The annual cost of poisoning, not including costs related to alcohol deaths, to the United States (based on lifetime cost of injury) was estimated in 1989 to be $8.5 billion (Rice et al., 1989). A major definitional limitation of this study was that it excluded costs related to poisoning from alcohol and other illicit drugs. Unfortunately, the Committee found no more recently published data. Adjusting the cost estimates from the Rice study to 2003 dollars using the Consumer Price Index provides an estimate of $12.6 billion for the current cost of poisoning.
Not only have the magnitude and cost of the poisoning problem been underappreciated, but the diverse nature of poisonings and the populations at risk have changed over time. While poisoning was initially viewed as a problem of young children, it now emerges as a concern across the entire lifespan. Half of all poison exposures reported to TESS occur among children 5 years of age; however, only 8 percent of the moderate to major effects from poisonings occur among those in the 5 years and under age group. Approximately 71 percent of moderate and major exposures occur in those over 19 years of age.
Unintentional death from exposure to hazardous household substances occurs primarily among children and youth, the group that also has the highest level of exposure to poisonous substances. However, suicide by poison and alcohol and illicit drug-related poison deaths occur in older adolescent and young adult populations (approximately 7.6 percent of the poison exposures reported to TESS are suspected suicides; another 3.5 percent are from intentional substance misuse or abuse). Death in the workplace from exposure to hazardous substances occurs primarily among working adults. Pesticide deaths are likely to be concentrated in rural farm populations, including immigrant and illegal laborers. Finally, the elderly are at risk of taking the wrong medications or the right medication at the wrong dose. Approximately 8 percent of poisoning exposures reported to TESS are from individuals over 59 years of age. In addition, elderly persons may be the source of medications that inadvertently poison young children.
This changing pattern of poisoning in the U.S. population has important implications for the provision of prevention and control services. Poison control centers were developed to respond primarily to parental concerns about the exposure of their young children to potential poisons and rely on telephone communication. Increasingly, these centers have become involved with the additional situations described above—suicide