One year epidemiological study of acute adult and adolescent poisoning admitted to Loghman Hospital, Tehran. 2004-2005

There is no center for poison control and surveillance in this country to gather information and analyze data. The Loghman Hospital is the only tertiary teaching hospital for poisoned patient with more than 65 years experience in Tehran that serves population in excess of 12 million in the capital city, so most poisoned patient refer to this center. The aim of this study was to investigate the epidemiology of hospital-referred poisoning in Loghman hospital as the representative of capital city according to International Classification of Disease (ICD10). All adults and adolescents more than 12 years old admitted to the Emergency toxicology clinic of the Loghman Hakim teaching hospital, from 21 March 2004 to 20 March 2005, were included in this study. We analyzed the clinical charts for etiological and demographical characteristics of the acutely poisoned patients who hospitalized. Variables included group of poisons, motivation, age, sex, history of mental illness and addiction, history of drug self poisoning, prognosis. There were 11,465 poisoning cases (5,583 females and 5,818 males and 64 unknown) among 26,078 patients admitted to the Emergency toxicology clinic. This was nearly half of all hospital admissions. Intentional poisoning was more common (74%) than accidental exposures (26%) including drug abuses. Pharmaceutical drugs especially antidepressants and sedative hypnotics were the major cause of the intoxication which codified as T42 (20.8%) and T43 (17.8%) respectively, followed by T40 (11.7%) that mainly consist of the opiates. There were not significant differences among patients regarding gender and season of poisoning. Two hundred and seventy two patients (1% of presentations) were died due to acute poisoning or its complications. The majority of them was due to narcotics overdose (43.7%) followed by pesticides (9.9%). Most of the deceased patients were male (80.1%) and less than 40 years old (67.6%). Although the rate of suicide is lower than western countries but the trend of deliberate self poisoning is more than population growth rate and because of substance abuse the sex distribution of poisoning is changed. It seems that national policy for the controlling of substance abuse is not efficient and need urgent intervention especially for high risk groups.