College of Veterinary Medicine, Department of Population Health and Pathobiology, North Carolina State University, Raleigh, NC, 27606, USA.
North Carolina Poison Control, Atrium Health, Charlotte, NC, 28208, USA.
Environ Health. 2024 Oct 5;23(1):80. doi: 10.1186/s12940-024-01121-y.
Harmful algal bloom occurrences have been increasingly reported globally and over time. Exposure to the variety of toxins and co-contaminants that may be present in harmful algal blooms can cause illness and even death. Poison control data is a valuable public health information source that has been used to characterize many types of toxin exposures, including harmful algal blooms. Prior studies have been limited by location and time, and knowledge gaps remain regarding cyanobacteria harmful algal bloom (cyanoHAB) exposure circumstances, and the breadth and severity of associated clinical effect.
The objective of this study was to characterize epidemiologic and clinical features of cyanoHAB exposure cases reported to 55 US poison control centers and available in the National Poison Data System (NPDS). We identified 4260 NPDS cyanoHAB exposure cases reported from 2010 to 2022, including symptomatic exposure cases with and without clinical effects related to the exposure and asymptomatic exposure cases. We assessed demographics; exposure routes, locations, chronicity; clinical effects; and medical outcomes. We calculated case rates annually and 13-year case rates by US geographic division.
Over half of cyanoHAB exposure cases were children < 20 years old (n = 2175). Most cyanoHABs exposures occurred in a "public area" (n = 2902, 68.1%); most were acute (≤ 8 h) (n = 3824, 89.8%). Dermal and ingestion routes and gastrointestinal effects predominated. 2% (n = 102) of cases experienced a moderate or major medical outcome; no deaths were reported. National rates increased from 0.4 cases/1 million (1 M) person-years in 2010 to 1.4 cases/1 M person-years in 2022. The Mountain division had the highest 13-year rate (7.8 cases/1 M person-years).
CyanoHAB exposure case rates increased 2010-2022, despite a decrease in all-cause exposure cases during the same period. NPDS data provide valuable public health information for characterization of cyanoHAB exposures, an emerging public health challenge.
有害藻类大量繁殖的情况在全球范围内日益频繁，时间跨度也越来越长。接触到大量有害藻类中可能存在的毒素和共存污染物，会导致疾病，甚至死亡。毒物控制数据是一种宝贵的公共卫生信息来源，已被用于描述多种类型的毒素暴露情况，包括有害藻类大量繁殖。先前的研究受到地点和时间的限制，关于蓝藻有害藻类大量繁殖（cyanoHAB）暴露情况、相关临床效应的广度和严重程度，仍存在知识空白。
本研究的目的是描述向 55 个美国毒物控制中心报告并可在国家毒物数据系统（NPDS）中获得的 4260 例美国 NPDS 蓝藻有害藻类大量繁殖暴露病例的流行病学和临床特征。我们确定了 2010 年至 2022 年期间报告的 4260 例 NPDS 蓝藻有害藻类大量繁殖暴露病例，包括有和无暴露相关临床效应的症状性暴露病例和无症状性暴露病例。我们评估了人口统计学特征；暴露途径、地点、持续性；临床效应；以及医疗结局。我们按美国地理区域计算了每年和 13 年的病例发生率。
超过一半的蓝藻有害藻类大量繁殖暴露病例为年龄小于 20 岁的儿童（n=2175）。大多数蓝藻有害藻类大量繁殖暴露发生在“公共区域”（n=2902，68.1%）；大多数为急性（≤8 小时）（n=3824，89.8%）。皮肤和摄入途径以及胃肠道效应占主导地位。2%（n=102）的病例出现中度或重度医疗结局；没有报告死亡。全国范围内的病例发生率从 2010 年的 0.4 例/100 万人年增加到 2022 年的 1.4 例/100 万人年。山区的 13 年发病率最高（7.8 例/100 万人年）。
尽管在同一时期所有原因的暴露病例减少，但 2010-2022 年蓝藻有害藻类大量繁殖暴露病例的发生率仍在增加。NPDS 数据为蓝藻暴露的特征描述提供了有价值的公共卫生信息，这是一个新出现的公共卫生挑战。
