Snakebite injuries: contributing factors and intentionality of exposure.

The objective was to study the intent of exposure to snakes and other factors contributing to snakebite injuries in order to develop prevention strategies. We used a retrospective chart review and a follow-up telephone interview of snakebite victims who were admitted to a tertiary care center between 1985 and 1994. The data collected included demographics, intent of exposure and host and environmental factors. I performed descriptive analysis. Twenty-four males and six females ranging in age from 2 to 93 years sustained bites from a variety of snakes including rattlesnakes, copperheads, and Egyptian cobra, and others. Sixty-seven percent (20/30) of all bites resulted from intentional exposures to snakes: professional snake handlers (7), snake hunts (8), and playing with (aggravating) snakes in the wild (5). Sixty-five percent (13/20) of intentional exposures involved novices in a recreational/home setting, and 35% (7/20) occurred in an occupational setting. Unintentional exposures occurred while victims were walking in wooded areas, fishing by streams, gardening, and washing dishes indoors. Forty percent (12/30) of all victims had consumed alcohol before the snakebite, 92% (11/12) of whom were nonprofessionals with intentional exposures. Only eight victims (seven of whom were professional handlers) were using protective equipment. I concluded that the majority of snakebite injuries resulted from intentional exposures to snakes in which a variety of factors such as the use of alcohol and lack of protective equipment likely played a role.