Pediatric Toxicology: An Updated Review.

Pediatricians should be familiar with principles of medical toxicology given that intentional and unintentional ingestions are commonly encountered in different medical settings. Most exploratory ingestions are well tolerated and do not cause significant health effects, but a few noteworthy exceptions can lead to serious illness and death. This article reviews common medications and household products likely to cause significant toxicity in pediatric patients, even in small, exploratory ingestions. Increasing cannabis exposures among children and adolescents are also reviewed. Additionally, indications for gastric decontamination with activated charcoal are reviewed. Finally, poisoning prevention strategies are reviewed. [Pediatr Ann. 2023;52(4):e139-e145.].

Survey of Home-Use UV Disinfection Products†.

The COVID-19 pandemic provided a commercial opportunity for traders marketing a range of ultraviolet (UV) radiation products for home-use disinfection. Due to concerns about the efficacy of such products and the potential for harmful levels of UV exposure to people, a range of products were purchased from on-line trading platforms. Spectral irradiance measurements were carried out to determine whether the products could be effective against the SARS-CoV-2 virus and whether they were likely to exceed internationally agreed exposure limits. It was concluded that many of the devices were not effective and many of those that were potentially effective presented a risk to users.

How COVID-19 Lockdown in Italy Has Affected Type of Calls and Management of Toxic Exposures: a Retrospective Analysis of a Poison Control Center Database From March 2020 to May 2020.

INTRODUCTION: Between early March 2020 and the end of May 2020, Italy issued strict measures to limit further spread of coronavirus disease 2019 (COVID-19) and became the first European country that imposed a lockdown on the population. The aim of this study was to assess the impact of these restricted conditions on the activity of the Poison Control Center (PCC) of Policlinico Umberto I Hospital-Sapienza University of Rome. METHODS: This was a retrospective analysis of calls received by the PCC during the lockdown period March 9, 2020 through May 31, 2020 compared to the same time period in year 2019 (reference). RESULTS: We observed a reduction in calls from hospitals and emergency departments and an increase in calls from private citizens about exposures to products or intoxications during the lockdown. There were increases in unintentional exposures and exposures to hand and surface sanitizers among household and cleaning products. There was a decrease in calls concerning medications, which were mostly from hospitals and emergency departments. We observed increases in exposures requiring clinical observations among adults and referral to the emergency department among pre-school children. CONCLUSIONS: Public health protection measures against COVID-19 to improve hygiene and maintain clean environments can increase exposures to hazardous products in the domestic environment. We observed an increase in unintentional exposures to household and cleaning products during the lockdown and an increase in ED referrals for pre-school children compared to the previous year. Our data suggest the need for improvements in public campaigns that promote safer handling of household products and prevent unnecessary exposures during a lockdown. The public health promotion activity can benefit the community after the pandemic and prepare the community for lockdowns in the future.

Increases in exposure calls related to selected cleaners and disinfectants at the onset of the COVID-19 pandemic: data from Canadian poison centres. / Augmentation du nombre d'appels relatifs à une exposition à certains nettoyants et désinfectants au début de la pandémie de COVID-19 : données des centres antipoison canadiens.

Little is known about the use or misuse of cleaning products during the COVID-19 pandemic. We compiled data from January to June in 2019 and 2020 from Canadian poison centres, and report on calls regarding selected cleaning products and present year-overyear percentage change. There were 3408 (42%) calls related to bleaches; 2015 (25%) to hand sanitizers; 1667 (21%) to disinfectants; 949 (12%) to chlorine gas; and 148 (2%) to chloramine gas. An increase in calls occurred in conjunction with the onset of COVID-19, with the largest increase occurring in March. Timely access to Canadian poison centre data facilitated early communication of safety messaging for dissemination to the public.

The Canadian Surveillance System for Poison Information (CSSPI) led by Health Canada is a developing network of poison centres, health authorities and regulatory agencies that facilitates early detection of poisoning incidents and alerting at the national level to inform harm reduction interventions. In response to the COVID-19 pandemic, concerns were raised over the potential for misuse of cleaning products and disinfectants; the CSSPI network monitored and assessed these concerns. An overall increase in calls about select cleaning products and disinfectants occurred concurrently with the pandemic, with percentage increases for selected products as high as 400% compared to the same period in the previous year.

Le Système canadien de surveillance des données sur les intoxications (SCSDI), dirigé par Santé Canada, est un réseau en développement composé de centres antipoison, d'autorités sanitaires et d'organismes de réglementation, qui facilite la détection précoce des incidents d'empoisonnement et une alerte rapide au niveau national afin d'éclairer les interventions en matière de réduction des risques. En réponse à la pandémie de COVID-19, des préoccupations ayant émergé quant au risque de mauvaise utilisation de produits de nettoyage et de désinfectants, le SCSDI a surveillé et évalué ces préoccupations. Une augmentation globale du nombre d'appels concernant plusieurs produits de nettoyage et désinfectants a eu lieu en concomitance avec la pandémie, certaines augmentations pouvant atteindre jusqu'à 400 % pour certains produits par rapport à la même période de l'année précédente.

Firearm purchasing and storage during the COVID-19 pandemic.

