Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
ANNUAL REPORT 2008 QUEENSLAND POISONS INFORMATION CENTRE 13 11 26 Poisons Information Centre Royal Children’s Hospital Pharmacy Department Level 1 Foundation Building Herston Road Herston QLD 4029 www.health.qld.gov.au/poisonsinformationcentre Queensland Poisons Information Centre Annual Report 2008 Table of Contents Mission Statement....................................................................................... 3 Role and Philosophy ................................................................................... 3 Location ...................................................................................................... 3 Telephone Access....................................................................................... 3 Hours of Operation ...................................................................................... 3 Website ...................................................................................................... 3 Staffing ....................................................................................................... 4 Medical Consultants.................................................................................... 5 Research Activities and Publication Reviews ............................................... 5 Data Collection and Feedback..................................................................... 6 Poison Prevention Activities......................................................................... 6 Training for QPIC Staff ................................................................................ 6 Poisons Education by QPIC Staff................................................................. 6 Calls to the QPIC ........................................................................................ 7 Examples of Calls to the QPIC..................................................................... 7 Calls to QPIC per Year ................................................................................ 8 Calls Received per Month............................................................................ 9 Average Calls Received per Hour................................................................ 10 Call Types................................................................................................... 11 Exposure Types .......................................................................................... 12 Query Types ............................................................................................... 13 Handling of Calls......................................................................................... 14 Persons Calling the QPIC............................................................................ 15 QPIC Annual Report 2008 1 Patient Type................................................................................................ 16 Gender Type............................................................................................... 17 Route of Exposure of Poisonings................................................................. 18 Top 10 Poisons ........................................................................................... 19 Appendix: Queensland Poisons Information System Report ......................... 20 QPIC Annual Report 2008 2 Mission Statement To maximise the health of the people of Queensland by providing timely, appropriate information in poisoning or suspected poisoning situations and by the promotion of poisoning prevention. Role and Philosophy The role of the Queensland Poisons Information Centre (QPIC) is to provide the public and health professionals with prompt, up-to-date and appropriate information, and advice to assist in the management of poisonings and suspected poisonings. Members of the public may be given first aid instructions, possible symptoms to watch for, advice on the need for medical attention in poisonings, and general advice on poisoning’s prevention and management. Unnecessary visits to medical facilities may be avoided in minor accidental poisonings by the timely provision of advice and reassurance. Health professionals are also given poisoning advice in the management of poisoned patients. Location The Queensland Poisons Centre is located in the Pharmacy Department of the Royal Children’s Hospital, Brisbane and has been in operation since 1973. The QPIC employs a team of pharmacists specialising in toxicology to handle poisoning calls. Telephone Access The Queensland Poisons Information Centre can be reached on 13 11 26. This number is available Australia-wide for the cost of a local call (excluding mobile phones). The QPIC receives calls from all over Queensland, northern New South Wales, Papua New Guinea and surrounding areas. Hours of Operation The QPIC operates Monday to Friday (08:30 to 21:00), Saturday (08:30 to 19:00) and Sunday (08:30 to 17:00). Outside these times, calls are diverted to the NSW Poisons Information Centre, which remains open on a 24-hour basis. During 2008, the QPIC continued to work some overnight shifts to assist the other Poisons Information Centres in taking calls from across other Australian states. Website For more information, visit the Queensland Poisons Information website at http://www.health.qld.gov.au/poisonsinformationcentre QPIC Annual Report 2008 3 Staffing Director Hugh Miller B Sc Pharm, Grad Cert Man, Dip Hosp Pharm (Admin) Manager Carol Wylie B Pharm, Dip Hosp Clin Pharm Specialists in Poisons Information The QPIC is staffed by a total of 3.4 Full Time Equivalent (FTE) of