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Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry.
J Med Toxicol. 2016 12; 12(4):365-369.JM

Abstract

INTRODUCTION

In the developing world, occupation has been identified as a risk factor for snake bite. Such an association has not been described in the USA. The objective of this study was to describe the epidemiology and clinical manifestations of occupational snake bite in patients reported to the ToxIC North American Snakebite Registry (NASBR).

METHODS

This was a prospective case series of patients reported to the ToxIC NASBR between January 1, 2014 and November 5, 2015. Variables collected included snake species, patient demographics, date and location of exposure, occupation, bite location, clinical manifestations, and management.

RESULTS

Of 180 adult snake bites reported, 25 (13.9 %; 95 % CI 9.2-19.8 %) were occupational in nature. Rattlesnake envenomations were common (80 %). Most snake bites (96 %) occurred in men. Occupations most associated with snake bite were landscaping (28 %) and working directly with snakes (24 %). Fifty-six percent of bites occurred in an outdoor work environment. Seventy-six percent of envenomations were to the upper extremities. Intentional interaction occurred in 40 % of cases, all of which sustained finger envenomations. No cases presented with apparent acute ethanol intoxication.

CONCLUSIONS

The majority of occupational snake bites occurred in men working outdoors and were unintentional injuries. Bites involving the upper extremity tended to result from intentional interactions. Acute ethanol intoxication did not appear to be involved with occupational envenomations.

Authors+Show Affiliations

Department of Medical Toxicology, Banner-University Medical Center Phoenix, 925 E. McDowell Road, 2nd Floor, Phoenix, AZ, 85006, USA. mspyres@gmail.com.Department of Medical Toxicology, Banner-University Medical Center Phoenix, 925 E. McDowell Road, 2nd Floor, Phoenix, AZ, 85006, USA.New Mexico Poison Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.North Texas Poison Center, Parkland Health and Hospital System, Dallas, TX, USA.Department of Medical Toxicology, Banner-University Medical Center Phoenix, 925 E. McDowell Road, 2nd Floor, Phoenix, AZ, 85006, USA.North Texas Poison Center, Parkland Health and Hospital System, Dallas, TX, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27234295

Citation

Spyres, Meghan B., et al. "Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry." Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology, vol. 12, no. 4, 2016, pp. 365-369.
Spyres MB, Ruha AM, Seifert S, et al. Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. J Med Toxicol. 2016;12(4):365-369.
Spyres, M. B., Ruha, A. M., Seifert, S., Onisko, N., Padilla-Jones, A., & Smith, E. A. (2016). Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology, 12(4), 365-369.
Spyres MB, et al. Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. J Med Toxicol. 2016;12(4):365-369. PubMed PMID: 27234295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. AU - Spyres,Meghan B, AU - Ruha,Anne-Michelle, AU - Seifert,Steven, AU - Onisko,Nancy, AU - Padilla-Jones,Angela, AU - Smith,Eric Anthony, Y1 - 2016/05/27/ PY - 2016/02/02/received PY - 2016/05/09/accepted PY - 2016/05/05/revised PY - 2016/5/29/pubmed PY - 2017/12/20/medline PY - 2016/5/29/entrez KW - Envenomation KW - Occupation KW - Risk factor KW - Snake bite SP - 365 EP - 369 JF - Journal of medical toxicology : official journal of the American College of Medical Toxicology JO - J Med Toxicol VL - 12 IS - 4 N2 - INTRODUCTION: In the developing world, occupation has been identified as a risk factor for snake bite. Such an association has not been described in the USA. The objective of this study was to describe the epidemiology and clinical manifestations of occupational snake bite in patients reported to the ToxIC North American Snakebite Registry (NASBR). METHODS: This was a prospective case series of patients reported to the ToxIC NASBR between January 1, 2014 and November 5, 2015. Variables collected included snake species, patient demographics, date and location of exposure, occupation, bite location, clinical manifestations, and management. RESULTS: Of 180 adult snake bites reported, 25 (13.9 %; 95 % CI 9.2-19.8 %) were occupational in nature. Rattlesnake envenomations were common (80 %). Most snake bites (96 %) occurred in men. Occupations most associated with snake bite were landscaping (28 %) and working directly with snakes (24 %). Fifty-six percent of bites occurred in an outdoor work environment. Seventy-six percent of envenomations were to the upper extremities. Intentional interaction occurred in 40 % of cases, all of which sustained finger envenomations. No cases presented with apparent acute ethanol intoxication. CONCLUSIONS: The majority of occupational snake bites occurred in men working outdoors and were unintentional injuries. Bites involving the upper extremity tended to result from intentional interactions. Acute ethanol intoxication did not appear to be involved with occupational envenomations. SN - 1937-6995 UR - https://www.unboundmedicine.com/medline/citation/27234295/Occupational_Snake_Bites:_a_Prospective_Case_Series_of_Patients_Reported_to_the_ToxIC_North_American_Snakebite_Registry_ L2 - https://dx.doi.org/10.1007/s13181-016-0555-7 DB - PRIME DP - Unbound Medicine ER -