling paraffin for domestic use in a variety of old bottles which had contained inoffen- sive products.
Do not drink
Pesticides, too, are often stored (or even sold) in inappropriate containers and may easily be mistaken for soft
World Health • 46th Year, No. 5, September-october 1993
Paraffin poisoning proved to be the second biggest cause of hospital admissions in Zimbabwe for poisoning due to household chemicals.
Carbon monoxide and
pesticides also regularly cause deaths and sickness - as do such natural hazards as snake-bites and scorpion stings.
drinks. Correct labelling in Zimbabwe calls for pesticides to be marked with a purple triangle (indicating a very dangerous poison), a red triangle (a dangerous poison), an amber triangle (a poison), or a green triangle (harm- ful if swallowed). For each category
cause (1192 cases) of admissions, African formers spraying insecticides. they should be wearing protective masks.
World Heolth • 46th Year, No. 5, September-{)ctober 1993
there are recommended safety precau- tions to be followed. Users should learn the recommended safety precau- tions for each coloured triangle.
A study of health hazards resulting from the use of pesticides based on organophosphates among farm work- ers in Zimbabwe showed that most poisoning incidents occur during the spraying season, December to March.
Another study, involving 942 people, found that 75% of urban poisoning cases were suicides and attempted suicides. The single most vulnerable group comprised those aged between 21 and 30 years. A sizeable amount of the health budget could be saved if stricter legislation were introduced in order to prevent access to pesticides by unauthorized persons.
In many countries, snake-bites are among the common causes of poison- ing. Anyone attending to a snake-bite victim should try to identify the snake or kill it and bring the specimen to the hospital for identification. The wound should be cleaned quickly, but gently, with soap and water so that there is no venom left on the skin. The victim should lie on one side to lessen the risk of vomit being inhaled, and should be moved as little as possible especially around the area of the bite.
All tight clothing should be removed or loosened before the swelling be- comes too severe to do so, and the
The ozone layer
Collecting snake venom in order to prepare life-saving serum.
wounded limb should be bandaged.
Ideally the victim should be trans- ported to a medical facility as soon as possible for specific treatment.
In the case of a scorpion sting or spider bite, the wound should be cleansed using an antiseptic solution and covered with a dry dressing. The patient should be reassured and a doctor should be consulted if the signs and symptoms persist. •
Or Ossy M. I Kasilo is Senior Lecturer in Clinical Pharmacy and Director, National Drug and Toxicology Information SeNice,
Department of Pharmacy, University of Zimbabwe Medical School. Or Charles F. B.
Nhachi is Associate Professor, Clinical Pharmacology and Toxicology, University of Zimbabwe Medical School, Box A 178, Avondale, Harare, Zimbabwe.
Emergency action for poisoning
Inhaled poison. Immediately get the person to fresh air, or open doors and windows wide. Avoid breathing fumes. If the victim is not breathing, start artificial respiration.
Poison on the skin. Remove con-
taminated clothing and flood the skin with water tor 10 minutes.
Then wash gently with soap and water and rinse. In case
of
a burn- ing sensation, consult your doctor.Poison in the eye. Flood the eye with generous amounts of water tor 15 minutes. Have the patient blink as much as possible while flooding the eye. Do not force the eyelia open. In case of irritation, consult an eye specialist.
Swallowed poison
• Medicines: Do not give any- thing by mouth until medical advice has been sought.
• Chemical household products:
If the patient is conscious and not having convulsions (fits). and can swallow - give milk or water immediately, then call for r.rofes- sional advice concerning further treatment.
ALWAYS KEEP WITH YOU: a
small bottle of syrup of ipecacu- anha. Use only when advised by the poison centre or hospital emergency department, or a physician or pharmacist.
The ozone layer is a protective envelope
of
ozone existing naturally in the stratosphere which absorbs most of the sun's ultraviolet radiation. Scientists have been concerned in recent years because an ever-increasing "hole" in this layer is occurring over the Antarctic and the layer is also thinning elsewhere, faster than predicted. Depletion covers North America, a large part of South America and Asia, nearly the whole of Europe, Australia and New Zealand.One plausible cause of this phenomenon is the release through human activities of gases containing chlorine and bromine which destroy ozone. Aerosols and the gases contained in old jettisoned refrigerators, mainly chlorofluorocarbons (CFCs). have been specifically blamed.
harmful effects on humans and aquatic organisms. Spring and summer are,
of
course, when people sunbathe and expose themselves to UV-B. Current estimates predict a 5%to 1 0% ozone depletion for mid-latitudes in summer by the year 2000 compared to the mid-1970s. Environmental impact assessment reports show that if there were a sustained 10% loss of ozone, one could expect a 26%
increase in the incidence of non-melanoma skin cancer owing to increased exposure to UV-B.
In spite of current international regulations, atmospheric levels of chlorine and bromine are expected to increase for another decade or so, causing an ozone decrease in the 1990s like that or stronger than that
of
the 1980s. The increased ultraviolet-B radiation (UV-B) can have possibleAll industrialized countries have taken steps to conform with the phase-out of CFCs by 1995, in accordance with the requirements
of
the amended Montreal Protocol. Ingeneral, developing countries too are taking action to substantially reduce their consumption of ozone-depleting chemicals.
Contributed by Eirah Gorre-Dale, Office of Information and Public Affairs, World Meteorological Organization, Case Postale 2300, 1211 Geneva 2, Switzerland
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