specialists in poisons information. The following people were available to be rostered on a part time basis as poison information specialists at the QPIC in 2008. Jessica Bunker B Pharm Sasanka Handunnetti B Pharm Anita Champion B Pharm Alicia Lorenz B Pharm Michele Cree B Sci B Pharm Grad Genevieve Messina B Pharm Dip Clin Pharm Felicity Davis B Pharm Lyn Robinson B Pharm Dip Hosp Pharm Danielle Dean B Pharm Sonya Stacey B Pharm PGDip (Child Health) PGCert (Health Mgmt) Kimberly Graham B Pharm Jenny Stubbs B Pharm Meghan Fitzpatrick B Pharm Michael Toon B Pharm Nicolette Graham B Pharm, M Clin Kriss Yunker BSc (Hons) B Pharm Pharm Fiona Gregory B Pharm FSHP Administration Natalie Burnham Consultants Numerous external consultants from a variety of Queensland organisations and government departments are available to the Poisons Information Centre, for advice or direct referral. These consultants range from the Queensland Museum and Queensland Herbarium staff, to the Environmental Health and Workplace Health and Safety officers. These departments and organisations continue to offer a valuable service to the Poisons Information Centre The Poisons Information Centre has access to a number of clinical toxicologists. These clinicians are available on a 24 hour roster for direct advice to a poisons centre specialist, or referral to a practitioner requiring management advice in a poisoning. QPIC Annual Report 2008 4 Medical Consultants Medical Toxicology Consultants are provided to physician callers for unusual, complicated or severe poisoning cases. Each day, coverage is provided for both adult and paediatric poisonings. (This service is available 24 hours per day). Braitberg, George. MB BS FACEM Buckley, Nick. MD FRACP Chan, Betty. MB BS, FACEM, PhD Daly, Frank. MB BS, FACEM Downes, Michael. MB ChB FACEM Dowsett, Robert. MB BS, FACEM Graudins, Andis. MB BS, PhD, FACEM, FACMT Gunja, Naren. MB BS, FACEM Isbister, Geoffrey. B Sc, MB BS, FACEM Jones, Alison. B Sc (Hons) Biochem, MD, FRCP, FRCPE, FiBIOL, FRACP Kerr, Fergus. MB BS, FACEM, MPH Little, Mark. MB BS, FACEM, MPH&TM, DTM&H (Lon) McCoubrie, David. MB BS, FACEM Monaghan, Mark. MB BS, FACEM Murray, Lindsay. MB BS, FACEM White, Julian. MB BS, MD FACTM Whyte, Ian. MB BS (Hon), FRACP, FRCPE Fellows in Training Alfred, Sam. MB BS, FACEM, Dip Tox Armstrong, Jason. MB ChB FACEM Page, Colin. MB BS, FACEM Research Activities and Publication Reviews • • • Provided advice as a member the Clinical Advisory Panel for 13HEALTH Reviewed poisoning sections of Australian Medicines Handbook - Drug Choice Companion: Emergency and Primary Care, Third Edition, 2008 Reviewed Royal Children’s Hospital Emergency Medicine Department Guidelines for Poisonings, 2008 Data Collection and Feedback • Provided feedback to Therapeutic Goods Administration on Therapeutic Goods Order Number 80: Children Resistant Packaging QPIC Annual Report 2008 5 Poisons Prevention Activities • • Produced ‘Preventing poisoning – tips and advice’ leaflet in conjunction with Health Promotion Unit, Queensland Health April 2008 Reviewed poisonous plants section of QPIC Website Training for QPIC Staff • • • • Two staff attended: Advanced course in Toxicological Emergencies Organised as part of Critical Care Medicines Workshop 2008, Queensland Health 25-26 July 2008 - Rockhampton Two staff attended: Toxicology workshop Medical Education Solutions October 2008 - Brisbane Two staff attended: All five New South Wales Poisons Centre meetings throughout the year One staff member attended: 2008 Toxinology Course Hosted by Sunshine Coast Health in conjunction with Australasian Emergency Medicine (ACEM), Australian College of Remote and Rural Medicine (ACRRM) and the Australian Venom Research Unit. 15-17 August 2008 Poisons Education by QPIC Staff • • • • • • • • Poisons Information Seminar presented to 2008 Ferny Grove High School Students 10 March 2008 Poisoning and Toxicology lecture provided to Masters of Pharmacy students from Griffith University 12 March 2008 Phone interview with ‘Extra’ on safety of consuming Aloe Vera Juice 7 April 2008 Phone interview with ‘ABC Longreach Radio’ on Child Resistant Packaging 8 May 2008 Lecture on Poisons Information and Prevention to pharmacy assistants and members of the public Keperra, Brisbane 18 May 2008 Phone interview with ‘Radio Pictures’ on Human and Animal Exposures to Cane Toads 21 July 2008 Phone interview with SBS on Hazards of Impaled Toys 3 October 2008 Poisoning and Toxicology lecture to Queensland Ambulance First Aid Officers Northgate, Brisbane 3 December 2008 QPIC Annual Report 2008 6 Calls to the QPIC Poisons can be hazardous to adults and children. Even the mildest chemicals can be poisonous to the person if the exposure is large enough. The QPIC receives calls about many potential poisons including medications, household products, workplace chemicals, animals and plants. Some examples of calls to the centre are listed below. Examples of Calls to the QPIC Example 1 A concerned father rang the QPIC after he noticed that several rat bait pellets were missing. The father suspected that his three year old son may have eaten the pieces that were laid inside the garage. The poison centre specialist reassured the father that in this quantity the substance was not considered toxic and no treatment would be necessary. However he was told to watch out for any delayed symptoms of unexplained nose bleeds, bleeding gums or blood in the faeces. The father was instructed to take his son to the GP if he experienced any of these symptoms. Example 2 An eighteen month old toddler was found at the open dishwasher