Acute poisoning is a condition characterized by sudden and severe exposure to a toxic substance (1–3). The symptoms of acute poisoning vary depending on the type and dosage of the toxic substance and may include nausea, vomiting, headache, coma, and even death (3, 4). This condition is a frequent cause of emergency department visits and hospitalizations, accounting for up to 10% of the emergency department’s caseload (5). According to a study conducted by the Pesticide Action Network North America (PANNA), approximately 385 million cases of acute poisoning occur worldwide each year. Among adults, the leading causes of acute poisoning are drugs, followed by carbon monoxide and alcohol (5, 6). Moreover, there are numerous substances, including organophosphates, that have the potential to induce acute poisoning (3, 7–10).

Most admissions of acute poisonings to the emergency department are attributed to deliberate self-harm rather than accidental incidents. Between 2015 and 2019, there was a notable 26% increase in the number of individuals attempting suicide through the ingestion of toxic substances or medication overdose (11). Additionally, a separate study indicates a significant surge in the rates of attempted suicides and suicides involving poisoning among young people during the COVID-19 pandemic (12). These emerging patterns underscore the imperative for further research aimed at comprehending the underlying risk factors associated with the choice of poisoning as a suicide method. Furthermore, there is a pressing need to develop effective prevention and intervention strategies to mitigate the risk of suicide related to poisoning.

It is worth mentioning that the etiology of acute poisoning has experienced notable transformations in recent years (13, 14). Previously prevalent causes of poisoning, such as paraquat and rodenticides, have become increasingly rare in emergency department settings (14, 15). Therefore, it is imperative to investigate the shifts in the causes of acute poisoning in recent years to enhance the efficient allocation of emergency medical resources.

In this study, we conducted a retrospective analysis encompassing patients diagnosed with acute poisoning in the emergency department between January 2017 and December 2022. The objective of this investigation was to provide a comprehensive depiction of the clinical and sociodemographic profiles associated with acute poisoning.

Acute poisoning is a major public health problem and an important reason for hospital emergency department visits (16–19). In this study, we investigated the clinical and sociodemographic profiles associated with acute poisoning cases, shedding light on the trends and risk factors in Chinese population. Among the 859 hospitalized patients diagnosed with acute poisoning, the majority of cases were female. The presence of underlying medical conditions, particularly depression, was identified as a significant risk factor for suicide attempt/suicide-related acute poisoning incidents. This finding highlights the association between mental health disorders and acute poisoning incidents. The substances involved in acute poisoning incidents varied, with drugs of abuse being the most common (53.2%), followed by pesticides (22.2%), carbon monoxide (11.8%), and alcohol (5.4%). It is worth noting that the incidence of poisoning due to paraquat, a previously common toxic agent, has decreased in recent years. This shift in poisoning patterns necessitates ongoing surveillance and adaptation of emergency medical resources to effectively respond to emerging toxicological challenges.

Suicide emerged as the leading cause of acute poisoning incidents, accounting for 75.9% of the cases. Furthermore, the temporal analysis revealed an upward trend in suicide-related cases, particularly after 2020. Notably, this timeframe aligns with the onset of the COVID-19 pandemic. The COVID-19 pandemic significantly altered daily routines and social interactions, amplifying the influence of the home environment on mental health. Lockdowns, quarantine measures, and remote work arrangements confined individuals to their homes, potentially exacerbating feelings of isolation and distress (20–23). This surge in psychological distress is closely linked to a substantially elevated risk of suicide and self-harm incidents amid the COVID-19 pandemic (20, 22, 24). The COVID-19 pandemic-induced uncertainties and anxieties further underscored the importance of home-based prevention strategies. Therefore, it is critical to develop effective prevention and intervention strategies to reduce the risk of suicide during the COVID-19 pandemic and during its subsequent years.

Gender differences in acute poisoning cases emerged as an essential factor to consider in suicide-related incidents. We found that females were more likely to be involved in acute poisoning incidents with suicidal intent compared to males. This aligns with previous research indicating gender-specific patterns in suicidal behavior (25–27). To assess the relationship between gender and suicide, Miranda-Mendizabal et al. (27) conducted a meta-analysis that included 67 studies, demonstrating a higher risk of suicide attempts in women compared to men (OR 1.96, 95% CI 1.54–2.50). Additionally, the study revealed that female-specific suicide risk factors, including depressive symptoms mentioned in our study, contributed to this higher risk. In the Chinese population, women are also identified as a significant risk factor for suicide. In a more recent study, Zheng et al. (26) prospectively included 237 patients treated for poisoning between May 2021 and May 2022, and their findings supported our results, with being female and anxious being significant risk factors for suicide. Thus, understanding these gender differences is essential for the development of gender-specific prevention and intervention strategies.

This study has some limitations. Firstly, this is a single center, retrospective study, which may limit the generalizability of the findings to other settings. Possibly shedding light on enhancing the representativeness of the results, future studies should consider a multi-center approach. Secondly, this study only looked at acute poisoning cases in the last 6 years. A longer time span of cases is needed to determine trends in the characteristics of acute poisoning.

This study provides valuable insights into the trends, profiles, and risk factors associated with acute poisoning cases, with a particular emphasis on suicide-related incidents and gender differences. The findings emphasize the importance of addressing mental health issues, particularly depression, in individuals at risk for suicide-related acute poisoning. By revealing changing toxicological patterns, identifying vulnerable populations, and recognizing urban-rural disparities, the study lays the groundwork for evidence-based public health initiatives to address the multifaceted challenge of acute poisoning.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethical approval was not required for the studies involving humans because this was a retrospective study and did not include personal information about the cases. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required from the participants or the participants’ legal guardians/next of kin in accordance with the national legislation and institutional requirements because this was a retrospective study and did not include personal information about the cases.

SL, LL, JM, HY, ZG, and QF collected and analyzed the data. JM and XX designed this study. All authors contributed to the article and approved the submitted version.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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