Abstract
Objective: To assess the cases of paracetamol poisoning in Brazil. Methods: Analysis of official records of deaths between 1996 and 2019 from the Brazil Mortality Information System (SIM), admissions between 2008 and 2020 from the Hospital Information System (SIH), and cases of poisoning between 2017 and 2020 in health services, reported to the Brazilian Notifiable Diseases Surveillance System (SINAN). In SIM and SIH, records with ICD-10 were included: F55, T39, X40, X60, and Y10. In SINAN, commercial products containing paracetamol were identified. Records were stratified by age, sex, and intentionality. Mean and standard error were calculated for each stratum based on the annual data, by federation unit. Poisoning reports by 1,000,000 inhabitants were calculated from each state and compared to the national average. Results: In total, 492 deaths, 5,666 hospital admissions, and 17,031 cases of paracetamol poisoning were recorded in the period. Deaths occurred mostly among adults (71.3% ± 3.0) and in suicide attempts (37.3% ± 2.7). Hospital admissions were more frequent in adults (69.7% ± 1.4), women (57.1% ± 2.5), and unintentional poisoning (80.2% ± 4.2). Poisoning reports was more also frequent among adults (71.4% ± 1.2), women (74.2% ± 0.6), and due to accidents (79.6% ± 1.8). The South and Southeast regions of the country presented the highest frequencies in all outcomes, above the national average. Conclusion: Paracetamol exposure is a concern for preventable poisonings, hospital admissions and deaths. More accurate data about paracetamol poisoning are required to support surveillance actions and the development of mechanisms to reduce poisoning, particularly related to adults, women and suicide attempts.
Highlights
IntroductionAs a nonopioid analgesic and antipyretic agent, paracetamol is one of the best-selling drugs in Brazil (Brasil, 2019b)
Paracetamol is one of the most popular over-the-counter medicines worldwide
A total of 492 deaths from paracetamol poisoning were identified in Brazil between 1996 and 2019, of which 183 were cases of suicide and 123 were accidental deaths (p < 0.004)
Summary
As a nonopioid analgesic and antipyretic agent, paracetamol is one of the best-selling drugs in Brazil (Brasil, 2019b) It is commercially available as tablets or oral solutions, isolated or associated with other active ingredients (Brasil, 2019a). The death form is standardized, filled in by the physician and collected by the Municipal or State Health Department It is a free file transfer protocol (FTP) system, and allows users to view files and join files from different periods as a historical series, combining them into the same file. Each record has a Hospital Admission Authorization, allowing the payment of fixed amounts for hospital and medical procedures by the SUS This system displays municipal and state data obtained from the Ministry of Health website by free FTP system
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