By Dzulkifli Abdul Razak
The Sun, January 2, 1996
Poisonings are a significant cause of mortality and morbidity. A 16th century physician, Paracelsus, noted that all substances known to man are poisons, only the amount or dose determines the effect.
The course of events below is to remind us that nearly everyone is at risk of acute and chronic toxic exposures to hazardous substances in the ambient environment. The poison diary records, month by month, some of the major events related to poisoning that occurred in 1995. Many of the events cited have been dealt with at some length in this column since April.
Based on existing documentation at the National Poison Centre (PRN) in the past one year, it is impossible to list out all the poisoning cases that were handled. Suffice it to say that the following is just the tip of the iceberg.
In the first part of the diary, we focus on the events that took place from January to June, with the aim of demonstrating the seriousness of poison-related incidents in our midst.
January
PRN started its services nationwide, after receiving the go- ahead from the Cabinet. Universiti Sains Malaysia (USM) was given the honour to house the centre based on the track record over work previously conducted at the university. In many of the cases mentioned below, the centre is privileged to have been of assistance.
The first major case that aroused public concern was the series of tests conducted on some Indonesia-made "kek lapis".
The tests revealed that the cakes contained harmful levels of sorbic and benzoic acid, in excess of 1,000 parts per million (ppm). These perservatives are restricted under the Food Act 1983 and Food Regulations 1985.
February
Next came the report of toxic colour pencils in the market. The dangers of lead, arsenic and chromium toxicities loomed for weeks until the sources were finally identified and action taken. The toxic colour pencils were later banned and withdrawn from the market.
PRN, which had gone into operation barely a month before that, received more than 100 phone calls from the public. Many sought advice and clarifications over the matter while others expressed deep concern. The centre was given an informal introduction to members of the public through a period of intense activity.
In the same month, PRN launched its inaugral bimonthly bulletin, PenawaRacun, to the general public. This became the mouthpiece of the Centre for the entire year.
March
Barely recovering from the toxic pencils incident, Malaysians were shocked by a report of the dumping of 41 drums containing 2,050kg of potassium cyanide in the resort island of Pangkor. The incident affected a number of nearby fish farms and endangering many more lives on the island.
Such haphazard action of dumping chemical wastes can cause death and pollute the environment. The potassium cyanide involved was supposedly not an industrial waste and it is estimated that the amount could kill 7 million people. The incident put Malaysians on their toes over other possible chemical dumping of waste products.
A senior police officer was quoted as saying that illegal dumping of scheduled wastes could be classified as manslaugther. The punishment for such an offence under Section 304 of the Penal Code is either a maximum prison term of 20 years, or a fine, or both, upon conviction.
There was also another alert on excessive benzoic acid found in some chilli pastes sold in the market nationwide. The tests carried out in some samples showed that the levels of benzoic acid were between 1,388 to 13,000 ppm. The minimum standard allowed under the Food Act 1983 and Food Regulations 1985 is below 1,000.
The centre also launched its first English bimonthly bulletin, prn8099, which is directed at the professionals. On the international scene, March 20 was a memorable day.
Sarin, a nerve gas, was used on Tokyo subways, killing at least 10 people and injuring more than 5,000 others. The incident, described as the worst in modern day Japan, was traced to a cult community - Aum Shinkri Kyo - led by one Shoko Asahara who faced murder and attempted murder charges.
April
Although no large public poison exposure was registered in this month, a no less tragic incident occurred involving food poisoning. It cost the life of a mother while her two children went into a coma following a dinner at home.
From the limited experiences of the previous months, PRN felt that a closer rapport with members of the public needed to be established. A collaboration with the The Sun's Healthtrack was initiated. Beginning the first week of April, a weekly column aimed at keeping issues related to poisons and poisonings alive among the public - "Poison Information" - was established.
Later in the month, a biweekly talkback column - "Poison Control" - was initiated in another English daily. This column provides avenues for the public to have their queries answered by the centre.
May
Unlike the previous month, May saw many more poison-related incidents, both at home and abroad.
A major toxic gas exposure took place in Ipoh. More than 30 people were affected and hospitalised. The gas was suspected to be highly concentrated chlorine from two gas cylinders disposed of at a metal scrapyard.
In the same month, the law against drunk-driving was proposed. This was in response to an increasing number of road and motor vehicle accidents.
In conjunction with the World No Tobacco Day on May 31, the World Health Organization adopted the message that "tobacco costs more than you think".
PRN launched a nationwide anti-smoking telecampaign, the first of its kind in the country. It was aimed at creating awareness among the public of the dangers of smoking and the poisons found in tobaccos. The response from the public and support from the mass media overwhelming.
PRN also started another biweekly column - "Racun" - in a popular Malay daily. At the same time, the Centre started a series on "Continuing Education on Clinical Toxicology" through its English bulletin.
In Japan, another toxic gas attack was attempted. A hydogen cyanide gas device was discovered at the Shinjuku subway station. The device was placed near a restroom vent where the gas would be dispersed through the subway ventilation system, enough to kill about 10,000 people. The attempt was fortunately foiled in time.
In China, a nuclear test on May 15, less than 48 hours after a Non-proliferation of Nuclear Weapons Treaty Review Conference in New York.
June
A 10-wheel tanker carrying more than 20,000kg of hydrochloric acid was found leaking near Taiping on its way to Prai from Johor. The leak was caused by the acid. The incident was attended to by nearby fire services department personnel.
In France, the government decided to resume a series of eight underground nuclear explosions in the South Pacific at Mururoa Atoll. One of the tests was on a new nuclear warhead. The tests were started in September last year and are scheduled to last May this year. The international community was appalled.
The writer is a professor and the director of the National Poison Centre, Universiti Sains Malaysia.
