Bøe Grethe Helen, Haga Christian, Andrew Erik, Berg Knut Joachim
Avdeling for giftinformasjon (Giftinformasjonen), Sosial- og helsedirektoratet, Postboks 8189 Dep, 0034 Oslo.
Tidsskr Nor Laegeforen. 2004 Jun 17;124(12):1624-8.
After the introduction of new regulations in 1981 and 1990 in Norway, over-the-counter sales of paracetamol and acetylsalicylic acid have been limited to 10 grams. From 1990 the sale of paracetamol has increased dramatically; that of acetylsalicylic acid has accordingly been reduced. We have investigated the morbidity and mortality from overdoses of analgesics, especially paracetamol, in the period 1990-2001.
We collected data from the inquiries received by the National Poisons Information Centre in Norway. Data on hospital admissions and deaths have been recorded from the Norwegian Patient Register. These data have also been used to collect anonymous case records from all patients who died following intake of paracetamol. We also sent questionnaires to 57 hospital departments in a survey of deaths from paracetamol poisoning.
Calls concerning paracetamol poisonings to the National Poisons Information Centre doubled to about 400 calls per year over the period. In 30% of cases serious poisoning was suspected. Hospital admissions diagnosed primarily as analgesic poisoning increased from 848 to 1162. On average, 52% of poisonings were caused by paracetamol, 13% by opioids, 5% by acetylsalicylic acid; in 27% the analgesic involved was not specified. 59 deaths were diagnosed as poisoning from analgesics as primary cause, 13 of them due to paracetamol, 26 to opioids, 2 to acetylsalicylic acid; in 18 cases the analgesic involved was not specified. The questionnaires gave insignificant additional information.
The number of paracetamol poisonings has increased since 1990 in accordance with the dramatic increase in sales of paracetamol in Norway. Although the mortality of paracetamol poisoning is low (1-2 deaths annually), it represents the most critical poisoning problem among non-opioid analgesics. It is important to monitor the morbidity and mortality of paracetamol poisoning, as new regulations introduced from 2003 will increase the availability of paracetamol and other selected non-opioid analgesics.
1981年和1990年挪威出台新规定后，对乙酰氨基酚和阿司匹林的非处方销售量限制为10克。自1990年以来，对乙酰氨基酚的销售量急剧增加；阿司匹林的销售量相应减少。我们调查了1990年至2001年期间因过量服用镇痛药，尤其是对乙酰氨基酚导致的发病率和死亡率。
我们收集了挪威国家毒物信息中心收到的咨询数据。医院入院和死亡数据已从挪威患者登记处记录。这些数据也用于收集所有因服用对乙酰氨基酚死亡患者的匿名病例记录。我们还向57个医院科室发送了问卷，以调查对乙酰氨基酚中毒导致的死亡情况。
在此期间，拨打国家毒物信息中心关于对乙酰氨基酚中毒的电话数量翻了一番，达到每年约400次。在30%的病例中怀疑有严重中毒。主要诊断为镇痛药中毒的医院入院人数从848人增加到1162人。平均而言，52%的中毒是由对乙酰氨基酚引起的，13%是由阿片类药物引起的，5%是由阿司匹林引起的；在27%的病例中，涉及的镇痛药未明确说明。59例死亡被诊断为主要由镇痛药中毒引起，其中13例因对乙酰氨基酚，26例因阿片类药物，2例因阿司匹林；在18例病例中，涉及的镇痛药未明确说明。问卷提供的额外信息不显著。
自1990年以来，挪威对乙酰氨基酚中毒的数量随着对乙酰氨基酚销售量的急剧增加而增加。尽管对乙酰氨基酚中毒的死亡率较低（每年1至2例死亡），但它是非阿片类镇痛药中最关键的中毒问题。监测对乙酰氨基酚中毒的发病率和死亡率很重要，因为2003年出台的新规定将增加对乙酰氨基酚和其他选定非阿片类镇痛药的可获得性。
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