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Injury Prevention

Impaired Driving
Child Passenger Safety
Teen Drivers
Water Related Injuries
Preventing Falls Amongst Older Adults
Playground Injuries
Poisioning

Impaired Driving

Alcohol-related motor vehicle crashes kill someone every 31 minutes and nonfatally injure someone every two minutes (NHTSA 2006). But there are effective measures that can be taken to prevent injuries and deaths from impaired driving.

Occurrence and Consequences

During 2005, 16,885 people in the U.S. died in alcohol-related motor vehicle crashes, representing 39% of all traffic-related deaths (NHTSA 2006).
In 2005, nearly 1.4 million drivers were arrested for driving under the influence of alcohol or narcotics (Department of Justice 2005). That’s less than one percent of the 159 million self-reported episodes of alcohol–impaired driving among U.S. adults each year (Quinlan et al. 2005).
Drugs other than alcohol (e.g., marijuana and cocaine) are involved in about 18% of motor vehicle driver deaths. These other drugs are generally used in combination with alcohol (Jones et al. 2003).
More than half of the 414 child passengers ages 14 and younger who died in alcohol-related crashes during 2005 were riding with the drinking driver (NHTSA 2006).
In 2005, 48 children age 14 years and younger who were killed as pedestrians or pedalcyclists were struck by impaired drivers (NHTSA 2006).

Cost

Each year, alcohol-related crashes in the United States cost about $51 billion (Blincoe et al. 2002).

Groups at Risk

Male drivers involved in fatal motor vehicle crashes are almost twice as likely as female drivers to be intoxicated with a blood alcohol concentration (BAC) of 0.08% or greater (NHTSA 2006). It is illegal to drive with a BAC of 0.08% or higher in all 50 states, the District of Columbia and Puerto Rico.
At all levels of blood alcohol concentration, the risk of being involved in a crash is greater for young people than for older people (Zador et al. 2000). In 2005, 16% of drivers ages 16 to 20 who died in motor vehicle crashes had been drinking alcohol (NHTSA 2006).
Young men ages 18 to 20 (under the legal drinking age) reported driving while impaired more frequently than any other age group (Shults et al. 2002, Quinlan et al. 2005).
Among motorcycle drivers killed in fatal crashes, 30% have BACs of 0.08% or greater (Paulozzi et al. 2004).
Nearly half of the alcohol-impaired motorcyclists killed each year are age 40 or older, and motorcyclists ages 40 to 44 years have the highest percentage of fatalities with BACs of 0.08% or greater (Paulozzi et al. 2004).
Of the 1,946 traffic fatalities among children ages 0 to 14 years in 2005, 21% involved alcohol (NHTSA 2006b).
Among drivers involved in fatal crashes, those with BAC levels of 0.08% or higher were nine times more likely to have a prior conviction for driving while impaired (DWI) than were drivers who had not consumed alcohol (NHTSA 2006).

Preventive Strategies

Effective measures to prevent injuries and deaths from impaired driving include:

Aggressively enforcing existing 0.08% BAC laws, minimum legal drinking age laws, and zero tolerance laws for drivers younger than 21 years old in all states (Shults et al. 2002, Quinlan et al. 2005).
Promptly suspending the driver's licenses of people who drive while intoxicated (DeJong et al. 1998).
Sobriety checkpoints (Elder et al. 2002).
Health promotion efforts that use an ecological framework to influence economic, organizational, policy, and school/community action (Howat et al. 2004; Hingson et al. 2006).
Multi-faceted community-based approaches to alcohol control and DUI prevention (Holder et al. 2000, DeJong et al. 1998).
Mandatory substance abuse assessment and treatment for driving-under-the-influence offenders (Wells-Parker et al. 1995).

Other suggested measures include:

Reducing the legal limit for blood alcohol concentration (BAC) to 0.05% (Howat et al. 1991; National Committee on Injury Prevention and Control 1989).
Raising state and federal alcohol excise taxes (National Committee on Injury Prevention and Control 1989).
Implementing compulsory blood alcohol testing when traffic crashes result in injury(National Committee on Injury Prevention and Control 1989).

