Toxicological exposures reported to a telephonic consultation service at a tertiary care hospital in Lebanon

Abstract

Introduction: This study aims to describe the epidemiology of toxicological exposures reported to a telephonic medical toxicology service at a tertiary care center in Lebanon during a 46-months period.

Methods: This study is a secondary analysis of a database for a telephonic medical toxicology service at a tertiary care center in Lebanon. Clinical information from all pediatric and adult patients, presenting with intentional or unintentional toxicological exposure, was entered into the database by the medical toxicology team.

Results: Four hundred and seventy-seven exposures were recorded from 1 March 2015 to 31 December 2018. Female patients were involved in 60.2% of cases. Children less than 5 years old constituted 23.5% of cases and adults aged 20–49 constituted 48.6%. Up to 51.6% of cases were intentional, with 37.7% resulting from suicidal attempts. The majority of patients displayed no effects (33.1%) or minor effects (39.2%). Almost half of patients were treated and discharged from the Emergency Department (ED) without further hospitalization, and another 18.9% of patients left the ED against medical advice. The most common pharmaceutical agents involved were sedative/hypnotics/antipsychotics (14.7%), analgesics (12.6%) and antidepressants (11.3%). The most common non-pharmaceutical agents involved were household cleaning substances (8.0%), pesticides (5.2%) and bites and envenomations (3.8%).

Conclusions: The results of this study suggest that sedative/hypnotics/antipsychotics, analgesics, antidepressants and household cleaning substances are the most common agents involved. Adult women and children ≤5 years old constitute a large portion of patients with toxicological exposures. Prevention strategies and policies should be implemented to mitigate these hazards.

Keywords:

• Toxicological exposures
• toxicology
• consultation service
• Lebanon
• Middle East

Acknowledgements

The authors thank Baian Alabdulbaqi, MBBS, Khalid Alaufi, MBBS, Musa Alfaifi, MBBS, Nadia Alhajri, MBBS, Mohammed Almalki, MBBS, Khalid Almulhim, MBBS, Shaikhah Alotiabi, MBBS, Nahar Alrewaili, MBBS, Waleed Alsukaiti, MBBS, Rawan Eskandrani, MBBS, Melissa Gittinger, DO, Pakhawadee Palungwachira, MD, Adam Pomerleau, MD, Ismail Sabei, MBBS, Aynur Sahin, MD, and Mohammad Sheeha, MBBS for their roles as remote toxicologists in the medical toxicology consultation service.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to the inclusion of information that could compromise the privacy of research participants.