with white detergent around her mouth and on her fingers. It appeared that the child put her fingers into the powder container on the inside of the dishwasher door. Her mother immediately rang the QPIC and stated that she didn’t know how much her daughter may have consumed. The mother was advised to wipe her daughter’s mouth and give a small drink of water. The poison centre specialist questioned the mother about whether her child had any symptoms. The toddler was crying and appeared to have a red mark on her lip which may be a burn from the detergent. The mother was advised to take her child to the hospital for immediate assessment. Example 3 Mr J.F was unloading his van when he suddenly felt a sharp pain on his arm. He told the staff at the QPIC he wasn’t sure what caused the pain, but he suspected a bite from small green spider, which he saw in the van. The man was told to wash the area with soap and water and apply a cold pack. He was also advised that he could take analgesics and antihistamines for the pain and swelling and that he should seek medical attention if his symptoms persisted or if there were any signs of infection. The caller was also advised to seek urgent medical attention if he showed any signs of an allergic reaction. Example 4 A junior medical officer phoned the QPIC for management advice after a young male adult presented to the emergency department in a small regional hospital. The patient had intentionally overdosed on paracetamol, diazepam, amitriptyline and ibuprofen. The poisons specialist conducted a risk assessment and established that the dose of amitriptyline was in the life threatening range. The doctor was immediately transferred to a consultant toxicologist for expert management advice. QPIC Annual Report 2008 7 Calls to QPIC per Year • Consistent increase in the number of calls to the QPIC every year since 2000 Ca lls per Year 36000 34000 Number of Calls 32000 30000 28000 26000 24000 22000 20000 2000 2001 2002 2003 2004 2005 2006 2007 2008 Year Calls to QPIC Per Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 QPIC Annual Report 2008 Number of Calls 24303 26470 26001 25978 27508 27803 28970 31441 33495 8 Calls Received per Month • • • Most calls/month were answered in September/October, the least number of calls/month were answered in July More calls occur in summer compared to winter Variation of 459 calls/month between the busiest and slowest times of the year Calls to QPIC Per Month in 2008 3100 3000 Number of Calls 2900 2800 2700 2600 2500 2400 be r be r No ve m be r De ce m be r O ct o te m gu st ep S Au Ju ly Ju ne ay M ril Ap ar ch M ua ry Fe br Ja n ua ry 2300 Month Calls to QPIC Per Month January February March April May June July August September October November December QPIC Annual Report 2008 Number of Calls 2903 2688 2680 2682 2640 2709 2580 2754 3039 3030 2924 2866 9 Average Calls Received Per Hour • Similar trend seen in the average number of calls for weekdays and weekends Most calls/hr received between 4-9pm Least number of calls/hr received between 12-3pm • • Average Number of Weekday Calls per Hour Average Number of calls per Hour 12.00 10.00 8.00 6.00 4.00 2.00 0.00 8 9 10 11 12 13 14 15 16 17 18 19 20 TIme of Day (24hr time) Average Number of Weekend Calls per Hour Average Number of Calls per Hour 12 10 8 6 4 2 0 8 9 10 11 12 13 14 15 16 17 18 Time of Day (24hr time) * The QPIC changed its closing time on Saturdays to 7pm (originally 5pm) on the 7 th of June 2008. QPIC Annual Report 2008 10 Call Types • The majority of calls to the centre involve exposures Call Types to QPIC 30000 Number of Calls 25000 20000 15000 10000 5000 0 Exposure Query Call Type Exposure Query Wrong Number Number Check Complaints Praise QPIC Annual Report 2008 Wrong Number Number of Calls 28053 3917 1399 114 7 5 Number Check Complaints Praise (%) 83.75% 11.69% 4.18% 0.34% 0.02% 0.01% 11 Exposure Types • Most exposures are classified as unintentional Pregnancy/Breast Feeding 0.50% Occupational 1.53% Environmental 0.12% Poison Information 0.06% Unknown 0.11% Therapeutic Error 7.27% Intentional 7.74% Unintentional 82.67% Exposure Types at the QPIC Exposure Type Unintentional Intentional Therapeutic Error Occupational Pregnancy/Breast Feeding Environmental Poison Information Unknown QPIC Annual Report 2008 Number of Calls 23164 2168 2038 428 140 34 18 35 (%) 82.67% 7.74% 7.27% 1.53% 0.50% 0.12% 0.06% 0.11% 12 Query Types • The majority of queries are drug and poison information calls Query Types at the QPIC Pregnancy/Breast Feeding 7.4% Drug Information 48.2% Poisons Information 44.3% Query Type Drug Information Poisons Information Pregnancy/Breast Feeding QPIC Annual Report 2008 Number of Calls 1883 1731 (%) 48.23% 44.34% 290 7.43% 13 Handling of Calls • • Most callers are advised to watch for possible symptoms, while remaining at home Less than 14% of callers are given an immediate referral to a doctor/hospital Handling of Calls Toxicologist contacted Vet First Aid Management details Referral to other agency Reassurance Refer to Dr/Hospital Symptoms possible 0 2000 4000 6000 8000 10000 12000 14000 Number of Calls Handling of Calls Symptoms possible Refer to Dr/Hospital Reassurance Referral to other agency Management details* First Aid Vet Toxicologist contacted Number of Calls 13204 4391 4385 4099 3488 1323 709 354 (%) 41.32% 13.74% 13.72% 12.83% 10.92% 4.14% 2.22% 1.11% *These patients are already at a GP surgery or a hospital. The QPIC provides management details to health professionals. QPIC Annual Report 2008 14 Persons Calling the QPIC • Most calls are from the general public; these calls can be from