National Poison Control Call Statistics, 2021
How many people call Poison Control each year?
In 2021, the 55 US poison control centers (Poison Control) provided telephone guidance for over 2.08 million human poison exposures.1 That's about:
- 6.1 poison exposures/1,000 population,
- 37.0 poison exposures in children younger than 6 years/1,000 children,
- 1 poison exposure reported to US poison control centers every 15 seconds.
|
Year: 2021 |
Calls |
|
Human Exposures |
2,080,917 |
|
Animal Exposures |
62,189 |
|
Confirmed Nonexposures |
4,974 |
|
Info Calls - Drug ID |
25,569 |
|
Info Calls - Other |
677,517 |
|
TOTAL |
2,851,166 |
How old are the people who Poison Control helps?
While children younger than six 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.
Figure 1. Age and Gender Distribution of U.S. Human Poison Exposure Cases, 2021
In 2021, across all ages, there were 627 poison exposures reported per 100,000 population. The highest incidence occurred in one- and two-year-olds, with 6,439 and 5,997 exposures/100,000 children in the respective age groups. For teens, 640 exposures per 100,000 population were reported.
Figure 2. Human Poison Exposures per 100,000 Population, by Age Group, 2021
In 2021, adults comprised 43% of all exposures, followed by children younger than 6 (41%), then teens (9%).
Figure 3. Human Poison Exposures by Age Group, 2021
Are most poisonings intentional?
Across all ages, 75.5% of poison exposures reported to U.S. poison centers in 2021 were unintentional, 19.3% were intentional, and 3.1% were adverse reactions. In children younger than 6 years, 99% of exposures were unintentional, compared to only 29.1% of teen exposures and 62.4% of adult exposures.
| Reason for Human Exposure Cases as Percent of All Cases by Age Group, 2021 | ||||||
| <6 Years | 6 - 12 Years | Teens | Adults | All Ages | ||
| Unintentional | ||||||
| General | 90.8% | 39.8% | 8.2% | 13.3% | 46.1% | |
| Environmental | 0.8% | 2.9% | 1.6% | 4.1% | 2.5% | |
| Occupational | 0.0% | 0.0% | 0.9% | 2.9% | 1.4% | |
| Therapeutic error | 6.1% | 22.7% | 9.6% | 21.8% | 14.2% | |
| Misuse | 0.6% | 12.3% | 6.7% | 15.9% | 8.6% | |
| Bite / sting | 0.5% | 2.5% | 1.2% | 2.5% | 1.5% | |
| Food poisoning | 0.3% | 0.9% | 0.6% | 1.5% | 0.9% | |
| Unknown | 0.0% | 0.3% | 0.2% | 0.4% | 0.2% | |
| Subtotal Unintentional | 99.0% | 81.4% | 29.1% | 62.4% | 75.5% | |
| Intentional | ||||||
| Intentional - Suspected suicide | 0.0% | 7.7% | 55.2% | 18.5% | 13.6% | |
| Intentional - Misuse | 0.0% | 5.7% | 4.8% | 4.1% | 2.6% | |
| Intentional - Abuse | 0.0% | 0.4% | 4.8% | 4.2% | 2.3% | |
| Intentional - Unknown | 0.0% | 0.3% | 1.9% | 1.4% | 0.8% | |
| Subtotal Intentional | 0.1% | 14.7% | 66.7% | 28.1% | 19.3% | |
| Adverse Reaction | 0.4% | 1.8% | 2.2% | 6.1% | 3.1% | |
| Other/Unknown | 0.6% | 2.0% | 2.0% | 3.4% | 2.1% | |
What are the most common substances implicated in poison exposures?
|
Substance Category |
No. Cases |
% |
|
Cosmetics/Personal Care Products |
95,848 |
10.8 |
|
Cleaning Substances (Household) |
94,279 |
10.7 |
|
Analgesics |
72,155 |
7.6 |
|
Dietary Supplements/Herbals/Homeopathic |
61,827 |
7.0 |
|
Foreign Bodies/Toys/Miscellaneous |
57,493 |
6.5 |
|
Vitamins |
42,784 |
4.8 |
| Antihistamines | 42,480 | 4.8 |
|
Topical Preparations |
37,362 |
4.2 |
|
Plants |
21,400 |
3.6 |
|
Pesticides |
28,972 |
3.3 |
In 2021, pain medications (analgesics) continued to lead the list of the most common substances implicated in adult poison exposures. Sedatives and sleeping medications, antidepressants, and cardiovascular drugs followed.
