IP International Journal of Forensic Medicine and Toxicological Sciences

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Online ISSN: 2456-9615

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IP International Journal of Forensic Medicine and Toxicological Sciences (IJFMTS) open access, peer-reviewed quarterly journal publishing since 2016 and is published under the Khyati Education and Research Foundation (KERF), is registered as a non-profit society (under the society registration act, 1860), Government of India with the vision of various accredited vocational courses in healthcare, education, paramedical, yoga, publication, teaching and research activity, with the aim of faster more...


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Malik, Sharma, Kumar Vashist, Sharma, Kumar, and Singh Yadav: An epidemiological study of poisoning trend in sonipat Haryana region-A one year study


Introduction

Poison is a substance that causes damage or injury to the body and endangers one’s life due to its exposure by means of ingestion, inhalation, or contact. Worldwide various agents such as agrochemicals, drugs or environmental agents are used as poisoning agents.1 There are more than 9 million natural and synthetic chemicals worldwide, and the list keeps growing inexorably.2 Organophosphorus (OP), Organochlorines (OC), Carbamates and Pyrethroids compounds are used as pesticides, herbicides, and chemical warfare agents in the form of nerve gases. Acute poisoning by these agents is a major global problem with thousands of deaths occurring every year.3 As per WHO records, more than 2 lakhs deaths occur per annum due to poisoning, of which maximum number of cases were agricultural professionals from developing countries. Acute poisoning is a medical emergency and morbidity and mortality related to poisoning is increasing day by day. In India, annually more than 50 thousand people die due to poisoning.4 As trends of poisoning varies from place to place, by knowing about patterns of poisoning of particular region, it will be easy to reach the source and reason behind poisoning cases, which will be helpful for prevention or reduction of it, as these tends to affect younger and productive age groups, which leads to increasing epidemiological social and medico-legal problem.5

Materials and Methods

In the present study 59 patients with severe poisoning came for postmortem at tertiary care Hospital in north India (Haryana region) from year 2012 to 2013, were studied for detail epidemiological and medicolegal analysis. Case of toxic effect of insecticide, pesticides and other noxious substance eaten as food and toxic effect of inhaled poisons were reported. This study include 40 males (M) and 19 females (F) consecutive cases with history of poison and route of administration (ingestion, inhalation and other), clinical symptom and signs help to diagnose the poisoning. The present study is an important and useful study of poisoning trends in north India.

Results

A total of 59 cases (40 males and 19 females) who died with alleged history of poisoning at tertiary care hospital at north India (Haryana region) in the time period of 2012 to 2013. Total 59 cases (49.17%) out of 120 were only of poisoning in that particular time (Table 1). Out of 59 cases 40 (67.8%) were male (M) and 19 (32.2%) were female (Table 2) (Figure 1). Male victims suffered poisoning more commonly than female victims. Numbers of male victim were probably more because India is a developing country and most of the people belong to middle or poor family. Financially they are facing more difficulty and due to this stress factor they follow the suicidal foot step. Others factor include troubles with relationships, or from bullying and a poor handling of emotions.

Table 1

Total post-mortem cases

Total poisoning Cases

120

59

Table 2

Sex

Total

Percentage

Male

40

67.8%

Female

19

32.2%

Figure 1

Figure 1

Gender distribution

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/66a92152-73a1-4f38-96c7-debea7808c23image1.png

Majority of victims with suspected use of poison 18 (30.5%) cases were found between the age group of 31-40 years, 17(28.8%) were in between 21-30 years, 9(15.3%) were in between 11-20 years, 6(10.2%) were in between 41-50 years, 5(8.5%) were in between 51-60 years, 2(3.4%) were in between 61-70 years and 1(1.7%) in between 71-80 years and 0-10 years, (Table 3) (Figure 2).

Table 3

Age

Total

Percentage

0-10

01

1.7

11-20

09

15.3

21-30

17

28.8

31-40

18

30.5

41-50

06

10.2

51-60

05

8.5

61-70

02

3.4

71-80

01

1.7

Figure 2

Age distribution

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/66a92152-73a1-4f38-96c7-debea7808c23image2.png

Majority of the Married patients 46 (77.9%) were attempted suicide than unmarried patients 13 (22.1%) (Table 4) (Figure 3). Regarding the social background of the patients, 49 (83.1%) reported from the rural area and 10 (16.9%) were reported from urban area (Table 5) (Figure 4)

Table 4

Marital status

N

%

Married

46

77.9

Unmarried

13

22.1

Figure 3

Marital status

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/66a92152-73a1-4f38-96c7-debea7808c23image3.png
Figure 4

Domicile

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/66a92152-73a1-4f38-96c7-debea7808c23image4.png
Table 5

Domicile

N

%

Rural

49

83.1

Urban

10

16.9

Regarding to the profession of the victims, 17 (28.1%) were housewife, 15 (25.4%) were labourer, 12 (20.3%) were farmer, 6 (10.1%) were doing private jobs), 4 (6.8%) were unemployed and students and 1 (1.2%) was doing other work (Table 6) (Figure 5)

Table 6

Profession

N

%

Labourer

15

25.4

Farmer

12

20.3

Private job

06

10.1

Unemployed

04

6.8

Student

04

6.8

Housewife

17

28.1

Other

01

1.2

Figure 5

Profession

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/66a92152-73a1-4f38-96c7-debea7808c23image5.png

Out of 59 cases, 25 (42.4%) were consumed organophosphorus for suicide, followed by unknown 19 (32.2), Aluminium phosphide (Celphos) 14 (23.7%) followed by alcohol with celphos 1 (1.7%) (Table 7) (Figure 6)

Table 7

Type of poison as per hospital record

Number of cases

%

Celphos

14

23.7

Organophosphate

25

42.4

Unknown

19

32.2

Alcohol + Unknown

1

1.7

Figure 6

Type of poison

https://s3-us-west-2.amazonaws.com/typeset-prod-media-server/66a92152-73a1-4f38-96c7-debea7808c23image6.png

Discussion

In the present study the commonest poisoning agent were organophosphorus compounds. Married males outnumbered females. Most of the cases were in the age group of 31-40 followed by 21-30 years. Acute poisoning was commonly seen among house wives, male laborers, farmers and students. Most of the victims belonged to rural region.

