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Monique A. Sheppard, PhD, Latifa M. Boyce, MPH, and Cecelia B. Snowden, PhD. Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705, 3017552728, sheppard@pire.org
BACKGROUND: Poisoning surveillance systems vary widely in objectives, methodology, and scope. Differential counting biases among certain demographic groups, outcomes, and intents may exacerbate the problem. This research explores the implications of counting biases associated with poisoning surveillance and evaluates the impact of an expanded case definition.
METHODS: Data were from the National Center for Health Statistics (NCHS) mortality, state hospital discharge for eight states in the northeastern region in the United States. ICD-9/CM codes were used to identify poison-related and poisoning deaths and hospital discharges.
RESULTS: The expanded definition had a greater impact on the fatal estimates than it did on the nonfatal estimates. Among the deaths and hospitalizations, 23% and 5% more cases, respectively, were observed than were identified by the Revised Framework for E code Groupings (CDC, 2003). The impact of using the expanded definition varied by age, sex, race/ethnicity, intent and state of residence. Cases for 5 to 9 year olds rose 20-fold, primarily due to missed toxic effects of gases, fumes and vapors.
CONCLUSIONS: The underlying cause of death and primary E code for hospitalizations underestimates cases exposed to toxic substances. Better case counts are critical to understanding the environmental public health impact of poisoning.
Learning Objectives: As a result of this session, participants will be able to
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.