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Poisoning ranks among most
common causes of household deaths

Note: In recognition of National Safety Month, the Transporter will publish a series of articles to promote safety. The ITD Safety Team encourages employees to put an extra focus this month into weekly safety meetings at work and to use the information at home as applicable. The focus this week is on poison prevention.

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Most preventable injuries happen where you'd think you're safest – at home. In fact, the National Safety Council estimates that 17 million people were injured at home and 62,000 died from their injuries. The leading cause of injuries and deaths came from: Poisonings, falls, choking, drowning and fires/flames. The focus this week is poisoning in the home.

Poisoning in the United States

Overview
A poison is any substance that is harmful to your body when ingested (eaten), inhaled (breathed), injected, or absorbed through the skin. Any substance can be poisonous if enough is taken. This definition does not include adverse reactions to medications taken correctly.

Poisonings are either intentional or unintentional. If the person taking or giving a substance did not mean to cause harm, then it is an unintentional poisoning. Unintentional poisoning includes the use of drugs or chemicals for recreational purposes in excessive amounts, such as an “overdose.”

It also includes the excessive use of drugs or chemicals for nonrecreational purposes, such as by a toddler. Intentional poisoning is the result of a person taking or giving a substance with the intention of causing harm. Suicide and assault by poisoning fall into this category. When the distinction between intentional and unintentional is unclear, poisonings are usually labeled “undetermined” in intent.

Occurrence (unintentional)
In 2005, 23,618 (72 percent) of the 32,691 poisoning deaths in the United States were unintentional, and 3,240 (10 percent) were of undetermined intent (CDC 2008). Unintentional poisoning death rates have risen steadily since 1992.

Unintentional poisoning was second only to motor vehicle crashes as a cause of unintentional injury death in 2005 (CDC 2008). Among people 35 to 54 years old, unintentional poisoning caused more deaths than motor vehicle crashes.

In 2006, unintentional poisoning caused about 703,702 emergency department (ED) visits (CDC 2008).

Almost 25 percent of these unintentional ED visits resulted in hospitalization or transfer to another facility (CDC 2008).

In 2006, poison control centers reported about two million unintentional poisoning or poison exposure cases (Bronstein et al. 2007).

Intentional
In the United States in 2005, 5,833 (18 percent) of the 32,691 poisoning deaths were intentional; 5,744 were suicides and 89 were homicides (CDC 2008).

In 2006, intentional poisoning led to about 220,924 emergency department (ED) visits; 216,358 involved self-harm and 3,982 were assaults (CDC 2008).

Among the self-harm poisoning ED visits, 162,096 (75 percent) resulted in hospitalization or transfer to another facility.

Self-harm poisoning was the second-leading cause of ED visits for intentional injury in 2006 (CDC 2008).

That same year, poison control centers reported 198,578 cases where the reason for poison exposure was a suspected suicide attempt (Bronstein et al. 2007).

Most common poisons (unintentional)
In 2004, 95 percent of unintentional and undetermined poisoning deaths were caused by drugs (WONDER 2007). Opioid pain medications were most commonly involved, followed by cocaine and heroin (Paulozzi et al. 2006).

Among those treated in EDs for nonfatal poisonings involving intentional, non-medical use (such as misuse or abuse) of prescription or over-the-counter drugs in 2004, opioid pain medications and benzodiazepines were used most frequently (SAMHSA 2006).

Intentional
In 2004, 75 percent of poisoning suicides were caused by drugs—both legal and illegal. The most commonly used drugs identified in drug-related suicides were psychoactive drugs, such as sedatives and antidepressants, followed by opiates and prescription pain medications (WONDER 2007).

Most (93 percent) nonfatal, poison-related suicide attempts involved pharmaceuticals. Among the 132,582 drug-related suicide attempts in the United States in 2005, sedatives and hypnotics, pain medications, and antidepressants were the most common drugs taken. Among pain medications, opioids were the most widely used, while benzodiazepines were the most common sedatives (SAMHSA 2007).

Groups at risk (unintentional)
Among those who died from unintentional poisoning in 2005:

Men were 2.1 times more likely than women
Native Americans had the highest death rate
Whites and blacks had comparable rates
The peak age was 45-49 years of age; and
The lowest mortality rates were among children less than 15 years old (CDC 2008).

Among people who unintentionally poisoned themselves, received treatment in emergency departments and survived in 2006:

Men were 1.5 times more likely than women;
The highest rates were in the 40-49 year old age group (CDC 2008).

Intentional
Among those who committed suicide by poisoning in 2005:

Men were 1.3 times more likely than women;
Whites were 3.6 times more likely than blacks; and
The peak age was 45-49 years old (CDC 2008).

Among those who intentionally harmed themselves with poison, received treatment in emergency departments, and survived in 2006:

Women were 1.6 times more likely than men; and
The peak age was 15-19 years old, with a secondary peak in the 40-44 age group (CDC 2008).