3
Magnitude of the Problem

The purpose of this chapter is to provide an overview of the occurrence of poisonings in the United States and to describe the distribution of poisoning reports in terms of a variety of demographic characteristics such as age, gender, and race. To provide such an overview, the chapter will also present a working definition of poisoning and drug overdose, highlighting the epidemiological implications of inclusion and exclusion of various categories of events from this classification. Even if definitions vary (as will be discussed in the following section), poisoning is an important problem of national scope. As noted in Chapter 1, more than 2 million people contact poison control centers annually for advice on poisoning exposures (Watson et al., 2003). In addition, poisoning is a leading cause of injury-related morbidity and mortality in the United States. The total health care costs associated with poisoning (see Chapter 6) are also substantial.

Temporal trends may affect the societal impact of poisoning and drug overdose in a variety of ways, given that the U.S. population is growing larger, older, and more ethnically diverse. Changing ethnic distributions, marked by an increasing proportion of Hispanics and Asian Americans, and an increasing proportion of the elderly population (http://www.census.gov) are important considerations for the future of poison prevention and control, particularly in light of research indicating that these groups have been relatively underserved by the existing poison control system (Kelly et al., 1997, 2003). Providing effective access to care for ethnically diverse groups will require overcoming both cultural and lan-



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