title: Paracetamol overdose in Victoria remains a significant health-care burden.
abstract: OBJECTIVE
  Paracetamol is the most frequently used analgesic in Australia and can be purchased without a prescription. We aimed to investigate the epidemiology and outcome of paracetamol overdoses occurring in Victoria, Australia.
  
  
  METHODS
  The Victorian admitted episode dataset was examined for all patients who had a diagnosis of paracetamol poisoning (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification [ICD-10-AM]: T39.1) or paracetamol adverse effect in therapeutic use (Y45.5) from July 1, 2000 to June 30, 2007. Data extracted included all ICD-10 codes related to their admissions, gender, age range, date of admission, and cause of death (if applicable).
  
  
  RESULTS
  Over 7 years, there was a total of 14,662 hospital admissions for paracetamol overdose with a mean of 2095 cases per year. Accidental overdoses comprised 15% (n = 2149) of cases. The overdose rate fell from 46 cases per 100,000 in 2001 to 39 cases per 100,000 in 2006 (P < 0.001). Most overdoses occurred in women (71%), and patients between 15 and 50 years old comprised 78% of all cases. Complications and mortality were relatively uncommon, with only 26 deaths directly attributable to paracetamol overdose over the 7 years. No child under 15 years old died from their overdose.
  
  
  CONCLUSIONS
  Admission to Victorian hospitals with paracetamol overdose presents an enormous and in many cases preventable health-care burden. Fortunately, there has been a gradual fall in admissions, and most cases appear relatively benign. Further reductions in overdose could be achieved with increased awareness by physicians and the general public regarding the potential for accidental overdose, and increasing funding for mental health initiatives.
authors.affiliation: Department of Gastroenterology, Austin Health, Heidelberg, Australia. Siddharth.sood@austin.org.au
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sood
authors.forename: Jessica
authors.initials: J
authors.lastname: Howell
authors.forename: Vijaya
authors.initials: V
authors.lastname: Sundararajan
authors.forename: Peter W
authors.initials: PW
authors.lastname: Angus
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Gow
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects / Q000506:poisoning*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D062787:Drug Overdose / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D008297:Male; D008603:Mental Health / Q000191:economics; D008875:Middle Aged; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
keywords: Australia; Victoria; acetaminophen; overdose