• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.9-15
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• 2008

Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

• Journal of Environmental Health Sciences
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• v.46 no.2
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• pp.184-191
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• 2020

Objectives: This study was performed to analyze cases of food poisoning outbreaks reported in Chungcheongnamdo Province in 2019 and report it as effective data for preventing food poisoning in the future. Methods: Food poisoning outbreaks were analyzed to detect virus, bacteria, and protozoa according to the Manual for Detection of Foodborne Pathogens in Outbreaks to clarify the causes of food poisoning that occurred in Chungcheongnam-do Province in 2019. Results: Among the 79 cases of food poisoning outbreaks, 59 cases (74.7%) were in general restaurants, 15 cases (19.0%) in food service institutions, three cases at banquets, and two cases in take-out food. The 42 cases at general seafood restaurants made up the majority of food poisoning in Chungcheongnam-do. Food poisoning pathogens were shown in 13 cases (86.7%) out of the 15 cases at food service institutions, and 10 cases were related to Norovirus. Among the 79 cases, food-borne pathogens were identified in 35 cases of outbreaks, accounting for 44.3%. The confirmed pathogens were as follows: bacteria (24 cases), Norovirus (12 cases) and Kudoa septempunctata. (five cases). The food-borne bacteria were pathogenic E. coli (12 cases), Staphylococcus aureus (six cases), Salmonella spp. (two cases), Campylobacter jejuni, Bacillus cereus, Clostridium perfringens, and Vibrio parahaemolyticus (one case). Conclusions: To prevent food poisoning, it is necessary to analyze regional characteristics and environments and to hold a campaign for the prevention of food poisoning based on that analysis. In addition, when food poisoning occurs, the results of analyzing its cause and spread based on accurate epidemiological survey need to be shared.

• The Korean Journal of Pesticide Science
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• v.12 no.2
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• pp.134-140
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• 2008

The data on pesticide poisoning death toll during 2000-2005 was obtained from Korean National Statistical Office and analysed to find out any precautionary measures against pesticide poisonings. Pesticide poisoning death toll showed slightly increasing trend with year up to about 3500 in 2005. Most of the pesticide poisoning death cases were intentional self-poisoning accounting for more than 80% of total pesticide poisoning death. The pesticide most often implicated in poisoning death were paraquat dichloride, a non-selective herbicide and organophosphate/carbamate insecticides. The regional distribution of pesticide poisoning death showed urban 21.6% and rural area 78.4%. As for the occupation of the dead, agricultural, forestry and fishery workers accounted for 27.4% and non-agricultural workers was 72.6% of pesticide poisoning death. Therefore, government need to take some precautionary measures to reduce the number of pesticide poisoning cases. It is strongly recommended that pesticide regulatory authorities encourage and train the agricultural workers to use safe storage boxes and enforce strict regulation for the prevention for the prevention of highly toxic pesticides sales to non-agricultural workers.

• Journal of Industrial Convergence
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• v.17 no.3
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• pp.9-16
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• 2019

In this study, we wanted to analyze the causes of food poisoning and its major occurrence in September 2018 and analyze the relevance of the HACCP certification system to report the correlation. Based on three-year food poisoning cases and causative substances data, and big data on HACCP certification companies and food poisoning frequency, Hygiene 1: 'Salmonella would have spread through school food processing medium.' Hypothesis 2: The difference in the number of food poisoning cases in the last three years as the number of HACCP certifier increases, the number of food poisoning cases will be verified and the cause of food poisoning in September 2018. Studies show that the food poisoning in September 2018 was caused by salmonella bacteria and that outsourced food provided through school meals was the cause. It was also shown that the expansion of HACCP certification did not significantly contribute to the reduction of food poisoning. Therefore, the management operation measures were proposed as a solution to prevent salmonella and to become HACCP certification that could reduce food poisoning.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.85-93
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• 2020

Purpose: The annual statistics for poisoning are reported based on the data from poison control centers in many advanced countries. In 2016 a study was conducted to analyze the 2016 Korea Poisoning status. This study was conducted to make a better annual report for poisoning statistics in Korea from a 2017-2018 national representative database. Methods: This study was a retrospective analysis of poisoning patients based on the data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2017-2018. Bite or sting injuries were not included. Results: A total of 17714 patients presented to 23 EDs because of poisoning. Adults above 20 years old age accounted for 84.6% of the population, while the proportion of intentional poisoning was 60.8%. The poisoning substance presented in the ED were therapeutic drugs (51.2%), gas (20.3%), pesticides (16.4%), and artificial substances (11.4%). Overall, 35% of patients were admitted for further treatment. The mortality was 2.4% (422 cases), and the most common fatal substances in order were carbon monoxide, other herbicides, and paraquat. Conclusion: This study showed the 2017-2018 status of poisoning in Korea. The prognosis is different from the cause of poisoning and the initial mental state of the patient. Therefore, appropriate methods for preventing poisoning and therapeutic plans in specific situations are needed.

• Journal of Food Hygiene and Safety
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• v.2 no.4
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• pp.215-237
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• 1987

This study was conducted to prepare some information about food poisoning outbreaks in Korea. In this study, all reported data were reviewed, but the data during recent ten years (1977-1986) were mainly analyzed because of data shortage. We used three year moving averages in order to investigate the trend to food poisoning outbreaks, by year, foodborne pathogens, specific foods, and place food contaminated or mishandled.

