Document Type : Original Article

Authors

1 Department of Emergency Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

2 Pathology and Stem Cell Research Center, Department of Pathology, kerman University of Medical Science, Kerman, Iran

Abstract

Background: The rise in drug and chemical production and availability has resulted in a growing issue of poisoning. Studying the epidemiology of poisonings aids in strategic planning and decision-making for the control and reduction of poisoning cases. This study was conducted to explore the epidemiology of fatal poisonings among young adults.
Methods: This cross-sectional study utilized data from the Kerman Legal Medicine Organization records, collected through census sampling. In total, the records of 507 individuals aged 14 to 29 years, who died from poisoning and were referred to the Kerman Legal Medicine Organization between 2012 and 2022, were included in the study. The data were analyzed using chi-square and logistic regression tests (SPSS software, with p<0.05).
Results: The majority of those who died from poisoning were males (67.1%), unmarried (72.8%), residing in urban areas (61.5%), and had under-diploma education (50.7%). Among opioids, methadone, and among chemical poisons, paraquat, were responsible for the highest number of fatal poisonings. The education level showed an inverse relation with chemical poisoning, and a direct relation with non-opioid drug poisoning (R=-0.130, p=0.006). The majority of individuals who died outside the hospital had opioid poisoning.
Conclusion: A strategic macro-decision on a national scale is crucial for preventing fatal poisonings. At the regional level, it is necessary to raise awareness among students aged over 14 years about methadone, the naloxone antidote, and herbicide paraquat. Supplying naloxone nasal spray to organizations that interact with addicts can effectively decrease fatalities from poisoning.