the patient themselves, a friend/relative or a carer Person Contacting the QPIC Reporter/Media 9 Not recorded 108 Pharmacist 268 Vet 509 Ambulance 1065 Nursing 1619 Medical 2913 Lay 25847 0 5000 10000 15000 20000 25000 30000 Number of Calls Persons calling the QPIC Lay Medical Nursing Ambulance Vet Pharmacist Not recorded Reporter/Media QPIC Annual Report 2008 Number of Calls 25847 2913 1619 1065 509 268 108 9 (%) 79.93% 9.01% 5.01% 3.29% 1.57% 0.83% 0.33% 0.03% 15 Patient Type • The majority of calls involved children Patient Type 20000 17198 18000 16000 Number of Calls 14000 12000 11761 10000 8000 6000 4000 1510 2000 0 Adult Patient Type Summary Adult Child Animal Child Number of Calls 11761 17198 1510 Animal (%) 38.60% 56.44% 4.96% * Children include all people under the age of 18 QPIC Annual Report 2008 16 Gender of Patients • Numbers of males and females are not significantly different Calls Based on Gender Unknown, 2.2% Male, 48.7% Female, 49.2% Gender Male Female Unknown QPIC Annual Report 2008 Number of Calls 11134 11252 494 (%) 48.7% 49.2% 2.2% 17 Route of Exposure of Poisonings • • The most common route of exposure is the oral route Many poisonings involve more than one route of exposure eg. both topical and eye Poisonings per Route of Exposure Not recorded 92 Route of Exposure Injected 143 Bites/Stings 1299 Inhaled 1551 Eye 2086 Topical 2289 Oral 23905 0 5000 10000 15000 20000 25000 30000 Number of Calls Route of Exposure Oral Topical Eye Inhaled Bite/Sting Injected Not recorded QPIC Annual Report 2008 Number of Calls 23905 2289 2086 1551 1299 143 92 (%) 76.22% 7.30% 6.65% 4.95% 4.14% 0.46% 0.29% 18 Top 10 Poisons • Paracetamol has consistently been the number one poison over several years The four most common calls for poisonings are all medications Many calls involve cleaning agents (refer to appendix), however bleach is the only cleaning agent to be listed in the top ten poisons list Although it is non toxic, silica gel is one of the substances generating many calls • • • Top 10 Poisons 2000 1800 Number of Calls 1600 1400 1200 1000 800 600 400 200 Number Poison 1 Paracetamol Benzodiazepines (eg. 2 3 4 5 6 7 8 9 10 diazepam, temazepam) Ibuprofen Selective Serotonin Reuptake Inhibitors (SSRI’s, eg. sertraline, paroxetine) Rodenticides: anticoagulant long acting Pyrethrin & Pyrethroid pesticides Silica Gel Bleach Spider bites (other than Redback, Funnel webs) Organophosphate pesticides QPIC Annual Report 2008 Organophosphate Spider bites (other than Redback, Funnelwebs) Bleach Silica Gel Pyrethrins & Pyrethroids Rodenticides a'coag long acting SSRIs Ibuprofen Benzodiazepines Paracetamol 0 Number of Calls (%) of Calls 1758 5.25% 950 732 2.84% 2.19% 681 2.03% 673 2.01% 629 625 525 1.88% 1.87% 1.57% 449 405 1.34% 1.21% 19 Appendix: Queensland Poisons Information System Report STATISTICS Data Range: 01/01/2008 to 31/12/20008 Total Calls: 33,495 Animals/ Plants Count Animals other Animal, other Bat/flying fox Bite: other/ unknown Cane toads Dog/cat Leech Lizard Platypus Snail/ slug ingestion 27 13 289 78 2 4 8 1 2 Snake 177 Total for Animals other 601 Insects Ant Bee Caterpillar Centipede Fire Ant Insect Millipede Mosquito Scorpion Tick Wasp/ hornet 41 27 28 49 7 76 6 3 33 95 72 Total for Insects 437 Marine animals Blue-ringed octopus Catfish Fish stings: other/ unknown Jellyfish, bluebottle (physalia) Jellyfish, chironex Jellyfish, irukandji Jellyfish: other/ unknown Marine animal bite/ sting: other/ unknown Stingray Stonefish Total for Marine Animals 1 23 28 10 2 4 5 23 10 14 120 Plants Algae, other Blue- green algae Mushrooms, amanita Mushrooms, chlorophyllum Mushrooms: other/ unknown QPIC Annual Report 2008 1 5 2 7 110 20 Plant: amarylidaceae other Plant: Apricot (cyanogenic glycosides) Plant: Asparagus fern Plant: cactus Plant: capsaicin Plant: cardiac glycosides:other/ unknown Plant: Chinaberry (Melia aziderach) Plant: colchicine Plant: Cyanogenic glycoside other Plant: Daffodil Plant: Datura (angel's trumpet) Plant: dermatitis Plant: Dieffenbachia Plant: Duranta Plant: Euphorbiacea Plant: Frangipani Plant: gastrointestinal irritants Plant: grayanotoxins Plant: identification Plant: lantana Plant: Mother- in-Laws tongue (oxalates) Plant: non-toxic Plant: Oleander (yellow), Cascabella thevetia Plant: Oleander, Nerium Plant: other/ unknown Plant: oxalate Plant: Pelargonium Plant: Philodendron Plant: Poinsettia Plant: poisonous (enquiries) Plant: pyrrolizidine alkaloids Plant: schefflera Plant: solanine Plant: stimulants Plant: thorn injury Plant: toxicodendrol Total for Plants 7 1 5 11 22 3 1 2 13 1 7 57 8 65 30 20 30 2 13 8 2 115 18 12 290 91 1 4 4 30 2 2 32 2 6 6 1,048 Spiders Funnel Web Spider Redback spider Spider other/ unknown White-tailed spider 11 149 451 11 Total for Spiders 622 Veterinary medicines Aquarium Products Vet: Animal vaccines Vet: Diethylcarbamazine Vet: external medicines: other/ unknown Vet: Fipronil (topical) Vet: flea collar Vet: Heart worm: other/ unknown Vet: Imidacloprid (topical) Vet: internal medicines: other/ unknown Vet: Ivermectin & related agents Vet: Organophosphate (top/ oral) Vet: Pimobendan Vet: Praziquantel QPIC Annual Report 2008 51 26 13 77 20 4 17 50 135 41 23 6 29 21 Vet: Pyrantel Vet: Pyrethrin (topical) Vet: Tilmicosin Vet: Topical infestation products: other/ unknown 31 48 1 42 Total for Veterinary medicines Total for Animals/Plants 614 3,440 Chemical 8.43% Count Adhesives Adhesive, glue, cement, paste: other/ unknown 138 Adhesives, cyanoacrylates Adhesives, epoxy resins Adhesives, model glues/ cements Adhesives, non-toxic glues, pastes, etc. 166 28 3 14 Total for Adhesives 349 Alcohols/ Glycols Alcohol, ethanol (beverage) Alcohol, ethanol (non-beverage) Alcohol, higher (butanol, propanol etc.) Alcohol: other/ unknown Ethylene glycol Glycol ethers Glycols: other/ unknown Isopropanol Methanol Methylated spirits propylene glycol Total for Alcohols/ Glycols 400 79 6 11 44 14 2 49 24 121 1 751 Chemicals general Borates (not insecticides) Bromides Capsaicin Chemicals: other/ unknown Cyanamide Metabisulphite Nitrates and nitrites Phosphorous Radioactive materials Silicones Sodium Chloride (salt) Styrene Sulphur Dioxide Sulphur: other/ unknown Tin compounds Total for Chemicals general 7 3 21 192 1 3 10 3 4 45 10 11 4 15 1 330 Cleaning agents Baby bottle cleaner Bleach (hypochlorite based) Bleach: (NaOH + hypochlorite) Bleach: other/ unknown Carpet cleaner Carpet deodoriser QPIC Annual Report 2008 14 165 267 95 24 9 22 Chlorine (see also pool chlorine) Cleaner: acidic Cleaner: alkaline Cleaner: all purpose/ hard surface Cleaner: ammonia based Cleaner: floor Cleaner: glass/ window Cleaner: industrial - general Cleaner: leather, vinyl, upholstery Cleaner: limonene Cleaner: other/ unknown Dettol Disinfectant, cationic detergent Disinfectant, essential oil based Disinfectant, other/ unknown Disinfectant, phenolic Drain cleaner - other/ unknown Drain cleaner - sodium hydroxide based Oven cleaner - other/ unknown Oven cleaner - sodium hydroxide based Phenol and other phenolics Sodium Carbonate Toilet bowl cleaner: powder, liquid Toilet bowl rim block cleaner/ deodoriser Toilet bowl rim liquid cleaner/ deodoriser Toilet cistern cleaner/ deodorant Vaporiser cleaning tablet Total for Cleaning Agents 37 200 350 247 25 49 92 26 4 39 130 146 352 1 39 9 9 18 79 81 23 16 85 112 91 19 15 2,868 Corrosives Acid: other/ unknown Alkalis (not cleaners) Ammonia (not cleaners) Ammonium bifluoride Battery Acid Copper sulphate Corrosives: other/ unknown Hydrochloric acid Hydrofluoric acid Hydrogen peroxide (not for medical use) ketone peroxide (inc. MEKP) Potassium permanganate Sodium Hydroxide Total for Corrosives 101 22 24 3 48 28 21 77 24 3 5 37 55 448 Detergents Detergent anionic/ non-ionic (not sink washing up type) 245 Detergent, sink washing up Dishwasher (auto) rinse agents Dishwasher cleaner Dishwasher deterg. liquid (auto) Dishwasher deterg. powder/ granule (auto) Dishwasher deterg. tablet (auto) 390 31 6 8 89 137 Total for Detergents 906 Fungicides Carbamate fungicide Copper fungicide QPIC Annual Report 2008 17 4 23 Fungicide:other/ unknown (non-medical) Total for Fungicides 21 42 Herbicides Carbamate herbicide Chlorophenoxy type herbicide Glufosinate Glyphosate Herbicide: other/ unknown Paraquat/ diquat Triazine herbicide Total for Herbicides 1 33 2 338 101 27 14 516 Hydrocarbons Benzene Diesel Fabric protection (eg Scotchguard) Formaldehyde/ formalin Hydrocarbon: other/ unknown Hydrocarbons, aromatic: other/ unknown Hydrocarbons, halogenated Kerosene Lighter fluid Methylene chloride (not paint strippers) Mineral turpentine Petrol Solvent abuse Tetrachloroethylene Toluene Toluene diisocyanate Xylene Total for Hydrocarbons 5 32 1 36 261 29 9 53 1 4 215 224 3 2 28 6 27 936 Ketones Acetone (not nail polish remover) ketones: other Total for Ketones 18 23 41 Pesticides & insecticides 2,4,5-T 2,4-D Amitraz Arsenic & Arsenicals Bacillus thuringiensis (insecticide) Biological insecticides other/ unknown Borates & boric acid pesticides Carbamate insecticides Carbamate/ other pesticides combinations Chlorinated h’carbon insecticides: other/ unknown Chlorophenoxy/ Dicamba Chloropicrin Copper chrome arsenate (wood preservative) Creosote (wood preservative) Dicamba Endosulphan Fipronil Fumigants: other Herbicide + Fertilizer QPIC Annual Report 2008 1 18 20 25 2 2 135 47 18 10 26 2 28 14 47 4 53 3 6 24 Hydramethylnon Imidacloprid Insect growth regulators, other MCPA Metaldehyde Methiocarb Methyl Bromide Organophoshate + other pesticide combinations Organophosphate Pesticide: other/ unknown Picloram Piperonyl butoxide Pyrethrins & Pyrethroids Rotenone Snail poison, other/ unknown Total for Pesticides & insecticides 2 46 7 54 13 1 11 47 405 119 16 27 630 4 7 1,850 Pool chemicals Pool chlorine Pool products: acid Pool products: other/ unknown Pool test kits/ solutions 141 46 20 5 Total for Pool chemicals 212 Rodenticides 1080/monoflouroacetate Rodenticides: a'coag long-acting Rodenticides: a'coag short-acting Rodenticides: other/ unknown Strychnine 19 673 39 67 17 Total for Rodenticides 815 10,055 Total for Chemical External medicines 24.64% Count Ear preparations Ear ointment Ear product other/ unknown Ear drops Total for Ear preparations 1 1 1 3 Eye preparations Contact lens preparations Eye drops: imidazoline based Eye drops: other/ unknown Eye ointment Eye products: other/ unknown Total for Eye preparations 9 4 28 1 1 43 Lotion, solution, powder, ointment, cream Acne preparations Antibiotic, topical Antifungal, topical Antipruritics (calamine lotion etc.) Antiseptic, top: iodine based QPIC Annual Report 2008 12 20 102 18 18 25 Antiseptic, top: mercurochrome Antiseptic, top: povidone- iodine based Antiseptic,top: alcohol Antiseptic,top: chlorhexidine Antiseptic,top: other Antiviral, topical Baby oil Chest rubs Corticosteroid, topical Cream/ Gel: methyl salicylate based Hydrogen peroxide Lice/ scabies preps: organophosphate based Lice/ scabies preps: other Lice/ scabies preps: pyrethrins based Lice/scabies preps: essential oil based Liniments: methyl salicylate based Liniments: other Lotions, creams, ointments: other/ unknown Nappy rash products Pinetarsol Shampoo antidandruff: other/ unknown Shampoo antidandruff: selenium based Shampoo antidandruff: