Escitalopram causes fewer seizures in human overdose than citalopram

1
DO DETERGENTS CAUSE CORROSIVE EYE LESIONS? A
MULTINATIONAL ANALYSIS OF DATA FROM 11 POISONS
CENTRES WITHIN THE SCOPE OF GHS PART 1 RESULTS
ON FEASIBILITY AND FREQUENCY OF EXPOSURE
Stürer A (1), Seidel C (2), Sauer O (3), Zilker T
(4), Koch, I (5), Hermanns-Clausen M (6), Hruby K
(7), Hüller G (8), Heppner HJ (9), Tutdibi E
(10), Desel H (11)
Formula
(1) Swiss Toxicological Information Centre,
Zurich, Switzerland
?
?


(2) Poisons Centre, Childrens University
Hospital, Bonn, Germany
?
(3) Poisons Centre, University Hospital, Mainz,
Germany

• Objective
• Lowering threshold values when migrating to
  Globally Harmonised System of Classification and
  Labelling of Chemicals (GHS) may increase the
  number of products labelled as corrosive.
• There is serious concern about inappropriate
  labelling of domestic cleaning products. which
  may increase the risk of medical malpractice of
  exposed patients.
• An expert judgement supported by poisons
  centres data may help to assign the most
  appropriate label.
• There are no data available concerning the
  frequency of human exposure, particularly eye
  injuries, caused by cleaning products in Austria,
  Germany and Switzerland. Few publications provide
  an overview of eye injuries caused by consumer
  products in the USA (1) or focus on selected
  product groups in other countries.

(4) Poisons Centre, Clinical Toxicology,
University Hospital rechts der Isar, Munich,
Germany
(5) Poisons Information Centre, Institute of
Toxicology, Berlin, Germany

• Aims
• Feasibility of case selection with a harmonized
  Categorization System for Agents (TDI-CSA
  www.klinitox.de/142.0.html )
• Collection of case incidence (part 1)
• Collection of clinical data on eye exposures
  caused by domestic cleaning products (part 2)

• Methods
• The study is performed by the Society of
  Clinical Toxicology (www.klinitox.de)
• MAGAM-Study Multinationale, retrospektive
  Analyse von Daten der Giftinformationszentren zur
  Frage korrosiver Augenläsionen durch feste
  Maschinengeschirrspülmittel und andere Wasch-,
  Pflege- und Reinigungsmittel.
• 9 German PCs and the PCs of Vienna and Zurich
  retrospectively selected data from 1998 through
  2007.
• Inclusion criteria human eye exposure with 6
  groups of household cleaning products
  (dishwashing tabs and powders, all purpose
  cleaners, manual dishwashing products, laundry
  detergents, toilet cleaners, drain cleaners.
• Categorization of products was carried out using
  the harmonized TDI Categorization System for
  Agents (TDI-CSA) (2). Toxicological
  Documentation and Information Network

(6) Poisons Information Centre, Centre f.
Pediat. and Adolesc. Med., Freiburg, Germany
(7) Austrian Poisons Information Centre,
Vienna, Austria
(8) Poisons Information Centre, Erfurt, Germany
(9) Poisons Centre, University Hospital,
Nuremberg, Germany

• Results (Part 1)
• Nearly all PCs could provide data for the whole
  period under review (1998 2007). Fig. 1
• Since 2002 the annual number of cases is about
  210,000 in Austria, Germany and Switzerland.
  Fig. 2
• With 1,841,438 human exposure cases Tab. 1
  approx.88 of all cases documented in PCs in the
  3 countries and within the 10 years period could
  be analysed in the study.
• The total incidence of eye exposure is 1.6
  (28,956).
• 11.3 is related to household cleaning products
  with a frequency of 3.1 eye exposures in this
  product group.
• Most eye exposures within the 6 subgroups due to
  laundry detergents (668) and all purpose cleaners
  (547). There were fewer exposures to toilet
  cleaners (400), manual dishwashing products
  (300), dishwashing tabs and powders (162) and
  drain cleaners (108).
• The incidence of eye exposure in the 6 subgroups
  varies from 0.7 (manual dishwashing products) to
  4.3 (all purpose cleaners).

(10) Poisons Centre, Department of General
Paediat.and Neonatology, Homburg, Germany
(11) GIZ-Nord Poisons Centre, University Medical
Centre, Göttingen, Germany

• Conclusion
• The feasibility of case selection among different
  PCs with a harmonized Categorization System for
  Agents has been proved.
• The incidence of exposure / eye exposure to 6
  groups of household cleaning products has been
  evaluated.
• By now, 2,185 eye exposures have been uploaded to
  the common database of the society. Currently
  these cases are evaluated as to eye injuries in
  order to assess the potential corrosion risk of
  detergents.

XXIX International Congress of the
EAPCCTStockholm May 2009
Contact Andreas Stürer Swiss Toxicological
Information Centre Freiestrasse 16 CH-8032
Zürich Switzerland andreas.stuerer_at_usz.ch

• References
• 1) McGwin G Jr et al. Consumer product-related
  eye injury in the United States, 1998-2002. J
  Safety Res. 200637(5)501-6.
• 2) Stürer A et al. TDI-Project A harmonized
  category system for products in poisons centres
  (PC). Clin Toxicol 200341498.