Fatal drug poisonings in a Swedish general population

Every seventh randomly selected deceased in three counties in southeastern Sweden during a one-year period was identified in the Cause of Death Register. Relevant case records (death certificates, files from hospitals and/or primary care centres and medico-legal files) were reviewed for all study subjects.Of 1574 deceased study subjects, 12 cases were classified as pharmaceutical drug poisonings according to the death certificates and 10 according to the medico-legal files. When reviewing all available data sources, 9 subjects (0.57%; 95% confidence interval: 0.20–0.94%) were classified as drug poisonings, corresponding to an incidence of 6.5 (95% confidence interval: 2.3–10.7) per 100 000 person-years in the general population. The drug groups most often implicated were benzodiazepines (33%), antihistamines (33%) and analgesics (22%).Fatal drug poisonings is a relatively common cause of death in Sweden. By using multiple sources of information when investigating the proportion of fatal poisonings in a population, more accurate estimates may be obtained.Drug poisonings, by pharmaceutical agents, have been reported to comprise approximately 1% of emergency department visits [1-3] and up to 0.4% of these result in a fatal outcome [1,3]. Among the deceased subjected to a forensic autopsy, 0.2% of the deaths have been reported to be caused by pharmaceutical drug poisonings [4]. The incidence of fatal pharmaceutical drug poisonings in a general population has previously been estimated to vary between 0.14 and 5.3 per 100 000 inhabitants based on data from single sources of information, such as hospital data [5,6] or forensic data [4,7-9]. The incidence of fatal drug poisonings in a general population has previously been estimated based on the official cause of death statistics [10-12]. However, in these compilations, pharmaceutical drug poisonings were not analysed separately. Since it can be expected that not all cases of fatal drug poisonings will be identified by usin