zinc pyrithione Topical non-steroidal agents Wart/ corn preps: other Wart/ corn preps: salicylic acid based Wart/corn preps: podophyllum based 1 24 175 38 27 1 73 59 66 16 49 50 17 17 18 49 25 49 266 9 7 8 13 14 1 14 9 Total for Lotion, solution, powder, ointment, cream 1,265 Miscellaneous external medications Topical preparations: other/ unknown Topical: Fluorouracil 57 4 Total for Miscellaneous external medications 61 Mouth preparations Mouth preparations: anaesthetic 3 1 12 5 62 3 5 7 17 Mouth preparations: anti- inflammatory Mouth preparations: other Mouth preparations: povidone- iodine Teething gels Throat lozenges- local anaesthetic Throat lozenges- no local anaesthetic Toothache drops: clove oil Toothache drops: other Total for Mouth preparations 115 Nasal/ Inhaled preparations Nose drop/ spray: imidazoline based Nose drop/ spray: steroid based Nose drop/spray: other/ unknown Vaporiser fluids and inhalants 23 3 9 193 228 Total for Nasal/ Inhaled preparations Total for External medicines QPIC Annual Report 2008 1,762 4.32% 26 Internal medicines Abuse/ Recreational Amphetamines and related drugs (abuse) Amyl nitrite and other volatile nitrites Cocaine Ecstasy/ other hallucinogenic agents Gamma hydroxybutyric acid (GHB) and related drugs Heroin Lysergic Acid Diethylamide (LSD) Marijuana Phencyclidine (PCP) Street Drugs, unknown Total for Abuse/ Recreational 47 2 5 20 23 5 1 26 1 1 131 Alimentary system 5HT3 antagonists (eg ondansetron) Antacids Antiemetics: other Antispasmodics: other Atropine Diphenoxylate/ atropine Domperidone Gastrointestinal preps: other/ unknown Glycerol H2 antagonists (eg cimetidine) Hyoscine/ hyoscyamine Ipecac Laxatives: other Laxatives: stimulant Loperamide Metoclopramide Prochlorperazine Propantheline Proton pump inhibitors (eg omeprazole) Sulfasalazine Ulcer treatment: other 6 75 3 6 19 11 9 31 2 27 77 2 76 56 23 79 10 1 175 13 1 Total for Alimentary system 702 Analgesic: other/ unknown Aspirin & other salicylates Aspirin/ Codeine combinations Ergot alkaloids Ibuprofen + codeine Methysergide Naratriptan Paracetamol Paracetamol/ antihistamine combination Paracetamol/ codeine 15mg combinations Paracetamol/ codeine 30mg combinations Paracetamol/ codeine 8-10mg combinations Paracetamol/ codeine liquid preparation Paracetamol/ codeine/ antihistamine Paracetamol/ Dextropropoxyphene Pizotifen 5 161 11 8 93 3 1 1758 12 37 168 135 22 107 27 18 Analgesics, other QPIC Annual Report 2008 27 Sumatriptan Sumatriptan Tramadol Zolmitriptan 4 132 1 Total for Analgesics, other 2,703 Anti-infective agents Aciclovir Amoxycillin Amoxycillin/clavulanic acid combinations Amphotericin Anthelmentics: other Antibiotics: other/ unknown Antimalarial drugs (other/ unknown) not quinine): other/unknown Antimicrobial: other/ unknown Antiviral drugs: other/ unknown Azithromycin Benzylpenicillin Cefaclor Ceftriaxone Cefuroxime Cephalexin Cephalosporins, other Chloramphenicol Chloroquine Ciprofloxacin Clarithromycin Co-trimoxazole Dapsone Dicloxacillin Doxycycline Efavirenz Enoxacin Erythromycin Famciclovir Flucloxacillin Fluconazole Fusidic acid/ sodium fusidate Gentamicin Griseofulvin Ivermectin & related agents Ketoconazole Lamivudine Mebendazole Metronidazole Minocycline Neomycin Norfloxacin Nystatin Oseltamivir Penicillins: other Phenoxymethylpenicillin Piperacillin Piperacillin/ tazobactim combinations Pyrantel Quinine Ribavirin Rifampicin Roxithromycin QPIC Annual Report 2008 7 213 65 2 3 33 1 3 2 2 1 37 2 1 113 2 25 1 15 17 12 1 7 47 2 1 45 4 14 8 1 2 2 34 10 1 33 45 9 1 7 5 1 17 17 1 1 91 21 4 4 60 28 Sulphonamides: other/ unknown Terbinafine Tetracyclines, other Ticarcillin/clavulanic acid combinations Tinidazole Tobramycin Trimethoprim Valaciclovir Total for Anti-infective Agents 9 7 2 3 1 2 30 8 1,115 Blood/ Blood forming tissues Anticoagulants: other/ unknown Blood products: other/ unknown Clopidogrel Dipyridamole Heparin Iron (not multivitamins) Tranexamic Acid Warfarin Total for Blood/ Blood forming tissues 5 2 35 8 4 58 4 83 199 Cardiovascular system ACE II Inhibitors: other ACE Inhibitor, other Alpha blocker, other Amiodarone Amlodipine Angina preps: other Antihypertensives (not diuretics): other Atenolol Beta blockers: other Bisoprolol Calcium antagonists:other Candesartan Captopril Cardiovascular drugs: other Carvedilol Clonidine Digoxin Diltiazem Enalapril Eprosarten Felodipine Flecainide Fosinopril Glyceryl trinitrate Hydralazine Irbesartan Isosorbide mononitrate Labetalol Lercanidipine Lignocaine Lisinopril Methyldopa Metoprolol Minoxidil Nicorandil Nifedipine QPIC Annual Report 2008 7 11 1 1 36 1 4 50 4 7 2 27 2 2 12 40 33 12 1 4 6 5 6 11 8 63 20 5 9 28 7 9 54 5 10 13 29 Olmesartan Perhexiline Perindopril Prazosin Propranolol Quinapril Ramipril Sotalol Telmisartan Trandolapril Verapamil 5 2 82 12 40 3 29 17 18 2 18 Total for Cardiovascular system 744 CNS depressants Acetazolamide Alprazolam Anaesthetics: inhalation Anaesthetics: other/ unknown Anaesthetics: topical/ local Anticonvulsant other Barbiturates Bromazepam Carbamazepine Chloral hydrate Clobazam Clonazepam Diazepam Flunitrazepam Gabapentin Lamotrigine Levetiracetam Lithium Lorazepam Midazolam Nitrazepam Oxazepam Oxcarbazepine Phenytoin Pregabalin Sedative/ hypnotic: other/ unknown Sulthiame Temazepam Tiagabine Topiramate Triazolam Valproic acid vigabatrin Zolpidem Zopiclone Total for CNS depressants 3 142 3 3 13 2 23 8 180 3 5 63 364 3 18 84 43 58 11 5 41 111 9 57 9 8 3 204 5 49 1 269 9 71 28 1,908 CNS stimulants Amitriptyline Antidepressants: other/ unknown Atomoxetine Caffeine Citalopram Clomipramine CNS stimulants: other/ unknown QPIC Annual Report 2008 86 19 