Dr. Rahmat Awang
The Sun, May 2 ,1995
THE CONCEPT OF POISON AND poisoning is often misunderstood. Many think that poisoning is an act involving two - the poisoner and the victim. We seldom realise that anything we touch, breathe or eat is a potential poison.
Potential poisons are everywhere - in our homes, our workplaces and other surroundings. They are not limited to the infamous cyanide or lead.
There is a need for the public to understand what a poison is, who is at risk, how it occurs and what effects it produces. We must develop the awareness of poisons and their dangers so that we become motivated and interested in the prevention of poisoning accidents. Many poisoning episodes are indeed avoidable.
The poisoning equation is, for many reasons, extremely complex. However, in many cases, only mild symptoms, if at all, are experienced by the victims. Still, it can sometimes be quite severe and life-threatening, resulting in unnecessary suffering and loss of life.
Three main factors are believed to play an important role in poisoning - the agent, host and environment. Each factor has many characteristics and is often not changeable.
Poisoning = Agent x Host x Environment
where agent is the active substance and/or the media that makes the victim sick or die, host is the person who is the victim of poisoning and environment is the circumstances that increase the probability of poisoning to happen.
It is when these three factors interact that poisoning occurs. When one of these factors is removed, poisonings are not likely to take place.
The agent
The agent is the element, usually a chemical, that causes the injury in a poisoning. According to Paraceisus, a sixteenth century physician, all elements known to man are poisons, and only the dose determines the effect. This definition of a poison is still applicable to this day.
Thus, the concept of a poison is helpful. When poisoning occurs regardless of whether it involves medicines, household substances, or plants, it is useful to know how much was actually ingested. In such cases, it is also important to know the minimum amount expected to cause any toxic symptoms and the name of the agent. This information helps in deciding the best possible course of action.
The host
The host is the person likely to be involved in the poisoning. Its characteristics include age, sex, physical or mental maturity and personality.
Age has a strong influence on poisonings. Well documented reports of poisoning cases suggest that 75% of such incidents happen to children below the age of five.
Two-year-olds are exposed to poisons more often than childred of any other age group. This is not surprising since children of this age are exploratory and have a limited sense of self-preservation.
Further, it was suggested that children who poison themselves have different personalities than those who don't. These children usually have more behavioural problems. The underlying cause could be related to an abnormal parent-child relationship. These children may be hyperactive, uncooperative, display negativism, and demand attention excessively. Also, males are at slightly greater risk than females.
The environment
Though a person's environment may not be a major factor, it contributes greatly to the risk of poisoning. The place where potential toxins are stored, the socioeconomic level of the family and the level of stress in the family are some of the elements that contribute to the poisoning. Common places where poisonings occur include the home, the workplace and the community.
In the home, family stress as well as the quality and quantity of parental supervision seem to be the leading environmental contributors to accidental poisoning.
Outside the home, accidental poisoning seems to be due to negligence and carelessness. The dumping of 41 drums of potassium cyanide on Pangkor island recently is a clear example of the prevailing attitude. We are fortunate that it did not claim any life unlike such tragic incidents as the one in Bhopal in 1985 that took 2,700 lives. Many more deaths from such accidental poisonings occur every year but the public however, is generally unaware of such incidences as it happens to single or a few individuals rather than en mass. Such incidents also tend to receive little publicity from the media.
Notwithstanding this, poisoning statistics will continue to rise as more and more chemicals are introduced into the environment as the country progresses.
