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Journal of Medical Toxicology

, Volume 15, Issue 1, pp 30–35 | Cite as

Study of Factors Contributing to Scorpion Envenomation in Arizona

  • Bethany K. Bennett
  • Keith J. Boesen
  • Sharyn A. Welch
  • A. Min KangEmail author
Original Article

Abstract

Introduction

Arizona has the highest incidence of scorpion envenomation reported to US poison control centers (PCCs). Most cases reported are from a residence, but specific details are limited.

Methods

Specialists at Arizona’s two PCCs prospectively completed the Factors of Envenomation in Arizona Residences Survey (FEARS) for residential scorpion exposures reported during 4-week periods in the summer and winter. Based on these results, a second questionnaire, FEARS-2, targeting indoor residential exposures was then administered.

Results

Among 382 FEARS responses, no significant differences were found between summer and winter exposures, except for rainfall in the previous 24 hours. Scorpions had previously been seen in 81.8% of exposures, and 29.4% reported a previous envenomation at the residence. Most exposures occurred indoors (86.5%) and in a bedroom (42.5%), where the scorpion was in the bed in 54.7% of cases. Among all stings in a bed, 72.7% occurred while sleeping. Children were stung more often in a family room (38.6% vs. 14.5%; p < .00001) and by a scorpion on the floor (53.5% vs. 35.0%; p = .0014). Distal extremities were stung most often, particularly the foot (34.5%), with most being while barefoot (81.9%).

Conclusion

A variety of characteristics and associations involving residential scorpion envenomations were identified. These details can be used to guide public education and primary prevention efforts to help decrease residential scorpion exposures.

Keywords

Centruroides sculpturatus Scorpions Poison control centers United States Surveys and questionnaires 

Notes

Funding

None.

Compliance with Ethical Standards

Conflict of Interest

None.

Supplementary material

13181_2018_690_MOESM1_ESM.pdf (96 kb)
ESM 1 (PDF 96 kb)
13181_2018_690_MOESM2_ESM.pdf (96 kb)
ESM 2 (PDF 95 kb)

References

  1. 1.
    Kang AM, Brooks DE. Nationwide scorpion exposures reported to US poison control centers from 2005 to 2015. J Med Toxicol. 2017;13(2):158–65.  https://doi.org/10.1007/s13181-016-0594-0.CrossRefPubMedGoogle Scholar
  2. 2.
    Valdez-Cruz NA, Dávila S, Licea A, Corona M, Zamudio FZ, García-Valdes J, et al. Biochemical, genetic and physiological characterization of venom components from two species of scorpions: Centruroides exilicauda Wood and Centruroides sculpturatus Ewing. Biochimie. 2004;86(6):387–96.  https://doi.org/10.1016/j.biochi.2004.05.005.CrossRefPubMedGoogle Scholar
  3. 3.
    Curry SC, Vance MV, Ryan PJ, Kunkel DB, Northey WT. Envenomation by the scorpion Centruroides sculpturatus. J Toxicol Clin Toxicol. 1983;21(4–5):417–49.CrossRefGoogle Scholar
  4. 4.
    Bibbs CS, Bengston SE, Gouge DH. Exploration of refuge preference in the Arizona bark scorpion (Scorpiones: Buthidae). Environ Entomol. 2014;43(5):1345–53.  https://doi.org/10.1603/EN14099.CrossRefPubMedGoogle Scholar
  5. 5.
    Boyer L. History of scorpion antivenom: one Arizonan’s view. Toxicon. 2013;69:14–20.  https://doi.org/10.1016/j.toxicon.2012.12.015.CrossRefPubMedGoogle Scholar
  6. 6.
    Armstrong EP, Bakall M, Skrepnek GH, Boyer LV. Is scorpion antivenom cost-effective as marketed in the United States? Toxicon. 2013;76:394–8.  https://doi.org/10.1016/j.toxicon.2013.09.001.CrossRefPubMedGoogle Scholar
  7. 7.
    Coorg V, Levitan RD, Gerkin RD, Muenzer J, Ruha AM. Clinical presentation and outcomes associated with different treatment modalities for pediatric bark scorpion envenomation. J Med Toxicol. 2017;13(1):66–70.  https://doi.org/10.1007/s13181-016-0575-3.CrossRefPubMedGoogle Scholar
  8. 8.
    Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.  https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefPubMedGoogle Scholar
  9. 9.
    Sharpe D. Your chi-square test is statistically significant: now what? Pract Assess Res Eval. 2015;20(8).Google Scholar
  10. 10.
    Beasley TM, Schumacker RE. Multiple regression approach to analyzing contingency tables: post hoc and planned comparison procedures. J Exp Educ. 1995;64(1):79–93.  https://doi.org/10.1080/00220973.1995.9943797.CrossRefGoogle Scholar
  11. 11.
    MacDonald PL, Gardner RC. Type I error rate comparisons of post hoc procedures for I x J chi-square tables. Educ Psychol Meas. 2000;60(5):735–54.  https://doi.org/10.1177/00131640021970871.CrossRefGoogle Scholar
  12. 12.
    Kang AM, Brooks DE. Geographic distribution of scorpion exposures in the United States, 2010–2015. Am J Public Health. 2017;107(12):1958–63.  https://doi.org/10.2105/AJPH.2017.304094.CrossRefPubMedGoogle Scholar
  13. 13.
    Santillán EG, Possani LD. North American scorpion species of public health importance with a reappraisal of historical epidemiology. Acta Trop. 2018.  https://doi.org/10.1016/j.actatropica.2018.08.002.

Copyright information

© American College of Medical Toxicology 2018

Authors and Affiliations

  1. 1.University of Arizona College of Medicine – Phoenix (UACOMP)PhoenixUSA
  2. 2.Arizona Poison and Drug Information CenterUniversity of Arizona College of PharmacyTucsonUSA
  3. 3.Center for Toxicology and Pharmacology Education and Research (CTPER)UACOMPPhoenixUSA
  4. 4.Banner Poison and Drug Information CenterPhoenixUSA
  5. 5.Department of Child HealthUACOMPPhoenixUSA
  6. 6.Division of Medical Toxicology and Precision Medicine, Department of MedicineUACOMPPhoenixUSA
  7. 7.Department of Medical ToxicologyBanner – University Medical Center PhoenixPhoenixUSA
  8. 8.Section of Toxicology, Department of MedicinePhoenix Children’s HospitalPhoenixUSA

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