Poisoning mortality in the United States: Comparison of national mortality statistics and poison control center reports

Study objective: To determine whether the distributions of age and poisoning categories for poisoning deaths are similar in death certificates as compiled by the National Center for Health Statistics (NCHS) and US poison control centers as reported by the Toxic Exposure Surveillance System (TESS). Methods: Data from both databases for 1994 were examined. Mortality data from NCHS were identified by applicable E-codes of the International Classification of Diseases-ninth revision (ICD-9). All fatalities described in the TESS report were coded to conform to the ICD-9 system. Results: A total of 16,527 poisoning deaths were recorded by NCHS; 766 deaths were reported by TESS. For NCHS and TESS, respectively, the age distribution of unintentional drug poisonings (N=7,823; 155) and unintentional non-drug poisonings (N=1,234; 102) differed (P<.001), whereas those for intentional poisonings (N=5,320; 413) did not differ significantly. In the NCHS and TESS data sets, respectively the relative distribution of death circumstances differed (P<.001) for unintentional drug poisonings (47% versus 20%), unintentional non-drug poisonings (8% versus 14%), intentional poisonings (32% versus 54%), and unknown or other circumstances (13% versus 12%). The distributions of poisoning circumstances and age categories were dependent on the data source (P<.001). There was no statistical agreement between the data sets in rankings of the 12 most frequent ICD-9 codes and toxins associated with poisoning deaths. Conclusion: Deaths reported in TESS represent 5% of the poisoning deaths tabulated by NCHS. Differences observed in the 2 data sets may lead to differing health policies to address poisoning hazards.