title: [Paracetamol poisonings after the lifting  of the place of sale restriction].
abstract: BACKGROUND
  Before 2003, the sale of paracetamol in Norway was restricted to pharmacies only. In November 2003 this place of sale restriction was lifted, allowing sale of paracetamol in non-pharmacy locations. The purpose of this study was to investigate the incidence, severity and mortality of paracetamol poisoning before and after the lifting of the place of sale restriction.
  
  
  METHODS
  Incidence was assessed using discharge data from three selected hospitals and the enquiry database of the National Poisons Information Centre (PIC). Evaluation of poisoning severity was based on degree of hepatotoxicity in admitted patients, number of requests regarding evaluation for liver transplantation at the National Transplantation Unit and PIC severity grading of cases. Data regarding mortality of paracetamol poisoning was obtained from the National Cause of Death Register. Data for the two-year period before (2001-2002) the place of sale restriction was lifted was compared with two years after (2005-2006).
  
  
  RESULTS
  There was no significant change in the number of hospital admissions due to paracetamol poisoning in any of the three hospitals following the lifting of the place of sale restriction. The number of inquiries to PIC regarding paracetamol intake showed a statistical significant increase. The extent of severe paracetamol poisoning might be rising, but the mortality of paracetamol poisoning does not appear to have increased since the place of sale restriction was lifted.
  
  
  CONCLUSIONS
  There is no evidence that the number of paracetamol poisonings or deaths has increased since the place of sale restriction was lifted. The proportion of patients with liver toxicity/liver damage, and the number of patients evaluated for liver transplantation may be increasing. However, the development in paracetamol poisoning should be monitored in the coming years.
authors: Avdeling giftinformasjon, Helsedirektoratet, Norway. chh@helsedir.no
authors: Christian
authors: C
authors: Haga
authors: Berit
authors: B
authors: Muan
authors: Monica
authors: M
authors: Cheung
authors: Mariann
authors: M
authors: Lyngra
authors: Carl Erik
authors: CE
authors: Strømsæther
authors: Olav
authors: O
authors: Lutro
authors: Erik
authors: E
authors: Andrew
mesh_terms: D000082:Acetaminophen / Q000097:blood / Q000506:poisoning*; D018712:Analgesics, Non-Narcotic / Q000097:blood / Q000506:poisoning*; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology; D062787:Drug Overdose / Q000453:epidemiology / Q000401:mortality; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000706:statistics & numerical data; D004366:Nonprescription Drugs / Q000506:poisoning*; D009664:Norway / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011039:Poison Control Centers; D012042:Registries
chemical_list: D018712:Analgesics, Non-Narcotic; D004366:Nonprescription Drugs; D000082:Acetaminophen