Overview

Any substance consumed in excess can result in poisoning.  Substances that result in a poisoning, and the populations at risk of poisoning, vary greatly by intent and lethality.  A poisoning occurrence is considered either unintentional or intentional.  An unintentional poisoning occurs when the person taking or giving the substance did not mean to cause harm.  An intentional poisoning (e.g. self-harm, suicide & assault) results from a person consuming or giving someone else a substance with the intention of causing harm.

Occurrence

In BC, poisoning is a leading cause of both unintentional and intentional injury, accounting for more than 20% of injury-related deaths and hospitalizations.

According to the report, Poisonings in British Columbia, 2000-2005, each day in BC:

• At least 1 poisoning-related death occurs

• 13 poisoning-related hospitalizations take place

• 33 requests are made to BC Ambulance Service (BCAS) to attend poisoning events

• 72 calls are made to DPIC for information and advice

Drugs or medicinal agents are the predominant substances that result in poisoning deaths and hospitalizations, accounting for approximately 84%.  According to BC Drug and Poison Information Centre (DPIC) data, the majority of calls were related to non-prescription (22.8%) and prescription (22.2%) medications, followed by cleaners (10.2%), plants and mushrooms (6.9%) and chemicals (6.4%).

Costs

According to The Economic Burden of Injury in Canada report:

• Unintentional poisonings cost $152 million, annually (2004).  Direct costs totaled $44 million and indirect costs were $109 million.
• Suicide/Self-Harm due to poisoning cost $202 million (2004).  Direct costs totaled $104 million and indirect costs were $98 million. 
• Males accounted for 64% of total unintentional poisoning costs and females accounted for 36% of total costs.
• Males accounted for 54% of total suicide/self-harm due to poisoning costs and females accounted for 46%.

Prevention

Current evidence suggests the following practices to prevent and reduce poisoning-related events:

• Keep dangerous products out of sight and out of reach of your child.
• Keep medicine and cleaning products locked up.
• Never call medicine "candy" and do not take medicine in front of a child because he or she might copy you.
• Avoid the use of cleaning products when children are close by.
• Keep all cigarettes, butts and ashtrays away from children.
• Keep products in their original containers. Make sure they are clearly labeled.
• Learn to identify poisonous household plants. Keep plants off the floor and away from crawling or walking children.
• Have a Poison Control emergency number handy in times of quick emergency.
• Place safety latches on all drawers or cabinets containing harmful products and use products that have child-resistant safety caps.  Be aware that child-resistant caps are not child-proof.
• Never administer Ipecac without instructions from a doctor or the Poison Control Centre.

Negative effects have been found regarding the use of warning labels – colourful stickers (e.g. Mr. Yuk) placed on the containers of hazardous substances to warn and deter children from handling or ingesting the contents.  Evidence suggests either no effect of the intervention or an increase in children’s handling of labeled medicine.  Warning stickers are not a good deterrent for children and may in fact serve as an attraction. Warning stickers can not be recommended for use as a poisoning deterrent for children.

Resources

Poisoning resources are readily available in BC, both for emergency situations and prevention information.

In Case of Emergency

• 911 Emergency Contact

• BC Drug and Poison Information Centre (BC DPIC)

Greater Vancouver: 604 682-5050

Phone toll-free: 1-800-567-8911

Website: www.dpic.org

For Poisoning and Prevention Information

• BC Drug and Poison Information Centre (BC DPIC)

Greater Vancouver: 604 682-5050

Phone toll-free: 1-800-567-8911

Website: www.dpic.org

• BC NurseLine

Phone toll-free in BC: 1-866-215-4700

Greater Vancouver: 604-215-4700

Deaf and hearing impaired toll-free province-wide: 1-866-TTY-4700

Website: www.bchealthguide.org/nurseline.stm

• Public Health Units/Community Health Centres

Offer a wide range of services to promote the optimal physical development, communication and cognitive abilities, healthy emotional attachment, and positive social development for all infants and children. Services include: breastfeeding clinics, nutrition information and consultation, parent and infant drop-in, child health clinics, and family and infant follow-up. Contact your local health authority for information.

• Baby’s Best Chance & Toddler’s First Steps

Baby's Best Chance Parents' Handbook of Pregnancy and Baby Care, the Sixth

Edition (2005), and Toddler’s First Steps, the Second Edition (2008) are published by the Government of British Columbia. Baby’s Best Chance covers ages 0 to 6 months and offers general safety tips. Toddler’s First Steps covers ages 6 to 36 months and include poison prevention and treatment information. Both of these resources are available from public health offices or via the BC Ministry of Health website: http://www.health.gov.bc.ca (select Reports and Publications).

• Canadian Poisonous Plants Information System

Poisonous plants by botanical and common names; includes interactive search tool.  Website: www.cbif.gc.ca/pls/pp/poison

For Poison Prevention Materials & Factsheets

• BC Drug and Poison Information Centre (DPIC):

o Phone Stickers: Lower Mainland, Toll Free (outside lower mainland)

o Fridge Magnets: Lower Mainland and Toll Free

o Posters: “Kids and Pills”, “Medicine Cabinet”, “Thirsty?”

o Pamphlets: “Poison Awareness” (includes First Aid for Poisoning):

English, Chinese, French, Korean, Persian, Punjabi, Spanish, Vietnamese; “Plant Awareness”: English only

o Factsheets: “Poisonings”, “Springtime Hazards”, “Holiday Hazards”

• Health Canada

o Consumer Product Safety

• Reports & Publications; Reports & Publications for Industry & Health Professionals: Stay Safe - An Education Guide to Hazard Symbols
• Reports & Publications; Publications for Consumer Education: Aim for Safety – Target the Label (Factsheet)

Phone: 1-866-662-0666

Website: www.hc-sc.gc.ca/cps-spc

Aboriginal Resources

Poisoning resources specific to aboriginal communities include:

• Health Canada; First Nations, Inuit and Aboriginal; Health Promotion; Keeping Safe-Injury Prevention: Preventing Unintentional Poisoning Includes poisoning prevention information as well as links to other resources.

Website: www.hc-sc.gc.ca

Content References

Han, G., Turcotte, K., Jivani, K., Babul, S. and Pike, I. (2009).  Poisonings in British Columbia 2000-2005. BC Injury Research and Prevention Unit. 

SMARTRISK. (2009). The Economic Burden of Injury in Canada.  SMARTRISK: Toronto, ON.