Estimates of acetaminophen (paracetamol)-associated overdoses in the United States

Objective To estimate the number of acetaminophen-associated overdoses in the United States and identify possible risk factors for intervention. Methods The investigators obtained estimates of acetaminophen-associated overdoses using different national databases. Two emergency room databases, a hospital discharge database, a national mortality file, and a poison surveillance database were used to identify cases. The FDA's spontaneous reporting system was searched to identify possible root causes for overdoses. Results Analysis of national databases show that acetaminophen-associated overdoses account for about 56000 emergency room visits and 26000 hospitalizations yearly. Analysis of national mortality files shows 458 deaths occur each year from acetaminophen-associated overdoses; 100 of these are unintentional. The poison surveillance database showed near-doubling in the number of fatalities associated with acetaminophen from 98 in 1997 to 173 in 2001. AERS data describe a number of possible causes for unintentional acetamillophen-associated overdoses. Conclusions Each year a substantial numbers of Americans experience intentional and unintentional acetaminophen-associated overdoses that, in severe cases, lead to serious illness and possible death. This summary of a series of analyses highlights the need for strategies to reduce this public health burden. Copyright (c) 2005 John Wiley & Sons, Ltd.