The goal of the current study is to evaluate pesticide exposure among Moroccan workers. This is the first study carried out in the Rabat-Sale-Kenitra (RSK) region (Northwest of Morocco). This investigation used a personal survey and toxicological analysis using blood and urine samples. All the analysis are explored at the toxicology and pharmacology laboratory of the Poison Control and Pharmacovigilance Center of Morocco (CAPM). This is a descriptive study, conducted over 4 months (October 2019-January 2020) among 54 workers. The personal survey collected data related to epidemiologic characteristics, exposure information, and the use of protection and prevention tools. All the workers undergo these analysis for the first time. Blood and urine samples were taken 20 hours after the last exposure to pesticides. We used & laquo; ChE check mobile & raquo; for the determination of plasma (BChE) and erythrocyte (AChE) acetylcholinesterase activity. A urine screening by liquid-liquid extraction was realized by gas chromatography coupled to mass spectrometry (GC-MS) and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). The spectral library includes 300 pesticides molecules and 5000 molecules for LC-MS/MS and for GC-MS respectively. The average age of workers was 45 +/- 8 years. All the participants were male except one female, and the body mass index was 25.36 +/- 3.87 kg/m2. Among the 54 participants, 54% were smokers and 37% showed mucosal irritations. The studied molecules belong to pyrethroids and organophosphates classes (Deltamethrin, Bifenthrin, Permethrin, Cypermethrin, Tetramethrin, Es-biothrin and Temephos). The period of exposure was from 1 to 36 years with an average of 25 hours per week. Sixty-one percent of workers confirmed that they use gloves, masks, and gowns at work. No acute poisoning was recorded during the period of exposure. The measured values of AChE and BChE were normal, with an average of 44.36 U/gHb and 3151.8 U/l, respectively. The search for pesticides in participants' urine was negative. These results may be related to the toxicokinetics of the different targeted compounds. Therefore, it is necessary to develop a specific method that targets the metabolites of the various pesticides used in Morocco. (c) 2025 Societe Franc & cedil;aise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Inappropriate use of plants represents a significant public health risk that is often underestimated. This study aims to determine the profile and consequences of intentional plant intoxication in Morocco over a 13-year period. This study was based on a retrospective analysis of cases of intentional plant intoxication reported to the Moroccan Poison Control and Pharmacovigilance Centre (MPCPC) between 1 January 2010 and 31 December 2022. The significance level was set at 5%. During the study period, the MPCPC recorded 189 cases of intentional herbal intoxication, representing 9.37% of all herbal intoxications occurring during this period (2016 cases). The average age of the patients was 29.77 years, with the majority being young adults (68.25%), adolescents (14.28%) and children under 15 (7.93%). The sex ratio (M/F) was 0.41 (71.04% female). Suicide attempts were the main cause of poisoning (87 cases), with Atractylis gummifera being the most commonly implicated plant (17 cases). Twenty-two cases were related to abortions, mainly caused by Peganum harmala (45.45%), drug addiction (16 cases), of which Datura stramonium was the most incriminated plant (5 cases), and plant mixtures (63.63%) were the most commonly used in criminal activities (11 cases). The route of administration was mainly oral (162 cases). Digestive, neurological and cardiac disorders, renal failure, rhabdomyolysis and liver damage were reported. The outcome was favourable in 103 cases, fatal in 4, including a 9-year-old girl who ingested Rumex divers, with sequelae in 2 cases and unknown in 80 cases. Calculation of the p-value revealed that several variables were highly significant. Inappropriate use of plants poses a significant risk to public health. It is essential to raise awareness of the dangers associated with these plants and to emphasise the importance of appropriate psychiatric support in cases of intentional intoxication.

To present the role of the CAPM in the management of poisoning cases including the professional cases. We focused on the methods and tools deployed by the CAPM for the toxicovigilance operational process and conducted a retrospective study of cases of occupational poisoning declared to the CAPM between 1980 and 2020. The toxicovigilance process adopted by the CAPM is based on six steps: collection of cases, analysis of cases, build of a database, detection of signals and their validation in alerts, and finally, minimization actions risks. The study of the CAPM database made it possible to count a total of 219,770 reports of poisoning cases excluding scorpion bites and envenomations between 1980 and 2020; among them professional poisonings represented 0.5% (1020 cases). These cases were collected from three sources, mainly by call centre available 24h, the consultation dedicated to heavy metal poisoning, or via the emergency toxicology laboratory which monitors cases of occupational heavy metal poisoning. The management of poisoning cases is essentially based on the use of antidotes available at the CAPM antidote centre. The CAPM has a sustainable toxicovigilance system, responsive and capable of monitoring the profile of poisonings in all circumstances from its information system. However, the under-reporting of cases of occupational poisoning blocks its health vigilance function in this field.

