Epidemiology and Disease Surveillance Unit, Department of State Health Services, Austin, TX 78756, USA.
Clin Toxicol (Phila). 2012 Nov;50(9):847-50. doi: 10.3109/15563650.2012.731511.
In early 2012, concentrated laundry detergent packs began to be marketed in the United States. Around May 2012, poison centers began to notice that they were handling serious exposures among young children to these products.
This investigation examined whether a surveillance algorithm might have identified the exposures to laundry detergent packs among young children.
Cases were exposures reported to Texas poison centers during January-June in 2009, 2010, 2011, and 2012. The monthly number of exposures reported in 2012 was determined. The mean for the corresponding month in the preceding 3 years (2009, 2010, 2011) was calculated. If the 2012 monthly value was greater than the historic mean plus two standard deviations, then the 2012 value was considered to be elevated. The comparison was made for eight case definitions involving combinations of age (5 years or less), vomiting, and substance being laundry detergent.
When compared to historic values, in 2012 the monthly total exposures and all exposures involving young children were not elevated. Exposures among young children involving vomiting did not become elevated until June 2012. Exposures involving any laundry detergent became elevated in March and remained elevated through June.
Surveillance of total exposures, all exposures involving young children, and exposures involving vomiting would not have been effective for identifying the influx of calls due to exposures to laundry detergent packs involving young children. Surveillance of any laundry detergent exposures would have identified these calls almost immediately.
2012 年初,浓缩洗衣粉包开始在美国市场销售。大约在 2012 年 5 月,中毒控制中心开始注意到他们正在处理许多幼儿因接触这些产品而出现严重中毒的情况。
本研究旨在探讨监测算法是否可以识别出幼儿接触洗衣粉包的情况。
本研究纳入了 2009 年至 2012 年 1 月至 6 月期间向德克萨斯州中毒控制中心报告的中毒病例。确定了 2012 年报告的每月中毒例数,并计算了前 3 年(2009 年、2010 年和 2011 年)同期的月平均值。如果 2012 年的每月值大于历史平均值加上两个标准差,则认为 2012 年的值偏高。将年龄(5 岁及以下)、呕吐和接触物质为洗衣粉的 8 种病例定义进行了比较。
与历史值相比,2012 年每月总暴露数和所有涉及幼儿的暴露数均未升高。直到 2012 年 6 月,幼儿呕吐相关暴露数才开始升高。任何洗衣粉相关暴露数在 3 月升高,并持续升高至 6 月。
对总暴露数、所有涉及幼儿的暴露数以及涉及呕吐的暴露数的监测无法有效识别因接触幼儿用洗衣粉包而导致的大量中毒报告。对任何洗衣粉暴露数的监测几乎可以立即识别这些报告。