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Abstract
Background Poisonings are a common cause of morbidity and mortality among adolescents. Yet surveillance data indicating current incidence rates (IRs) and time trends are lacking, making policy development and service planning difficult. We utilised population based primary care data to estimate adolescent poisoning rates according to intent across the UK.
Methods A cohort study of 1 311 021 adolescents aged 10–17 years, between 1992 and 2012, was conducted using routine primary care data from The Health Improvement Network. IRs and adjusted IRRs with 95% CIs were calculated for all poisonings, intentional, unintentional, unknown intent and alcohol related poisonings, by age, sex, calendar time and socioeconomic deprivation.
Results Overall poisoning incidence increased by 27% from the period 1992–1996 to 2007–2012, with the largest increases in intentional poisonings among females aged 16–17 years (IR 391.4/100 000 person years (PY), CI 328.9 to 465.7 for age 17 years in 1992–1996; 767.0/100 000 PY, CI 719.5 to 817.7 in 2007–2012) and alcohol related poisonings in females aged 15–16 years (IR 65.7/100 000 PY, CI 43.3 to 99.8 rising to 130.0/100 000 PY, CI 110.0 to 150.0 for age 15 years). A strong socioeconomic gradient for all poisonings persisted over time, with higher rates among the more deprived (IRR 2.63, CI 2.41 to 2.88 for the most vs least deprived quintile in 2007–2012).
Conclusions Adolescent poisonings, especially intentional poisonings, have increased substantially over time and remain associated with health inequalities. Social and psychological support for adolescents should be targeted at more deprived communities, and child and adolescent mental health and alcohol support service provision should be commissioned to reflect the changing need.
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Footnotes
Contributors All authors were involved in the conception and design of the study. LJT and EO were involved in the acquisition and preparation of the data. EGT undertook the analysis and drafted the manuscript. All authors contributed to interpreting the findings and revising the manuscript.
Competing interests None declared.
Ethics approval The Health Improvement Network (THIN) primary care data were used for this research. The company that owns THIN (Cegedim Strategic Data Medical Research) has received ethical approval for studies using only precollected, anonymised data to undergo only a scientific review. This applies to this study and the authors have complied fully with this procedure. A research protocol was submitted to the scientific review committee and the protocol was approved in October 2009. Patient informed consent is not required under this agreement, nor is additional ethics approval from either the NHS ethics committees or from the University of Nottingham.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. Data are collected and owned by Cegedim Strategic Data and can be accessed by licensed purchasers. Data can be accessed by contacting: Cegedim House, Pound Road Chertsey, Surrey, KT16 8EH8, UK; Tel +44 87 00 43 51 69; Fax +44 87 00 43 51 71.