|
Substance Category |
No. Cases |
% |
|
Analgesics |
136,380 |
11.2 |
|
Sedative/Hypnotics/Antipsychotics |
91,521 |
7.5 |
| Antidepressants | 86,134 | 7.1 |
|
Cardiovascular Drugs |
82,576 | 6.8 |
|
Cleaning Substances (Household) |
76,832 | 6.3 |
|
Alcohols |
54,591 | 4.5 |
|
Anticonvulsants |
46,258 | 3.8 |
|
Antihistamines |
41,590 | 3.4 |
|
Stimulants and Street Drugs |
39,465 | 3.2 |
|
Pesticides |
36,599 | 3.0 |
What substances cause the most serious poisonings?
Between 2017 and 2021, pain medications were the most frequent causes of pediatric fatalities reported to Poison Control.
| Substance category | No. of Fatal Cases | % of Fatal Cases |
| Analgesics | 60 | 20.55 |
| Fumes/Gases/Vapors | 57 | 19.52 |
| Unknown Drug | 22 | 7.53 |
| Batteries | 16 | 5.48 |
| Cardiovascular Drugs | 15 | 5.14 |
| Stimulants and Street Drugs | 14 | 4.79 |
| Antihistamines | 13 | 4.45 |
| Alcohols | 10 | 3.42 |
| Chemicals | 9 | 3.08 |
| Anesthetics | 7 | 2.40 |
In 2021, the substance categories with the largest number of deaths across all ages (and including intentional exposures) include Acetaminophen, Sedative/Hypnotics/Antipsychotics, Miscellaneous Alcohols, Pharmaceutical and Illegal Opioid Preparations, and Miscellaneous Stimulants and Street Drugs.
| Substance category | No. of Fatal Cases | % of Fatal Cases |
| Analgesics | 60 | 20.6 |
| Fumes/Gases/Vapors | 57 | 19.5 |
| Unknown Drug | 22 | 7.5 |
| Batteries | 16 | 5.5 |
| Cardiovascular Drugs | 15 | 5.1 |
| Stimulants and Street Drugs | 14 | 4.8 |
| Antihistamines | 13 | 4.5 |
| Alcohols | 10 | 3.4 |
| Chemicals | 9 | 3.1 |
| Anesthetics | 7 | 2.4 |
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.)
Figure 4. Outcomes of U.S. Human Poison Exposure Cases, 2021
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.
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.
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
US 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 US poison control data, check out the Annual Reports of the American Association of Poison Control Centers :
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Other US Poisoning Data Sources
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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. 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.
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. 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.
 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. 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 US with synthetic opioids has led to alarming medical consequences like naloxone resistance.
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
Keeping Families Safe Around Medicine, SafeKids Worldwide, March 2014
References
- Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, Pham NPT, Weber J. 2020 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th Annual Report. Clin Toxicol (Phila). 2021 Dec;59(12):1282-1501. doi: 10.1080/15563650.2021.1989785. PMID: 34890263.
- WISQARS.CDC.gov; EXPLORE FATAL INJURY DATA VISUALIZATION TOOL. Year Range: 2020; Unintentional All Injury Deaths; Sex: Both Sexes; Age Range: All Ages; Race: All Races; Ethnicity: All Ethnicities; All Injury Types; All Counties; All States
- United States, Congress, National Center for Health Statistics, et al. "Drug Poisoning Deaths in the United States, 1980–2008." Drug Poisoning Deaths in the United States, 1980–2008, U.S. Department Of Health And Human Services, Dec. 2011.
- Centers for Disease Control and Prevention. Drug Overdose Deaths in the U.S. Top 100,000 Annually
- Centers for Disease Control and Prevention. Understanding Drug Overdoses and Deaths
- Centers for Disease Control and Prevention. Annual Surveillance Report of Drug-Related Risks and Outcomes — United States, 2017. Surveillance Special Report 1. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Published August 31, 2017. https://www.cdc.gov/drugoverdose/pdf/pubs/2017cdc-drug-surveillance-report.pdf.
- Ciccarone, D. Editorial: Fentanyl in the US heroin supply: a rapidly changing risk environment. International Journal of Drug Policy. 2017;46:107–111.
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