(21) Suicide Poisoning Mortality: A Comparison of The National Poison Control Center and CDC National Datasets

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 352

Presenting Author(s)

Silvia Perez-Vilar, PhD
– Senior Epidemiologist, US Food and Drug Administration, Silver Spring, Maryland, United States

Co-Author(s)

Jummai Apata, MBBS, DrPH
– DHHS/FDA, Silver Spring, Maryland, United States
Dinci Pennap
– US Food and Drug Administration, Silver Spring, Maryland, United States
Andrew Mosholder, MPH, MD
– US Food and Drug Administration, Silver Spring, Maryland, United States

Background: Intentional self-harm is among the top ten leading causes of death in the United States (U.S.) with poisoning being one of the major methods of suicide. National rates of intentional self-poisoning have steadily increased from 2000 through 2018 based on data from suicide-related exposure calls to the U.S. Poison Control Centers (PCCs). While clinical outcomes of intentional self-poisoning may range from no effect to death, suicide poisoning mortality remains a public health concern and future research to address this concern will rely on the quality of available mortality data sources.

Objectives: To compare suicide poisoning mortality trends in the National Poison Data System (NPDS) to the CDC’s nationally representative Wide-ranging Online Data for Epidemiologic Research (WONDER) and Web-based Injury Statistics Query and Reporting System (WISQARS) databases.

Methods: The NPDS data from cases reported to all 55 PCCs are available in near real-time, covering a wide array of substances and including the reasons for overdoses and subsequent clinical outcomes. We assessed NPDS data (2000 to 2021) on self-poisoning mortality and compared annual number of reported suicide cases to the annual number of deaths in CDC WONDER and WISQARS (1999 to 2019) databases, which provide national mortality data based on death certificates (identifying cause of death, injury intent, injury mechanism and demographic data), and nationally projected fatal and nonfatal injury data from Emergency Department (ED) surveillance data, respectively. We plotted linear graphs for annual number of deaths and tested the linear relationships between the number of deaths in the NPDS and each of the CDC databases using simple linear regression models.

Results: The mean annual deaths from self-poisoning during the study period were 702 (SD 142), 4644 (SD 730), and 6119 (SD 626) respectively, in NPDS, WISQARS and WONDER data. The proportion of total self-poisoning deaths nationwide in WONDER constituted by NPDS suicide deaths ranged from 8% (in 2002 and 2003) to 14% (in 2019). The correlation coefficients for the linear relationships between NPDS/WISQARS and NPDS/WONDER deaths, respectively, were 0.18 (p-value < 0.001) and 0.21 (p-value < 0.001).

Conclusions: CDC WONDER data which presents final vital statistics data includes more self-poisoning deaths compared to the WISQARS ED surveillance data. While NPDS data are available more rapidly, the NPDS captures a small (8-14%) proportion of deaths by self-poisoning compared to CDC WONDER data and the proportion captured may not be consistent enough to accurately predict national trends in self-poisoning deaths from trends in NPDS cases.