Abstract The Poison Control and Pharmacovigilance Centre of Morocco (CAPM), is a public institution affiliated to the Ministry of Health. Its objective is improving the health of the Moroccan population by reducing morbidity, mortality and economic expenses related to poisoning and adverse effects of health products. Since its creation in 1989, the CAPM has set up a medical telephone hotline operational 24 hours, intended for the public and health professionals, including occupational physicians. The CAPM is responsible for responding, particularly in the event of an emergency, to any request for risk assessment and any request for opinion or advice concerning the diagnosis, prognosis and treatment of human poisoning, whether accidental or voluntary, individual or collective, acute or not, caused by any natural or synthetic product or substance, available on the market or present in the environment or in the workplace. The CAPM has a toxicology and clinical pharmacology laboratory, operational since 1994. It covers emergency medical toxicology as well as drug dosages for the therapeutic monitoring of patients. Furthermore, the CAPM has an antidote unit which ensures the availability and rationalization of the use of antidotes necessary to improve the management of poisonings. However, the CAPM suffers from under-reporting concerning professional poisoning which requires the establishment of collaboration between the CAPM and the associations of occupational physicians to realize the interest of the spontaneous notification of occupational poisonings, which will allow the tracing of the epidemiological profile for this type of poisoning and to establish integrated strategies for managing these poisonings.

Background and objectives. - Various reasons make the kidney particularly sensitive to toxicity linked to the medicinal plants (MP) use widely consumed in our country. Thus, the present study aims to determine the prevalence, spatio-temporal, epidemiological and clinical characteristics of identified cases, as well as the plants species incriminated in these nephrotoxicity reports. Method. - This is a retrospective analytical study from 2011 to 2018 of MP nephrotoxicity cases declared to the Antipoison and Pharmacovigilance Center of Morocco (CAPM). The data was collected from poisoning complaint forms received at the phytovigilance unit and calls received by the toxicological information unit. Results. - Out of 1758 cases recorded by the CAPM, we have 63 cases of nephrotoxicity (3.58%) mostly in Rabat-Sal & eacute;-K & eacute;nitra region (89%). Adults were the most affected (68%). Aristolochia longa L. (Aristolochia-Bereztem) is the most incriminated in this poisoning type (76% of reported cases), consumed alone or in the form of a mixture. The plants use particularly targeted cancer diseases (44%). Around 33% of patients reported having consumed these plants in their natural state. Honey was used to mix these preparations. Other plants mixtures of unknown nature obtained from herbalists and traditional practitioners (Msakhen and Hachimi brand products) were responsible for 7% of cases of nephrotoxicity. Tubulointerstitial nephritis constitutes the most common renal lesion (83%). The outcome of nephrotoxicity was unfavorable in 46% of cases. Conclusion. - These results remind us of the need to monitor the adverse effects of MP through the phytovigilance system in order to promote rational and safe use of this therapy, in the absence of a codified and official national pharmacopoeia. (c) 2024 Societe Franc,aise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.

Abstract Objective The Poison Control and Pharmacovigilance Centre of Morocco (CAPM) plays a crucial role in managing cases of heavy metal occupational poisoning by managing an antidote unit. The objective of our study was to describe the functioning of the antidote unit in Morocco, and evaluate its role in managing cases of heavy metal occupational poisoning. Methods In this retrospective study, all cases of lead and mercury poisoning received through the toxicological information unit at CAPM, were collected from 2020 to 2023. We described the characteristics of the treatment received by these patients as DMSA (2,3-dimercaptosuccinique acid). Results We recorded 11 patients intoxicated by lead or lead and mercury in occupational circumstances. Succimer® 200 mg (DMSA) was given in a therapeutic scheme of 30mg/kg/day, three times a day during five days. The antidotes unit delivered 39 DMSA boxes. Of the 11 patients, nine needed one course of the treatment and two patients needed two courses of the treatment. Both clinically and biologically, the patients responded well to the treatment, and no adverse effects were observed with DMSA. Conclusion The implementation of the antidote cell at CAPM demonstrated its effectiveness in providing timely and appropriate treatment to patients exposed to high levels of lead and mercury. By offering rapid interventions, the antidote cell played a pivotal role in improving patient outcomes and minimizing the clinical consequences of heavy metal poisoning.

