Recorded presentation

Dawn S Hui, BM, Medical School, University of Texas at Southwestern, 4217 Wycliff Avenue, Apt 4, Dallas, TX 75219, 214-597-5911, dsh27@columbia.edu, Robert S Hoffman, MD, NYC Poison Control Center, 455 First Avenue, Room 123, New York, NY 10016, and Nadine R. Levick, MD, MPH, Pediatric Emergency Medicine, Columbia University, New York, 137 West 110th Street, 7B, New York, NY 10026.

Purpose: Poisoning mortality data is accessible, yet few population-based studies have been published. A recent comprehensive study on adults (1985-1995) demonstrated an increase in poison-related mortality. This contrasts sharply with a concurrent decrease in general injury-related mortality. This present study additionally includes the pediatric population and expands the period to 1981-2001.

Methods: ICD-9 and ICD-10 codes were used to extract poisoning mortality data from the CDC WISQAR database. Data were stratified by intent, and age was grouped in 10-year intervals.

Results: From 1981-2001, the overall age-adjusted death rate from unintentional poisoning increased 145% from 2.01 to 4.92 per 100,000. This trend was not uniform, as increases occurred exclusively in those aged 20-59 (peak 355% in those aged 40-49) and decreases occurred in the children under the age of 10 (55% decrease). Suicidal poisoning death rates decreased 28%, (from 2.52 to 1.81 per 100,000), across all age groups (range -52% to -5%).

Conclusions: Poisoning is a significant public health concern, and caused 22,242 deaths in 2001. From 1981-2001, the increase in poisoning mortality was due solely to unintentional poisonings in those aged 20-59, while unintentional poisoning deaths in the children and the elderly declined. This biphasic distribution suggests that factors such as substance abuse, medication errors, prescribing practices, and injury prevention initiatives contribute differently to poisoning deaths in different age groups. Given that these are distinct realms of research and practice, the inclusion of diverse substances and circumstances under the rubric “poison” poses a dilemma for establishing effective poison prevention strategies.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe recent trends in poisoning mortality by age group and intent, and recognize the importance of these trends in the context of all- injury mortality.
• Identify the various components that make up poisoning as defined by the ICD-9 system.
• Discuss the impact of the ICD-9 coding system on poison research and poison prevention practices.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation