Toxicovigilance in the UK during the COVID-19 pandemic

This study assesses the impact of the COVID-19 pandemic on enquiry numbers to the United Kingdom (UK) National Poisons Information Service (NPIS) to inform public health interventions. Phone enquiries were extracted and analysed from the UK Poisons Information Database (UKPID) in calendar years 2018 to 2020. Data collected included information on call, patient, and exposure characteristics for all enquiries and for specific enquiries involving selected agents of interest. During the first national lockdown there was a significant decrease in the proportion of enquiries about intentional exposures (20.6%) compared to pre lockdown (26%) and control periods (22.6%) (P < 0.001), potentially due to reluctance to attend healthcare facilities. Exposures regarding dental analgesics also increased significantly in lockdown (5.15%) compared to pre-lockdown (2.6%) and the control period (3.4%) (P < 0.001) likely due to limited access to dental services. Enquiries about hand sanitisers exposures showed a significant increase during lockdown (92) compared to pre-lockdown (32) and control (45) (P < 0.001) likely due to increased availability. No significant increases in exposures were identified for selected pharmaceuticals of interest and only a small number of enquiries relating to exposures with essential oils, methanol, Chinese herbal medicines antihistamines and deliberate bleach ingestion which offered reassurance from a public health perspective. This data led to public health interventions such as tweets, updates to guidance and advice to healthcare professionals and the public. Toxicovigilance is a key public health tool and poison centre enquiry data is helpful in identifying toxic exposures for any future pandemics or large-scale chemical incident.