Higher poison victims were found among males (40 cases, 67.8%) than females (19 cases, 32.2%) which were similar with other studies2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 where as contradict the studies8, 9, 10, 11, 12 in which incidence was high among females.

Majority of victims were in the age group of 30 to 40 years (30.5%) followed by 20 to 30 year age group (28.81%). This is a cause for concern as this age group is the most productive group of any society. This can be explained by the fact that the person of this age group are suffering from stress of the modern lifestyles. These findings are in agreement with other studies.2, 3, 4, 5, 6, 7, 8, 9 Among 59 cases 46 (77.9%) were married remaining 13 (22.1%) were unmarried, these findings were correlated with the previous maximum studies.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 Regarding the social background of the victims 49 victims (83.1%) were belongs to rural area and 10 (16.9%) were belongs to urban area, these findings were in concurrence with the previous studies.1, 2, 3, 4, 5, 6, 7, 8, 9, 10 Occupationally, many cases were found among laborers (15 cases, 25.4%), farmers (12 cases, 20.3%) and house wives (17 cases, 28.1%) as these groups are more vulnerable groups and easily exposed to the poisoning agents. Poverty, inadequate income to run the family, monsoon failure was responsible for higher incidence of poisoning among laborers and farmers.14 Factors like dowry, cruelty by the in-laws, family quarrels, maladjustment in married life and dependence of women on husband are responsible for the higher incidence of poisoning among house wives.15 As agriculture is the main occupation of the people in our country and organophosphorous and Aluminium phosphide were commonly and easily available to farmers for their crops and their storage purpose. In our study the most commonly used agent for poisoning was organophosphorus 25 (42.4%) followed by aluminium phosphide 14 (23.7%). Organophosphorus poisoning is the most common suicidal poisoning substance in our study which was correlated with previous studies.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

We observed, poisoning was common among productive age group (21-40 years) that produce a huge socio economic burden on the society. The use of certain poisons to commit suicide depends on the availability and accessibility of the agent to an individual.12

Conclusion

The present study highlights the trends of poisoning in the region of Haryana. Poisoning was more frequent in younger male populations of rural areas and affecting the married people most. The major occupation of Indian people was agriculture (farmer) and usage of insecticides and pesticides is extensively used, so preventive measures in the form of public awareness, judicial usage, storage, spraying in fields with use of protective measures of insecticide should be promoted.

Source of Funding

None.

Conflict of Interest

None.

References

1 

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A Srivastava S S Peshin T Kaleekal S K Gupta An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical SciencesHum Exp Toxicol20052462798510.1191/0960327105ht527oa

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A Mishra An epidemiological study of poisoning trends in eastern region of NepalJ Indian Acad Forensic Med201941150210.5958/0974-0848.2019.00012.5

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P Verma M Nigam R Kulkarni P K Mishra P Misar Pesticides - Our Friends or FoeJ Indian Acad Forensic Med20184014751

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R Patel G Algotar U Solanki U Parekh T Mehta Study of patterns of death due to aluminium phosphide poisoning conducted at V.S. general hospital, AhmedabadInt J Int Med Res2015227380

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Y Zhang B Yu N Wang T Li Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016BMJ Open201888e02188110.1136/bmjopen-2018-021881

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T Karikalan M Murugan Profile of poisoning case in a tertiary care hospital,. Tamil NaduJ Evol Med Dent Sci2014356127546010.14260/jemds/2014/3692

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D Pokhrel S Pant A Pradhan S Mansoor A comparative retrospective study of poisoning cases in central, zonal and district hospitalsKathmandu Univ J Sci Eng Technol20084140810.3126/kuset.v4i1.2882

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B Singh K Kishore A K Chaudhary Epidemiological profile of complete suicidal poisoning cases autopsied at Autopsy centre, RIMS, RanchiInt J Med Toxicol Forensic Med2017713242

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B S Vinay S Gurudatta Pawar P I Inamadaa Profile of poisoning cases in district and medical college hospitals of north KarnatakaIndian J Forensic Med Toxico200822712

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V P Singh B R Sharma D Harish K Vij A ten year study of poisoning cases in a tertiary care hospitalIndian J Forensic Med Toxico20042111

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S Singh B K Sharma P L Wahi B S Anand K S Chugh Spectrum of acute poisoning in adults (10 year experienceJ Assoc Physicians India19843275614



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© This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article type

Original Article


Article page

118-121


Authors Details

Yogender Malik, Gaurav Sharma, Yogesh Kumar Vashist, Balraj Sharma, Sunil Kumar, Sangram Singh Yadav


Article History

Received : 28-07-2021

Accepted : 26-08-2021

Available online : 28-09-2021


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