• Journal of Food Hygiene and Safety
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• v.12 no.3
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• pp.240-253
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• 1997

The main problems contributing to food poisoning outbreaks in institutional settings and a home were reviewed and analyzed through the epidemiological investigations of food poisoning. The major documented factors included improper holding temperatures, inadequate cooking, poor personal hygiene, cross-contamination and contaminated equipment, food from unsafe sources, failure to follow food hygiene policies, and lack of education, training, monitoring and superivision. Usually more than one factor contributed to the development of an outbreak. (1) Use of improper holding temperatures was the single most important factor contributing to food poisoning. They included improper cooling, allowing a laps of time (12 hours or more) between preparing food and eating it, improper hot holding, and inadequate or improper thawing. Food thermometers were not used in most of the instances. (2) In inadequate cooking, the core temperature of food during and after cooking had not been measured, and routine monitoring was limited to recording the temperature of plated meals. Compared with conventional methods of cooking, microwave ovens did not protect against food poisoning as effectively. Centralized food preparation potentially increased the risk of food poisoning outbreaks. (3) Poor personal hygiene both at the individual level (improper handwashing and lack of proper hygienic practices) and at the institutional level (poor general sanitization) increased the risk of transmission. Person to person transmission of enteric pathogens through direct contact and via fomites has been noted in several instances. (4) Obtaining food from unsafe sources was a risk factor in outbreaks of food poisoning. Food risks were high when food was grown or harvested from contaminated areas. Possibilities included contamination in the field, in transport, at the retail site, or at the time it was prepared for serving. (5) Cross-contamination and inadequate cleaning/handling of equipment became potential vehicles of food poisoning. Failure to separate cooked food from raw food was also a risk factor. (6) Failure to follow food hygiene policies also provided opportunities for outbreaks of food poisoning. It included improper hygienic practices during food preparation, neglect of personnel policies (involvement of symptomatic workers in food preparation), poor results on routine inspections, and disregarding the results and recommendations of an inspection. (7) Lack of formal and in-service education, training, monitoring, and supervision of food handlers or supervisors were critical and perhaps neglected elements in occurrences of food poisoning.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.71-77
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• 2015

Purpose: Acute endosulfan poisoning is rare but causes significant morbidity and mortality. The aim of our study is to describe complications and features of seizure and determine factors associated with mortality in acute endosulfan poisoning. Methods: Twenty-eight adult patients with acute endosulfan poisoning admitted to our emergency department during a 15-year period were studied retrospectively. The clinical features of seizure, use of antiepileptic drugs during seizure, and hospital courses were evaluated. Clinical factors between survived group and non-survived group were compared for identification of factors associated with mortality. Results: Of the 28 patients with endosulfan poisoning, 4 patients (14.3%) died and 15 (53.6%) patients developed generalized tonic-clonic seizure. Thirteen patients (46.4%) and 5 patients (17.9%) progressed to status epilepticus (SE) and refractory status epilepticus (RSE), respectively. SE and RSE were associated with mortality. Almost all significant complications including shock, acute renal failure, hepatic toxicity, rhabdomyolysis, and cardiac injury developed in SE and RSE patients. Conclusion: SE and RSE were important contributors to death in endosulfan poisoning. Emergency physicians treating endosulfan poisoning should make an effort not to progress seizure following endosulfan poisoning to SE and RSE using a rapid and aggressive antiepileptic drug.

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.81-87
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• 2011

Purpose: Incidents of suicide attempt and acute poisoning in the elderly population is rising. This study investigated the clinical nature of acute poisoning and differences between the survival and mortality groups in the elderly. Methods: We retrospectively investigated 325 patients with acute poisoning who visited the emergency department. Patients were divided into two groups, one survival and one death group. Information regarding patient sex, age, root cause of poisoning, time of year of poisoning, type of intoxicant, duration of time between intoxicant ingestion and arrival at the emergency department, total length of hospital stay, and any previous suicide attempts and subsequent hospitalization were collected. An initial Glasgow Coma Scale (GCS) and an initial and final Poison Severity Score (PSS) for each patient was calculated. Results: The survival rate for men was higher than for women in this study. The most common reason of drug intoxication was suicide, with accidental ingestion and substance abuse occurring in descending frequency. Seasonal factors were reflected in the data with the highest number of incidents occurring in spring and the lowest number in winter. Compared with the mortality group, the survival group had a lower initial PSS with a higher GCS. Conclusion: We conclude that being female, having suicide as a root cause, agrochemicals as an intoxicant, low initial Glasgow Coma Scale and high initial Poisoning Severity Score, are all associated with poor prognosis.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.27-32
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• 2005

Purpose: The frequency of carbon monoxide poisoning has been decreased in the interior of the Korea. But occasionally it is occurred and the risk of exposure is high in working place so far. Because of the characteristics of gas, the detection of exposure and poisoning could be delayed and fatality is high. We should apprehend of carbon monoxide poisoning. So we would report analysis of patients with carbon monoxide poisoning. Methods: A retrospective review of CO poisoned patients visited emergency department from January 2000 to December 2004 was conducted. Results: 24 patients were enrolled. Their average of age was $37.6\pm20.9$ years old and COHb was $19.4\pm13.32\%$. The blood level of initial COHb and mental status on arrival were not correlated each other. The blood level of initial COHb and loss of consciousness were not correlated, too. Initial electrocardiography (EKG) was not correlated with cardiac enzymes such as CK-MB and troponin I. But base excess was correlated with mental status on arrival and complication such as rhabdomyolysis. Hyperbaric oxygen therapy was correlated with base excess and mental status on arrival. Conclusion: The clinical features of carbon monoxide poisoning are nonspecific. For proper diagnosis, it is important that we should consider patient's environment and take patient's history carefully. The blood level of initial COHb does not reflect severity of poisoning accurately. So We should determine the treatment of choice depending on patient's status.