Toxico-hygienic and economic aspects of acute non-occupational chemical poisonings in the Republic of Moldova during the period 2019-2023

Abstract

Introduction. Acute non-occupational chemical poisoning is a current public health problem in the Republic of Moldova, affecting both children and adults. The global increase in the use of chemical substances and mixtures raises the risk of chemical poisoning, which ranks fourth among the causes of injury in children, after road traffic injuries, burns, and drowning. It also generates a significant economic burden, and its quantification contributes to making informed decisions regarding the efficient allocation of resources. Material and methods. A descriptive, retrospective, cross-sectional study was conducted based on statistical data from the statistical form f.18-săn and other national reports for the period 2019-2023. Cases of chemical poisoning were analyzed, excluding other types of poisoning. The evaluated indicators included incidence, mortality, distribution by age group and etiology, as well as the direct costs of their treatment. Results. The analysis of statistical data revealed a total of 9,579 intoxications, with an overall incidence of 69.5 cases per 100,000 inhabitants. The most common causes were medications, which accounted for 41.8% (n = 4,002), followed by alcohol – 18.8% (n = 1,798), toxic gases – 14.5% (1,385 cases), and pesticides – 4.4% (n = 417). During the 2019-2023 period, children had a higher incidence, with 130.58 cases per 100,000 children, while adults recorded 52.21 cases. The peak incidence of chemical poisonings was recorded in 2019, at 64.8 cases per 100,000 population (24%, 95% CI: 23.12– 24.83), while the lowest was in 2020, at 56.5 cases per 100,000 population (15.6%, 95% CI: 14.88–16.34). Over the fiveyear period, treatment costs for chemical poisoning totaled 58 million lei, highlighting the burden on the health system. Conclusions. Acute non-occupational chemical poisonings continue to be a significant public health problem in the Republic of Moldova, generating not only an impact on the morbidity and mortality of the population but also a considerable economic burden on the health system, highlighted by treatment expenses that amounted to over 57 million lei during the 2019-2023 period. Preventive, educational, and informational measures for the population, including awareness campaigns, are essential for reducing the number of acute poisonings of chemical etiology.