Poisoning

Poisoning is the harmful effect which occurs when toxic substances are introduced into the body.[1] The term "poisoning" is a derivative of poison, a term describing any chemical substance that may harm or kill a living organism upon ingestion.[2] Poisoning can be brought on by swallowing, inhaling, injecting or absorbing toxins through the skin. Toxicology is the practice and study of symptoms, mechanisms, diagnoses, and treatments correlated to poisoning.[3]

## Contents

* 1 Levels of exposure
* 1.1 Acute exposure
* 1.2 Chronic exposure
* 2 Methods
* 2.1 Accidental poisonings
* 2.2 Industry and warfare
* 2.3 Pesticide exposure
* 2.4 Toxication
* 3 Precautionary measures
* 4 Treatment
* 5 See also
* 6 References
* 7 External links

## Levels of exposure

When a living organism is introduced to a poison, the symptoms that follow successful contact develop in close relation to the degree of exposure.[4]

### Acute exposure

Acute toxicity/poisoning consists of a living organism being harmfully exposed to poison once or more times during a brief period, with symptoms manifesting within 14 days since administration.[5]

### Chronic exposure

Chronic toxicity/poisoning involves a living organism being exposed to a toxin on multiple instances over an extended period of time, whereas the symptoms either develop gradually or after a protracted latent period.[6] Chronic poisoning most commonly occurs following exposure to poisons that bioaccumulate, or are biomagnified, such as mercury, gadolinium, and lead.[7]

## Methods

### Accidental poisonings

Template:Owidslider In 2020, America's Poison Centers' NPDS (National Poison Data System) report determined that 76.9% of recorded toxin exposures were accidental, with the rest of the statistics either being deliberate or unexpected.[8] A large portion of these accidental incidents occurred due to mistakenly taking the incorrect medicine, or doubling one's dose by mistake.[8]

### Industry and warfare

Arsenic trioxide is a white, crystalline powder that closely resembles sugar. The 1858 Bradford sweets poisoning incident happened because it was mistaken for a sugar substitute ("daff").

Nerve gases are synthetic substances used in industry or warfare that are specifically engineered to bring harm to living organisms.[9] They may paralyze a person in a matter of seconds or cease organ function, quickly resulting in death. They're considered to be biologically derived neurotoxins, which are a genre of toxic agents that act specifically against the nervous system. Inhaled or ingested cyanide (or Zyklon B) was used as a method of execution in gas chambers.[10] This method of poisoning instantly starved the body of energy by inhibiting the enzymes in mitochondria that produce ATP.[11] Intravenous injection of an unnaturally high concentration of potassium chloride, such as in the execution of prisoners in parts of the United States, quickly stops the heart by eliminating the cell potential necessary for muscle contraction.[12]

### Pesticide exposure

Most biocides, including pesticides, are created to act as poisons to target organisms. Although acute or less observable chronic poisoning can also occur in non-target organisms (secondary poisoning), including the humans who apply the biocides and other beneficial organisms.[13] For example, the herbicide 2,4-D imitates the action of a plant hormone, which makes its lethal toxicity specific to plants. Indeed, 2,4-D is not a poison, but is classified as harmful.[14]

### Toxication

Many substances regarded as poisons are toxic only indirectly through toxication. An example is "wood alcohol" or methanol, which is not poisonous itself but is chemically converted to toxic formaldehyde and formic acid once it reaches the liver.[15] Many drug molecules are made toxic in the liver, and the genetic variability of certain liver enzymes makes the toxicity of many compounds differ between people.

## Precautionary measures

Poisoning prevention poster from New Zealand

As mandated in GHS, various safety-orientated government agencies from around the globe have put into place the usage of pictograms when labelling toxic substances.[16][17] The hazard symbol which labels a substance as capable of poisoning depicts the imagery of a human skull in front of two bones crossing one another.[18]

GHS precautionary statements, which advise users to exercise caution or be aware of the substance's potentially dangerous features, are added to a legal toxins' labelling.[19] Toxic substances can also come with instructions on how to handle the product, what compounds to avoid mixing the product with, and how to treat a victim at risk of poisoning who has come in contact with the product.[20]

Various poison control centers are also available to assist in diagnosing, managing, and preventing possible incidents of poisoning.[21] Many are accessible through phone calls or official websites.

