| Abstract | Otrovanje je kliničko stanje koje karakterizira iznenadna ili postupna ugroženost jednog ili više organskih sustava tijela zbog kontakta s otrovom. Ovisno o vrsti otrova, u slučaju ovog rada, kiseline ili lužine, putu otrovanja, količini otrova i brzini medicinske intervencije simptomi, ishod i slijed liječenja mogu se značajno razlikovati. Kućne kemikalije, u koje spadaju i nagrizajuća sredstva čest su izvor otrovanja u dječjoj populaciji. Ukoliko dođe do ingestije nagrizajućeg sredstva iz skupine kućnih kemikalija od strane djeteta, najčešće se radi o sredstvima za čišćenje sanitarne keramike i kanalizacijskih odvoda. Sredstva za čišćenje spadaju u grupu predmeta opće uporabe prema odredbama Zakona o predmetima opće uporabe, zasebno su uređena Uredbom od deterdžentima koja propisuje način stavljanja na tržište. Također, uređuju se i Uredbom o razvrstavanju, označavanju i pakiranju (na engleskom jeziku: Classification, Labelling and Packaging, CLP) iz 2008. godine koja osigurava razvrstavanje, označavanje i pakiranje kemijskih tvari prema Globalnom harmoniziranom sustavu (engleski: Globally Harmonised System, GHS). CLP uredba detaljno propisuje označavanje, pakiranje, distribuciju i skladištenje potencijalno opasnih kemikalija među koje spadaju i nagrizajuća sredstva. Cilj ovog rada bio je analizirati trendove trovanja djece nagrizajućim sredstvima u kućanstvu od 2002. do 2018. godine te ispitati informiranost roditelja djece predškolske dobi o opasnostima povezanim s nagrizajućim sredstvima prisutnim u kućanstvu te njihovo poznavanje oznaka i piktograma opasnosti, te procijeniti utjecaj promjena u zakonskoj regulativi te drugih provedenih mjera u smanjivanju učestalosti otrovanja. U sklopu rada analizirane su dvije ankete, provedene 2002. i 2015. godine, podaci o hospitalizacijama uzrokovanim nagrizajućim sredstvima unutar te dvije godine te analiza podataka centra za kontrolu otrovanja za razdoblje od 2006. do 2018. Nadalje, napravljen je pregled nagrizajućih kemikalija prisutnih u sredstvima za primjenu u kućanstvu. Analizom je utvrđeno da se informiranost roditelja poboljšala u manjoj mjeri, međutim da se broj prijavljenih trovanja predškolske djece nije smanjio, štoviše trend prijavljenih trovanja pokazuje kontinuiran rast. To ukazuje na potrebu dodatne edukacije, informiranja javnosti i zdravstvenih djelatnika, te pogotovo roditelja, o opasnostima nagrizajućih sredstava za primjenu u kućanstvu i ispravnim mjerama postupanja u slučaju otrovanja. Potrebno bi bilo razmotriti i potrebu boljeg nadzora pridržavanja uredbi i zakona koji se bave označavanjem i pakiranjem tih sredstava. |
| Abstract (english) | Poisoning is a clinical state characterized by a sudden or gradual risk to one or more organs that came in contact with the poison. In clinical practice poisoning caused by corrosives, meaning acidic and alkaline chemicals, are quite common. Depending on the substance, path of ingestion, quantity and reaction time the course of action and outcome differs greatly. Household chemicals, which include corrosives, are a common source of poisoning with children. When it comes to ingestion of household chemicals containing corrosives in children, the most frequent sources are sewage drain cleaning agents and cleaning substances intended for use in bathrooms. These chemicals are categorized as items for wide use and are subject to regulations regarding said items. The cleaning agents are also separately subject to regulations concerning detergents which dictates their distribution on the market. Additionally, corrosive chemicals are subject to Classification, Labelling and Packaging regulations (CLP) of the European Union. In use since 2008, the CLP regulations dictate in detail the classification, labeling and packaging of chemicals according to the Globally Harmonised System (GSH). The aim of this thesis was to analyze the trends regarding poisoning of children with household chemicals containing corrosives from 2002 to 2018 and to evaluate if the parents of such children are aware of the dangers presented by inadequate storage and labeling of such chemicals, weather they recognize their labeling and warning signs. Moreover, using the data for each individual year there was an effort to estimate the usefullness of different approaches aimed at reducing the risk of poisoning with household chemicals in children. Those included the change of legal regulations, different warning signs as well as changes in the system of education. The scope of this thesis included the analysis of two surveys conducted with parents of young children in 2002 and 2015 as well as analyzing the data regarding patients hospitalized because of corrosive ingestion in 2002 and 2015. Additional analysis included annual reports of the Croatian Poison Control Center between 2006 and 2018. The results showed that parents in 2015 were slightly better informed then in 2002, however the number of young children who were poisoned didn't decline and a continuous growth in number of cases has been noted. Everything listed above implies that the Croatian public, healthcare workers and especially the parents need to be better informed when it comes to dangers of corrosive substances in the household. Furthermore, there appears to be a need for stricter control and further improvement of regulations regarding labeling and packaging of corrosive chemicals intended for household use. |