Motor vehicle injuries are the leading cause of death among children in the U.S.1 But many of these deaths can be prevented. Placing children in age- and size-appropriate car seats and booster seats reduces serious and fatal injuries by more than half.2

How big is the problem?

In the United States during 2005, 1,335 children ages 14 years and younger died as occupants in motor vehicle crashes, and approximately 184,000 were injured. That’s an average of 4 deaths and 504 injuries each day.
Among children under age 5, in 2006, an estimated 425 lives were saved by car and booster seat use.

What are the risk factors?

One out of four occupant deaths among children ages 0 to 14 years involved a drinking driver. More than two-thirds of these fatally injured children were riding with a drinking driver.
Restraint use among young children often depends upon the driver’s seat belt use. Almost 40% of children riding with unbelted drivers were themselves unrestrained.
Child restraint systems are often used incorrectly. One study found that 72% of nearly 3,500 observed car and booster seats were misused in a way that could be expected to increase a child’s risk of injury during a crash.

How can injuries to children in motor vehicles be prevented?

Child safety seats reduce the risk of death in passenger cars by 71% for infants, and by 54% for toddlers ages 1 to 4 years.
There is strong evidence that child safety seat laws, safety seat distribution and education programs, community-wide education and enforcement campaigns, and incentive-plus-education programs are effective in increasing child safety seat use.
The National Highway Traffic Safety Administration recommends booster seats for children until they are at least 8 years of age or 4'9" tall.
For children 4 to 7 years, booster seats reduce injury risk by 59% compared to seat belts alone.
All children ages 12 years and younger should ride in the back seat. Adults should avoid placing children in front of airbags. Putting children in the back seat eliminates the injury risk of deployed front passenger-side airbags and places children in the safest part of the vehicle in the event of a crash.
Overall, for children less than 16 years, riding in the back seat is associated with a 40% reduction in the risk of serious injury. To learn more about effective interventions to increase child safety seat use, visit CDC's Motor Vehicle Occupant Safety page.

What are CDC’s research and program activities in this area?

Child passenger restraint use and emergency department-reported injuries: A special study using the National Electronic Injury Surveillance System-All Injury Program, 2004
CDC’s Injury Center conducted a special study of the NEISS-All Injury Program for 635 injured children aged 12 years or under treated at 15 hospital emergency departments (ED) in 2004. These children all sustained injuries in motor-vehicle crashes. Multiple injury diagnoses were collected and parents of children were interviewed about motor-vehicle crash circumstances. The study found that nine percent of the children were unrestrained and 36% were inappropriately restrained.11

ICARIS 2 Child Counseling Study
CDC's Injury Center researchers conducted a cross-sectional, list-assisted random-digit-dial telephone survey of randomly selected children in English or Spanish-speaking households in all 50 states and the District of Columbia. The main outcome measures were respondents’ reports that they or their children received injury-prevention counseling from their child’s health care provider in the 12 months preceding the interview, children’s practices of safety behaviors, and the association of injury-prevention counseling and such behaviors. Findings suggest that, although the prevalence of pediatric injury-prevention counseling remains low, such counseling was associated with safer behaviors.12

ICARIS 2 Child Restraint Study (in progress)
CDC’s Injury Center funded the Second Injury Control and Risk Survey, a nationally representative cross-sectional telephone survey conducted in all 50 states. Respondents were asked about their children’s restraint practices (ages 0-12 years) during the past 30 days. While there have been several observational studies that record restraint use at one point in time, this study is investigating whether parents are always using correct restraints or whether children are sometimes inappropriately restrained during a one-month period.

Identifying risk factors and examining outcomes for older children involved in motor vehicle crashes
CDC’s Injury Center is supporting the Children’s Hospital of Philadelphia to examine risk factors and outcomes for children younger than 16 years of age who were involved in motor vehicle crashes. Researchers are interviewing parents to learn about their typical use of child restraints and the particular restraint in use at the time of the crash. Interview questions also assess the parent’s understanding of child restraint laws in their state and explore how the motor vehicle crash has affected the child's daily life. This information will be considered with data about the types of injuries sustained in the crash, the child’s position in the car, and demographic characteristics of the child and driver. This research is part of an ongoing surveillance system that is a collaborative effort between researchers at the Children’s Hospital of Philadelphia and State Farm Insurance. The study will shed light on the impact of motor vehicle crashes on children’s daily lives. Results will be used to improve prevention strategies.

