Epidemiology

Several classes of compounds are used as rodenticides or rat poisons. Because these compounds are accessible in the home, young children are at risk. According to the American Association of Poison Control Centers, in 1997 there were 17,562 reported exposures to rodenticides in the United States. Of these, 16,562 were unintentional exposures, and 15,065 of the total exposures involved children under 6 years of age. Nearly 6000 patients were treated in a health care facility. There were 6 deaths, and 3 involved long-acting warfarins. About 150 exposures resulted in moderate to major morbidity. Individuals at risk are suicide victims, attempted homicide or abuse victims, exterminators, the intoxicated, the impaired elderly, and psychiatric patients. Intentional ingestions are often associated with significant morbidity and mortality. Most accidental exposures occur in children under 6 years of age and result in minimal or no toxicity. 124

Most commonly used rodenticides are the anticoagulants, derivatives of fluoroacetic acid, alpha-methyl-thiourea, and various inorganic compounds ( Tab.!e 1Z„6:1). The toxic mechanisms and degree of toxicity vary depending on the specific compound. Rodenticides may be classified according to the type of compound, time of onset of signs and symptoms, and degree of toxicity. Common rodenticides will be grouped and discussed by degree of toxicity. The pathophysiology, clinical features, diagnosis, and treatment will be described for each entity.

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