Paracetamol overdosage in Jerusalem.

Forty-nine subjects were identified in the years 1978-83 in four major hospitals in Jerusalem as suspected of paracetamol overdosage. The apparent yearly incidence of paracetamol overdosage in the Jewish population in Jerusalem increased from 0.6/100,000 in 1978 to 4.5/100,000 in 1983. Two subgroups were identified: 13 children, the majority aged 2 to 4 years; and 36 young adults less than 39 years old, mostly in the 18- to 21-year age-group. In children, overdosage was caused by accident, in adults by attempted suicide. Morbidity was minimal, and transient liver function disturbances were found in only two subjects. Toxic levels were found in 2 of the 20 cases tested for paracetamol plasma concentration. Nevertheless, 31 subjects (63%) were hospitalized, and 29 of these were treated with N-acetylcysteine. The availability of the plasma paracetamol assay for diagnosis and of N-acetylcysteine as a specific antidote makes it possible to deal more effectively with the problem of paracetamol overdosage as a community health hazard.