Introduction.- Atractylis gummifera L., also known as glue thistle, is the leading cause of death from plant poisoning in Morocco. The aim of this study was to draw up an epidemiological profile of intoxications by this plant, in order to analyze the risk factors associated with vital prognosis. Method.- A retrospective descriptive study was carried out on all cases of poisoning by Atractylis gummifera L. reported to the Moroccan Poison and Pharmacovigilance Centre (CAPM) between 2009 and 2020, with known outcome. Results.- A total of 165 cases of poisoning by Atractylis gummifera were retained out of 191 cases reported to CAPM. The sex ratio (M/F) was 0.38. Most cases were due to accidental exposure (90.3%), with the child age group predominating (53 cases). Patients showed signs of intoxication of moderate intensity (PSS grade 2) in 68.5% of cases. The overall case-fatality rate was 11.5%, with a child-specific case-fatality rate of 28.1% and a male-specific case-fatality rate of 32.4%. Bivariate logistic regression analysis revealed that the risk factors for death were male gender, age <= 14 years, rural residence, the occurrence of hepatitis, the occurrence of intoxication in a public place, and an exposure time of more than 6 hours. On the other hand, the presence of gastrointestinal damage and a general state of health impairment, here understood as the presence of fever and/or hypersialorhea and/or chills and/or dehydration, were protective factors. Conclusion.- The true incidence of A. gummifera intoxication remains underestimated due to undiagnosed and unreported cases. The death rate from A. gummifera poisoning must be taken into account by the authorities. Prevention remains the most effective means of combating this type of poisoning and raise awareness of the risks of consuming this plant, as part of a national multi-sectoral strategy. Further studies need to incorporate the management of this type of poisoning as a predictive factor, in order to develop the appropriate therapeutic management.

IntroductionL’Atractylis gummifera L. connue sous le nom de chardon à glu, représente la première cause de décès par intoxication par plante au Maroc. L’objectif de ce travail était de tracer le profil épidémiologique des intoxications par cette plante afin d’en analyser les facteurs de risque associés au pronostic vital.MéthodeUne étude rétrospective descriptive a été menée sur tous les cas d’intoxication par Atractylis gummifera L. déclarés au Centre Antipoison et de Pharmacovigilance du Maroc (CAPM) entre 2009 et 2020 et dont l’issue était connue.RésultatsAu total, 165 cas d’intoxications par Atractylis gummifera ont été retenus sur 191 cas déclarés au CAPM. Le sex-ratio (H/F) était de 0,38. La plupart des cas étaient dus à une exposition accidentelle (90,3 %), dont le groupe d’âge des enfants était prédominant (53 cas). Les patients présentaient des signes d’intoxication d’une intensité modérée (PSS grade 2) dans 68,5 % des cas. Le taux de létalité générale était de 11,5 % avec une létalité spécifique à l’enfant de 28,1 % et de 32,4 % chez le sexe masculin. L’analyse de régression logistique bivariée a révélé que les facteurs de risque de décès étaient le sexe masculin, l’âge≤14 ans, la résidence en milieu rural, la survenue d’une hépatite, l’occurrence d’une intoxication dans un lieu public ainsi qu’un délai d’exposition supérieur à 6heures. En revanche, la présence d’une atteinte du système gastro- intestinal et d’une atteinte de l’état général, ici entendue comme présence de fièvre et/ou hypersialorhée et/ou frissons et/ou déshydratation constituaient des facteurs protecteurs.ConclusionL’incidence réelle de l’intoxication par A. gummifera reste sous-estimée en raison des cas non diagnostiqués et non déclarés. Le taux de décès engendré par cette dernière doit être pris en considération par les autorités. La prévention reste le moyen le plus efficace pour lutter contre ce type d’intoxication et renforcer la sensibilisation sur les risques de la consommation de cette plante dans le cadre d’une stratégie nationale multisectorielle. D’autres études doivent intégrer le mode de prise en charge de ce type d’intoxication en tant que facteurs prédictifs afin d’élaborer une conduite à tenir adaptée.

