Descotes Jacques, Testud François
Centre Antipoison-Centre de Pharmacovigilance, 162 Avenue Lacassagne, 69424 Lyon cedex 03, France.
Toxicol Appl Pharmacol. 2005 Sep 1;207(2 Suppl):599-603. doi: 10.1016/j.taap.2005.02.019.
The concept of toxicovigilance encompasses the active detection, validation and follow-up of clinical adverse events related to toxic exposures in human beings. Poison centers are key players in this function as poisoning statistics are essential to define the cause, incidence and severity of poisonings occurring in the general population. In addition, the systematic search for unexpected shifts in the recorded causes of poisonings, e.g., following the introduction of a new product, or change in the formulation or recommended use of an old product, allows for a rapid detection of potential adverse health consequences and the implementation of preventive or corrective measures. However, toxicovigilance is genuinely a medical and not only a statistical approach of human toxicity issues. In contrast to epidemiology, toxicovigilance is based on the in-depth medical assessment of acute or chronic intoxications on an individual basis, which requires detailed information that poison centers can rarely obtain via emergency telephone calls and that epidemiologists cannot collect or process. Validation of this medical information must primarily be based on toxicological expertise to help identify causal links between otherwise unexplained pathological conditions and documented toxic exposures. Thus, toxicovigilance can contribute to hazard identification and risk assessment by providing medically validated data which are often overlooked in the process of risk assessment. So far, very few structured toxicovigilance systems have been set up and hopefully national and international initiatives will bridge this gap in our knowledge of the toxicity of many chemicals and commercial products in human beings.
毒物警戒的概念包括对与人类有毒暴露相关的临床不良事件进行主动检测、验证和跟踪。中毒控制中心在这一职能中发挥着关键作用，因为中毒统计数据对于确定普通人群中中毒的原因、发生率和严重程度至关重要。此外，系统地查找中毒记录原因的意外变化，例如在引入新产品之后，或旧产品的配方或推荐用途发生变化时，有助于快速发现潜在的健康不良后果并实施预防或纠正措施。然而，毒物警戒实际上是一种医学方法，而不仅仅是对人类毒性问题的统计方法。与流行病学不同，毒物警戒基于对个体急性或慢性中毒的深入医学评估，这需要详细信息，而中毒控制中心很少能通过紧急电话获得这些信息，流行病学家也无法收集或处理这些信息。这种医学信息的验证必须主要基于毒理学专业知识，以帮助确定原本无法解释的病理状况与记录在案的有毒暴露之间的因果关系。因此，毒物警戒可以通过提供医学验证的数据来促进危害识别和风险评估，而这些数据在风险评估过程中往往被忽视。到目前为止，很少有结构化的毒物警戒系统建立起来，希望国家和国际层面的举措能够填补我们在许多化学品和商业产品对人类毒性知识方面的这一空白。