Keywords

Main Subjects

  1. Albano GD, Malta G, La Spina C, Rifiorito A, Provenzano V, Triolo V, et al. Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries. Toxics. 2022;10(11):654.
  2. De Presgrave RF, Camacho LAB, Boas MHSV. A profile of unintentional poisoning caused by household cleaning products, disinfectants and pesticides. Cad Saude Publica. 2008;24(12):2901–8.
  3. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Hassanian-Moghaddam H, Abdollahi M. Pattern of acute poisoning in Tehran-Iran in 2003. Hum Exp Toxicol. 2007;26(9):753–6.
  4. Wang L, Wu Y, Yin P, Cheng P, Liu Y, Schwebel DC, et al. Poisoning deaths in China, 2006–2016. Bull World Health Organ. 2018;96(5):314.
  5. Ahmadi H, Hosseini J, Rezaei M. Epidemiology of tramadol overdose in Imam Khomeini hospital, Kermanshah, Iran (2008). J Kermanshah Univ Med Sci. 2011;15(1):72–7.
  6. Soltaninejad K, Hassanian-Moghaddam H, Shadnia S. Methadone related poisoning on the rise in Tehran, Iran. Asia Pacific J Med Toxicol. 2014;3(3):104–9.
  7. Saki K, Bahmani M, Zamanian G, Abbasi N, Aidy A, Manouchehri A, et al. Evaluation of morphine, methadone, digoxin, and dronabinol poisoning during the years 2017 to 2019 in Ilam, Iran. Casp J Intern Med. 2023;14(2):356–64.
  8. Aghababaeian H, Ahvazi LA, Ostadtaghizadeh A. The methanol poisoning outbreaks in Iran 2018. Alcohol Alcohol. 2019;54(2):128–30.
  9. Delirrad M, Mohammadi AB. New Methanol Poisoning Outbreaks in Iran following COVID-19 Pandemic. Alcohol Alcohol. 2020;55(4):347–8.
  10. Alinejad S, Zamani N, Abdollahi M, Mehrpour O. A narrative review of acute adult poisoning in Iran. Iran J Med Sci. 2017;42(4):327–46.
  11. Nourbakhsh F, Barangi S, Dadpour B, Tajoddini S. Aluminum phosphide poisoning, mechanism of action and treatment: A literature review. J Kerman Univ Med Sci. 2019;26(5):406–19.
  12. Moghadamnia AA, Abdollahi M. An epidemiological study of poisoning in Northern Islamic Republic of Iran. East Mediterr Heal J. 2002;8(1):88–94.
  13. Mahmoudi GA, Asaee R. Epidemiologic study of Organophosphate and Organochlorate pesticides poisoning in hospitalized patients in khorramabad Shohada Ashayer hospital from Mars to August 2006. Yafte. 2008;10(1):3–10.
  14. Nasiri E, Talebi P, Mahmoudpour Q, Rezaei Orimi J. Epidemiology Study on Poisoning in Patients Received Pre-hospital Emergency Services in Ghaemshahr, Iran. J Guilan Univ Med Sci. 2021;30(1):28–39.
  15. Torkashvand F, Sheikh Fathollahi M, Shamsi S, Kamali M, Rezaeian M. Evaluating the Pattern of Acute Poisoning in Cases Referred to the Emergency Department of Ali-ebn Abi Taleb Hospital of Rafsanjan from October 2013 to September 2014. J Rafsanjan Univ Med Sci. 2015;14(4):311–24.
  16. Mohammad Hosseini S, Karimi Z, Afrasiyabifar A, Naeimi E, Moghimi M, Sadat SJ. Causes of Acute Poisoning Hospital Admission in Shahid Beheshti Hospital of Yasuj, 2008. Armaghane danesh. 2012;17(3):263–71.
  17. Faziollahi ZZ, Maleki M, Shaikhi N. Epidemiology of adult poisoning in Talegani of Urmia 2004-2007. J Urmia Nurs Midwifery Fac. 2010;8(2):69–74.
  18. Mahmoudi GA, Astaraki P, Farhadi A, Nazari Y. The evaluation of poisoning mortality in the admitted patients in Shohada Ashayer hospital of Khorramabad from 2006 to 2010. Yafte. 2013;15(1):43–50.
  19. Afzali S, Mani Kashani K, Abbasi Kolsoum F. Pattern of Mortality Due to Poisoning by Drugs and Chemical Agents in Hamadan Iran 2005-2007. Qom Univ Med Sci J. 2008;2(2):27–31.
  20. Jalilian J, Shayeste Y. Demographic features and causes of death due to poisoning in vulnerable group of Golestan province during 2010-2016. Iran J Emerg Care. 2017;1(1):43–51.
  21. Oraie M, Hosseini MJ, Islambulchilar M, Hosseini SH, Ahadi-Barzoki M, Sadr H, et al. A Study of Acute Poisoning Cases Admitted to the University Hospital Emergency Department in Tabriz, Iran. Drug Res (Stuttg). 2017;67(3):183–8.
  22. Ghodsi Z, Moghaddam SS, Saadat S, Yoosefi M, Rezaei N, Ostadrahimi H, et al. Trend of fatal poisoning at national and provincial levels in Iran from 1990 to 2015. Public Health. 2019 May;170:78–88.
  23. Moghadam Nia AA, Abdollahi M. An epidemiological study of acute poisoning in Babol during 1993-95. J Babol Univ Med Sci. 1999;1(1):19–26.
  24. Yeganeh RA, Salehi NA, Moghadam HH, Taremi M, Ahmadi M, Sharifi M, et al. Mortality Resulting from Poisoning with Depilatory Agent in Patients Who Referred to Loghman Hakim Hospital from 1991 to 2003. Sci J Forensic Med. 2006;12(2):90–4.
  25. Mahdizadeh G, Manouchehri AA, Zarghami A, Moghadamnia AA. Prevalence and causes of poisoning in patients admitted to shahid beheshti hospital of babol in 2011-2012. J Babol Univ Med Sci. 2015;17(7):22–8.
  26. Rahmani AH, Jafari M, Farnam M, Zafari J. Evaluation of Epidemiologic of Drug Poisoning in the Ahvaz Razi Hospital in the Years of 2004-2008. Sci J Forensic Med. 2015;21(1):43–6.
  27. Masoumi G, Eizadi-Mood N, Akabri M, Sohrabi A, Khalili Y. Pattern of Poisoning in Isfahan. J Isfahan Med Sch. 2011;29(163):2003–10.
  28. Jafarzadeh S, Mobasheri F, Care ZMIJ of E, 2017‏ U. Characteristics of Hospitalized Patients due to Intentional and Unintentional Poisoning in Fasa City, 2014-2016‏. Iran J Emerg Care‏. 2017;1(2):9–18.
  29. Shokrzadeh M, Jalilian J, Hoseinpoor R, Hajimohammadi A, Delaram A, Shayeste Y. Prevalence and causes of unintentional poisonings in patients admitted to the 5Azar Hospital of Gorgan, during 2008–2015. Beyhagh. 2017;21(4):1–11.
  30. Shojaei Baghini M, NaseriBooriAbadi T, Rastgoo M, Poornakhaei M, Mohammadpour A. Epidemiology of poisoning in patients admitted to Afzalipour Teaching Hospital in Kerman, Iran. Iran J Epidemiol. 2022;18(2):91–103.
  31. Afzali S, Rashidi P. A One-Year Study of Mortality Due to Drug and Chemical Poisoning in Sina Hospital of Hamadan. Sci J Hamadan Univ Med Sci. 2003;10(3):62–6.
  32. Mehrpour O, Akbari A, Jahani F, Amirabadizadeh A, Allahyari E, Mansouri B, et al. Epidemiological and clinical profiles of acute poisoning in patients admitted to the intensive care unit in eastern Iran (2010 to 2017). BMC Emerg Med. 2018;18(1):1–9.
  33. Ramezanzadeh H, Khosravi N, Hosseininejad SM, Mahmoodi M, Zakariaei Z, Sadeghi M. Epidemiological Aspects of Opioid Poisoning in Northern Iran: A Registry-Based Clinical Study. Heal Serv Insights. 2024;17:1–5.
  34. Razmarai Iranagh S, Kazemi S, Nejadrahim R, Rajaei Salmasi M, Hosseinzadeh P. Demographic and epidemiological features of patients admitted due to poisoning in hospitals of Urmia University of Medical Sciences. Iran J Forensic Med. 2022;28(1):17–26.
  35. Shokrzadeh M, Hajimohammadi A, Delaram A, Shayeste Y. Characteristics of patients hospitalized with Tramadol intoxication in Gorgan, Iran, 2008-2015. J Maz Univ Med Sci. 2017;26(146):185–90.
  36. Eizadi-Mood N, Sabzghabaee AM, Badri S. Paraquat poisoning: What the acute care physician needs to know? J Isfahan Med Sch. 2011;29(148):997–1006.
  37. Kavousi-Gharbi S, Jalli R, Rasekhi-Kazerouni A, Habibagahi Z, Marashi SM. Discernment scheme for paraquat poisoning: A five-year experience in Shiraz, Iran. World J Exp Med. 2017;7(1):31.