IS THE YEW REALLY POISONOUS TO YOU

Background: Taxus species, commonly referred to as yew plants, have th e reputation of being inordinately toxic. Case reports which chronicle human near-fatal yew berry ingestions and countless fatalities in liv estock present a sober profile to the treating toxicologist. Very ofte n, a limited number of adverse reports influence decisions on all expo sures to that potential poison. The objective of this investigation wa s to profile the toxicity of exposures to Taxus spp and determine what percentage of exposures were associated with significant morbidity. M ethods: The individual computerized files of all exposures to Taxus sp p were retrieved from American Association of Poison Control Centers ( AAPCC) Toxic Exposure Surveillance System (TESS) and placed in a relat ional database. Reports from 1985-1994 were analyzed. The cases were e xamined to determine patient demographics, the outcome of exposures, t he ultimate disposition of the patients, treatment, and symptoms. AAPC C TESS definitions were used to assess outcomes. Results: The number o f exposures identified from the 10-year subset was 11,197. Children le ss than 12 years of age were involved in 96.4% (<6 years 92.7%; 6-12 y ears, 3.7%) of the exposures. When the final outcome of the exposure w as documented (n = 7269), no adverse effects occurred in 92.5% and min or effects were experienced in 7.0%. Moderate (more pronounced, but no t life-threatening) effects were experienced by 30 individuals and maj or (life-threatening) effects occurred in 4 people. There were no fata lities. Decontamination therapy, when compared to no therapy, had no i mpact on patient outcome. 6.3% were admitted for psychiatric or medica l care. When symptoms were related to Taxus spp exposures, the most fr equent symptoms were gastrointestinal (65.5%), followed by dermal (8.3 %), neurological (6.0%), and cardiovascular (6.0%). Discussion: There are limitations to the interpretation of AAPCC TESS data which may lea d to bias in favor of positive outcomes. However, the large sample siz e may minimize the limitations. Conclusion: Taxus spp exposures result only rarely in significant morbidity. Consistent with published case reports, the most common symptoms were gastrointestinal. Decontaminati on had no impact on patient outcome.