Abstract Objective The objective of our study was to describe the epidemiological features of occupational heavy metal poisoning cases recorded by the Poison Control and Pharmacovigilance Centre of Morocco (CAPM) between 1980 and 2022. Methods We conducted a cross sectional study including occupational heavy metal poisoning cases notified to CAPM between 1980 and 2022. Results We recorded 27,545 cases of poisoning notified to the CAPM (all substances), from which 96 were related to heavy metal poisoning cases (0,34%). From these 96 cases, we recorded 15 cases of occupational poisonings (15%). Among these 15 cases, lead was incriminated in 10 cases and lead with mercury in five cases. Five cases occurred in clandestine lead mines, three cases occurred in a clandestine battery recycling factory, and five cases were associated with silver mining. All the cases were males, and the mean age was 37 years. The mean blood lead level was 539,58µg/L [181-1040] before treatment, and 383,33 [62-616] after treatment (p =0,49); the mean blood mercury level was 239 µg/L [87-430] before treatment, and 38,7 µg/L [13,3-25,4] after treatment (p=0,8). The mean urinary mercury level was 246,33 µg/L. The treatment received was DMSA (2,3-dimercaptosuccinique acid). The DMSA was used in 13 cases (86 %) at a dose of 30mg/kg/day, three times daily during five days. Conclusion Occupational heavy metal poisoning cases in Morocco are a reality. The main substances incriminated were lead followed by mercury. Almost all cases needed chelation. More screening and prevention actions are needed.

Abstract Objective Lead is a heavy metal used in several types of industrial activities including mining. The objective of our work was to report the characteristics of occupational lead poisoning in three workers. Methods We report three cases of lead poisoning among workers in clandestine lead mines in Jerada in eastern Morocco, declared to the Poison Control and Pharmacovigilance Centre of Morocco (CAPM). Results Case 1: 52 years, working in clandestine mines in Jerada (Twisit, sidi boubker) since 2005, symptomatology (painful abdominal syndrome with pallor, headache, insomnia, nausea, vmsst), biology (anemia at 9.1g/dL, normal kidney function, alkaline phosphatase 319UI/L Gamma GT 544 IU/L, initial blood lead level 936.4µg/L), first DMSA (2,3-dimercaptosuccinique acid) treatment, control blood lead level 567.30µg/L. Case 2 40 years, working in clandestine mines in Jerada (Twisit, sidi boubker) since 2005, symptomatology (tingling of the lower limbs, lower back pain), first DMSA treatment, control blood lead level 241µg/L. Sept and Oct 2018: return to work at the mine, resumption of symptoms: abdominal pain, tingling of the lower limbs and back pain, blood lead level 537µg/L. Second course of DMSA: five days of treatment, control lead level 459µg/L. Case 3 42 years, worked in clandestine mines in Jerada (Twisit, sidi boubker) for 10 years, arrested two years ago, symptomatology (neuropathy of the lower limbs, gingival hypertrophy, abdominal pain), initial blood lead level 531µg/L. Conclusion Lead poisoning constitutes an often overlooked public health problem; collaboration between the clinicians, occupational physicians and CAPM allows early detection, treatment and prevention.

OBJECTIVES:To highlight the complications associated with the products and practice of healers "Ferraga" who treat young children using traditional Moroccan pharmacopoeia. METHODS:This is a retrospective analysis of cases of products and practice of "Ferraga" intoxication in young children reported to the Moroccan Poison Control and Pharmacovigilance Center (MPCPC), Rabat, Morocco, from 2010-2020. RESULTS:During the study period, 24 cases of products and practice of "Ferraga" poisoning were reported to MPCPC, Rabat, Morocco. The average age of the patients was 2.48 years. The oral route was noted in 21 cases. The vast majority of patients (23 cases) exhibited symptoms upon admission, predominantly of digestive (16 cases), respiratory (3 cases), and neurological (4 cases). However, 29.16% of patients presented with both digestive and respiratory symptoms, 20.83% had digestive and neurological symptoms, and 4 cases manifested all 3 types of symptoms. The outcome was positive in 18 patients and fatal in 2 infants. CONCLUSION:Products and practice of "Ferraga" poisoning in children remains a major health problem. It is crucial to implement a strategy to combat this type of practice in order to reduce the prevalence of such poisoning.