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Teen Drivers

Motor vehicle crashes are the leading cause of death for U.S. teens, accounting for 36% of all deaths in this age group (CDC 2006). However, research suggests that the most strict and comprehensive graduated drivers licensing programs are associated with reductions of 38% and 40% in fatal and injury crashes, respectively, of 16-year-old drivers (Baker et al. 2007).

Occurrence and Consequences

In the U.S. during 2004, 4,767 teens ages 16 to 19 died of injuries caused by motor vehicle crashes. During 2005, nearly 400,000 motor vehicle occupants in this age group sustained nonfatal injuries severe enough to require treatment in an emergency department (CDC 2006).
The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. In fact, per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash (IIHS 2006).
In 2005, teenagers accounted for 10 percent of the U.S. population and 12 percent of motor vehicle crash deaths (IIHS 2006).
The presence of teen passengers increases the crash risk of unsupervised teen drivers; the risk increases with the number of teen passengers (Chen 2000).

Cost

Persons aged 15 to 24, who represent only 14% of the U.S. population, account for 30% ($19 billion) of the total costs of motor vehicle injuries among males and 28% ($7 billion) of the total costs of motor vehicle injuries among females (Finkelstein et al. 2006).

Groups at Risk

In 2004, the motor vehicle death rate for male drivers and passengers age 16 to 19 was more than one and a half times that of their female counterparts (19.4 per 100,000 compared with 11.1 per 100,000) (CDC 2006).
Crash risk is particularly high during the first year that teenagers are eligible to drive (IIHS 2006).

Risk Factors

Teens are more likely than older drivers to underestimate hazardous situations or dangerous situations or not be able to recognize hazardous situations (Jonah 1987).
Teens are more likely than older drivers to speed and allow shorter headways (the distance from the front of one vehicle to the front of the next). The presence of male teenage passengers increases the likelihood of these risky driving behaviors among teen male drivers. (Simons-Morton 2005).
Among male drivers between 15 and 20 years of age who were involved in fatal crashes in 2005, 38% were speeding at the time of the crash and 24% had been drinking (NHTSA 2006a, NHTSA 2006b).
Compared with other age groups, teens have the lowest rate of seat belt use. In 2005, 10% of high school students reported they rarely or never wear seat belts when riding with someone else (CDC 2006b).
- Male high school students (12.5%) were more likely than female students (7.8%) to rarely or never wear seat belts (CDC 2006b).
- African-American students (13.4%) and Hispanic students (10.6%) were more likely than white students (9.4%) to rarely or never wear seat belts (CDC 2006b).
At all levels of blood alcohol concentration (BAC), the risk of involvement in a motor vehicle crash is greater for teens than for older drivers (IIHS 2006).
- In 2005, 23% of drivers ages 15 to 20 who died in motor vehicle crashes had a BAC of 0.08 g/dl or higher (NHTSA 2006b).
- In a national survey conducted in 2005, nearly 30% of teens reported that within the previous month, they had ridden with a driver who had been drinking alcohol. One in ten reported having driven after drinking alcohol within the same one-month period (CDC 2006b).
- In 2005, among teen drivers who were killed in motor vehicle crashes after drinking and driving, 74% were unrestrained (NHTSA 2006b).
In 2005, half of teen deaths from motor vehicle crashes occurred between 3 p.m. and midnight and 54% occurred on Friday, Saturday, or Sunday (IIHS 2006

Resource

The Guide to Community Preventive Services
Offers recommendations about motor vehicle injury prevention issued by the Task Force on Community Preventive Services.

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Water Related Injuries

How big is the problem?

