The impact of COVID-19 management on the risk of exposure to specific chemical products: a multicentric Italian study based on 2017-2021 Poison Centers consultancies

Felice Giordano^1*Lucrezia Lanciotti¹Rosanna Maria Fidente¹Attias Leonello¹Valeria Margherita Petrolini²Carlo Alessandro LOCATELLI²Giuseppe Bacis³Mariapina Gallo³Francesco Gambassi⁴Alessandra Ieri⁴Anna Lepore⁵Leonardo Pennisi⁵Francesco Coletta⁶Simone Esposito⁶Marco Marano⁷Mara Pisani⁷Lucilla Baldassarri¹

• ¹National Institute of Health (ISS), Rome, Italy
• ²Pavia Poison Centre and National Toxicology Information Centre, Laboratories of Clinical and Experimental Toxicology, IRCCS Hospital of Pavia, Istituti Clinici Scientifici Maugeri, Pavia, Italy, Pavia, Italy
• ³Bergamo Poison Control Center - ASST Papa Giovanni XXIII Hospital, Bergamo, Italy, Bergamo, Italy
• ⁴Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy, Firenze, Italy
• ⁵Poison Centre of Puglia, Policlinico Riuniti di Foggia, Foggia, Italy, Foggia, Italy
• ⁶Emergency Anesthesia, Burn Intensive Care Unit and Poison Control Center, AORN Antonio Cardarelli, Naples, Italy, Napoli, Italy
• ⁷Pediatric Poison Control Center, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy, Roma, Italy

Introduction. In Italy, the emergency of COVID-19 led to the promotion of preventive measures like hygiene protocols, biocides use, and lockdowns. This study assesses whether the Italian COVID-19 prevention Decrees led to significant changes in exposure to specific chemicals, also examining the post-COVID-19 period (2021). Materials and Methods. This multicentric observational study analyzed 2017-2021 exposure data to specific chemicals coming from six Italian Poison Centres (PCs). A multivariate analysis valued the association between the exposure to a specific product category and the predictive variables in different periods of 2020 and 2021, calculating crude and adjusted ORs and applying the Bonferroni correction for multiple comparisons. Results. The issuing of Decrees against COVID-19 conducted to peaks in exposure to chemicals. Higher proportions of children aged 1–5 were found among patients exposed to Laundry detergents (PC-DET-1) and Handwashing products (Soaps and Gel/Spray). For Gel/Spray, significant increases in the risk of exposure in 2020 (OR-lockdown period=4.61; OR-post-lockdown period=4.43) and 2021 (OR-whole year=4.34) were observed. Adults (>19) account for higher percentages among patients exposed to All-purpose products (PC-CLN-2) and to Surface Disinfectants (PP-BIO-2). A significant increase was also found for PP-BIO-2 in lockdown period of 2020 (OR=1.64). The risk of exposure to Biocides for human (PP-BIO-1) was almost statistically significant in post-lockdown period of 2020 (OR=1.74). Discussion. This study evaluated the risk of exposure to chemicals during 2020 and 2021 vs 2017-2019, considering the association between periods and exposures to specific chemicals as a crucial factor to correctly conduct these kinds of epidemiological studies.