Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry

• Published in: Journal of medical toxicology 2016-12, Vol.12 (4), p.365-369
• Main Authors: Spyres, Meghan B., Ruha, Anne-Michelle, Seifert, Steven, Onisko, Nancy, Padilla-Jones, Angela, Smith, Eric Anthony
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Agkistrodon; Animals; Antivenins - therapeutic use; Biomedical and Life Sciences; Biomedicine; Bites; Case studies; Crotalus; Demographic variables; Demography; Epidemiology; Ethanol; Extremities; Female; Finger Injuries - diagnosis; Finger Injuries - epidemiology; Finger Injuries - therapy; Humans; Intoxication; Male; Middle Aged; Occupational Diseases - diagnosis; Occupational Diseases - epidemiology; Occupational Diseases - therapy; Occupational hazards; Occupations; Original; Original Article; Pharmacology/Toxicology; Prospective Studies; Registration; Registries; Risk analysis; Risk Factors; Snake bites; Snake Bites - diagnosis; Snake Bites - epidemiology; Snake Bites - therapy; Snakes; Treatment Outcome; United States - epidemiology; Upper Extremity - injuries; Working conditions
• ISSN: 1556-9039; 1937-6995
• DOI: 10.1007/s13181-016-0555-7

Introduction In the developing world, occupation has been identified as a risk factor for snake bite. Such an association has not been described in the USA. The objective of this study was to describe the epidemiology and clinical manifestations of occupational snake bite in patients reported to the ToxIC North American Snakebite Registry (NASBR). Methods This was a prospective case series of patients reported to the ToxIC NASBR between January 1, 2014 and November 5, 2015. Variables collected included snake species, patient demographics, date and location of exposure, occupation, bite location, clinical manifestations, and management. Results Of 180 adult snake bites reported, 25 (13.9 %; 95 % CI 9.2–19.8 %) were occupational in nature. Rattlesnake envenomations were common (80 %). Most snake bites (96 %) occurred in men. Occupations most associated with snake bite were landscaping (28 %) and working directly with snakes (24 %). Fifty-six percent of bites occurred in an outdoor work environment. Seventy-six percent of envenomations were to the upper extremities. Intentional interaction occurred in 40 % of cases, all of which sustained finger envenomations. No cases presented with apparent acute ethanol intoxication. Conclusions The majority of occupational snake bites occurred in men working outdoors and were unintentional injuries. Bites involving the upper extremity tended to result from intentional interactions. Acute ethanol intoxication did not appear to be involved with occupational envenomations.