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Venomous snake bites at work reported to poison centers.

Authors
Forrester-MB; Baker-SD
Source
Clin Toxicol 2014 Aug; 52(7):729
NIOSHTIC No.
20048090
Abstract
Background: Venomous snake bites can result in serious injury and even death. They may occur under a variety of circumstances, including while the victim is working. The intent of this study was to describe venomous snake bites at work that were reported to poison centers. Methods: Cases were all bites by venomous snakes native to the US reported to a state-wide poison center system during 2000-2013. Bites not followed to a final medical outcome were included. Cases were grouped into those where the exposure site was coded as "workplace" (Work) and all others (Other). The distribution of cases by selected factors was determined for the 2 groups. Comparisons were made by calculating the rate ratio (RR) and 95% confidence interval (CI). Results: Of 5,684 total venomous snake bites, 104 (2%) occurred at work. The type of work was recorded in 33 cases, of which the most common were oil field worker, gardener/landscaper, and water meter reader. The distribution by type of snake for Work and Other cases, respectively, were copperhead (38% vs 56%, RR 0.67, 95% CI 0.52 - 0.86), rattlesnake (43% vs 28%, RR 1.52, 95% CI 1.22 - 1.90), cottonmouth (12% vs 9%, RR 1.30, 95% CI 0.76 - 2.23), and coral snake (8% vs 7%, RR 1.17, 95% CI 0.60 - 2.30). The patients were 20 years or older in 98% of the Work and 77% of the Other cases (RR 1.28, 95% CI 1.24 - 1.32). Of these adult patients, 98% of Work and 70% of Other were male (RR 1.41, 95% CI 1.36 - 1.45). The season in which the bite occurred for Work and Other cases, respectively, was December-February (7% vs 3%, RR 2.50, 95% CI 1.20 - 5.21), March-May (34% vs 32%, RR 1.05, 95% 0.80 - 1.38), June-August (32% vs 41%, RR 0.78, 95% CI 0.58 - 1.03), and September- November (28% vs 24%, RR 1.15, 95% CI 0.84 - 1.57). The patient was already at/en route to a healthcare facility in 85% of both groups (RR 0.99, 95% CI 0.91 - 1.08). The medical outcome was moderate effect, major effect, death, or unable to follow-potentially toxic in 64% of Work and 68% of Other cases (RR 0.95, 95% CI 0.83 - 1.10). The most common clinical effects for Work and Other cases were puncture (86% vs 86%, RR 1.00, 95% CI 0.92 - 1.08), dermal edema (70% vs 72%, RR 0.98, 95% CI 0.86 - 1.11), dermal pain (66% vs 65%, RR 1.02, 95% CI 0.89 - 1.17), and ecchymosis (22% vs 27%, RR 0.81, 95% CI 0.56 - 1.16). The most common treatments were antivenin (53% vs 50%, RR 1.05, 95% CI 0.88 - 1.26) and IV fluids (53% vs 50%, RR 1.06, 95% CI 0.88 - 1.27). Conclusion: Only a small proportion of the venomous snake bites occurred while working. Venomous snake bites that occurred while working were more likely that all others to involve rattlesnakes, occur during March-May, and involve adults and males. However, the management, clinical effects, and outcome of bites that occurred while working were similar to all others.
Keywords
Venomous snakes; Snakes; Poison control; Poisons; Work environment; Worker health; Employee exposure; Case studies; Demographic characteristics; Exposure assessment; Surveillance; Men; Occupations; Seasonal factors; Statistical analysis; Oil industry; Gardeners; Landscape services workers; Public utilities; Author Keywords: Snake bite; Poison center; Work
Contact
M. B. Forrester, Department of Health Services, Austin, TX, USA
CODEN
CTPPA5
Publication Date
20140801
Document Type
Abstract
Funding Type
Cooperative Agreement
Fiscal Year
2014
Identifying No.
Cooperative-Agreement-Number-U60-OH-008473
Issue of Publication
7
ISSN
1556-3650
Source Name
Clinical Toxicology
State
TX
Performing Organization
Texas State Department of Health Services
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division