16 12 109 7 2 30 Dexamphetamine Donepezil Dothiepin Doxepin Duloxetine Escitalopram Fluoxetine Fluvoxamine Galantamine Imipramine Methylphenidate Mianserin Mirtazapine Moclobemide Modafinal Monoamine oxidase inhibitors: other/ unknown Nortriptyline Paroxetine Quetiapine Reboxetine Rivastigmine Sertraline SSRIs: other Stimulants: other/ unknown Trimipramine Venlafaxine Ziprasidone Total for CNS stimulants 37 3 27 13 22 125 108 64 2 20 74 7 127 11 3 6 4 59 217 7 1 213 4 5 3 178 10 1,601 Hormones Androgenic and anabolic agents Antiandrogenic/ antioestrogenic agents: other/ unknown Cabergoline Carbimazole Clomiphene Corticosteroid Cyproterone Hormones: other/ unknown Letrozole Melatonin Oestrogens/ progestins (not oral contraceptives) Oral contraceptives Oral contraceptives, emergency Propylthiouracil Raloxifene Tamoxifen Thyroid preps: other/ unknown Thyroxine Total for Hormones 3 3 4 11 2 217 5 25 1 16 28 395 1 3 1 8 5 163 891 Immunosuppressives Azathioprine Chemotherapy agents: other/ unknown Cyclosporin Immunomodifiers: other/ unknown Mercaptopurine Methotrexate QPIC Annual Report 2008 4 15 3 5 2 26 31 Mycophenolate Tacrolimus 3 3 Total for Immunosuppressives 61 Metabolism Acarbose Alendronate Amino acid Atorvastatin Calcium salts Diet aids - OTC Electrolytes: other/ unknown Ezetimibe Fluoride Folic Acid Gemfibrozil Glibenclamide Gliclazide Glimepiride Glipizide Hypoglycaemics, oral: other/ unknown Insulin Lipid lowering: other/ unknown Metabolic agents: other/ unknown Metformin Orlistat Phentermine Pioglitazone Potassium salts Pravastatin Risedronate Rosiglitazone Rosuvastatin Sibutramine Simvastatin Vitamin A Vitamin B group Vitamin C Vitamin D Vitamin E Vitamin K Vitamins, compound - iron Vitamins, compound - no iron Vitamins: other/ unknown Total for Metabolism 1 17 7 64 85 2 7 6 102 55 2 6 23 8 1 3 32 10 5 67 7 45 6 13 9 14 4 15 6 29 6 25 49 30 8 3 186 53 51 1,062 Miscellaneous internal medicines Acamprosate Acetylcysteine Acitretin Antidotes Antismoking products: nicotine Antismoking products: other/ unknown Artificial sweeteners Bupropion Disulfiram Echinacea Finasteride Herbal/ homeopathic preparations QPIC Annual Report 2008 2 6 2 6 27 2 2 19 2 9 4 289 32 Isotretinoin Medication, unknown Naltrexone Radiographic agents Sildenafil Sodium Chloride 0.9%(saline) St Johns Wort Tadalafil Tetrabenazine Vaccines Vardenafil Varenicline Total for Miscellaneous internal medicines 7 98 8 1 10 3 8 3 2 39 3 30 582 Narcotic analgesics Buprenorphine Codeine Dextropropoxyphene Fentanyl Hydromorphone Methadone Morphine Oxycodone Pethidine Total for Narcotic analgesics 30 95 9 12 1 14 36 91 3 291 Narcotic Antagonists Naloxone 4 Total for Narcotic antagonists 4 Other CNS drugs Amisulpride Antiparkinsonian agents: other/ unknown Antipsychotics: other/ unknown Aripiprazole Baclofen Benzhexol Benztropine Betahistine Botulinum toxin (Botox) Chlorpromazine Clozapine Haloperidol Levodopa/ benserazide combinations Levodopa/ carbidopa combinations Muscle relaxants: other/ unknown Neuroleptics: other/ unknown Olanzapine Pericyazine Prochlorperazine Pyridostigmine Risperidone Thioridazine Trifluoperazine Zuclopenthixol Total for Other CNS drugs QPIC Annual Report 2008 12 5 7 19 31 5 31 5 4 72 23 23 15 10 2 1 159 23 22 1 146 3 4 2 625 33 Renal (genito-urinary system) Diuretics, potassium sparing Diuretics: other/ unknown Oxybutynin Renal drugs: other/ unknown Tamsulosin Urinary alkalinisers Total for Renal (genitor-urinary system) 17 84 13 1 2 2 119 Respiratory system Zafirlukast Adrenaline Antihist./ decongest.+ aspirin Antihist./ decongest.+ paracetamol Antihist./decongest. + antitussive Antihistamine other Antihistamine/ decongestant Antitussives: other/ unknown Bromhexine Caffeine Cetirizine Corticosteroid, inhaled Cyproheptadine Decongestant + antitussive Decongestant + expectorant Decongestant + paracetamol + antitussive Decongestant + paracetamol + codeine Desloratadine Dexchlorpheniramine Dextromethorphan Dihydrocodeine Dimenhydrinate Diphenhydramine Doxylamine Eformoterol Fexofenadine Guaiphenisin Ipratropium Loratadine Montelukast Orciprenaline Pheniramine Phenylephrine Pholcodine Promethazine Pseudoephedrine Respiratory drugs: other/ unknown Salbutamol Salmeterol Salmeterol + Corticosteroid Sodium Cromoglycate Terbutaline Terfenadine Theophylline Tiotropium Trimeprazine Total for Respiratory system QPIC Annual Report 2008 1 18 2 59 43 44 279 8 38 54 45 21 13 9 3 14 56 5 105 42 6 2 18 61 1 57 29 2 53 23 1 4 41 20 133 61 4 60 9 4 2 4 2 9 64 3 1,532 34 Rheumatoid disease & gout adalimumab Allopurinol Celecoxib Colchicine Diclofenac Glucosamine Hydroxychloroquine Ibuprofen Indomethacin Ketoprofen Ketorolac Leflunomide Lumiracoxib Mefenamic Acid Meloxicam Naproxen NSAIDs: other/ unknown Piroxicam Probenecid Sulindac 3 23 34 22 141 13 8 732 27 6 2 2 2 17 45 48 10 6 2 1 Total for Rheumatoid disease & gout 1,144 15,402 Total for Internal me dicines 37.74% Other Batteries Battery, alkaline Battery, disc/ button type Battery, penlight/ dry cell Total for Batteries 58 50 2 110 Car products Brake fluid Car products: other/ unknown Radiator coolant/ Antifreeze: ethylene glycol Radiator coolant/ Antifreeze: other/ unknown Transmission fluid 29 78 9 5 4 Total for Car products 125 Total for Chemical terrorism 0 Chemical Terrorism Chemical Terrorism 0 Dental Products Dental care products: other/ unknown Denture cleaning -powder Denture cleaning tablet Mouthwash: ethanol containing Mouthwash: non ethanol containing Toothpaste with fluoride Toothpaste without fluoride Total for Dental products 4 5 13 27 51 43 1 144 Foreign bodies Coins Desicants: other/ unknown QPIC