During the yuletide, a time when children and youths are generally on holidays, it involves more travels, visitations, eating of varieties of meals and junk foods, acquiring new pets, meeting strangers, and moving into new abodes. During this season, many intentional and unintentional cases of poisoning do occur. Examples include the consumption of spoilt food, over-consumption of alcohol or drugs during celebrations, especially among youths, feeding of party leftovers, and bones to pet animals.
A particular incident played out last Christmas day, which prompted this discourse. Three bottles of the same brand of a popular malt drink served had three different tastes, in fact, one tasted alcoholic! Poisoning is simply an injury or death caused by swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases into the body. Exposure to agrochemicals, prescription medicines or over-the-counter drugs, and environmental agents are the major causes of poisoning. People at higher risk for poisoning include young children, because they tend to put things in their mouth; older people, who can be confused and mix up their medicines; workers whose jobs involve chemicals; and people with substance use disorders, particularly those using opioid drugs.
Workers in various occupations such as radiation units, painters, printers, welders, farm handlers, may also be exposed to several types of poisonings or occupational hazards. Among adults, death from acute poisoning is most commonly, as a result of either smoke inhalation or illegal drug use, while chronic poisoning could occur due to cigarette smoking and alcohol consumption. The unintentional consumption of drugs is the most common causes of fatal poisonings in small children. Opioids (Codeine and morphine) and barbiturates (pentobarbitone) are well-known dangers, but drugs for high blood pressure, mental health, and diabetes, are also hazardous.
For pet animals – dogs, cats, horses, birds and rabbits – exposure to insecticides, herbicides, anticoagulant rodenticides, ornamental plant toxins, insect and snake bites and stings, lead in paints, solvents, and cosmetics, and inadvertent placement of veterinary and human drugs as well as household cleaning materials like bleaches, dishwashing powders, oven cleaners, drain cleaners, methylated spirits, within their reach, are frequent causes of poisoning. The most common cause of neurological symptoms from toxins in livestock is lead poisoning, from old paints and pesticides, or from eating poisonous plants. Factors contributing to plant poisoning are starvation, accidental eating, and browsing habits. It was revealed at the Gender and Inclusion Summit 2023 (GS-23), held recently at the Federal Capital Territory, Abuja that over 200,000 Nigerians die annually from food poisoning.
This number is on the increase owing to sharp, unsafe, and unscrupulous practices by some citizens. Such include the use of hazardous chemicals like Sniper® insecticide for storage and preservation of perishable agricultural products, the use of carbide to ripen fruits, tendering of meat with paracetamol by food vendors, using formaldehyde to preserve fish, injecting poultry with hormones to conceal disease, and harmful food colouring, among others. Microbes may also spread to food at any time while the food is grown, harvested or slaughtered, processed, stored, shipped, or prepared. The comatose power supply during this period may exacerbate infection. The average cost of poison management per patient is estimated at about USD$168, which is high, given the purchasing power of an average Nigerian citizen.
Global classification of poisonings looks at three areas: Physical, health, and environmental hazards. Physical hazards are substances that threaten physical safety, and that can cause injury, illness and death. Fires, explosive materials, temperature (hot or cold), noise, radiation, spills on floors and unguarded machines are some examples of physical hazards. Health hazards occur where substances may cause lethality to the entire body, specific organs, major/minor damage, or cause cancer. The liver (major organ for metabolism) and kidneys (major organ for excretion) are common organs affected by chemical poisoning. Reproductively, poisonous substances may cause adverse effects in either sexual function or fertility to either a parent or the offspring.
An environmental hazard is any condition, process, or state adversely affecting the environment. Carbon monoxide continues to be one of the most common causes of environmental poisoning globally. In Nigeria, where individual households provide their own electricity, the use of generators is common, often used in poorly-ventilated buildings with potential for carbon monoxide poisoning. Risks and consequences of poisonings can be mitigated by timely interventions such as proper education of children on safety and inherent dangers of chemicals, keeping drugs and other chemicals out of the reach of children and animals, keeping all household products in their original bottles, locking up chemicals in a safe place, never mixing chemicals, ensuring that lids are tight and secure before putting away their containers, and maintaining good environmental sanitation.
A central concept of poisoning is that the effect may be dose-dependent, as even water can lead to water intoxication when taken in too high a dose, whereas for even a very toxic substance such as snake venom, there is a dose below, which there is no detectable toxic effect. Management of poisoning generally involves reducing absorption by removing the patient from the source of poisoning and if inhaled, get to fresh air immediately, if on the skin or eyes, take off any clothing, and rinse with running water for about 15 to 20 minutes. The airway, breathing, circulation, disability (ABCD) sequence of first aid is encouraged, after which, prompt hospital or veterinary care, as the case may be, should be sought while medical staff should be provided with a detailed history to effectively treat the patient.
Such include what substances you think the patient may have swallowed, how long ago, whether it was accidental or deliberate, if swallowed or inhaled, and how much was taken. Most exposures to poisons can be treated with general emergency care and, if necessary, with symptomatic intensive-care measures. The belief that palm oil could serve as an antidote to poison is just a myth, and may pose its own health risk. The insurgence of fake and adulterated drugs and drinks in the country is quite worrisome and alarming. It is high time the Federal Government of Nigeria (FGN) increased funding and strengthened the standard operating procedures modulating the activities of regulatory bodies – National Agency for Food and Drug Administration and Control (NAFDAC), National Drug Law Enforcement Agency (NDLEA), and Standards Organisation of Nigeria (SON).
NAFDAC should improve its operations and deliver its mandate of regulating and controlling the importation, exportation, manufacture, advertisement, distribution, sale and use of food, drugs, cosmetics, medical devices, packaged water, chemicals and detergents. Education of the populace is also important as some of the cases of poisoning are intentional. In addition, rather than spread lean and ineffective budgets on new bureaucracies, the Federal Government should appropriate meaningful budgets to the task forces – Nigeria Police Force, Nigeria Immigration Service, and the Nigeria Customs Service, as they counter fake and counterfeit products. Furthermore, establishment of poison control centres in the six geopolitical zones of the country, is germane, as recommended by the World Health Organisation (WHO).
Poisons centres play an important role in identifying and assessing the toxic risks in a population, collecting data to improve knowledge about the effects of chemicals on One Health, and contribute to national capacities required under the International Health Regulations for surveillance, preparedness and response for public health events involving chemical agents. This will enable attending physicians and veterinarians to address each case individually, with much more accurate poisoning risk assessment. “Eewu bę loko Longę, Longę fun ara rę eewu ni”. Literally means, let us be extremely careful of situations that have a past history of danger. Have a healthy and happy 2024!
Dr. Adenubi, an Associate Professor and Veterinarian, is a columnist with FarmingFarmersFarms, email@example.com, +2348025409691.