Abstract
There are over 2 million human exposure cases reported to United States poison centers annually. Much of the data involves exposure through ingestion, dermal contact, inhalation, ocular, or parenteral routes. There is limited data characterizing exposure via atypical routes. We conducted a retrospective review of the California Poison Control System Database for a 24-month period from January 2012 to December 2013 for poison exposure that occurred through the otic, vaginal, or rectal route. There were a total of 634 cases involving single-route and single-substance atypical poison exposure. There were 287 (45 %) cases of otic exposure, 190 (30.0 %) cases of vaginal exposure, and 157 (25 %) cases of rectal exposure. Five hundred forty (85 %) of the cases were unintentional. Gasoline exposure through the otic route occurred in 83 (13.1 %) cases, followed by hydrogen peroxide (4.7 %), acetaminophen (3.8 %), and miconazole (2.7 %). Adverse effects occurred in 336 (53 %) cases. No deaths were reported. The most common treatment was observation only, occurring in 396 (62.4 %) cases. The majority of the cases did not warrant hospital evaluation (73.5 %). This is the first retrospective characterization study of atypical routes of poison exposure. These results may provide education to providers and the public regarding risks of exposure to substances through atypical routes.
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References
Mowry, J., Spyke, D., Mantilena, L., et al. (2013). 2012 Annual report of the American association of poison control centers’ national poison data system (NPDS): 30th Annual report. Clinical Toxicology, 51, 949–1229.
Millar, A. F. (1916). Perchloride of mercury poisoning by absorption from the vagina. British Medical Journal, 2(2909), 453–454.
Jones, P., Mutsvunguma, R., & Prahlow, J. A. (2014). Accidental death via intravaginal absorption of methamphetamine. Forensic Science, Medicine and Pathology, 10(2), 234–238.
Kundavaram, P., Majumdar, S., & Das, S. (2013). Intra-aural route of insecticide poisoning. Toxicology International, 20(2), 102–103.
Ong, M. L., & Glew, S. (1989). Paraquat poisoning: Per vagina. Postgraduate Medical Journal, 65(769), 835–836.
Doss, P. L., & Gowitt, G. T. (1988). Investigation of a death caused by rectal insertion of cocaine. The American Journal of Forensic Medicine and Pathology, 9(4), 336–338.
Cantrell, F. L., Breckenridge, H. M., & Jost, P. (2006). Transrectal methamphetamine use: A novel route of exposure. Annals of Internal Medicine, 145(1), 78–79.
Sheibani, S., & Gerson, L. B. (2008). Chemical colitis. Journal of Clinical Gastroenterology, 42(2), 115–121.
Senthikumaran, S., Balamurgan, N., Menezes, R., et al. (2011). An unusual case of attempted suicide by rectal administration of parathion. Journal of Forensic and Legal Medicine, 18(8), 383–384.