In 2005, there were 3,582 fatal unintentional drownings in the United States, averaging ten deaths per day. An additional 710 people died, from drowning and other causes, in boating-related incidents.
More than one in four fatal drowning victims are children 14 and younger.1 For every child who dies from drowning, another four received emergency department care for nonfatal submersion injuries.
Nonfatal drownings can cause brain damage that may result in long-term disabilities including memory problems, learning disabilities, and permanent loss of basic functioning (i.e., permanent vegetative state).

Who is most at risk?

Males: In 2005, males were four times more likely than females to die from unintentional drownings in the United States.
Children: In 2005, of all children 1 to 4 years old who died, almost 30% died from drowning.1 Although drowning rates have slowly declined,1, 3 fatal drowning remains the second-leading cause of unintentional injury-related death for children ages 1 to 14 years.
Minorities:
- Between 2000 and 2005, the fatal unintentional drowning rate for African Americans across all ages was 1.3 times that of whites. For American Indians and Alaskan Natives, this rate was 1.8 times that of whites.1
- Rates of fatal drowning are notably higher among these populations in certain age groups. The fatal drowning rate of African American children ages 5 to 14 is 3.2 times that of white children in the same age range. For American Indian and Alaskan Native children, the fatal drowning rate is 2.4 times higher than for white children.1
- Factors such as the physical environment (e.g., access to swimming pools) and a combination of social and cultural issues (e.g., valuing swimming skills and choosing recreational water-related activities) may contribute to the racial differences in drowning rates. If minorities participate less in water-related activities than whites, their drowning rates (per exposure) may be higher than currently reported.5

What are the major risk factors?

Lack of barriers and supervision. Children under one year most often drown in bathtubs, buckets, or toilets.6 Among children ages 1 to 4 years, most drownings occur in residential swimming pools.6 Most young children who drowned in pools were last seen in the home, had been out of sight less than five minutes, and were in the care of one or both parents at the time.7 Barriers, such as pool fencing, can help prevent children from gaining access to the pool area without caregivers’ awareness.
Age and recreation in natural water settings (such as lakes, rivers, or the ocean). The percent of drownings in natural water settings increases with age. Most drownings in those over 15 years of age occur in natural water settings.
Lack of appropriate choices in recreational boating. In 2006, the U.S. Coast Guard received reports for 4,967 boating incidents; 3,474 boaters were reported injured, and 710 died. Among those who drowned, 9 out of ten were not wearing life jackets. Most boating fatalities from 2006 (70%) were caused by drowning; the remainder were due to trauma, hypothermia, carbon monoxide poisoning, or other causes. Open motor boats were involved in 45% of all reported incidents, and personal watercraft were involved in another 24%.
Alcohol use. Alcohol use is involved in up to half of adolescent and adult deaths associated with water recreation and about one in five reported boating fatalities.10, 11 Alcohol influences balance, coordination, and judgment, and its effects are heightened by sun exposure and heat.
Seizure disorders. For persons with seizure disorders, drowning is the most common cause of unintentional injury death, with the bathtub as the site of highest drowning risk.

What has CDC research found?

A CDC study about self-reported swimming ability14 found that:

Younger respondents reported greater swimming ability than older respondents;
Self-reported ability increased with level of education (i.e., high school graduate, college graduate, etc.);
Among racial groups, African Americans reported the most limited swimming ability; and
Men of all ages, races, and educational levels consistently reported greater swimming ability than women.

Details about additional studies and their findings are highlighted in the Water-Related Injuries: CDC Activities fact sheet.

How can water-related injuries be prevented?

To help prevent water-related injuries:

Designate a responsible adult to watch young children while in the bath and all children swimming or playing in or around water. Adults should not be involved in any other distracting activity (such as reading, playing cards, talking on the phone, or mowing the lawn) while supervising children.
Always swim with a buddy. Select swimming sites that have lifeguards whenever possible.
Avoid drinking alcohol before or during swimming, boating, or water skiing. Do not drink alcohol while supervising children.
Learn to swim. Be aware that the American Academy of Pediatrics does not recommend swimming classes as the primary means of drowning prevention for children younger than 4. Constant, careful supervision and barriers such as pool fencing are necessary even when children have completed swimming classes.
Learn cardiopulmonary resuscitation (CPR). In the time it might take for paramedics to arrive, your CPR skills could make a difference in someone’s life. CPR performed by bystanders has been shown to improve outcomes in drowning victims.
Do not use air-filled or foam toys, such as “water wings”, “noodles”, or inner-tubes, in place of life jackets (personal flotation devices). These toys are not designed to keep swimmers safe.