Annual Report 2008 16 68 35 Faeces/ urine/ blood Foreign body: other/ unknown Glass Nappy Needlestick, unknown Silica gel Toys Total for Foreign bodies 41 194 9 13 2 625 122 1,090 Gases & fumes Carbon dioxide Carbon monoxide Chlorine gas (mixing bleach & acid) Cyanide Gas, fume, vapour: other/ unknown Helium Hydrocarbon propellants (inc. CFCs) Hydrogen sulfide Lacrimators (mace spray, tear gas etc) (not fumigants) Metal fume fever Methane and natural gas Nitrous oxide Phosphine Polymer fume fever Propane and other simple asphyxiants Refrigeration gas Smoke/toxic products of combustion Total for Gases & fumes 4 16 30 20 126 2 53 4 1 18 4 2 10 2 16 24 25 357 Hair Products Conditioner,hair Hair care: other Hair colours (not peroxide) Hair colours (peroxide) Hair gel, hair mousse Hair rinses, perms Hair spray Shampoo (non- medicated) Total for Hair products 12 57 41 51 13 2 18 80 274 Handyman/ Tradesman Asbestos Asphalt/ bitumen Building/handyman products: other/ unknown Caulking compounds and construction putties Cement Concrete Fertiliser: bead Fertiliser: other/ unknown Fibreglass Fibreglass hardener: other/ unknown Insulation material Lime (Calcium Oxide) Methyl ethyl ketone peroxide Oils: lubricating, engine, machine PCB + PBB (Polychlorinated biphenyls) Plant rooting hormone (indole butyric acid etc.) QPIC Annual Report 2008 25 5 52 28 14 9 59 85 10 6 2 22 13 74 1 4 36 Plastic Polystyrene Rust remover: other/ unknown Soil/ potting mix Soldering flux Water crystals, soil wetting agents Wetting agents, garden Total for Handyman/Tradesman 30 32 18 20 4 16 5 534 Laundry products Detergent, laundry Dry cleaning agent Fabric softener Ironing aid/ starch Laundry products: other/ unknown Nappy cleaner Pre-wash stain remover Total for Laundry products 229 4 20 20 75 68 90 506 Metals Alum Aluminium Barium sulfate Barium, soluble salts Cadmium Chromium salts Copper Heavy metal: other/ unknown Iodine (non- medical) Lead Mercury (not thermometers) Nickel Rust (iron oxide) Selenium Silver Zinc Total for Metals 4 9 2 2 3 6 15 1 19 65 40 1 2 12 12 20 213 Misc enquiries 13 HEALTH referral Abusive/ obscene call Complaint Disposal of chemicals/ medicines etc Drink spiking Drug Information (general) First Aid, general Leaflet/ Sticker/ Pamphlet Legislation/ labelling Poison Information/ Prevention Praise Speaker/ Presentation request Tablet/capsule Identification To be coded Website enquiry/ comment Total for Misc enquires 787 5 6 34 25 113 4 128 12 170 3 2 32 0 8 1,329 Nail products Nail hardeners Nail polish QPIC Annual Report 2008 8 92 37 Nail polish remover: acetone Nail polish remover: ethyl acetate Nail polish remover: other/ unknown Nail products: other/ unknown Total for Nail products 55 36 23 39 253 Noxious food Ciguatera Fish poisoning (food, not envenomations) Food additives Food allergy Food poisoning Food products Food recall/ food scare Food spoilage Pet food Water (toxic/ contaminated) Total for Noxious food 10 7 43 13 111 158 12 112 19 80 565 Oils Camphor Clove oil (not toothache drops) Essential oil: other/ unknown 36 16 203 Eucalyptus oil Fragrant oil/ pot pourri oil Massage oils Peppermint oil Tea tree oil 175 53 6 14 48 Total for Oils 551 Other household agents Air freshener - liquid Air freshener - plug in Air freshener - solid Air freshener - spray Candle/ Wax Cigarettes and tobacco products Cold/ Freezer pack Dyes, fabric Dyes, food Dyes: other/ unknown Fabric freshener Fire extinguisher, BCF/ halon type Fire extinguisher, dry powder type Fire extinguisher, foam type Fire extinguisher, other/ unknown Fire starters Fireworks Fluorescent light bulb Glowstick, cyalume Household:other/ unknown Incense/ aromatherapy Insect coils, other/ unknown Insect coils, pyrethrin based Insect repellants -DEET based Insect repellants: other/ unknown Kitty litter Matches Meat absorption pad Naphthalene Paradichlorobenzene QPIC Annual Report 2008 63 27 8 53 9 127 70 5 5 10 8 1 29 2 2 23 2 36 250 33 8 5 21 157 101 15 4 33 44 6 38 Thermometer - mercury Thermometer: other/ unknown Total for Other household agents 104 10 1,271 Paints & similar Paint stripper, methylene chloride based Paint stripper: other/unknown Paint thinner (not mineral turpentine) Paint, anti-algae Paint, anti-corrosion Paint, lead Paint, oil-based Paint, two pack Paint, water-based (house) Paint: other/ unknown Varnishes and lacquers Wood stains Total for Paints & similar 11 10 47 3 3 12 33 13 47 107 6 9 301 Personal Hygiene Aftershave Anti-perspirants and deodorants Baby wipes Bath oil, bubble bath, bath preparations Cleanser, skin Cologne Cosmetics: other/ unknown Creams, lotions (non- medicinal) Depilatories Lipsticks and lip balms Make-up Perfume Shaving Cream Soap Sunscreen/ suntan products Talcum powder Total for Personal hygiene 34 105 4 90 42 1 39 85 37 26 25 99 13 98 65 30 793 Polishes Polish, car Polish, floor (inc Waxes and sealers) Polish, furniture Polish, metal Polish, shoe/boot Polish: other/ unknown Total for Polishes 8 1 14 14 8 1 46 Stationary, arts & crafts Arts, craft, hobby, writing products: other/ unknown Blu tac etc. Chalk Charcoal Clay QPIC Annual Report 2008 5 9 16 8 3 Correction Fluid 21 Crayon 14 Office supplies: miscellaneous 9 Paint, artist (non-water colour) 13 Paint, artist (water colour) 13 39 Paper/ cardboard 14 Pencil 17 Pens/ ink (inc. Stamp pad ink, textas) 160 Photographic chemicals 9 Photographic products: other/ unknown 2 Total for Stationary, arts & crafts Total for Other Total Poisons Involved 313 8,802 21.57% 39,461 *Some poisons result in exposures by more than one route. These receive a count for each exposure route. QPIC Annual Report 2008 40