Tyrrell Edward G, Orton Elizabeth, Sayal Kapil, Baker Ruth, Kendrick Denise
Division of Primary Care, School of Medicine, University of Nottingham, NottinghamNG7 2RD, UK.
Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, NottinghamNG7 2UH, UK.
J Public Health (Oxf). 2017 Jun 1;39(2):e1-e9. doi: 10.1093/pubmed/fdw075.
Accurate and up to date data on changes in poisoning incidence among young people are lacking. Recent linkage of UK primary care, hospital and mortality data allows these to be quantified to inform service delivery.
An open cohort study of 1 736 527 young people aged 10-24 between 1998 and 2014 was conducted using linked data from the Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics deaths. Incidence rates (IRs) by poisoning intent were calculated by age, sex, deprivation and year.
Total poisoning IRs increased by 25% from 1998/99 to 2013/14 [adjusted incidence rate ratio (aIRR) 1.25, 95% CI: 1.20-1.30]. Patterns differed markedly by intent. Intentional poisoning rates increased by 52% while unintentional rates remained unchanged. Intentional rates increased almost exclusively among females, gradually between 1998/99 and 2013/14 among 16-18 (88% increase) and 19-24 (36% increase) year olds but only increased among 10-15 year olds in the last 2 years (79% increase). A 2-fold increased risk of poisoning for the most compared to least deprived quintile existed (aIRR 2.21, 95% CI: 2.02-2.23) and remained over time.
Commissioning of primary and secondary prevention services needs to address the growing problem of intentional poisonings among young people.
缺乏关于年轻人中毒发生率变化的准确且最新的数据。英国初级保健、医院和死亡率数据的近期关联使得能够对这些数据进行量化，以为服务提供提供信息。
利用临床实践研究数据链、医院事件统计数据和国家统计局死亡数据，对1998年至2014年间1736527名10至24岁的年轻人进行了一项开放队列研究。按中毒意图、年龄、性别、贫困程度和年份计算发病率。
从1998/99年到2013/14年，总中毒发病率增加了25%[调整发病率比（aIRR）1.25，95%置信区间：1.20 - 1.30]。不同意图的模式差异显著。故意中毒率增加了52%，而非故意中毒率保持不变。故意中毒率几乎仅在女性中增加，在1998/99年至2013/14年间，16 - 18岁（增加88%）和19 - 24岁（增加36%）的人群中逐渐增加，但仅在最后两年10 - 15岁的人群中增加（增加79%）。与最贫困五分位数相比，最富裕五分位数的中毒风险增加了两倍（aIRR 2.21，95%置信区间：2.02 - 2.23），且这种情况一直存在。
初级和二级预防服务的委托需要解决年轻人中日益严重的故意中毒问题。
