Poisoning Classification

Robert Flanagan

1. Develop links with International Program on Chemical Safety (IPCS) and explore possible use of (condensed versions of) IPCS poisoning coding classifications in ICECI/ICD. [N.B . Detailed hierarchical classifications are available for chemical class, ‘use’ (pharmaceutical, pesticide, etc.), biological agents, severity, and ‘mechanism of exposure’. Available in English, French, Portuguese, Spanish.
2. Produce toolkit for use with ICD-9/ICD-10 to enable users to assemble acute poisoning deaths data by agent/age/sex/year and possibly also by circumstances of exposure (currently difficult as poisoning deaths coded to many different places). Will also have the advantage of emphasizing problems to coders, coroners, etc. and should help promote revision/modification of ICD to make the poisoning categories more logical and thus the data more accessible. Aim to publish in a refereed, cited journal.
3. Eventual aim must be to store and make accessible information on the actual agents involved in acute poisoning cases (also coded as at present in ‘E’ codes as alone, + alcohol, or + two or more compounds, one of which can be alcohol). ‘Circumstances of exposure’ data must also be available as now.
4. Choice of ‘main poison’ in the case of a multiple overdose is not important for toxicological purposes as information on the likely course of events can often be inferred by knowledge of age/sex and also the toxicity of the compounds involved.
5. Aim to produce summary paper on E&W, Scotland, U.S. acute poisoning data as a basis for comparison with deaths data generated by other countries.