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?

Cosmetics and personal care products continued to lead the list of the most common substances implicated in pediatric exposures in 2021. Cleaning substances and pain medications followed. These exposures are nearly always unintentional.

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.

Outcome by Exposure Intent, 2020

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.

Outcome by Age Group, 2020

 
Many poison exposures can be safely observed at home without an ER visit. Overall, 68.7% of poison exposures were observed without medical intervention in 2020. For poison exposures occurring in children younger than 6 years, 89.2% were only observed at home (without going to an ER or seeing a physician). In contrast, only 56.7% of adult cases were managed at the exposure site without medical intervention.

Percent of Exposures not Managed in a Health Care Facility by Age Group, 2020

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 :

Other US Poisoning Data Sources

According to the CDC, unintentional poisoning is the leading cause of injury death in the US, comprising nearly 42% of these fatalities in 2020 and surpassing motor vehicle traffic fatalities as the leading cause of injury death in the US in 2009.Provisional data from CDC's National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the US during the 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before. The majority of those cases, approximately 75%, involved an opioid. The number of drug overdose deaths has quadrupled since 1999. The continuous rise in prescribing, use, and abuse of opioid drugs and the subsequent increase in opioid related deaths has come to be known as the opioid epidemic. 
Total US Drug Deaths: Provisional counts for 2016 are based on data available for analysis as of 8/2017.
Counts through 2015 are based on final annual data.
4
 

total US drug deaths

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
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

Medicine Safety for Children: An In-Depth Look at Calls to Poison Centers, SafeKids Worldwide, March 2015

Keeping Families Safe Around Medicine, SafeKids Worldwide, March 2014

References

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