INTRODUCTION

This self-learning course provides information on toxic substances and poisoning, how they occur, and how to avoid them. Guidance to face emergency situations owing to intoxications is also provided. A glossary and a section of links to full texts, databases, virtual libraries, and a directory of information centers and toxicological advisory services of Latin America and the Caribbean is offered to expand your knowledge and to answer any further question.

Suggestions to cope with an emergency

  1. A first aid emergency kit, as the one recommended in chapter 10, should be available at home, at the community center, or at the workplace.
  2. Study this manual, mainly chapters 4 to 9 where applicable measures to treat poisoning cases are explained.
  3. Practice some first aid measures to apply them in emergency cases.

Information for physicians

In chapter 5 (“First aid”) and 9 (“How to assist an intoxicated person outside the hospital”), the parts of the text separated by horizontal lines contain information specifically addressed to physicians.

What to do when you do not know a term used in the manual

Use the glossary to find the term (technical terms used in the tables for physicians do not appear in the glossary).

Toxicology centers and programs against poisoning

In many countries there are specialized centers whose tasks include the provision of advice to treat and prevent poisoning cases and the dissemination of information about drugs, pesticides, and poisonous animals, domestic products, and chemical substances used at work. The physicians of such centers know what to do when someone ingests or breathes a hazardous chemical substance or is affected by splashes on the skin or eyes.

Most of these centers provide telephone assistance day and night, and in some countries help is offered by radio. Sometimes they have available specific antidotes (for example, against bites of serpents or spiders) and have beds to treat intoxicated people.

In many countries, toxicology centers collaborate with other institutions in national programs to prevent poisoning and improve treatment. These institutions include:

  • hospitals and other centers where intoxicated people are treated;
  • organizations that collect information on poisoning;
  • organizations that manufacture or use toxic substances;
  • governmental services that regulate the use of chemical products at the national level; and
  • universities and teaching centers that train physicians and other professionals on how to treat poisoning cases.

Centers of information and toxicological advisory services in Latin America and the Caribbean

Latin America is one of the main targets for action because it uses a great diversity and quantity of chemical substances. The development of toxicology, however, varies from country to country and the manufacturing of potentially toxic products in the countries is usually faster than the progress achieved.

The following analysis describes the current situation of a Latin American institution that copes with health problems resulting from chemical intoxication: the toxicology centers for information, advice, and care.

Current situation:

Countries that have more than one center:

  • Argentina, Brazil, Colombia, Chile, Mexico, and Venezuela.

The area and population of these countries have led to the creation of several centers. For instance, there are currently 32 centers in Brazil and 15 in Argentina.

Countries that have one center are:

  • Bolivia, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Nicaragua, Peru, Panama, Paraguay, Suriname, and Uruguay.

Centers tend to work in partnership with institutions of the same country to strengthen information exchange, harmonize poisoning reports to facilitate working on the basis of evidence, standardize laboratory techniques, and register poisoning treatments. Some existing networks include:

a. SINITOX (Sistema Nacional de Informações Tóxico-Farmacológicas), in Brazil, created in 1980.
b. REDARTOX (Red Argentina de Toxicología)
c. RITA (Red de Información Toxicológica y Alerta), in Chile.
d. RETOMEX (Red Toxicológica de México).
e. SIVEINTOX (Sistema Venezolano Integrado de Toxicología), recently implemented in Venezuela.

Countries where there are no toxicology centers:

  • Honduras, the Dominican Republic, and English-speaking Caribbean countries.

The centers of the Region differ both in infrastructure and in material and human resources. They have a multidisciplinary staff which includes mainly physicians specialized in toxicology, pharmaceutics, chemists, biochemists, biologists, pharmacologists, etc.

The centers are located in different places; mostly in hospitals and universities. Some are located in ministries of health units and in the industrial sector.

The centers provide services related to information and toxicological advice, preventive actions, training, research, etc.

To see a directory of toxicology centers that provide information and advice in the Region, visit the following address: or consult the list of links included in this course.