Poison Statistics National Data 2020

Reports to U.S. Poison Control Centers

How many people rely on Poison Control each year?

In 2020, the 55 U.S. poison control centers provided telephone guidance for over 2.1 million human poison exposures.1 That's about: 

  • 6.4 poison exposures/1000 population,
  • 37.9 poison exposures in children younger than 6 years/1000 children,
  • 1 poison exposure reported to U.S. poison control centers every 15 seconds.

Year: 2020

Calls

Human Exposures

2,128,198

Animal Exposures

66,745

Confirmed Nonexposures

5,160

Info Calls - Drug ID

32,291

Info Calls - Other

1,084,277

TOTAL

3,316,671

How old are the people that Poison Control helps?

While young children (younger than 6 years) comprise a disproportionate percentage of the cases, poisoning affects ALL age groups, from infants to seniors. Peak poisoning frequency occurs in one- and two-year-olds, but poisonings in teens and adults are more serious. Notice that the greater proportion of males in poison exposures occurring in children younger than 13 years switches to a female predominance in teens and adults.

Age in Years and Gender Distribution of Human Exposure Cases, 2020

Across all ages, there were 633 poison exposures reported per 100,000 population. The highest incidence occurred in one- and two-year-olds (6,780 and 6,398 exposures/100,000 children in the respective age groups). For ages 20 years or older, 367 exposures were reported per 100,000 population.

Exposures per 100,000 Population by Age Group, 2020

In 2020, adults comprised almost half of all exposures (47%), followed by children younger than 6 (39%), then teens (8%).

Human Exposures by Age Group, 2020

Are most poisonings intentional?

Across all ages, 76.9% of poison exposures reported to U.S. poison centers in 2020 were unintentional, 18.3% were intentional, and 2.7% were adverse reactions. In children younger than 6 years, 99.2% of exposures are unintentional, compared to only 31.4% of teen exposures and 63.2% of adult exposures.

Reason for Human Exposure Cases by Age Group, 2020

 

 

<6 Years

6 - 12 Years

Teens

Adults

All Ages

Unintentional

 

 

 

 

 

 

 

General

92.1%

41.8%

9.1%

14.7%

48.3%

 

Environmental

0.7%

3.3%

2.1%

4.9%

2.9%

 

Occupational

0.0%

0.0%

0.9%

2.6%

1.2%

 

Therapeutic error

5.0%

22.3%

9.4%

20.3%

13.0%

 

Misuse

0.6%

11.8%

7.3%

16.0%

8.6%

 

Bite / sting

0.5%

3.1%

1.7%

2.9%

1.8%

 

Food poisoning

0.3%

1.1%

0.7%

1.5%

0.9%

 

Unknown

0.0%

0.2%

0.2%

0.4%

0.2%

 

Subtotal Unintentional

99.2%

83.6%

31.4%

63.2%

76.9%

Intentional

 

 

 

 

 

 

 

Intentional - Suspected suicide

0.0%

5.5%

50.7%

18.5%

12.5%

 

Intentional - Misuse

0.0%

5.8%

5.3%

4.1%

2.6%

 

Intentional - Abuse

0.0%

0.4%

6.1%

4.1%

2.3%

 

Intentional - Unknown

0.0%

0.9%

2.2%

1.4%

0.9%

 

Subtotal Intentional

0.0%

12.6%

64.3%

28.0%

18.3%

Adverse Reaction

0.3%

1.8%

2.2%

5.2%

2.7%

Other/Unknown

0.5%

2.0%

2.2%

3.5%

2.1%

What are the most common substances implicated in poison exposures?

Cosmetics and personal care products lead the list of the most common substances implicated in pediatric exposures (children younger than 6 years, NPDS, 2020). Cleaning substances and pain medications follow. These exposures are nearly always unintentional.

Substance Category

No. Cases

%

Cosmetics/Personal Care Products

109,327

11.8

Cleaning Substances (Household)

104,459

11.3

Analgesics

69,955

7.6

Foreign Bodies/Toys/Miscellaneous

62,004

6.7

Dietary Supplements/Herbals/Homeopathic

59,575

6.4

Vitamins

45,537

4.9

Topical Preparations

39,819

4.3

Antihistamines

39,807

4.3

Pesticides

31,141

3.4

Plants

31,018

3.4

 

Pain medications lead the list of the most common substances implicated in adult poison exposures (20 years old or older, NPDS, 2020). Sedatives and sleeping medications, household cleaning substances, and antidepressants follow. These exposures are often intentional.

Substance Category

No. Cases

%

Analgesics

134,918

10.7

Sedative/Hypnotics/Antipsychotics

97,968

7.8

Cleaning Substances (Household)

91,678

7.3

Antidepressants

86,922

6.9

Cardiovascular Drugs

84,010

6.7

Alcohols

58,458

4.6

Anticonvulsants

47,714

3.8

Cosmetics/Personal Care Products

42,113

3.3

Antihistamines

41,581

3.3

Pesticides

38,140

3.0

What substances cause the most serious poisonings?

Frequency statistics are only a part of the poisoning story. To determine where to focus prevention efforts, we also need to know which poisonings are serious.

Fumes, gases, or vapors (including carbon monoxide), followed closely by pain medications, were the most frequent causes of pediatric fatalities reported to Poison Control between 2016 and 2020. The table below shows poisoning fatalities in children younger than 6 years reported to US Poison Control from 2016 through 2020.

