Toxicology

on all the cases submitted by the 55 regional poison centers to the National Poison Data System to help

clinicians stay abreast of the changing landscape of exposures (Clin Toxicol 2023;61:717-939). The data

contained within this chapter were published in 2023 and contain cases from 2022. The most recent annual

reports can be found at https://www.poisoncenters.org/annual-reports.

In 2022, 2,064,875 human exposures were reported. Fatalities were reported in 1491 cases (Table 1).

residence (1.81%).

Most of the reported cases (1,159,170) occurred in children, defined in the report as younger than 20

years. To add perspective, 968,189 cases were reported in children 12 years and younger.

The most common reasons associated with these exposures were unintentional (76.4%), intentional

(18.9%), and adverse reactions (2.7%). Of note, therapeutic errors accounted for 331,539 (16.1%) of

all cases. The scenarios reported for therapeutic errors included inadvertent double dosing (30.8%),

incorrect dose (16.4%), incorrect medication administered or taken (15%), doses administered too close

in time (11.1%), and inadvertent exposure to another person’s medication (8.5%).

Routes of exposure included ingestion (82.7%), inhalation/nasal (7.6%), dermal (6.9%), and ocular

(4.1%). Of the 1491 exposure-related fatalities, most were by ingestion (83.4%), followed by inhalation/

nasal (7.3%) and parenteral (2.7%).

Only 30.6% of exposures were managed in a health care facility, with 3.4% managed in critical care units.

in only 12.4% of the exposures. The most common gastric decontamination strategy was the use of

activated charcoal (1.6% of total exposures), followed by other emetic agents (0.9%), cathartics (0.1%),

whole bowel irrigation (0.05%), and gastric lavage (0.02%).

Most Common Medication-Related Toxic Exposures

% of Total Cases

All human exposures

Analgesics

Antidepressants

Antihistamines

Cardiovascular drugs

Sedatives/hypnotics/antipsychotics

11.51

5.61

4.81

4.74

4.60

Adult exposures (≥ 20 yr of age)

Analgesics

Sedatives/hypnotics/antipsychotics

Antidepressants

Cardiovascular drugs

Alcohols

Anticonvulsants

11.09

7.37

7.30

7.06

4.39

3.81

Pediatric exposures (< 6 yr of age)

Analgesics

Dietary/herbal/homeopathic supplements

Antihistamines

Vitamins

Topical preparations

9.54

6.65

5.03

4.85

4.06

Information from: Gummin DD, Mowry JB, Beuhler MC, et al. 2022 annual report of the American Association of Poison Control Centers’ National Poison Data System