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. 2025 Dec 14;14(6):tfaf177.
doi: 10.1093/toxres/tfaf177. eCollection 2025 Dec.

Toxicovigilance in the UK during the COVID-19 pandemic

Nicholas Brooke  1 , Gillian Carter  2 , Pardeep Jagpal  3 , Meghan Cook  1 , Stephen Jones  2 , David Cole  1 , Sian Harbon  2   4 , Elamin Donohoe  5 , Muhammad Elamin  3 , Ruben Thanacoody  5 , Raquel Duarte-Davidson  1
Affiliations

Toxicovigilance in the UK during the COVID-19 pandemic

Nicholas Brooke et al. Toxicol Res (Camb). .

Erratum in

Abstract

This study assesses the impact of the COVID-19 pandemic on enquiry numbers to the United Kingdom (UK) National Poisons Information Service (NPIS) to inform public health interventions. Phone enquiries were extracted and analysed from the UK Poisons Information Database (UKPID) in calendar years 2018 to 2020. Data collected included information on call, patient, and exposure characteristics for all enquiries and for specific enquiries involving selected agents of interest. During the first national lockdown there was a significant decrease in the proportion of enquiries about intentional exposures (20.6%) compared to pre lockdown (26%) and control periods (22.6%) (P < 0.001), potentially due to reluctance to attend healthcare facilities. Exposures regarding dental analgesics also increased significantly in lockdown (5.15%) compared to pre-lockdown (2.6%) and the control period (3.4%) (P < 0.001) likely due to limited access to dental services. Enquiries about hand sanitisers exposures showed a significant increase during lockdown (92) compared to pre-lockdown (32) and control (45) (P < 0.001) likely due to increased availability. No significant increases in exposures were identified for selected pharmaceuticals of interest and only a small number of enquiries relating to exposures with essential oils, methanol, Chinese herbal medicines antihistamines and deliberate bleach ingestion which offered reassurance from a public health perspective. This data led to public health interventions such as tweets, updates to guidance and advice to healthcare professionals and the public. Toxicovigilance is a key public health tool and poison centre enquiry data is helpful in identifying toxic exposures for any future pandemics or large-scale chemical incident.

Keywords: Covid-19; Toxicosurveillance; chemical surveillance; poison centres; public health; toxicovigilance.

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Figures

Fig. 1
Fig. 1
Trend of phone enquiries (all agents) reported to the National Poisons Information Service over time during 2020 (COVID-19) in comparison to 2018 and 2019.
Fig. 2
Fig. 2
Comparison of total phone enquiries to the XXX comparing for the 12 week period following 1st national lockdown to the 12 weeks preceding lockdown and a control period 2019.
Fig. 3
Fig. 3
Trend of phone enquiries (all agents) in children under 6 reported to the NPIS over time during 2020 (COVID-19) in comparison to 2018 and 2019.
Fig. 4
Fig. 4
Comparison of total phone enquiries in children under 6 yr to the NPIS for the 12 week period following 1st national lockdown to 12 weeks preceding lockdown and a control period (2019).
Fig. 5
Fig. 5
Trend of phone enquiries (all agents) with intentional (self harm) circumstances reported to the NPIS over time during 2020 (COVID-19) in comparison to 2018 and 2019.
Fig. 6
Fig. 6
Comparison of total number of phone enquiries where circumstances were intentional (self harm) to the National Poisons Information Service for the 12 week period following 1st national lockdown to the 12 weeks preceding lockdown and a control period (2019).
Fig. 7
Fig. 7
Trend of phone enquiries regarding dental analgesic preparations reported to the National Poisons Information Service over time during 2020 (COVID-19) in comparison to 2018 and 2019.
Fig. 8
Fig. 8
Comparison of total phone enquiries for dental analgesia preparations made to the National Poisons Information Service for the 12 week period following 1st national lockdown to 12 weeks preceding lockdown and a control period (2019).
Fig. 9
Fig. 9
Trend of phone enquiries regarding hand sanitisers in children under 6 reported to the National Poisons Information Service over time during 2020 (COVID-19) in comparison to 2018 and 2019.
Fig. 10
Fig. 10
Comparison of total phone enquiries for hand sanitisers in children under 6 yr made to the National Poisons Information Service for the 12 week period following 1st national lockdown to 12 weeks preceding lockdown and a control period (2019).
Fig. 11
Fig. 11
Trend of phone enquiries regarding inhalation of cleaning products reported to the National Poisons Information Service over time during 2020 (COVID-19) in comparison to 2018 and 2019.
Fig. 12
Fig. 12
Examples of public health messages in relation to toxicovigilance.
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References

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