Study of Factors Contributing to Scorpion Envenomation in Arizona

Introduction: Arizona has the highest incidence of scorpion envenomation reported to US poison control centers (PCCs). Most cases reported are from a residence, but specific details are limited. Methods: Specialists at Arizona’s two PCCs prospectively completed the Factors of Envenomation in Arizona Residences Survey (FEARS) for residential scorpion exposures reported during 4-week periods in the summer and winter. Based on these results, a second questionnaire, FEARS-2, targeting indoor residential exposures was then administered. Results: Among 382 FEARS responses, no significant differences were found between summer and winter exposures, except for rainfall in the previous 24 hours. Scorpions had previously been seen in 81.8% of exposures, and 29.4% reported a previous envenomation at the residence. Most exposures occurred indoors (86.5%) and in a bedroom (42.5%), where the scorpion was in the bed in 54.7% of cases. Among all stings in a bed, 72.7% occurred while sleeping. Children were stung more often in a family room (38.6% vs. 14.5%; p <.00001) and by a scorpion on the floor (53.5% vs. 35.0%; p =.0014). Distal extremities were stung most often, particularly the foot (34.5%), with most being while barefoot (81.9%). Conclusion: A variety of characteristics and associations involving residential scorpion envenomations were identified. These details can be used to guide public education and primary prevention efforts to help decrease residential scorpion exposures.