Acute vitamin A toxicity following ingestion of a large fish liver is rare in Morocco. We report the first cases of vitamin A poisoning following the ingestion of fish liver. The Poison Control Centre of Morocco received the case of a family of two girls 8 and 13 years old and their father, complaining of abdominal pain, vomiting, headache, diarrhea, photophobia and facial erythema several hours after consumption of tuna liver for lunch. We suspected acute vitamin A intoxication due to their diet history. Four days later; the 8-year-old girl developed an intracranial hypertension. On day 9 after ingestion, her serum retinol levels were elevated at 2.72 mu mol/l.(c) 2022 Soci acute accent et acute accent e Franc , aise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.

La toxicité aiguë de la vitamine A suite à l’ingestion de foie d’un gros poisson est rare au Maroc. Nous rapportons les premiers cas marocains d’intoxication à la vitamine A suite à l’ingestion de foie de poisson. Le Centre antipoison et de Pharmacovigilance du Maroc a reçu le cas d’une famille Une famille de trois personnes: deux filles, respectivement 13ans et 8ans et leur père de 45 ans ; sans antécédents particuliers ; se plaignant de douleurs abdominales, de vomissements, de maux de tête, de diarrhée, de photophobie et d’érythème facial plusieurs heures après la consommation de foie de thon au déjeuner. Le diagnostic d’une hypervitaminose A a été évoqué. Les patients ont reçu un traitement symptomatique. L’évolution a été marquée par l’apparition ; deux jours après ; d’une desquamation autour de la bouche et du nez chez les trois personnes. La petite fille de huit ans a présenté une hypertension intracrânienne nécessitant son hospitalisation. Le fond d’œil a objectivé un œdème papillaire stade1, son hémogramme et sa fonction rénale étaient normaux. Le dosage de la vitamine A (rétinol) plasmatique était élevé à 2,72μmol/l neuf jours après l’ingestion de foie de thon (N: 0,90-1,20) confirmant ainsi l’intoxication par la vitamine A L’évolution clinique était marquée, huit semaines après, par une amélioration avec résolution de l’œdème papillaire.

Les envenimations par morsures de serpents nécessitent dans la majorité des cas le recours à un antivenin. Un feedback sur l'utilisation de l'antivenin pour une meilleure évaluation de son utilisation est souvent problématique. Au Maroc, le Centre antipoison et de pharmacovigilance du Maroc (CAPM) assure la collecte et le suivi des données liées aux envenimations grâce à l'implantation d'un système de notification spécifique. Décrire les caractéristiques épidémiologiques cliniques et évolutives des patients victimes de morsures de serpents traités par l'antivenin Inoserp® MENA, et notifiés au CAPM entre 2015 et 2020. Il s'agit d'une étude rétrospective de tous les cas présentant une morsure de serpent traités par Inoserp® MENA et notifiés au CAPM entre le 10 août 2015, date de première utilisation de l'antivenin, et le 31 décembre 2020. L'analyse a porté sur la fréquence des morsures, l'origine géographique et l'âge des patients, le service hospitalier de prise en charge, la symptomatologie à l'admission, l'identification du serpent si disponible, le délai de l'administration de l'antivenin et le devenir des patients. L'efficacité de l'antivenin a été jugée par la correction de la thrombocytopénie, et la tolérance par la fréquence des effets indésirables. Durant la période de l'étude, 556 cas de morsures traités par Inoserp® MENA ont été notifiés au CAPM. Les victimes avaient entre 1 et 82 ans avec un âge médian de 29 ans. Le sexe-ratio était de 1,8. Les enfants dont l'âge était inférieur à 16 ans représentaient 28,3 % de l'ensemble des cas. La survenue de morsure chez la femme enceinte a été rapportée dans 7 cas (1,3 %). La région Sous Massa (Sud du Maroc) était la plus représentée avec 131 cas (23,9 %), suivie par la région Marrakech-Safi (Centre) avec 87 cas (15,9 %), puis par la région Drâa-Tafilalet (Sud-est) avec 74 cas (13,5 %). À l'admission, le syndrome vipérin concernait 550 patients (98,9 %) et le syndrome cobraïque 4 patients (0,7 %). Deux patients (0,4 %) ne présentaient pas de signe d'envenimation. Dans les 91 cas où l'espèce a pu être identifiée, Daboia mauritanica était responsable de 55 cas de morsures (60,4 %), suivi de Cerastes cerastes avec 22 cas (24,2 %). Parmi les patients présentant un syndrome vipérin, 171 patients (66,5 %) sur 257 cas évalués ont présenté une thrombopénie. Dans la majorité des cas, l'antivenin a été administré dans un service de réanimation (87,5 %) et le délai médian d'administration de l'antivenin était de 6 heures. Le nombre d'ampoules administrées était de 2 en moyenne par patient. Chez les patients ayant une thrombopénie, une normalisation du taux de plaquettes a été mise en évidence dans la majorité des cas (78,3 %). L'évolution était favorable pour 528 patients (95,0 %) et des séquelles ont été rapportées chez seulement 3 patients (0,5 %). Le nombre de cas de décès enregistrés était de 25 cas (4,5 %). À noter que toutes les grossesses ont évolué favorablement. Le nombre de patients ayant présenté des effets indésirables suite à l'administration de l'antivenin étaient de 15 (2,7 %), dont 6 ont présenté un choc anaphylactique et une patiente avait présenté une maladie sérique. Tous ces patients ont évolué favorablement. Cette étude rétrospective conduite sur 556 patients a permis de décrire les caractéristiques épidémiologiques, cliniques et évolutives des envenimations par morsure de serpent traitées par Inoserp® MENA au Maroc. Selon les résultats de cette étude, Inoserp® MENA est efficace dans l'amélioration de l'hémostase et bien toléré. Une étude clinique prospective permettrait de confirmer ces résultats.