## Treatment

Seeking medical attention is strongly advised if someone is thought to have been exposed to or consumed a poison, mainly from a nearby poison control centre.[22][23] It is advised to provide medical personnel with information regarding the poisoning, the patient's age, weight, and any other drugs they may be taking in addition to the symptoms of the illness. Try to determine what was ingested, the amount and how long since the person was exposed to it. If possible, have on hand the pill bottle, medication package or other suspect container.[24]

The treatment will depend on the substance to which the patient is exposed. Depending on the type of poisoning, some first aid measures may help. Treatments include activated charcoal, induction of vomiting and dilution or neutralizing of the poison.[25]

## See also

* EPA list of extremely hazardous substances
* Lists of poisonings
* List of poisonous plants
* List of types of poison
* Opioid epidemic in the United States
* Suicide by poisoning

## References

1. ↑ "Poisoning". https://medlineplus.gov/poisoning.html.
2. ↑ Cammack, Richard, ed (2006-01-01) (in en). Oxford Dictionary of Biochemistry and Molecular Biology (2 ed.). Oxford University Press. doi:10.1093/acref/9780198529170.001.0001. ISBN 978-0-19-852917-0. http://www.oxfordreference.com/view/10.1093/acref/9780198529170.001.0001/acref-9780198529170.
3. ↑ "Toxicology" (in en). https://www.niehs.nih.gov/health/topics/science/toxicology.
4. ↑ Calabrese, E.J. (2014), Dose–Response Relationship, Elsevier, pp. 224–226, doi:10.1016/b978-0-12-386454-3.00991-x, ISBN 978-0-12-386455-0
5. ↑ Gold, Victor, ed (2019) (in en). The IUPAC Compendium of Chemical Terminology: The Gold Book (4 ed.). Research Triangle Park, NC: International Union of Pure and Applied Chemistry (IUPAC). doi:10.1351/goldbook.at06800. https://goldbook.iupac.org/.
6. ↑ Elhag, Ibtihag Yahya (2023), "Role of AI in ADME/Tox toward formulation optimization and delivery", A Handbook of Artificial Intelligence in Drug Delivery (Elsevier): pp. 301–345, doi:10.1016/b978-0-323-89925-3.00011-3, ISBN 978-0-323-89925-3
7. ↑ Chojnacka, K.; Mikulewicz, M. (2014), Bioaccumulation, Elsevier, pp. 456–460, doi:10.1016/b978-0-12-386454-3.01039-3, ISBN 978-0-12-386455-0
8. ↑ 8.0 8.1 Gummin, David D.; Mowry, James B.; Beuhler, Michael C.; Spyker, Daniel A.; Bronstein, Alvin C.; Rivers, Laura J.; Pham, Nathaniel P. T.; Weber, Julie (2021-12-02). "2020 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th Annual Report" (in en). Clinical Toxicology 59 (12): 1282–1501. doi:10.1080/15563650.2021.1989785. ISSN 1556-3650. PMID 34890263. https://www.tandfonline.com/doi/full/10.1080/15563650.2021.1989785.
9. ↑ Patton, James. "Gas in The Great War" (in en-us). History and Philosophy of Medicine. https://www.kumc.edu/school-of-medicine/academics/departments/history-and-philosophy-of-medicine/archives/wwi/essays/medicine/gas-in-the-great-war.html.
10. ↑ Stewart, Ken. "Zyklon-B | Description, Manufacturer, & Facts | Britannica" (in en). https://www.britannica.com/science/Zyklon-B.
11. ↑ Jethava, Durga; Gupta, Priyamvada; Kothari, Sandeep; Rijhwani, Puneet; Kumar, Ankit (2014). "Acute cyanide Intoxication: A rare case of survival" (in en). Indian Journal of Anaesthesia 58 (3): 312–314. doi:10.4103/0019-5049.135045. ISSN 0019-5049. PMID 25024476.
12. ↑ Simon, Gábor (2023-04-04). "Detection of Fatal Potassium Overdose: A Case Report and Review of the Literature" (in en). Diagnostics 13 (7): 1339. doi:10.3390/diagnostics13071339. ISSN 2075-4418. PMID 37046560.
13. ↑ Kapeleka, Jones A.; Sauli, Elingarami; Ndakidemi, Patrick A. (2021-10-03). "Pesticide exposure and genotoxic effects as measured by DNA damage and human monitoring biomarkers" (in en). International Journal of Environmental Health Research 31 (7): 805–822. doi:10.1080/09603123.2019.1690132. ISSN 0960-3123. PMID 31736325. Bibcode: 2021IJEHR..31..805K. https://www.tandfonline.com/doi/full/10.1080/09603123.2019.1690132.
14. ↑ Carvalho, Laíse M.; Soares-Filho, Antônio F.; Lima, Maciel S.; Cruz-Filho, João F.; Dantas, Taisa C. M.; Luz, Geraldo E. (February 2021). "2,4-Dichlorophenoxyacetic acid (2,4-D) photodegradation on WO3-TiO2-SBA-15 nanostructured composite" (in en). Environmental Science and Pollution Research 28 (7): 7774–7785. doi:10.1007/s11356-020-11085-4. ISSN 0944-1344. PMID 33037546. Bibcode: 2021ESPR...28.7774C. https://link.springer.com/10.1007/s11356-020-11085-4.
15. ↑ Jones, A W (2021). "Clinical and forensic toxicology of methanol". Forensic Sci Rev (Central Police University) 33 (2): 117–143. PMID 34247144.
16. ↑ Boelhouwer, Eric; Davis, Jerry; Franco-Watkins, Ana; Dorris, Nathan; Lungu, Claudiu (September 2013). "Comprehension of hazard communication: Effects of pictograms on safety data sheets and labels". Journal of Safety Research 46: 145–155. doi:10.1016/j.jsr.2013.06.001. ISSN 0022-4375. PMID 23932696.
17. ↑ "Globally Harmonized System of Classification and Labelling of Chemicals". 2023-03-21. https://www.canada.ca/en/health-canada/services/environmental-workplace-health/occupational-health-safety/workplace-hazardous-materials-information-system/globally-harmonized-classification-labelling-chemicals.html.
18. ↑ "Know Your Hazard Symbols (Pictograms)" (in en). https://ehs.princeton.edu/news/know-your-hazard-symbols-pictograms.
19. ↑ Vereinte Nationen, ed (2007). Globally harmonized system of classification and labelling of chemicals: GHS (2nd revised ed.). New York: United Nations. ISBN 978-92-1-116957-7.
20. ↑ Vereinte Nationen, ed (2011). Globally harmonized system of classification and labelling of chemicals: GHS. United Nations (4th revised ed.). New York: United Nations. ISBN 978-92-1-117042-9.
21. ↑ "Poison control center - PAHO/WHO | Pan American Health Organization" (in en). 2021-01-14. https://www.paho.org/en/topics/poison-control-center.
22. ↑ "Poisoning Prevention | Child Safety and Injury Prevention| CDC Injury Center" (in en-us). 2020-07-02. https://www.cdc.gov/safechild/poisoning/index.html.
23. ↑ Yadav, Sharad; Shah, Gautam Kumar; Verma, Dharmesh; Yadav, Prakash Chand (2022-07-22). Study of profile, pattern and outcomes of oral poisoning cases admitted in emergency department of Janakpur provincial hospital, Nepal. doi:10.5281/zenodo.6879818. https://zenodo.org/record/6879818.
24. ↑ "Poisoning: First aid - Mayo Clinic". https://www.mayoclinic.org/first-aid/first-aid-poisoning/basics/ART-20056657?p=1.
25. ↑ Avau, Bert; Borra, Vere; Vanhove, Anne-Catherine; Vandekerckhove, Philippe; De Paepe, Peter; De Buck, Emmy (December 2018). "First aid interventions by laypeople for acute oral poisoning". The Cochrane Database of Systematic Reviews 12 (12). doi:10.1002/14651858.CD013230. ISSN 1469-493X. PMID 30565220.

