| Author/s | Perera N, Eddleston M, Hill SL, Alldridge G, Thomas SH |
| Year | 2010 |
| Type of publication | Conference proceeding |
| Link | https://doi.org/10.3109/15563651003740240 |
| Abstract | Objective: Poisoning with ethylene glycol or methanol is one of the most common reasons for referral to a consultant clinical toxicologist in the UK, because there may be diagnostic difficulty or severe toxicity. In addition, availability of specific assays and antidotes is inconsistent. This retrospective study was performed to describe clinical characteristics and management of ethylene glycol or methanol poisoning to inform future planning of services, including supply of antidotes and assays. Methods: Retrospective national study of telephone enquiries to the National Poisons Information Service (NPIS) for the year to September 2008, where the specific terms ethylene glycol or methanol had been used. Results: There were 175 NPIS enquiries about ethylene glycol or methanol, involving 148 separate exposures, 24 (16%) of which not systemic. The 124 systemic exposures affected 70 males (56%) and 35 (28%) females (sex not recorded in 19); 112 (90%) involved ethylene glycol, 11 (9%) involved methanol and 1 (1%) involved both. Eight (6%) patients were less than 20 and 12 (10%) more than 50 years old; 39 (31%) cases were recorded as acidotic (pH < 7.3 or “acidotic”) and 31 (25%) as admitted to HDU or ITU. Ethylene glycol or methanol concentrations were recorded as performed in 48 cases (39%). Results were <200 mg/L in 7 (14%), 200–500 mg/L in 5 (10%), 500–1000 mg/L in 10 (21%), >1000 mg/L in 10 (21%) and were not available at the time of the enquiry in the remainder (33%). Fomepizole was used in 5 (4%) cases, ethanol in 61 (49%) cases and both in 6 (5%) cases. Dialysis was used or was advised in 33 (27%) cases. Conclusion: This preliminary study does not measure incidence of ethylene glycol or methanol poisoning because the search terms do not capture all products containing these substances and because some cases may never be discussed with NPIS. However, it does demonstrate that males are more frequently involved, exposures more commonly involve ethylene glycol and ethanol was the antidote most frequently employed. Further prospective studies are required to estimate incidence and need for assays and antidotes more accurately. |