Figure 1: Availability of data in the participating PCs Figure 2: Number of cases searched for the 6 product groups Table 1: Allocation of cases to the 6 product groups (No 3–6) referring to all routes / eye exposure (total – range of variation among PCs DO DETERGENTS CAUSE CORROSIVE EYE LESIONS? A MULTINATIONAL ANALYSIS OF DATA FROM 11 POISONS CENTRES WITHIN THE SCOPE OF GHSPART 1: RESULTS ON FEASIBILITY AND FREQUENCY OF EXPOSURE Stürer A (1), Seidel C (2), Sauer O (3), Zilker T (4), Koch, I (5), Hermanns-Clausen M (6), Hruby K (7), Hüller G (8), Heppner HJ (9), Tutdibi E (10), Desel H (11) “Formula” (1) Swiss Toxicological Information Centre, Zurich, Switzerland ? ? + = (2) Poisons Centre, Childrens University Hospital, Bonn, Germany ? (3) Poisons Centre, University Hospital, Mainz, Germany • Objective • Lowering threshold values when migrating to “Globally Harmonised System of Classification and Labelling of Chemicals” (GHS) may increase the number of products labelled as corrosive. • There is serious concern about inappropriate labelling of domestic cleaning products. which may increase the risk of medical malpractice of exposed patients. • An “expert judgement” supported by poisons centres data may help to assign the most appropriate label. • There are no data available concerning the frequency of human exposure, particularly eye injuries, caused by cleaning products in Austria, Germany and Switzerland. Few publications provide an overview of eye injuries caused by consumer products in the USA (1) or focus on selected product groups in other countries. (4) Poisons Centre, Clinical Toxicology, University Hospital rechts der Isar, Munich, Germany (5) Poisons Information Centre, Institute of Toxicology, Berlin, Germany • Aims • Feasibility of case selection with a harmonized Categorization System for Agents (TDI-CSA: www.klinitox.de/142.0.html ) • Collection of case incidence (part 1) • Collection ofclinical data on eye exposures caused by domestic cleaning products (part 2) Methods • The study is performed by the Society of Clinical Toxicology (www.klinitox.de): MAGAM-Study = “Multinationale, retrospektive Analyse von Daten der Giftinformationszentren zur Frage korrosiver Augenläsionen durch feste Maschinengeschirrspülmittel und andere Wasch-, Pflege- und Reinigungsmittel“. • 9 German PCs and the PCs of Vienna and Zurich retrospectively selected data from 1998 through 2007. • Inclusion criteria: human eye exposure with 6 groups of household cleaning products (dishwashing tabs and powders, all purpose cleaners, manual dishwashing products, laundry detergents, toilet cleaners, drain cleaners. • Categorization of products was carried out using the harmonized TDI* Categorization System for Agents (TDI-CSA) (2). *[Toxicological Documentation and Information Network] (6) Poisons Information Centre, Centre f. Pediat. and Adolesc. Med., Freiburg, Germany (7) Austrian Poisons Information Centre, Vienna, Austria (8) Poisons Information Centre, Erfurt, Germany (9) Poisons Centre, University Hospital, Nuremberg, Germany Results (Part 1) • Nearly all PCs could provide data for the whole period under review (1998 – 2007). [Fig. 1] • Since 2002 the annual number of cases is about 210,000 in Austria, Germany and Switzerland. [Fig. 2] • With 1,841,438 human exposure cases [Tab. 1]approx.88% of allcases documented in PCs in the 3 countries and within the 10 years period could be analysed in the study. • The total incidence of eye exposure is 1.6% (28,956). • 11.3% is related to household cleaning products with a frequency of 3.1% eye exposures in this product group. • Most eye exposures within the 6 subgroups due to laundry detergents (668) and all purpose cleaners (547). There were fewer exposures to toilet cleaners (400), manual dishwashing products (300), dishwashing tabs and powders (162) and drain cleaners (108). • The incidence of eye exposure in the 6 subgroups varies from 0.7% (manual dishwashing products) to 4.3% (all purpose cleaners). (10) Poisons Centre, Department of General Paediat.and Neonatology, Homburg, Germany (11) GIZ-Nord Poisons Centre, University Medical Centre, Göttingen, Germany Conclusion • The feasibility of case selection among different PCs with a harmonized Categorization System for Agents has been proved. • The incidence of exposure/eye exposure to 6 groups of household cleaning products has been evaluated. • By now, 2,185 eye exposures have been uploaded to the common database of the society. Currently these cases are evaluated as to eye injuries in order to assess the potential corrosion risk of detergents. XXIX International Congress of the EAPCCTStockholm May 2009 Contact: Andreas StürerSwiss Toxicological Information Centre Freiestrasse 16 CH-8032 Zürich Switzerland email@example.com • References • 1) McGwin G Jr et al. Consumer product-related eye injury in the United States, 1998-2002. J Safety Res. 2006;37(5):501-6. • 2) Stürer A et al. TDI-Project: A harmonized category system for products in poisons centres (PC). Clin Toxicol 2003;41:498.