[Pesticide poisoning referred to the Poison Center of Milan in 1995-1998]. / Intossicazioni da prodotti antiparassitari rilevate dal Centro Antiveleni di Milano nel periodo 1995-1998.

From 1995 through 1998 the Poison Control Centre of Milan identified 7594 cases of suspected or confirmed cases of acute pesticide poisoning. Domestic use products accounted for 4483 (59%) of the cases. Of these, 84% occurred at home and 48% in children under five. The most frequently reported domestic use products were pyrethrins/pyrethroids (26%), fertilizers (19%) and camphor/naphthalene (12%). Of 3111 cases (41%) due to agricultural products, 10% were children under five and 69% were males. Half of the poisonings from agricultural products occurred at home, the remainder at workplace. The products most frequently reported were organophosphates (26%), pyrethrins/pyrethroids (9%), and carbamates (9%). These preliminary data indicate the importance of implementing prevention programs to reduce pesticide poisonings with particular reference to young children.

Experience with hair testing in the clinical biochemistry laboratory of Ca' Granda Niguarda Hospital, Milan, Italy.

In our laboratory, analysis of human hair for drugs of abuse detection was first performed in 1980. In the last 10 years we have processed about 2000 subjects/year ('living subjects' only). In the last 3 years we have also introduced hair analysis of cocaine: at first only in clinical applications, but for the last 2 years this analysis is now routine. Our application of hair analysis includes: clinical toxicology, medico-legal and administrative agencies. Requests come for example from several Committees for Driving Licenses, Addiction Treatment Centers and Legal Authorities. Hair samples are currently collected from the occipital area at the back of the head, which appears to show less variability in hair growth rate. At present we perform hair analysis using highly sensitive radioimmunoassay screening methods for the detection of parent drug and/or metabolites. All positive cases of cocaine and opiates abuse are confirmed by gas chromatography-mass spectrometry in electron impact or chemical ionization mode. Positive cases for opiates are also analysed using a specific morphine radioimmunoassay kit. Data show that, when the opiates/morphine ratio is higher than 6, we are dealing with consumption of codeine and/or dihydrocodeine. In our routine work last year there were 177 (263 samples) positive opiates subjects out of 2244 patients; positive cocaine subjects were 290 (362 samples) out of 2001 patients. Guidelines for hair analysis in Lombardia have been established based on the experience of our laboratory. Furthermore it will be possible to apply a unique protocol for all Committees for Driving Licenses, involving hair testing in addition to urine assay.