Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Highly Accessed Research article

A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: Epidemiology, intention and follow-up

Cathrine Lund1, Brita Teige2, Per Drottning3, Birgitte Stiksrud4, Tor Olav Rui5, Marianne Lyngra6, Øivind Ekeberg1, Dag Jacobsen1 and Knut Erik Hovda7*

Author Affiliations

1 Department of Acute Medicine, Oslo University Hospital Ullevaal, Kirkeveien 166, Oslo, 0407, Norway

2 Institute of Forensic Medicine, University of Oslo, Oslo, Norway

3 Department of Acute Medicine, Lovisenberg Hospital, Lovisenberggata 17, Oslo, 0456, Norway

4 Department of Medicine, Diakonhjemmet Hospital, Diakonveien 12, Oslo, 0319, Norway

5 Department of Medicine, Oslo University Hospital Aker, Trondheimsveien 235, Oslo, 0316, Norway

6 Department of Medicine, Akershus University Hospital, Sykehusveien 27, Nordbyhagen, 1424, Norway

7 The National Center for NBC Medicine, Department of Acute Medicine, Oslo University Hospital, Kirkeveien 166, Oslo, 0407, Norway

For all author emails, please log on.

BMC Public Health 2012, 12:858  doi:10.1186/1471-2458-12-858

Published: 9 October 2012

Abstract

Background

Up to date information on poisoning trends is important. This study reports the epidemiology of all hospitalized acute poisonings in Oslo, including mortality, follow-up referrals, and whether the introduction of over-the-counter sales of paracetamol outside pharmacies had an impact on the frequency of poisonings.

Methods

All acute poisonings of adults (≥16 years) treated at the five hospitals in Oslo from April 2008 to April 2009 were included consecutively in an observational cross-sectional multicentre study. A standardized form was completed by the treating physician, which covered the study aims. All deaths by poisoning in and outside hospitals were registered at the Institute of Forensic Medicine.

Results

There were 1065 hospital admissions of 912 individuals; 460 (50%) were male, and the median age was 36 years. The annual incidence was 2.0 per 1000. The most frequent toxic agents were ethanol (18%), benzodiazepines (15%), paracetamol (11%), and opioids (11%). Physicians classified 46% as possible or definite suicide attempts, 37% as accidental overdoses with substances of abuse (AOSA), and 16% as other accidents. Twenty-four per cent were discharged without any follow-up and the no follow-up odds were highest for AOSA. There were 117 deaths (eight in hospital), of which 75% were males, and the median age was 41 years. Thus, the annual mortality rate was 25 per 100 000 and the in-hospital mortality was 0.8%. Opioids were the most frequent cause of death.

Conclusions

The incidence of hospitalized acute poisonings in Oslo was similar to that in 2003 and there was an equal sex distribution. Compared with a study performed in Oslo in 2003, there has been an increase in poisonings with a suicidal intention. The in-hospital mortality was low and nine out of ten deaths occurred outside hospitals. Opioids were the leading cause of death, so preventive measures should be encouraged among substance abusers. The number of poisonings caused by paracetamol remained unchanged after the introduction of over-the-counter sales outside pharmacies and there were no deaths, so over-the-counter sales may be considered safe.

Keywords:
Epidemiology; Mortality; Paracetamol; Substance abuse; Toxicology