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Greene Shepherd, PharmD; Wendy Klein-Schwartz, PharmD, MPH

Arch Pediatr Adolesc Med. 1998;152:1181-1185.

Objective  To describe the epidemiological features of poisoning deaths in adolescents in the United States.

Design  Descriptive analysis of poisoning deaths in persons aged 10 to 19 years in the United States from January 1, 1979, to December 31, 1994, based on national mortality data.

Study Population  Adolescents whose cause of death was identified as poisoning using International Classification of Diseases, Ninth Revision codes.

Main Outcome Measure  Nature of injury (accident vs suicide).

Results  There were 4129 suicides and 3807 accidental deaths due to poisoning. Victims were most frequently male and white. However, poisoning was more often the method of suicide in adolescent girls than in boys (28.0% vs 8.7%). The number of deaths (7138 vs 798) and death rate (2.36 vs 0.28 per 100,000 population) were higher in 15- to 19-year-olds vs 10- to 14-year-olds. The distribution of substances involved was different for 10- to 14-year-olds compared with 15- to 19-year-olds and for suicides compared with accidents. Among 10- to 14-year-olds, drugs other than alcohol accounted for 232 (85.3%) of 272 suicides but only 118 (22.4%) of 526 accidental deaths. Gases and vapors played an important role in accidental deaths and suicides in 15- to 19-year-olds and in accidents in 10- to 14-year-olds.

Conclusions  The rates of suicides and accidental poisoning deaths were lower in 10- to 14-year-olds compared with 15- to 19-year-olds. Areas where injury-prevention efforts might have an influence on adolescent fatalities include management of depression, substance abuse education, and use of carbon monoxide detectors or shutoff switches.

From Maryland Poison Center, University of Maryland School of Pharmacy, Baltimore. Dr Shepherd is now with the North Texas Poison Center and the University of Texas Southwestern Medical Center, Dallas.

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