Differences in Marine Toxin Poisonings Reported to US Poison Centers After Pandemic Restrictions

Abstract

This study investigated whether marine toxin poisonings reported to U.S. Poison Centers changed during the height of the pandemic period (April 2020 to December 2021). The National Poison Data System was queried for single-substance human exposure calls between 1 January 2000 and 31 March 2022 pertaining to ichthyosarcotoxins. Incidence rate ratios for exposure calls were calculated using mixed-effects negative binomial regression. Call counts were aggregated by year and regressed on a binary indicator for occurrence during pandemic restrictions. During the peak pandemic period, exposure calls decreased for several toxins: ciguatera poisoning: 0.57 (0.43, 0.76); clupeotoxic fish poisoning: 0.12 (0.04, 0.39); diarrhetic shellfish poisoning: 0.28 (0.16, 0.49); paralytic shellfish poisoning: 0.23 (0.17, 0.33); scombroid fish poisoning: 0.46 (0.36, 0.57). However, palytoxin poisoning (1.94 (1.32, 2.84)) and tetrodotoxin poisoning (1.73 (1.46, 2.04)) exposure calls appear to have increased. All results were Bonferroni-significant (p ≤ 0.0009). Sensitivity analyses suggest the PLTX increase began prior to pandemic restrictions, whereas the TTX increase appeared to be directly associated with the restrictions. Both men and women reported increases in TTX exposure calls. The TTX increase could be associated with potentially increased participation in outdoor activities, as TTX exposures are linked to amphibia, echinoderms, fish, and mollusks, among other animals.