Acute Poisoning Surveillance in Thailand: The Current State of Affairs and a Vision for the Future

Acute poisoning is a major public health threat worldwide, including Thailand, a country in Southeast Asia with over 67 million inhabitants. The incidence and characteristics of poisoning in Thailand vary greatly depending on the reporting body. This systematic review aims to provide a comprehensive description of the state of poisoning in Thailand. It identifies common trends and differences in poisoning by reporting centers and regional studies. Almost half of the cases and three-fourths of the deaths involved pesticide poisonings associated with agricultural occupations. However, increasing urbanization has led to an increase in drug and household chemical poisoning. Though the majority of reported poisonings remain intentional, a trend towards unintentional poisonings in pediatric and geriatric populations should not be dismissed. Unique poisonings such as mushroom, botulism, and tetrodotoxin poisonings are also closely related to the Thai lifestyle. Following this extensive review of the Thai poisoning literature, it is apparent that further support of the poison control center in Thailand is needed to improve poisoning surveillance, research, prevention, and intervention. 1. Introduction Poisoning is a significant worldwide public health problem. According to the World Health Organization (WHO), it is the ninth leading cause of death in young adults (15–29 years old). Based on the disability-adjusted life years (DALYs), it is responsible for the loss of over 7.4 million years of healthy life. In 2004, an estimated 346,000 people globally died from unintentional poisoning. Disproportionately, 91% of these deaths were from low- and middle-income countries [1]. Characteristics of acute poisoning differ between countries. In the United States of America, unintentional poisoning from analgesic and narcotic substances represents the major burden [2]. However, for countries in Asia, that is, Taiwan, India, and Sri Lanka, the majority of the reported poisoning cases are intentional, often involving pesticides. Despite poisoning surveillance, the true burden of poisoning in this region is thought to be grossly underreported. Contrary to the poison control centers in developed countries, more than 90 percent of the cases reported to the poison control center databases in Asia are selectively reported by physicians rather than by the lay public [3]. Thailand, a country in Southeast Asia with an estimated population of 67 million, is undeniably affected by this public health threat. However, the burden of poisoning has not been well described. In order to