Poisoning Reports According to the national Chemicals Act and the Poison Information Regulation
- BfR Case Database
- Which Poisonings Have to Be Reported?
- Who Is Required to Make the Report?
- How Are Reports Processed?
- Which Information Has to Be Included in a Poisoning Report According to the National Chemicals Act?
- When Are Reports Issued?
- Where Can the Legal Provisions for Reporting Requirements Be Found?
- Processing of Case Data
- Use of Data Case
Physicians are required to report poisonings according to § 16e (2) of the national Chemicals Act. Poisonings caused by chemical substances or products (including cases with suspected poisoning) are reported to the BfR in an anonymised form.
Once submitted, case reports are assessed, structured and stored in a dedicated poisoning case database. Currently the BfR database comprises about 120,000 poisoning cases (as of March 2021). These data are used among other purposes in risk assessment processes of authorities.
Since 1990, physicians have been required to report cases of poisoning to the BfR. Assessment of the submitted case reports may, for example, facilitate a detailed overview on frequency and developing trends of accidents originating from chemical substances and products. This may offer important hints on how meaningful prevention measures can be derived. In addition, the effects of those measures can be evaluated after their introduction.
Poisonings caused by products outside the scope of the national Chemicals Act, e. g., pharmaceuticals, medical devices, tobacco products, cosmetics, are also recorded in the 'BfR Case Database'.
Poisonings which have to be reported are, for example, health impairments caused by:
- Chemical substances and products including
- Gases, e. g., from fires
- Construction agents
- Plant protection products
- Harmful chemical agents from the environment and from technical incidents
- Poisonous plants, fungi and animals
- Inhalative poisonings (e. g., caused by fire)
- Oral poisonings (e. g. swallowing by mistake)
- Eye irritation and chemical burns
- Skin irritation and chemical burns
Every physician who is called in to treat or assess the outcome of a medical disorder/disease stemming from a suspected exposure to
- Hazardous substances
- Hazardous mixtures
- Products which may contain or release harmful substances or mixtures
- Biocidal products
is required to submit relevant information about the poisoning to the BfR.
In case of occupational exposure within the scope of an employer’s liability insurance association or a public accident insurer (workplace, school) these entities are required to initiate the reporting process.
In addition to statutory reporting, the BfR also receives information submitted voluntarily (e. g., by those affected themselves).
Either a dedicated form (pdf file) according to the national Poisons Information Regulation or an anonymised medical report is submitted.
The notification form is consigned by post, fax or e-mail to:
German Federal Institute for Risk Assessment
Unit Exposure Assessment of Hazardous Products
Notifications of poisonings must contain the following information:
- Products and substances involved
- Names (product names)
- If available, product identifiers such as UFI, CAS No, EC No
- Amount ingested
- Method of exposure
- Age and gender/sex of patient
- Symptoms and available medical reports
- In case of acute poisoning after end of medical treatment
- In case of chronic disorders after making a medical diagnosis
- In case of medical advice provided in the course of health disorders after its conclusion
- In case of fatal outcomes after conclusion of an autopsy
Accident insurers may make bulk notifications submitting their case reports on a monthly or three-monthly basis.
Every case is assessed by the BfR staff according to toxicological criteria and registered in the BfR Case Database .Standardisation of data allows information to be retrieved later on, e. g., product name (agent name), most important chemical component in terms of health hazards, exposure route, circumstances of exposure (occupational/private, accidental/suicidal/…) as well as age band and gender/sex of the patient/s.
The degree of poisoning severity of a case is graded depending on the symptoms and the information in medical reports in accordance with the internationally approved WHO Poisoning Severity Score (http://www.who.int/ipcs/poisons/pss.pdf). The toxic agent(s) and, if available, the most toxic substance responsible for poisoning (e.g., chemical products) are classified according to their intended use by means of various classification systems, e.g., the TDI Agent classification system (TKS, https://www.klinitox.de/142.0.html; website available in German only).
All data gathered in the BfR Case Database are used intensively during risk assessment by the BfR and other national and European authorities. In addition, the BfR answers many requests for information from representatives of science, insurance companies, industry associations and the media. No information is disclosed that enables conclusions to be drawn about individual cases.
By law, the BfR provides each accident insurer with the previous year’s annual compilation review of all occupational poisoning cases submitted by those insurers. All accident insurers that have submitted cases in the year in question also receive an evaluation of the cases they have reported.