LAUSR

38th International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) 22–25 May 2018, Bucharest, Romania 1. Results from the EU LiquiCaps study: a comparison between cases exposed to liquid laundry detergent and automatic dishwashing capsules Laura Settimi, Felice Giordano, Luciana Cossa, Laura Lauria, Ehi Idahosa-Taylor, Stacey Wyke, Charlotte Hague, Rob Orford, Esther Feistkorn, Nina Glaser, Irma De Vries, Anja WijnandsKleukers, Franca Davanzo, Anna Celentano, Fabrizio Sesana, Sergey Zakharov, Karolina Mrazova, Patricia Casey, Edel Duggan, Feargal O’Connor, Silvia Plackova, Blažena Cagáňova, Fátima Rato, Rafael Wagner, Elke Färber, Raquel Duarte-Davidson and Herbert Desel Italian National Institute of Health, Rome, Italy; La Sapienza University, Rome, Italy; Public Health England, Chemicals and Poisons Department, Centre for Radiation, Chemical, and Environmental Hazards, Chilton, United Kingdom; Federal Institute for Risk Assessment, Berlin, Germany; Poison Control Centre, Utrecht, Netherlands; Poison Control Centre, Milan, Italy; Toxicological Information Centre, Prague, Czech Republic; Poison Control Centre, Dublin, Ireland; Poison Control Centre, Bratislava, Slovak Republic; Poison Control Centre, Lisbon, Portugal; Poison Control Centre, Göttingen, Germany Objective: In 2015, a study on hazardous detergent mixtures contained in soluble packaging for single use (LiquiCaps study) was launched by the EU Commission to assess the effectiveness of the new safety measures on liquid laundry detergent capsules (LLDCs), implemented in June 2015 (Regulation No 1297/2014). Within the LiquiCaps study, cases of exposure to LLDCs and other liquid detergents in soluble capsules (OLDCs) were identified. The present contribution provides a comparison between cases exposed to different types of detergent capsules. Methods: Detailed information on cases exposed to LLDCs and OLDSCs between 1 August 2015 and 31 May 2016 were collected prospectively according to standardized procedures by the poison centers (PCs) of Utrecht, Milan, Prague, Dublin, Bratislava, Lisbon, and Göttingen. Distribution of cases by age (<1; 1–2; 3–4; ≥5 years) and severity of poisoning (none, low, moderate, high, according to the Poisoning Severity Score) for cases exposed to different types of capsule detergents were compared by using Pearson’s chi-squared test or Fisher’s exact test. A logistic regression model was used to measure the strength of the associations between detergent type and severity of poisoning by maximum likelihood estimates of the odds ratios (ORs) and related 95% confidence intervals (CIs), adjusted by age. Results: A total of 882 cases of interest were identified, including 754 (75.9%) exposed to LLDCs, 123 (25.3%) to automatic dishwashing capsules (ADWCs), and 5 (0.5%) to other products (excluded). Distributions by age and severity of poisoning for cases exposed to LLDCs and ADWCs were different at a highly statistically significant level (p < .001, respectively). Age distribution was characterized as follows (LLDCs versus ADWCs): 5.8% versus 10.6% (<1 year), 51.7% versus 71.5% (1–2 years), 29.1% versus 6.5% (3–4 years), and 3.0 versus 9.8 (≥5 years). Among cases exposed to LLDCs, poisoning severity was none in 34.5%, low in 52.1%, moderate in 13.4%, high in one child aged <1 year who developed airway irritation and esophageal edema. Conversely, among cases exposed to ADWCs poisoning severity was none in 61.8%, low in 34.1%, and moderate in 4.1%. The odds of suffering moderate/high severity effects was four times higher for exposures to LLDCs in comparison to ADWCs (adjusted by age OR 4.5; 95% CI 1.6–12.6, p < .0001). Conclusion: During the observation period, exposures to LLDCs continued to be more hazardous than those to ADWCs. Since both products contains highly hazardous ingredients, differences in formulation (ADWCs half liquid/half powder; LLDCs liquid) should be considered as main determinants of the reported findings. 2. Favorable acute toxicity profile of noscapine in children Colette Degrandi, Jutta Trompelt, Andreas Vagt, Carola Seidel, Dagmar Prasa, Claudia Zatloukal and Cornelia Reichert National Poisons Centre, Tox Info Suisse, Zürich, Switzerland; Poisons Information Centre, Mainz, Germany; Poisons Information Centre, Berlin, Germany; Poisons Information Centre, Bonn, Germany; Poisons Information Centre, Erfurt, Germany; Poisons Information Centre, Vienna, Austria Objective: Noscapine, an alkaloid from Papaver somniferum, has been in clinical use since 1960 as a centrally acting antitussive with no sedative or respiratory depressive properties. The maximal therapeutic dose for adults and children >12 years is 150mg/day, for children 3–12 years 75mg/day, and for children 0.5–3 years 37.5 mg/day divided in 3–6 doses. Noscapine seems to have a favorable side effect profile, but modern approval studies are lacking. The aim of the study was to determine the acute toxicity profile of noscapine in overdose, since available information is very limited. Methods: Retrospective review of acute noscapine overdoses in children (<16 years) reported to six poison centres in Germany, Austria, and Switzerland. Included were cases with singlesubstance exposure, polysubstance exposure with co-ingestants of low toxicity (e.g., guaifenesin, plant extracts), sufficient evidence of exposure, a follow-up for at least 3 hours, and a high 2018 Informa UK Limited, trading as Taylor & Francis Group CLINICAL TOXICOLOGY 2018, VOL. 56, NO. 6, 453–608 http://dx.doi.org/10.1080/15563650.2018.1457818