Poisoning with biocidal products before and after the COVID-19 pandemic: report from the Croatian Poison Control Centre

Data collected by the Croatian Poison Control Centre (CPCC) in 2020 showed a significant increase in poisoning incidence with surface disinfectants and hand sanitisers compared to the same period in 2019. Considering that this rise in poisoning with biocidal products (BPs) coincided with the start of the COVID pandemic, we wanted to see if there was a trend by analysing six-years' worth of CPCC records of biocidal poisoning cases covering the COVID-19 pre-pandemic, pandemic, and post-pandemic period (2019-2024). During that period, we received 1320 BP-related calls (8.0 % of a total of 16.441 calls), and 99 % involved four types of BPs: surface disinfectants (542 cases), hand sanitisers (325 cases), insecticides (283 cases), and rodenticides (119 cases). Most poisonings were accidental and involved ingestion and inhalation as the exposure routes. Most patients were asymptomatic or had mild to moderate symptoms, while severe symptoms were mainly observed in suicide attempts, accounting for less than 3.0 % of the cases. Our analysis confirmed an increase in poisoning cases with hand sanitisers during the height of the pandemic (2020-2021) compared to the pre-pandemic 2019, with the numbers somewhat decreasing afterwards (2022-2024), although the number of cases remained higher than before the pandemic. The number of poisonings with surface disinfectants remained similar before and during the pandemic (2019-2021) but showed an increasing trend after the pandemic (2022-2024). Poisoning with rodenticides and insecticides remained stable across all periods. Our findings reinforce the need for greater public awareness of preventive measures, including appropriate labelling and packaging of biocidal products, and for the promotion of safe behaviour in households and workplaces.