National Poisons Information Service, Royal Infirmary of Edinburgh , Edinburgh , UK.
Clin Toxicol (Phila). 2014 Jun;52(5):549-55. doi: 10.3109/15563650.2014.908203. Epub 2014 Apr 16.
Although there are extensive systems in place for pharmacovigilance, similar systems for detecting adverse health effects relating to pesticide exposure are rare. In 2004, the National Poisons Information Service (NPIS) pesticide surveillance study was implemented to identify cases requiring health care contact in the UK. This report describes the epidemiology of pesticide exposures reported to poison centres in the UK over a 9-year period.
Data on exposures were gathered through monitoring access to the NPIS's online clinical toxicology database TOXBASE(®) and through monitoring calls to the four NPIS units (Edinburgh, Cardiff, Newcastle and Birmingham). Severity was judged by both caller and NPIS staff.
During the 9 years, 34,092 enquiries concerning pesticides were recorded; 7,804 cases of pesticide exposure were derived from these enquiries. Exposures were predominantly unintentional and acute (6,789; 87.0%); 217 (2.8%) and 755 (9.7%) were chronic unintentional and acute deliberate self-harm exposures, respectively. The majority of cases occurred in children, especially the 0-4 year age group The minimum incidence of pesticide exposure requiring health care contact was 2.0 cases/100,000 population per year. Reported numbers were 6- to 25-fold greater than those picked up through other UK pesticide toxicovigilance schemes. There were 81 cases of severe toxicity and 38 cases of fatal exposure. Deliberate self-harm accounted for 62.3% of severe cases and 79% of deaths. Aluminium phosphide, paraquat, diquat and glyphosate were responsible for most severe and fatal cases.
The data gathered from this pesticide surveillance study indicate that poison centre resources can usefully monitor pesticide exposures resulting in health care contact in the UK. The NPIS may usefully be one component of the UK's response to European legislation requiring surveillance of complications resulting from pesticide use.
尽管有广泛的药物警戒系统，但类似的检测农药暴露相关不良健康影响的系统却很少。2004 年，英国国家毒物信息服务处（NPIS）实施了农药监测研究，以确定英国需要医疗保健接触的病例。本报告描述了在 9 年期间向英国毒物中心报告的农药暴露的流行病学情况。
通过监测 NPIS 在线临床毒理学数据库 TOXBASE(®)的访问情况以及通过监测 NPIS 四个单位（爱丁堡、卡迪夫、纽卡斯尔和伯明翰）的来电情况，收集了有关暴露的数据。严重程度由来电者和 NPIS 工作人员共同判断。
在 9 年期间，共记录了 34092 次有关农药的咨询；从这些咨询中得出了 7804 例农药暴露病例。暴露主要是意外的和急性的（6789；87.0%）；217 例（2.8%）和 755 例（9.7%）分别为慢性意外和急性故意自我伤害暴露。大多数病例发生在儿童中，尤其是 0-4 岁年龄组。需要医疗保健接触的农药暴露的最低发病率为每 10 万人每年 2.0 例。报告的数字比其他英国农药毒理学监测计划高出 6-25 倍。有 81 例严重毒性和 38 例致命暴露病例。故意自我伤害占严重病例的 62.3%，占死亡病例的 79%。磷化铝、百草枯、敌草快和草甘膦是大多数严重和致命病例的原因。
本农药监测研究收集的数据表明，毒理中心资源可有效地监测导致英国医疗保健接触的农药暴露。NPIS 可能是英国应对欧洲立法要求监测农药使用引起的并发症的一种有用手段。
