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Methanol poisoning and long term sequelae - a six years follow-up after a large methanol outbreak.

Paasma R, Hovda KE, Jacobsen D - BMC Clin Pharmacol (2009)

Bottom Line: The patients that failed to respond were searched for in the Estonian Register of Population and through their General Practitioner.Six years later, 26/86 were dead, 33/86 could not be tracked down, and so only 27/86 of these were followed up and examined: 22/66 of the patients in Group I, and 5/20 in Group II were found and examined.On follow-up, apparently new neurological and visual complications were identified in 36% and 36%, respectively. 35% of the patients initially discharged with sequelae and 29% discharged without were dead six years later; 27% of them from alcohol intoxication.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anesthesiology and ICU, Foundation Pärnu Hospital, Pärnu, Estonia. kehovda@yahoo.no

ABSTRACT

Background: Mass poisonings with methanol are rare but occur regularly both in developed and in developing countries. Data from the poisoning episodes are often published, but follow-up-data is scarce. We therefore conducted a six year follow-up study after the large methanol outbreak in Estonia in September 2001.

Methods: Surviving victims from the outbreak were contacted and invited to an interview and a clinical evaluation by an ophthalmologist and a physician. The patients that failed to respond were searched for in the Estonian Register of Population and through their General Practitioner.

Results: During the outbreak in 2001, 86/111 hospitalized patients survived: 66 without sequelae (Group I) and 20 with sequelae (Group II). Six years later, 26/86 were dead, 33/86 could not be tracked down, and so only 27/86 of these were followed up and examined: 22/66 of the patients in Group I, and 5/20 in Group II were found and examined. From Group I, 8/22 were identified with new neurological impairment and 8/22 with new visual disturbances after discharge. From Group II, visual disturbances (n = 4) and neurological impairment (n = 3) were still present in all patients. Among the 26 dead, 19 were from Group I, and seven were from Group II. Alcohol intoxication was the most frequent cause of death (7/26).

Conclusion: All sequelae were still present six years after the initial poisoning suggesting that these were irreversible damages. On follow-up, apparently new neurological and visual complications were identified in 36% and 36%, respectively. 35% of the patients initially discharged with sequelae and 29% discharged without were dead six years later; 27% of them from alcohol intoxication.

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Overview of the methanol outbreak in Estonia in 2001 and the follow-up study in 2007.
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Figure 1: Overview of the methanol outbreak in Estonia in 2001 and the follow-up study in 2007.

Mentions: In September 2001, illegal spirits containing 50–100% methanol were sold and consumed in the western part of Estonia in the Pärnu region. Out of a total of 147 patients admitted to hospital with suspicion of methanol poisoning, 36 did not have detectable serum methanol on admission, leaving a total of 111 hospitalized patients with verified methanol exposure. A total of 68 patients died: 25 in the hospital, whereas 43 were found dead from methanol poisoning outside the hospital. Thus, methanol poisoning was verified in a total of 154 patients (Figure 1). Patients were mainly treated with NaHCO3 infusion, ethanol infusion, dialysis and mechanical ventilation [9].


Methanol poisoning and long term sequelae - a six years follow-up after a large methanol outbreak.

Paasma R, Hovda KE, Jacobsen D - BMC Clin Pharmacol (2009)

Overview of the methanol outbreak in Estonia in 2001 and the follow-up study in 2007.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667428&req=5

Figure 1: Overview of the methanol outbreak in Estonia in 2001 and the follow-up study in 2007.
Mentions: In September 2001, illegal spirits containing 50–100% methanol were sold and consumed in the western part of Estonia in the Pärnu region. Out of a total of 147 patients admitted to hospital with suspicion of methanol poisoning, 36 did not have detectable serum methanol on admission, leaving a total of 111 hospitalized patients with verified methanol exposure. A total of 68 patients died: 25 in the hospital, whereas 43 were found dead from methanol poisoning outside the hospital. Thus, methanol poisoning was verified in a total of 154 patients (Figure 1). Patients were mainly treated with NaHCO3 infusion, ethanol infusion, dialysis and mechanical ventilation [9].

Bottom Line: The patients that failed to respond were searched for in the Estonian Register of Population and through their General Practitioner.Six years later, 26/86 were dead, 33/86 could not be tracked down, and so only 27/86 of these were followed up and examined: 22/66 of the patients in Group I, and 5/20 in Group II were found and examined.On follow-up, apparently new neurological and visual complications were identified in 36% and 36%, respectively. 35% of the patients initially discharged with sequelae and 29% discharged without were dead six years later; 27% of them from alcohol intoxication.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anesthesiology and ICU, Foundation Pärnu Hospital, Pärnu, Estonia. kehovda@yahoo.no

ABSTRACT

Background: Mass poisonings with methanol are rare but occur regularly both in developed and in developing countries. Data from the poisoning episodes are often published, but follow-up-data is scarce. We therefore conducted a six year follow-up study after the large methanol outbreak in Estonia in September 2001.

Methods: Surviving victims from the outbreak were contacted and invited to an interview and a clinical evaluation by an ophthalmologist and a physician. The patients that failed to respond were searched for in the Estonian Register of Population and through their General Practitioner.

Results: During the outbreak in 2001, 86/111 hospitalized patients survived: 66 without sequelae (Group I) and 20 with sequelae (Group II). Six years later, 26/86 were dead, 33/86 could not be tracked down, and so only 27/86 of these were followed up and examined: 22/66 of the patients in Group I, and 5/20 in Group II were found and examined. From Group I, 8/22 were identified with new neurological impairment and 8/22 with new visual disturbances after discharge. From Group II, visual disturbances (n = 4) and neurological impairment (n = 3) were still present in all patients. Among the 26 dead, 19 were from Group I, and seven were from Group II. Alcohol intoxication was the most frequent cause of death (7/26).

Conclusion: All sequelae were still present six years after the initial poisoning suggesting that these were irreversible damages. On follow-up, apparently new neurological and visual complications were identified in 36% and 36%, respectively. 35% of the patients initially discharged with sequelae and 29% discharged without were dead six years later; 27% of them from alcohol intoxication.

Show MeSH
Related in: MedlinePlus