If you have a swimming pool at home:

Install a four-sided, isolation pool fence that completely separates the house and play area of the yard from the pool area. The fence should be at least 4 feet high. Use self-closing and self-latching gates that open outward with latches that are out of reach of children. Also, consider additional barriers such as automatic door locks or alarms to prevent access or notify you if someone enters the pool area.
Remove floats, balls and other toys from the pool and surrounding area immediately after use. The presence of these toys may encourage children to enter the pool area or lean over the pool and potentially fall in.

If you are in or around natural bodies of water:

Know the local weather conditions and forecast before swimming or boating. Strong winds and thunderstorms with lightning strikes are dangerous.
Use U.S. Coast Guard approved life jackets when boating, regardless of distance to be traveled, size of boat, or swimming ability of boaters.
Know the meaning of and obey warnings represented by colored beach flags.
Watch for dangerous waves and signs of rip currents (e.g. water that is discolored and choppy, foamy, or filled with debris and moving in a channel away from shore). If you are caught in a rip current, swim parallel to shore; once free of the current, swim toward shore.

Unintentional falls are a threat to the lives, independence and health of adults ages 65 and older. Every 18 seconds, an older adult is treated in an emergency department for a fall, and every 35 minutes someone in this population dies as a result of their injuries.

Although one in three older adults falls each year in the United States, falls are not an inevitable part of aging. There are proven strategies that can reduce falls and help older adults live better and longer.

The following materials give an overview of the problem of older adult falls and how they can be prevented.

Fact Sheets

Falls Among Older Adults: An Overview
This fact sheet gives an overview of the problem of falls among older adults in the United States. You will also find prevention tips and links to resources developed by CDC.

Costs of Falls Among Older Adults
This fact sheet describes the costs of falls among older adults - more than $19 billion annually – and includes information on how these costs are calculated and distributed.

Hip Fractures Among Older Adults
More than 90% of hip fractures among adults 65 and older are the result of a fall. This sheet provides information on the number of hip fractures, groups at risk, and prevention tips.

Falls in Nursing Homes
Falls are more common in nursing homes than in the overall community. You can learn about the extent of falls in nursing homes, their causes, and some prevention strategies.

CDC Fall Prevention Activities
This page highlights CDC-sponsored projects aimed at preventing falls among older adults.

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Brochures

Two brochures, developed by CDC and redesigned in partnership with the CDC Foundation and MetLife Foundation, provide steps that older adults and those who care for them can take to reduce the risk of falls and related injuries. Both are available in English, Spanish, and Chinese.

What YOU Can Do to Prevent Falls
Highlights four key strategies for preventing falls.

Check for Safety: A Home Fall Prevention Checklist for Older Adults
Lists things to check for and fix in the home to reduce the risk of falls.

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Posters

Four posters were developed in partnership with the CDC Foundation and MetLife Foundation. Each highlights one of four key strategies for preventing older adult falls. All are available in English, Spanish, and Chinese.

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Resources for Practitioners and Community-Based Organizations

Preventing Falls: What Works A CDC Compendium of Effective Community-based Interventions from Around the World

This compendium is designed for public health practitioners and community-based organizations. It describes 14 scientifically tested and proven interventions.

Preventing Falls: How to Develop Community-based Fall Prevention Programs for Older Adults

This “how to” guide is designed for community-based organizations who are interested in developing their own effective fall prevention programs.

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Figures and Maps

Figures and maps depict statistics about fall-related deaths and injuries. See trends in fall-related death and nonfatal injury rates and compare death rates by sex and by state.

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Podcasts

Downloadable podcasts from CDC’s Injury Center are available on topics including older adult fall prevention, poisoning prevention, teen driving safety and Injury Center research findings, programs and activities.

