1. Increased acetaminophen related calls to Finnish PIC better reflect acetaminophen sales than serious poisonings
- Author
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Mikko J. Parry, Kalle Hoppu, Helena Isoniemi, and Anna-Maria Koivusalo
- Subjects
Adult ,medicine.medical_specialty ,Poison Control Centers ,Nonprescription Drugs ,Toxicology ,030226 pharmacology & pharmacy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Retrospective analysis ,Humans ,030212 general & internal medicine ,Finland ,Cause of death ,Acetaminophen ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,digestive, oral, and skin physiology ,Commerce ,General Medicine ,Middle Aged ,medicine.disease ,University hospital ,3. Good health ,Emergency medicine ,Age distribution ,Medical emergency ,Chemical and Drug Induced Liver Injury ,Drug Overdose ,business ,medicine.drug - Abstract
Acetaminophen (APAP) or paracetamol is a commonly encountered medicine in poisonings. We studied the changes in APAP related calls to the Finnish poison information centre (FPIC), and serious intoxications, involving hepatotoxicity or death in 2001-2014. These data were compared with paracetamol sales in Finland.This is a retrospective analysis of the FPIC database calls, national cause of death registry, registries of liver transplantations and molecular adsorbent recycling system (MARS)-treated patients from Helsinki University Hospital together with the National Institute of Health and Welfare registry of patients hospitalized. Data on APAP sales were obtained from the Finnish Medicines Agency.Between 2001 and 2014, the number of calls/year related to human APAP exposures to the FPIC increased from 227 to 1058. No change in the age distribution of enquiries was seen. Most calls involved minors: 58% (range 52-64%) for children under 6 years old, and 9% (range 6-14%) for children of 6-15 years. In Finland, APAP related fatalities have gradually increased from an average of 7/year (range 4-10) in 2000-2005 to an average of 11/year (range 6-17) in 2010-2013, whereas the number of liver transplantations remained low, average 0.6/year (range 0-2). For patients in need of MARS-treatment, a slight decrease was seen. Total APAP sales increased from 5.6 (47% prescription, 53% OTC) to 29.7 (81% prescription, 19% OTC). DDD/1000 inhabitants/day from 2001 to 2014 is recorded. Best linear relationship (RDuring the study period, we see an increase in FPIC exposure calls accompanied by an increase in APAP sales. Changes in the chosen indicators for serious poisonings show only a weak association. Despite an evident trend between sales and fatalities, the correlation with fatality remains weak due to the small number of fatalities.
- Published
- 2017