Doctor’s obligation to report intoxications remains under the European chemicals legislation REACH
Whether in the home or industrial environment, chemicals and chemical products are part of daily life. However, some products may entail risks to health. Germany has a unique statutory reporting and documentation system for the adverse effects of chemical products and substances. This is to remain in place after the entry into force of the new European chemicals legislation REACH. Cases of severe intoxication with chemicals or chemical products are rare. However, even minor risks must be identified early on so that intoxication symptoms can be treated quickly and any permanent damage prevented. That is why the attending doctors in Germany will still be obliged to report any reasonable suspicion to the Federal Institute for Risk Assessment (BfR). The Institute now presents the evaluated data for 2006: 4,551 cases of intoxication were reported to BfR in the year under review. The brochure "Medical notifications of intoxications 2006" provides an overview with concrete case descriptions and comparative figures from the previous years.
The obligation for doctors to report intoxication cases came into force on 1 August 1990 pursuant to § 16e of the Chemicals Act. BfR collects and evaluates the reports. Most of the 4,551 reports received last year involved intoxications with chemical products followed by intoxications with chemical parent substances. There were also lower proportions of intoxications with pesticides, medicinal products, cosmetics, foods and other products.
Out of the 4,551 notifications 89.4 percent came from employers' liability insurance associations, the rest from clinics, doctors’ surgeries and poison information and treatment centres. Most of the intoxication cases involved accidents with chemicals or chemical products at work. However, accidents also happen in the home. There were extensive reports in the media last year about a spray used to seal off surfaces in the kitchen and bathroom. Although the product could be rapidly withdrawn from the market with the support of BfR, around 150 consumers suffered, in some cases severe, irritation of the respiratory tract down to pulmonary oedemas. Burns to the eyes, skin, mouth and throat caused by chemicals happen from time to time. Frequently, these are cases of mixing up products like for instance when a cleaning product is ingested.
The purchase of chemicals on the Internet may also have serious consequences. Dangerous substances and products are sold on the Internet, some of which can have life-threatening effects. Frequently, consumers are unable to obtain chemicals of this kind in normal retail outlets and on the Internet no or insufficient information is provided about the health risks. There was one case of a young woman who took a product to reduce weight which was offered for sale on the Internet. What she didn’t know was that the 2,4-dinitrophenol (DNP) contained in the product can lead to circulatory failure and she eventually died. The sniffing of deodorant sprays can also have life-threatening consequences as documented by the case of one young man described in the brochure, too.
The recording and evaluation of reported cases of intoxications provides an important basis for the realistic evaluation of the threat to human health from chemicals. In its annual reports on medical notifications BfR regularly provides information on the current intoxication situation in Germany. Manufacturers and distributors are also informed by BfR about any health impairments caused by their products.
The brochure “Medical notifications of intoxications” contains an overview of all reports of intoxications in 2006, a notification form for doctors and a list of the contact details of the poison information and treatment centres. It is available free of charge in German and English and can be requested in writing by e-mail or fax. It can also be downloaded from the Institute’s website www.bfr.bund.de. In the section “Publications/Brochures and Leaflets”, you will find all annual reports of the documentation office since 1995.