## External links

Classification|

* ICD-10: Xxx.x
* ICD-9-CM: xxx

|

* v
* t
* e

* Poisoning
* Toxicity
* Overdose (T36–T65, 960–989)

History of poison

Inorganic|

| Metals|

| Toxic metals|

* Beryllium
* Cadmium
* Lead
* Mercury
* Nickel
* Silver
* Thallium
* Tin

|

Dietary minerals|

* Chromium
* Cobalt
* Copper
* Iron
* Manganese
* Zinc

Metalloids|

* Arsenic

Nonmetals|

* Sulfuric acid
* Selenium
* Chlorine
* Fluoride

Organic|

| Phosphorus|

* Pesticides
* Aluminium phosphide
* Organophosphates

|

Nitrogen|

* Cyanide
* Nicotine
* Nitrogen dioxide poisoning

CHO|

* alcohol
* Ethanol
* Ethylene glycol
* Methanol
* Carbon monoxide
* Oxygen
* Toluene

Pharmaceutical|

| Drug overdoses|

| Nervous|

* Anticholinesterase
* Aspirin
* Barbiturates
* Benzodiazepines
* Cocaine
* Lithium
* Opioids
* Paracetamol
* Tricyclic antidepressants

|

Cardiovascular|

* Digoxin
* Dipyridamole

Vitamin poisoning|

* Vitamin A
* Vitamin D
* Vitamin E
* Megavitamin-B6 syndrome

Biological1|

| Fish / seafood|

* Ciguatera
* Haff disease
* Ichthyoallyeinotoxism
* Scombroid
* Shellfish poisoning
* Amnesic
* Diarrhetic
* Neurotoxic
* Paralytic

|

Other vertebrates|

* amphibian venom
* Batrachotoxin
* Bombesin
* Bufotenin
* Physalaemin
* birds / quail
* Coturnism
* snake venom
* Alpha-Bungarotoxin
* Ancrod
* Batroxobin

Arthropods|

* Arthropod bites and stings
* bee sting / bee venom
* Apamin
* Melittin
* scorpion venom
* Charybdotoxin
* spider venom
* Latrotoxin / Latrodectism
* Loxoscelism
* tick paralysis

Plants / fungi|

* Cinchonism
* Ergotism
* Lathyrism
* Locoism
* Mushrooms
* Strychnine

1 including venoms, toxins, foodborne illnesses.

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