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Emerg Med Clin North Am. 2015 Feb;33(1):153-77. doi: 10.1016/j.emc.2014.09.011. Epub 2014 Nov 15.

Intentional and inadvertent chemical contamination of food, water, and medication.

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Division of Medical Toxicology, Department of Emergency Medicine, CT Poison Control Center, American College of Medical Toxicology, Hartford Hospital, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA. Electronic address:
Department Clinical Pharmacy, WVU School of Pharmacy, WV Poison Center, 3110 Maccorkle Ave SE, Charleston, WV 25304, USA.


Numerous examples of chemical contamination of food, water, or medication have led to steps by regulatory agencies to maintain the safety of this critical social infrastructure and supply chain. Identification of contaminant site is important. Environmental testing and biomonitoring can define the nature and extent of the event and are useful for providing objective information, but may be unavailable in time for clinical care. Clinical diagnosis should be based on toxidrome recognition and assessment of public health implications. There are several resources available to assist and these can be accessed through regional poison control centers or local/state public health departments.


Chemical terrorism; Food contamination; Medication contamination; Risk communication; Supply chain; Water contamination

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