 

Substance category

No. Cases

%

Fumes/Gases/Vapors

53

19.0

Analgesics

49

17.6

Unknown Drug

23

8.2

Cardiovascular Drugs

18

6.5

Antihistamines

17

6.1

Batteries

15

5.4

Stimulants and Street Drugs

10

3.6

Alcohols

8

2.9

Antidepressants

8

2.9

Chemicals

8

2.9

 

The substance categories with the largest number of deaths across all ages (and including intentional exposures) include sedatives and sleeping medications, opioids, alcohols, acetaminophen, stimulants and street drugs (NPDS, 2020).

How serious are poison exposures?

In 2020, 83% of poison exposures reported to U.S. poison centers were nontoxic, minimally toxic, or had at most a minor effect.(Includes the National Poison Data System codes: no effect; minor effect; not followed, nontoxic; and not followed, minimally toxic.)

Outcomes of Human Exposures, 2020

Intentional exposures were significantly more serious, with nearly three times as many serious outcomes (major or fatal effects) compared to unintentional exposures. Of the intentional exposures, 37% were major effects or deaths compared to just 3% of unintentional exposures and 10% of all exposures.

Outcome by Exposure Intent, 2020

Exposures in teens and adults were also considerably more serious, with 21% of teens and 19% of adults having a moderate, major or fatal effect compared to 1% of children younger than 6 years. Most exposures in children younger than 6 years (96%) were nontoxic, minimally toxic, or had at most a minor effect.

Outcome by Age Group, 2020
 
Many poison exposures can be safely observed at home without an ER visit. Overall, 68.7% of poison exposures were observed without medical intervention in 2020. For poison exposures occurring in children younger than 6 years, 89.2% were only observed at home (without going to an ER or seeing a physician). In contrast, only 56.7% of adult cases were managed at the exposure site without medical intervention.
Percent of Exposures not Managed in a Health Care Facility by Age Group, 2020

These nontoxic or minimally toxic poison exposures that can be safely observed at home are the cases that will most likely be amenable to triage by webPOISONCONTROL®.

Real-time poison exposure data enables surveillance

U.S. poison centers collect data in real time and upload those data every 6.15 minutes (median time to upload). Real-time data are used to find hazardous products quickly, follow substance abuse trends, and detect chem/bioterrorism incidents. Under a grant from the CDC, the American Association of Poison Control Centers and its member poison centers conduct automated, continuous surveillance of poison exposure cases. Alerts are sent when there are an unexpectedly large number of cases in an hour, when there’s an unexpectedly high frequency of a specific symptom, or when there are cases with combinations of clinical effects suggestive of specific poisonings that might require a rapid public health response. Toxicologists promptly investigate these alerts and inform public health officials if outliers are suspicious for events or products of concern.

For more detailed U.S. poison control data, check out the Annual Reports of the American Association of Poison Control Centers:

Other U.S. Poisoning Data Sources

According to the CDC, unintentional poisoning is the leading cause of injury death in the U.S., comprising nearly 42% of these fatalities in 20202 and surpassing motor vehicle traffic fatalities as the leading cause of injury death in the U.S. in 2009.3 Provisional data from CDC's National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the U.S. during the 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.4 The majority of those cases, approximately 75%, involved an opioid. The number of drug overdose deaths has quadrupled since 1999.5 The continuous rise in prescribing, use, and abuse of opioid drugs and the subsequent increase in opioid related deaths has come to be known as the opioid epidemic. 
Total US Drug Deaths: Provisional counts for 2016 are based on data available for analysis as of 8/2017.
Counts through 2015 are based on final annual data.
4
 total US drug deaths

The opioid epidemic was initially fueled by the use of prescription opioids like methadone, oxycodone, and hydrocodone.  Prescribing patterns for opioid medications followed an upward trend from 2006 to 2012.6 Increased awareness, education, and discussion surrounding opioid use has helped to reign in the prescribing habits of many providers and from 2012-2016, opioid prescription rates declined by 4.9% annually.6  

In 2008 it was also reported that the number of deaths involving prescription opioids surpassed the combined number of deaths from both heroin and cocaine use.6 In subsequent years, the number of deaths due to drug overdose, including the number of cases involving opioids, continued to rise. However, by 2015, use of heroin, cocaine, methamphetamines, and synthetic opioids like fentanyl were gaining in popularity. The sharpest rise in drug related fatalities was seen in 2016 and was associated with use of fentanyl and fentanyl analogs with over 20,000 deaths occurring that year.4

drugs involved in US overdose deaths
Drugs involved in US overdose deaths,, 2000 to 2016.
4

The substantial increase in fentanyl deaths has been linked to illicitly manufactured fentanyl that is used to adulterate other drugs of abuse or sold to unsuspecting users under the guise of another drug name.7 The potency of these synthetic opioids can range from approximately 3-10,000 times the strength of morphine by weight and the adulteration of heroin being sold in the U.S. with synthetic opioids has led to alarming medical consequences like naloxone resistance.8

AAPCC Data Disclosure Statement

Related Links

Summary of Poison Statistics for the Washington, DC region

Summary of National Poison Statistics, Reports to US Poison Centers, 2019

Summary of National Poison Statistics, Reports to US Poison Centers, 2018

Summary of National Poison Statistics, Reports to US Poison Centers, 2017

Summary of National Poison Statistics, Reports to US Poison Centers, 2016

Summary of National Poison Statistics, Reports to US Poison Centers, 2015

Summary of National Poison Statistics, Reports to US Poison Centers, 2014

The Rise of Medicine in the Home: Implications for Today's Children, SafeKids Worldwide, March 2016

Medicine Safety for Children: An In-Depth Look at Calls to Poison Centers, SafeKids Worldwide, March 2015

Keeping Families Safe Around Medicine, SafeKids Worldwide, March 2014

References

 

 

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