Tags

Type your tag names separated by a space and hit enter

Increasing frequency and fatality of poison control center reported exposures involving medication and multiple substances: data from reports of the American Association of Poison Control Centers 1984-2013.
Clin Toxicol (Phila). 2016 Aug; 54(7):590-6.CT

Abstract

CONTEXT

Medication use has become increasingly prevalent in the United States, with up trending use of both prescription and over the counter medication. The increasing use and availability of medication may be changing the nature of poisoning fatality.

OBJECTIVE

To evaluate changes in fatal poisoning over time, with respect to fatalities involving one or more medications, using annual reports published by the American Association of Poison Control Centers (AAPCC).

MATERIALS AND METHODS

AAPCC annual reports were reviewed from 1984 to 2013. Data from tables in each annual report titled Number of Substances Involved in Human Exposure Cases and Summary of Fatal Exposures were abstracted. Fatality rates and changes in these rates over time were calculated for exposures to 1, 2, or ≥ 3 substances. All substances detailed in Summary of Fatal Exposures tables were then coded as medication or non-medication. The percentage of fatalities involving 1, 2, or ≥ 3 medications was calculated and trended over time. Subset analysis was performed to compare the periods 1984-2005 and 2006-2013 in order to limit confounding from changes in reporting. Secondary analysis linking the number of substances cases were exposed to and the fatality rate was performed for data from 2006-2013.

RESULTS

There were 59,866,357 human exposures and 29,659 fatalities reported from 1984 to 2013. There were 49.5 fatalities per 100,000 exposures. The majority of fatalities (52.2%) involved more than one substance, although multiple substances were involved in only 8.3% of exposures. Fatality rates increased over time and were higher for cases involving multiple substances. Medications were involved in 79.2% of fatalities, a percentage that increased from 70% in the 1980s to nearly 90% after 2010. In recent years, the majority of fatalities have involved multiple medications. For data from 2006-2013 there was a strong association between fatality rate and number of substances involved in an exposure (221 additional fatalities per 100,000 exposures for each additional substance involved in an exposure).

DISCUSSION AND CONCLUSION

Multiple substance exposures have become a greater percentage of cases reported to the AAPCC and have higher fatality rates than single substance exposures. The majority of fatal poisonings reported to the AAPCC between 1984 and 2013 involved medication. The percentage of fatal poisonings involving medication increased over the interval, as did the percentage of fatalities involving more than one medication. Fatalities involving multiple medications are now the most common type of fatal poisoning reported to the AAPCC.

Authors+Show Affiliations

a Weill Cornell Medical Center, Emergency Medicine , New York , NY , USA ;a Weill Cornell Medical Center, Emergency Medicine , New York , NY , USA ;a Weill Cornell Medical Center, Emergency Medicine , New York , NY , USA ;b Williams College , Williamstown , MA , USA.a Weill Cornell Medical Center, Emergency Medicine , New York , NY , USA ;

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27214065

Citation

Greenwald, Peter W., et al. "Increasing Frequency and Fatality of Poison Control Center Reported Exposures Involving Medication and Multiple Substances: Data From Reports of the American Association of Poison Control Centers 1984-2013." Clinical Toxicology (Philadelphia, Pa.), vol. 54, no. 7, 2016, pp. 590-6.
Greenwald PW, Farmer BM, O'Neill M, et al. Increasing frequency and fatality of poison control center reported exposures involving medication and multiple substances: data from reports of the American Association of Poison Control Centers 1984-2013. Clin Toxicol (Phila). 2016;54(7):590-6.
Greenwald, P. W., Farmer, B. M., O'Neill, M., Essner, R. A., & Flomenbaum, N. E. (2016). Increasing frequency and fatality of poison control center reported exposures involving medication and multiple substances: data from reports of the American Association of Poison Control Centers 1984-2013. Clinical Toxicology (Philadelphia, Pa.), 54(7), 590-6. https://doi.org/10.1080/15563650.2016.1183777
Greenwald PW, et al. Increasing Frequency and Fatality of Poison Control Center Reported Exposures Involving Medication and Multiple Substances: Data From Reports of the American Association of Poison Control Centers 1984-2013. Clin Toxicol (Phila). 2016;54(7):590-6. PubMed PMID: 27214065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increasing frequency and fatality of poison control center reported exposures involving medication and multiple substances: data from reports of the American Association of Poison Control Centers 1984-2013. AU - Greenwald,Peter W, AU - Farmer,Brenna M, AU - O'Neill,Matthew, AU - Essner,Rachel A, AU - Flomenbaum,Neal E, Y1 - 2016/05/23/ PY - 2016/5/24/entrez PY - 2016/5/24/pubmed PY - 2017/3/3/medline KW - Combination drug therapy KW - manganese KW - mortality KW - poisoning KW - trends SP - 590 EP - 6 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 54 IS - 7 N2 - CONTEXT: Medication use has become increasingly prevalent in the United States, with up trending use of both prescription and over the counter medication. The increasing use and availability of medication may be changing the nature of poisoning fatality. OBJECTIVE: To evaluate changes in fatal poisoning over time, with respect to fatalities involving one or more medications, using annual reports published by the American Association of Poison Control Centers (AAPCC). MATERIALS AND METHODS: AAPCC annual reports were reviewed from 1984 to 2013. Data from tables in each annual report titled Number of Substances Involved in Human Exposure Cases and Summary of Fatal Exposures were abstracted. Fatality rates and changes in these rates over time were calculated for exposures to 1, 2, or ≥ 3 substances. All substances detailed in Summary of Fatal Exposures tables were then coded as medication or non-medication. The percentage of fatalities involving 1, 2, or ≥ 3 medications was calculated and trended over time. Subset analysis was performed to compare the periods 1984-2005 and 2006-2013 in order to limit confounding from changes in reporting. Secondary analysis linking the number of substances cases were exposed to and the fatality rate was performed for data from 2006-2013. RESULTS: There were 59,866,357 human exposures and 29,659 fatalities reported from 1984 to 2013. There were 49.5 fatalities per 100,000 exposures. The majority of fatalities (52.2%) involved more than one substance, although multiple substances were involved in only 8.3% of exposures. Fatality rates increased over time and were higher for cases involving multiple substances. Medications were involved in 79.2% of fatalities, a percentage that increased from 70% in the 1980s to nearly 90% after 2010. In recent years, the majority of fatalities have involved multiple medications. For data from 2006-2013 there was a strong association between fatality rate and number of substances involved in an exposure (221 additional fatalities per 100,000 exposures for each additional substance involved in an exposure). DISCUSSION AND CONCLUSION: Multiple substance exposures have become a greater percentage of cases reported to the AAPCC and have higher fatality rates than single substance exposures. The majority of fatal poisonings reported to the AAPCC between 1984 and 2013 involved medication. The percentage of fatal poisonings involving medication increased over the interval, as did the percentage of fatalities involving more than one medication. Fatalities involving multiple medications are now the most common type of fatal poisoning reported to the AAPCC. SN - 1556-9519 UR - https://wwww.unboundmedicine.com/medline/citation/27214065/Increasing_frequency_and_fatality_of_poison_control_center_reported_exposures_involving_medication_and_multiple_substances:_data_from_reports_of_the_American_Association_of_Poison_Control_Centers_1984_2013_ DB - PRIME DP - Unbound Medicine ER -