Three decades of pediatric drug intoxication trends in Taiwan (1985-2020)

Background: Pediatric drug intoxication is a significant public health issue worldwide. The present study aimed to delineate the epidemiology, exposure-related conditions, and outcome severity of pediatric drug intoxication cases in Taiwan for over a 36-year period. Methods: This retrospective cohort study analyzed pediatric drug intoxication cases registered in Taiwan Poison Control Center (PCC-Taiwan) database between 1985 and 2020. Data on patient demographics, toxic substances, exposure-related conditions, and outcome severity were extracted and analyzed. Descriptive statistics were used to summarize the findings. Results: Altogether, 19 893 pediatric drug intoxication cases were reported. The majority of cases involved boys (54.7%), and the highest percentage of cases occurred in children aged 0 to 2 years (56.4%), but there is a second, relatively lower peak in adolescents, where female cases outnumbered the male cases. Pharmaceuticals were the predominant toxic substances (70.3%), with most drug intoxication cases being acute (97.2%) and occurring at home (88.8%). Witnesses were present in 62.8% of the cases. The outcomes were mostly asymptomatic (51.0%) or involved mild discomfort (34.1%), with severe complications and mortality occurring in 0.76% and 0.37% of the cases, respectively. Unintentional poisoning accounted for 85.4% of the cases, whereas intentional poisoning was noted in 12.1% of the cases, with the highest rate seen in adolescents aged 15 to 17 years. Intentional cases mainly involved suicide attempts (68.4%) and predominantly occurred in girls (70.7%). Conclusion: This analysis of data obtained from PCC-Taiwan database for over 36 years reveals bimodal trends in pediatric drug intoxication, showing high rates in young children due to unintentional exposures and peaks in intentional poisoning among adolescent girls. Pharmaceuticals were the predominant toxic agents. Future efforts should focus on age- and sex-targeted preventions, public education on medication safety, and age-specific interventions.