To better understand motivations behind purchase and storage of firearms during the COVID-19 pandemic, we used Amazon Mechanical Turk to conduct an online survey of individuals who did and did not purchase a firearm since 1 January 2020 in response to COVID-19. The survey was fielded between 1 and 5 May 2020. We asked about motivations for purchase, changes in storage practices and concern for themselves or others due to COVID-19. There were 1105 survey respondents. Most people who purchased a firearm did so to protect themselves from people. Among respondents who had purchased a firearm in response to COVID-19 without prior household firearm ownership, 39.7% reported at least one firearm was stored unlocked. Public health efforts to improve firearm-related safety during COVID-19 should consider increasing access to training and framing messages around the concerns motivating new firearm purchase.

Fuzzy logic programming and adaptable design of medical products for the COVID-19 anti-epidemic normalization.

BACKGROUND: The COVID-19 prevention and control constantly affects lives worldwide. In this paper, household medical products were analyzed using fuzzy logic. Considering the household anti-epidemic status, economic and environmental benefits, the adaptable design method of anti-epidemic products in the vestibule was proposed. The measure of adaptable design method still have shortcomings. Therefore, an improved method that is based on fuzzy logic programming is required. METHOD: Firstly, common medical product types used in vestibules and household anti-epidemic products were identified and summarized into product sets. Then matching degree matrix was obtained by functional configuration decomposition and matching calculations. Secondly, experts were invited to evaluate the paired comparative probability matrices and linguistic variables, and the evaluation data were converted by trapezoidal membership functions, fuzzy numbers and the defuzzification method to obtain the usage probability values (PR) for product functions. Finally, the matching degree value (P) and the product function (PF) were calculated by adaptability measure formula, and product function, the adaptability factor and the adaptability (A) were obtained. RESULTS AND DISCUSSION: Our results show that the degree of adaptability of each product function in the product set from PF1 to PF10can be evaluated. Based on the principles of sorting of values from high to low, the top five PF (n = 10) for P value is PF10, PF5, PF6, PF8 and PF1; The top five PF for P value is PF2, PF1, PF3, PF7 and PF8; The top five PF for A value is PF2(0.242), PF1(0.232), PF5(0.225), PF8(0.222) and PF3(0.221). These values allow us to summarize and draw visual charts according to the above data sorting mode. The higher the value of the product function, the more it can be prioritized for design development with functional cost savings, simplification or clustering. CONCLUSION: This study proposes an adaptable design method based on fuzzy logic programming. The data results in this study can guide the development and programming of the vestibule anti-epidemic products. The higher adaptability value of a product function indicates that it is more capable of being simplified, clustered, and adapting to changes in the product set.

Minimization of spreading of SARS-CoV-2 via household waste produced by subjects affected by COVID-19 or in quarantine.

Currently available evidence supports that the predominant route of human-to-human transmission of the SARS-CoV-2 is through respiratory droplets. Indirect hands contact with surfaces contaminated by infectious droplets subsequently touching the mouth, nose or eyes seems to be another route of an indirect contact transmission. Persistence of the virus on different surfaces and other materials has been reported in recent studies: SARS-CoV-2 was more stable on plastic and stainless steel than on copper and cardboard. Viable virus was detected up to 72 h after application to different surfaces, although infectivity decay was also observed. This evidence suggests the likelihood that waste generated from patients affected by COVID-19 or subjects in quarantine treated in private houses or in areas different from hospitals and medical centres could be contaminated by SARS-CoV-2. Consequently, waste streams may represent a route for viral spreading being a potential risk also for the operators directly involved in the different phases of waste management. To address this concern, a specific multidisciplinary working group was settled by the Italian National Institute of Health (ISS) during the COVID-19 emergency, in order to establish guidelines related to solid waste collection, delivering, withdrawal, transport, treatment and disposal. Temporary stop of waste sorting, instructions for the population on how to package waste, instructions for Companies and operators for the adoption of adequate personal protection equipment (PPE), the use and sanitation of proper vehicles were among the main recommendations provided to the community by publications of freely downloadable reports and infographics in layman language. Incineration, sterilization and properly managed landfills were identified as the facilities to be preferentially adopted for the treatment of this kind of waste, considering the main inactivation strategies of SARS-CoV-2 (e.g. treatment length > 9 days and temperature > 70 °C for more than 5 min).

Remote psychophysical evaluation of olfactory and gustatory functions in early-stage coronavirus disease 2019 patients: the Bologna experience of 300 cases.

BACKGROUND: An objective evaluation of coronavirus disease 2019 in the first days of infection is almost impossible, as affected individuals are generally in home quarantine, and there is limited accessibility for the operator who should perform the test. To overcome this limitation, a recently validated psychophysical self-administered test was used, which can be performed remotely in the assessment of early-stage coronavirus disease 2019 patients. METHODS: Olfactory and gustatory functions were objectively assessed in 300 patients in the first 7 days from coronavirus disease 2019 symptom onset. RESULTS: Seventy per cent of the patients presented olfactory and/or gustatory disorders. The dysfunctions detected were mainly complete anosmia (47 per cent) or ageusia (38 per cent). A significant correlation was found between taste dysfunction and female gender (odds ratio = 1.936, p = 0.014) and fever (odds ratio = 2.132, p = 0.003). CONCLUSION: The psychophysical evaluation protocol proposed is an effective tool for the fast and objective evaluation of patients in the early stages of coronavirus disease 2019. Chemosensitive disorders have been confirmed to be frequent and early symptoms of the coronavirus infection, and, in a significant number of cases, they are the first or only manifestation of coronavirus disease 2019.