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Websites About Older Adults and Falls

Looking for more information? Click on the links below for other organizations working to prevent older adult falls.

American Association of Retired Persons - An organization for people 50 and older that provides information and education, advocacy, and community services through a national network of local chapters and experienced volunteers. *

Gerontological Society of America - A multidisciplinary organization dedicated to the scientific study of aging and to the translation and dissemination of research for practice and policy. *

Home Safety Council - A national nonprofit organization dedicated to preventing home-related injuries. *

National Council on Aging - An advocacy organization dedicated to improving the health and independence of older persons and to increasing their contributions to communities, society, and future generations. *

National Institute on Aging (NIA) - One of the National Institutes of Health, the NIA promotes healthy aging by conducting and supporting biomedical, social, and behavioral research and public education.

National Osteoporosis Foundation - A voluntary, nonprofit health organization and resource for information about the causes, prevention, and treatment of osteoporosis, a risk factor for fall-related fractures. *

National Resource Center for Safe Aging– The Center gathers and shares information and resources on senior safety with public health professionals, older adults, and their families. *

National Safety Council - A nonprofit, nongovernmental, international public service organization dedicated to protecting life and promoting health. *

U.S. Administration on Aging - The Administration works to raise awareness among other federal agencies, organizations, groups, and the public about both the contributions and needs of older Americans. It also informs older people and their caregivers about the benefits and services available to help them.

U.S. Consumer Product Safety Commission - The federal regulatory agency that protects the public against unreasonable risks of injuries and deaths from consumer products.

Playground Injuries

Each year in the United States, emergency departments treat more than 200,000 children ages 14 and younger for playground-related injuries (Tinsworth 2001).

Occurrence and Consequences

About 45% of playground-related injuries are severe—fractures, internal injuries, concussions, dislocations, and amputations (Tinsworth 2001).
About 75% of nonfatal injuries related to playground equipment occur on public playgrounds (Tinsworth 2001). Most occur at schools and daycare centers (Phelan 2001).
Between 1990 and 2000, 147 children ages 14 and younger died from playground-related injuries. Of them, 82 (56%) died from strangulation and 31 (20%) died from falls to the playground surface. Most of these deaths (70%) occurred on home playgrounds (Tinsworth 2001).

Cost

In 1995, playground-related injuries among children ages 14 and younger cost an estimated $1.2 billion (Office of Technology Assessment 1995).

Groups at Risk

While all children who use playgrounds are at risk for injury, girls sustain injuries (55%) slightly more often than boys (45%) (Tinsworth 2001).
Children ages 5 to 9 have higher rates of emergency department visits for playground injuries than any other age group. Most of these injuries occur at school (Phelan 2001).

Risk Factors

On public playgrounds, more injuries occur on climbers than on any other equipment (Tinsworth 2001).
On home playgrounds, swings are responsible for most injuries (Tinsworth 2001).
A study in New York City found that playgrounds in low-income areas had more maintenance-related hazards than playgrounds in high-income areas. For example, playgrounds in low-income areas had significantly more trash, rusty play equipment, and damaged fall surfaces (Suecoff 1999).

Poisioning

A poison is any substance that is harmful to your body when ingested (eaten), inhaled (breathed), injected, or absorbed through the skin. Any substance can be poisonous if enough is taken. This definition does not include adverse reactions to medications taken correctly.

Poisonings are either intentional or unintentional. If the person taking or giving a substance did not mean to cause harm, then it is an unintentional poisoning. Unintentional poisoning includes the use of drugs or chemicals for recreational purposes in excessive amounts, such as an “overdose.” It also includes the excessive use of drugs or chemicals for nonrecreational purposes, such as by a toddler. Intentional poisoning is the result of a person taking or giving a substance with the intention of causing harm. Suicide and assault by poisoning fall into this category. When the distinction between intentional and unintentional is unclear, poisonings are usually labeled “undetermined” in intent.

Information about both lead and carbon monoxide poisoning can be found on other CDC web pages; see sources of additional information for the relevant websites. Statistics below include poisoning from all substances, including lead and carbon monoxide.