Objective: This study aims to describe the main epidemiological characteristics of benzodiazepine intoxication in Morocco. Methods: This is a retrospective study of cases of benzodiazepine poisoning reported at the Poison Control and Pharmacovigilance Center of Morocco between 2012 and 2016. Results: During the period 2012-2016, 1,544 cases of benzodiazepine poisoning were recorded in Morocco. The average age of the addicts is 21.68 ± 14.41 years. According to the data of the study, 70% are Female, with a sex ratio of 2.25.The suicidal act represents a significant percentage with 31.5% of cases. Almost all patients were orally intoxicated with 97.1%.The signs presented are various according to the quantity ingested and the time elapsed before the treatment in particular the psychiatric, neurological, digestive and cardiovascular disorders. Unfortunately, three cases died. The other cases survived with or without sequelae. Conclusion: benzodiazepines are drugs used in the treatment of several disorders such as anxiety, insomnia and psychomotor agitation. Unfortunately, many people do not know how to use this type of medicine.which exposes them to poisoning, for this reason it is necessary to carry out sensitization campaigns for the good use of benzodiazepines at the national level. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.396-400

Suicide by self-poisoning is a major public health problem worldwide both in terms of morbidity and mortality. This study aims to discuss its epidemiological features and to identify the potential factors of clinical outcome among women in Morocco. A retrospective study spanning 34 years examined a number of characteristics of suicide cases among women by poisoning in Morocco based on the database of health monitoring system of Moroccan Poison Control Center (MPCC). A total of 17,012 women have experienced at least one suicidal poisoning, with 346 confirmed deaths (3.1% if we consider the known clinical outcome). The annual number of registered cases increased year by year [min = 4 cases; max = 1166 cases]. The average age was 23.4 years old. The home was the main place for the suicide of Moroccan women. The most common method of suicide was drug overdose (54.8%) especially in women under 65. More than half of the victims had developed gastro-intestinal disorders (54.1%) associated or not with other disorders. Most of the poisonings needed only gastrointestinal decontamination (77.6%). According to the results of the multiple regression analysis, age (ORa = 1.017; 95%IC [1.003- 1.031]; p < 0.05), incriminated product represented by drugs (ORa = 0.218; 95%IC [0.105-0.454]; p < 0.001), pesticides (ORa = 4.821; 95%IC [2.719-8.547]; p < 0.001), mineral products (ORa = 18.242; 95%IC [9.169-36.293]; p < 0.001) and plants (ORa = 3.748; 95%IC [1.483-9.470]; p < 0.01), as well as origin of the suicide victims (ORa =1.505; 95%IC [1.082-2.095]; p < 0.05) explain the observed variability of the evolution of clinical outcome. In reality, the number of women who have committed or attempted to suicide by deliberate ingestion of toxic products must be much higher. High variability of suicide rates exists across different epidemiologic characteristics. This study may lead to better treatment of patients and also help to collect better data about the problem. (c) 2021 Elsevier Ltd. All rights reserved. Selection and peer-review under responsibility of the scientific committee of the Fourth edition of the International Conference on Materials & Environmental Science.