ORIGINAL ARTICLE Survey On Methanol Poisoning Epidemic in Rafsanjan City in Year 2013 Vahid Mirzaee 1 , Zahra Riahi 2 , Zahra Sharifzadeh 1 , Moein Kardoust Parizi 2 *, Amir Adineh Pour 1 1 Department of Internal Medicine, Faculty of Medicine Rafsanjan University of Medical Sciences, Rafsanjan, Iran 2 Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Corresponding Author: Moein Kardoust Parizi, E-mail: moeinkardost@yahoo.com ABSTRACT Background: Examination and early detection of the methanol toxicity epidemic are very important, so identification and initiation of appropriate therapy can significantly reduce morbidity and mortality. Therefore, this study was aimed to investigation methanol poisoning epidemic in Rafsanjan city. Methods: This case series study was conducted in 252 patients with methanol poisoning in 2013 in the Ali-ibn-Abi-Talib hospital of Rafsanjan. Data were through interviews and records that were collected at hospital admission. Due to the large number of patients and the possible lack of ability of rapid measurement of serum levels of methanol and need of rapid intervention, treatment to reduce any further complications, early diagnosis and treatment were carried out by clinical history and interpretation of arterial blood gas test results. Data record on provided checklists and then analyzed using SPSS version 19. Results: The mean pH was 0.13±7.27. The most frequent clinical features were visual disturbances (39.7%), dyspnea (1.2%), and gastrointestinal symptoms (7.1%). There was a trend towards decreasing PCO2 with decreasing pH amongst the patients surviving. The opposite trend was demonstrated in the dying; the difference was highly significant by linear regression analyses (P< 0.001). Conclusions: Methanol poisoning still has a high morbidity and mortality, mainly because of late diagnosis and treatment. Respiratory arrest, coma and severe metabolic acidosis upon admission were strong predictors of poor outcome. Early admission and ability of respiratory compensation of metabolic acidosis were associated with survival. INTRODUCTION Methyl alcohol (methanol) is a toxic and inexpensive sub- stance among illicit drinks (1). There is a slight level of methanol in commercially available alcoholic drinks while these drinks contain sufficient amounts of ethanol. In con- trast, handmade alcoholic drinks contain high levels of methanol, which can lead to poisoning. Most of the patients survive, but some cases result in death, which cannot be even prevented using intensive care, dialysis, and treatment with antidotes (2). Poisoning by counterfeit alcoholic drinks is one of the most hazardous poisonings that sometimes leads to death (3-5). Since the sale, production, and consumption of alcoholic beverages are legally prohibited in Iran, there is a high possibility of profiteering and fraud in their pro- duction. There is not any detailed report available on the amount of alcohol consumption in Iran, but the increase in alcohol poisoning and even death indicates that substandard and counterfeit alcoholic beverages have targeted the young population’s health (5). Alcoholic beverages are among the preparations that have taken the lives of many people to date Published by Mehrabani Publishing LLC. Copyright (c) the author(s). This is an open access article under CC BY license (https://creativecommons.org/licenses/by/4.0/) http://dx.doi.org/10.24200/imminv.v2i3.47 and sometimes lead to their intoxication. One of the haz- ardous pesticides is wood alcohol or methanol (5,6). Due to reported cases of mass epidemics of methanol poisoning, familiarity with the principles of diagnosis and treatment of them are of paramount importance in some cities of the country (5,7,8). World Health Organization (WHO) reports that 7.5% of people in a public communication attempt alcohol abuse on average (9). Although statistics in our country is about 0.1%, which is much lower than this amount (10), the remarkable thing is that most cases of alcohol abuse and its related data are reported in the country (11). Most of the people who con- sume alcohol in our country involve adolescents and youth aged from 18 to 20 years old who turn to it for curiosity or experience of new substance; although no information is available on the epidemiology, management, and treatment of alcohol poisoning (12). The present knowledge about human poisoning with methanol largely pertains to the studies conducted on lab- oratory animals due to the existing restrictions. The exam- ination and early diagnosis of epidemic poisonings with Internal Medicine and Medical Investigation Journal E-ISSN: 2474-7750 Homepage: www.imminv.com ARTICLE INFO Article history Received: Feb 20, 2017 Accepted: Mar 9, 2017 Published: Aug 4, 2017 Volume: 2 Issue: 3 Conflicts of interest: None Funding: None Key words Rafsanjan, Poising, Methanol, Epidemic