Occurrence

Unintentional

In 2005, 23,618 (72%) of the 32,691 poisoning deaths in the United States were unintentional, and 3,240 (10%) were of undetermined intent (CDC 2008). Unintentional poisoning death rates have been rising steadily since 1992.
Unintentional poisoning was second only to motor vehicle crashes as a cause of unintentional injury death in 2005 (CDC 2008). Among people 35 to 54 years old, unintentional poisoning caused more deaths than motor vehicle crashes.
In 2006, unintentional poisoning caused about 703,702 emergency department (ED) visits (CDC 2008).
Almost 25% of these unintentional ED visits resulted in hospitalization or transfer to another facility (CDC 2008).
In 2006, poison control centers reported about two million unintentional poisoning or poison exposure cases (Bronstein et al. 2007).

Intentional

In the United States in 2005, 5,833 (18%) of the 32,691 poisoning deaths were intentional; 5,744 were suicides and 89 were homicides (CDC 2008).
In 2006, intentional poisoning led to about 220,924 emergency department (ED) visits; 216,358 involved self-harm and 3,982 were assaults (CDC 2008).
- Among the self-harm poisoning ED visits, 162,096 (75%) resulted in hospitalization or transfer to another facility.
Self-harm poisoning was the second-leading cause of ED visits for intentional injury in 2006 (CDC 2008).
That same year, poison control centers reported 198,578 cases where the reason for poison exposure was a suspected suicide attempt (Bronstein et al. 2007).

Most common poisons

Unintentional

In 2004, 95% of unintentional and undetermined poisoning deaths were caused by drugs (WONDER 2007). Opioid pain medications were most commonly involved, followed by cocaine and heroin (Paulozzi et al. 2006).
Among those treated in EDs for nonfatal poisonings involving intentional, nonmedical use (such as misuse or abuse) of prescription or over-the-counter drugs in 2004, opioid pain medications and benzodiazepines were used most frequently (SAMHSA 2006).

Intentional

In 2004, 75% of poisoning suicides were caused by drugs—both legal and illegal. The most commonly used drugs identified in drug-related suicides were psychoactive drugs, such as sedatives and antidepressants, followed by opiates and prescription pain medications (WONDER 2007).
Most (93%) nonfatal, poison-related suicide attempts involved pharmaceuticals. Among the 132,582 drug-related suicide attempts in the United States in 2005, sedatives and hypnotics, pain medications, and antidepressants were the most common drugs taken. Among pain medications, opioids were the most widely used, while benzodiazepines were the most common sedatives (SAMHSA 2007).

Costs

In 2000, poisonings led to $26 billion in medical expenses and made up 6% of the economic costs of all injuries in the United States.
Males accounted for 75% of the total costs of poisoning injuries ($19 billion).
Females accounted for 25% of the total costs of poisoning injuries (almost $7 billion) (Finkelstein et al. 2006).

Groups at Risk

Unintentional
Among those who died from unintentional poisoning in 2005:

men were 2.1 times more likely than women;
Native Americans had the highest death rate;
whites and blacks had comparable rates;
the peak age was 45-49 years of age; and
the lowest mortality rates were among children less than 15 years old (CDC 2008).

Among people who unintentionally poisoned themselves, received treatment in emergency departments and survived in 2006:

men were 1.5 times more likely than women;
the highest rates were in the 40-49 year old age group (CDC 2008).

Intentional
Among those who committed suicide by poisoning in 2005:

men were 1.3 times more likely than women;
whites were 3.6 times more likely than blacks; and
the peak age was 45-49 years old (CDC 2008).

Among those who intentionally harmed themselves with poison, received treatment in emergency departments, and survived in 2006:

women were 1.6 times more likely than men; and
the peak age was 15-19 years old, with a secondary peak in the 40-44 age group (CDC 2008).

Sources of Additional Information

Organizations
American Association of Poison Control Centers, Inc.

National Center for Environmental Health: Carbon monoxide poisoning

National Center for Environmental Health: Lead Poisoning Prevention Program

Substance Abuse and Mental Health Services Administration

CALL 1-800-222-1222 if you have a poisioning emergerncy

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