Intoxications (poisonings) refer to the harmful effects of substances (noxious agents, poisons) on the body (ICD-10 X49.-!: Accidental intoxication by and exposure to noxious substance(s); ICD-10-GM Y57.-!: Adverse effects of therapeutic use of medicines and drugs).
Intoxications can be classified as follows:
According to cause
- Accidental (accidental)
- Professional
- Suicidal
According to the course form
- Acute
- Subacute
- Chronic
According to the type of poison
- Inorganic poisons
- Poisonous plants
- Poisonous animals (Germany: almost exclusively insect bites).
- Organic poisons
According to the point of attack of the poison
- Blood Poisons
- Liver poisons
- Nerve toxins
- Kidney toxins
- Etc.
The type of poisons is constantly changing. The following poisonings are common:
- Alcohols (esp. ethanol (ethanol); ICD-10-GM T51.-: Toxic effects of alcohol)
- Inorganic substances (ICD-10-GM T57.-: Toxic effect of other inorganic substances).
- Gases, vapors, fumes, unspecified (ICD-10-GM T59.-: Toxic effect of other gases, vapors, or other smoke]).
- Toxins ingested with food (plants (esp. aconite/aconitine), fungi (orellanus, tuberous leaf fungus), etc.; ICD-10-GM T62.-: Toxic effect of other harmful substances ingested with food; ICD-10-GM T61.-: Toxic effect of harmful substances ingested with edible marine animals).
- Carbon monoxide (ICD-10-GM T58: Toxic effect of carbon monoxide).
- Contact with poisonous animals (esp. insect bites; ICD-10-GM T63.-: Toxic effect due to contact with poisonous animals).
- Food (especially alcoholic beverages)
- Drugs (ICD-10-GM T36.-: Poisoning by systemically acting antibiotics; ICD-10-GM T50.-: Poisoning by diuretics and other and unspecified medicines, drugs, and biologically active substances).
- Metals (ICD-10-GM T56.-: Toxic effect of metals).
- Nicotine (ICD-10-GM T65.2: Tobacco and nicotine).
- Pesticides (ICD-10-GM T60.-: Toxic effects of pesticides [pesticides]).
- Cosmetics
- Lamp oil (infants)
Gender ratio: balanced
Frequency peak: in childhood, poisoning accidents with household chemicals, plants or drugs predominate. Adolescents and young adults often suffer intoxication from abuse of alcohol or drugs. In adulthood, intoxications with pharmaceuticals predominate.
The incidence (frequency of new cases) for adults is about 100-200 cases of poisoning per 100,000 inhabitants per year (in Germany). A high number of unreported cases must be assumed, since by far not all cases of poisoning, e.g. with alcohol, lead to an inquiry in a poison information center.
In 2011, more than 200,000 cases of poisoning were hospitalized in Germany. Of these, a large proportion were due to mental and behavioral disorders involving psychotropic substances. According to the cause of death statistics, a total of just under 3,300 people died in 2011 as a result of poisoning by medicines, drugs, biologically active substances and substances not used for medical purposes.Life-threatening mushroom poisoning is rare in Germany.
The most common toxidromes of substances or substance classes are shown under “Symptoms – complaints” including clinical symptoms, leading symptoms and toxins (examples).
The most frequent chronic poisonings are caused by alcohol and tobacco. However, they will not be discussed here.
In Germany, there is an obligation to report poisonings.
