Epidemiological characteristics of acute poisoning cases in Shanghai from 2016 to 2018
2016年上海市全市门急诊急性中毒病例40 371例，2017年49 858例，2018年52 279例，发病率分别为1.67‰、2.06‰和2.16‰，呈现逐年上升趋势。急性中毒主要由酒精、药物和有毒动物引起。酒精、药物中毒发病率呈现逐年上升趋势：酒精中毒发病率分别由0.66‰上升到0.88‰，药物中毒发病率由0.62‰上升到0.95‰；有毒动物引起的中毒发病率呈现逐年下降趋势，由0.16‰下降到0.11‰。3年中酒精中毒发病率各个年龄段男性均高于女性，发病率高峰均集中在18~59岁之间。药物中毒17岁及以下组男性发病率高于女性（
P< 0.001），其他年龄组均为女性高于男性，发病率高峰均在60岁及以上组。精神类药物中毒发病率在各个年龄组均在前三位，尤其在18岁及以上年龄组中，3年来一直居于首位。引起中毒的有毒动物主要为不明节肢动物、毒蛇、有毒千足类，3年间不明节肢动物引起的中毒发病率最高，但发病率逐年下降（ P< 0.001）。有毒动物引起的中毒病例的空间分布结果显示，崇明区、浦东新区和嘉定区发病率较高。 结论
In 2015-2017, poisoning ranks fifth among the top 10 death causes in Shanghai, and acute poisoning prevention and control is becoming more and more grim.
The purpose of this study is to describe the relevant toxicants and epidemiological tendency of reported acute poisoning in Shanghai.
We collected registered acute poisoning case information from Shanghai health information system under Shanghai Information Center for Health, including demographic characteristics and clinic diagnosis. There were totally more than 140 000 cases reported from 2016 to 2018. The distributions of toxicants, victims, and poisoning time were described by year. The incidence tendency was analyzed by chi-square test, focusing on the acute poisoning cases caused by alcohol, drug abuse, and poisonous animals. The space distribution of acute poisoning cases caused by poisonous animals were analyzed by GIS 9.3.1.
There was an ascendant tendency in both case amount (40 371 cases in 2016, 49 858 cases in 2017, and 52 279 cases in 2018) and morbidity (1.67‰ in 2016, 2.06‰ in 2017, and 2.16‰ in 2018) of patients who received outpatient service or emergency treatment for acute poisoning from 2016 to 2018 in Shanghai. Alcohol, drug abuse, and poisonous animals were the three main causes of acute poisoning. The morbidity caused by alcohol (from 0.66‰ to 0.88‰) and drug abuse (0.62‰ to 0.95‰) ascended, while that caused by poisonous animals descended year by year (from 0.16‰ to 0.11‰). In the three years, the alcohol poisoning morbidity in men was always higher than that in women in all age groups; the peak of the morbidity was the in the age group from 18 to 59 years for both genders. For drug abuse poisoning morbidity, women's was higher than men's except in the age group under 17 years, and the peak of the morbidity was in the age group over 60 years for both genders. Psychotropic drug abuse was the main cause of drug abuse poisoning in all age groups, especially in the patients older than 18 years where it ranked the first cause in the drug abuse poisoning morbidity category. The main kinds of poisonous animals that caused the acute poisoning cases were unknown arthropods, snakes, and millipedes. Unknown arthropods ranked the first cause in the poisonous animals poisoning morbidity category, and the morbidity descended year by year (
P< 0.001). The poisoning cases caused by poisonous animals were mainly distributed in Chongming, Pudong, and Jiading districts. Conclusion
According to the increasing morbidity of acute poisoning cases in Shanghai in this study, it is urgent to take prevention and control actions. We should take different strategies toward different poisoning causes.