Leo Schep

Publications of Leo Schep

• Comparing bromism with methyl bromide toxicity.

  Authors: Daniel Armstrong, Leo Schep

  Clinical toxicology (Philadelphia, Pa.). 05/2009;

• The adverse effects of hydrogen cyanamide on human health: an evaluation of inquiries to the New Zealand National Poisons Centre.

  Authors: Leo Schep, Wayne Temple, Michael Beasley

  Clinical toxicology (Philadelphia, Pa.). 11/2008;

  Introduction. Hydrogen cyanamide is used in New Zealand to induce bud break in kiwifruit vines. The aim of this investigation was to evaluate the calls received by the New Zealand National PoisonsIntroduction. Hydrogen cyanamide is used in New Zealand to induce bud break in kiwifruit vines. The aim of this investigation was to evaluate the calls received by the New Zealand National Poisons Centre (NZNPC) attributed to acute hydrogen cyanamide exposure, and to ascertain the clinical effects of such exposures. Methods. Call data from the NZNPC telephone collection databases regarding human hydrogen cyanamide exposures were analyzed retrospectively for the years 1990-2006. Results. There were 68 human exposures, 69% were male and 22% female; 88% were adults and there were no suicide attempts. Common exposure routes were inhalation (56%) and skin contact (28%). The workplace accounted for 45% of calls. The predominant toxic effects were nausea and vomiting (29%), headache (22%), contact dermatitis (19%), and erythema (18%). Discussion. Reported symptoms and signs were consistent with the expected effects of hydrogen cyanamide exposure. Other reports of similar exposures describe higher degrees of illnesses among workers using hydrogen cyanamide, which might have been because of lack of training, inadequate access to personal protective equipment, and the absence of engineering controls. Conclusions. Based on the calls received by the NZNPC, acute exposure to hydrogen cyanamide in the workplace or acute exposure to those living within the vicinity of its use may not pose a significant immediate threat to human health.

• Compliance with poisons center referral advice and implications for toxicovigilance.

  Authors: Martin Watts, John S Fountain, David Reith, Leo Schep

  Journal of toxicology. Clinical toxicology. 02/2004; 42(5):603-10.

  BACKGROUND: When Poisons Information, or Poisons Control Centers (PCC) give directive advice in response to general public calls it is usually assumed that the advice will be followed, but it isBACKGROUND: When Poisons Information, or Poisons Control Centers (PCC) give directive advice in response to general public calls it is usually assumed that the advice will be followed, but it is difficult to measure the actual compliance of callers to a PCC. Epidemiological data regarding the incidence of poisoning incidents (Toxicovigilance) often utilizes reports of calls to a PCC. METHODS: Retrospective review of advice given to all callers to the New Zealand National Poisons Centre (NZNPC) from a defined area for the calendar year 2001. Callers to the NZNPC telephone hotlines who were advised to attend or not to attend the hospital Emergency Department (ED) were subsequently matched with actual ED visits. RESULTS: The compliance rate for those advised to attend the ED was 76.1%, whereas those advised not to attend had a compliance rate of 98.7%. The overall compliance rate was 94.1%. Of the patients presenting to the ED with a potential poisoning, only 10.2% were referred by the PCC. The callers referred by PCC and direct ED visitors appeared to differ in some respects. CONCLUSIONS: Compliance with PCC telephone advice is similar to the compliance rates in many other health interventions. Comparisons between populations calling a PCC and those self-presenting to an ED show that PCC data may not reflect the true burden of poisoning to health care systems.