Trends in hospitalized accidental poisoning.

Accidental poisoning has emerged in the last 20 years as a well-recognized public health problem. Mortality statistics (Registrar General's "Annual Statistical Reviews") have shown until very recently a steadily increasing toll from this cause; and hospital admissions for poisoning, accidental and deliberate, have shown a steep upward trend (Ministry of Health and General Register Office "Reports on Hospital In-patient Enquiry"). The matter has been considered one of urgency in relation to medical care (Dooley, 1962; Graham, 1962; Goulding and Watkin, 1965), to domestic accidents as a whole (MacQueen, 1960; Backett, 1965), and to industrial hazard (Chief Inspector of Factories, "Annual Reports"). Recognition of the problem is not confined to Great Britain (Dooley, 1962; Jacobziner, 1966). Both in the United Kingdom (MacQueen, 1960) and elsewhere (Backett, 1965), domestic poisoning accidents have been shown in hospital and community practice to be especially a problem of young children. The present study confirms the belief that poisoning is far commoner in the home than in industry. The Registrar General's Mortality Statistics for England and Wales ("Annual Statistical Reviews") shows similarly that most fatal accidental poisonings occur in the home. But, in contrast with morbidity, fatal episodes are mainly a problem of the elderly. One reason for the last fact is the special hazard to the elderly of coal gas, a form of poisoning which often proves lethal before sufferers can be taken to hospital. A second reason is the steeply rising case fatality with age in hospitalized patients ("Hospital In-patient Enquiry"), and a third is the solitary habit of many old people which precludes discovery and rescue. Although epidemiologically hospitalized poisoning cases form a truncated group, which includes neither the majority of fatalities nor most minor episodes, trends and characteristics of hospital cases nevertheless draw attention to changing problems which lead to dangerous situations. The main purpose of the present communication is to draw attention to recent trends observed during a 16-year period of hospital admissions for accidental poisoning in Cardiff residents.