Abstract:
OBJECTIVE:To evaluate the effects on suicidal behaviour of legislation limiting the size of packs of paracetamol and salicylates sold over the counter. DESIGN:Before and after study. SETTING:UK population, with detailed monitoring of data from five liver units and seven general hospitals, between September 1996 and September 1999. SUBJECTS:People who died by suicidal or accidental overdose with paracetamol or salicylates or who died of undetermined causes; patients admitted to liver units with hepatic paracetamol poisoning; patients presenting to general hospitals with self poisoning after taking paracetamol or salicylates. MAIN OUTCOME MEASURES:Mortality from paracetamol or salicylate overdose; numbers of patients referred to liver units or listed for liver transplant; numbers of transplantations; numbers of overdoses and tablets taken; blood concentrations of the drugs; prothrombin times; sales to pharmacies and other outlets of paracetamol and salicylates. RESULTS:Numbers of tablets per pack of paracetamol and salicylates decreased markedly in the year after the change in legislation on 16 September 1998. The annual number of deaths from paracetamol poisoning decreased by 21% (95% confidence interval 5% to 34%) and the number from salicylates decreased by 48% (11% to 70%). Liver transplant rates after paracetamol poisoning decreased by 66% (55% to 74%). The rate of non-fatal self poisoning with paracetamol in any form decreased by 11% (5% to 16%), mainly because of a 15% (8% to 21%) reduction in overdoses of paracetamol in non-compound form. The average number of tablets taken in paracetamol overdoses decreased by 7% (0% to 12%), and the proportion involving >32 tablets decreased by 17% (4% to 28%). The average number of tablets taken in salicylate overdoses did not decrease, but 34% fewer (2% to 56%) salicylate overdoses involved >32 tablets. After the legislation mean blood concentrations of salicylates after overdose decreased, as did prothrombin times; mean blood concentrations of paracetamol did not change. CONCLUSION:Legislation restricting pack sizes of paracetamol and salicylates in the United Kingdom has had substantial beneficial effects on mortality and morbidity associated with self poisoning using these drugs.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Hawton K,Townsend E,Deeks J,Appleby L,Gunnell D,Bennewith O,Cooper Jdoi
10.1136/bmj.322.7296.1203keywords:
subject
Has Abstractpub_date
2001-05-19 00:00:00pages
1203-7issue
7296eissn
0959-8138issn
1756-1833journal_volume
322pub_type
杂志文章abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7099.18
更新日期:1997-07-05 00:00:00
abstract::On 1 April the Department of Health introduced the mandatory collection of data on the ethnic group of patients admitted to hospital. Its coding was based on a national minimum standard for classifying ethnic groups, ostensibly using the categories in the 1991 census. In the census, however, one in four people from et...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.311.7011.1006
更新日期:1995-10-14 00:00:00
abstract:OBJECTIVE:To assess the effect of weight loss induced by a very low energy diet on moderate and severe obstructive sleep apnoea in obese men. Design Single centre, two arm, parallel, randomised, controlled, open label trial. Blocked randomisation procedure used for treatment allocation. Setting Outpatient obesity clini...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.b4609
更新日期:2009-12-03 00:00:00
abstract:OBJECTIVE:To determine whether peer review medical audit in a primary care setting changes clinical behaviour in relation to the management of hypertension. DESIGN:Review of medical records in general practices to identify hypertensive patients followed up by assessment of the pre-educational and post-educational mana...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7085.942
更新日期:1997-03-29 00:00:00
abstract::In July 1992 Dr Keith Mumby, a clinical ecologist, appeared before the professional conduct committee of the General Medical Council on five charges to do with his practice of clinical ecology. He was found guilty of two of the charges--touting for publicity and failing to give a patient adequate medical attention--an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6870.122
更新日期:1993-01-09 00:00:00
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doi:10.1136/bmj.d2786
更新日期:2011-05-19 00:00:00
abstract:OBJECTIVE:To evaluate the effect of support with human chorionic gonadotrophin in the luteal phase in women taking part in an in vitro fertilisation programme after buserelin and human menopausal gonadotrophin were used to hyperstimulate their ovaries. DESIGN:Controlled group comparison. SETTING:Outpatient department...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6686.1483
更新日期:1989-06-03 00:00:00
abstract:OBJECTIVES:To examine the association of plasma caffeine concentrations during pregnancy with fetal growth and to compare this with relations with reported caffeine intake. DESIGN:Prospective population based study. SETTING:District general hospital, inner London. SUBJECTS:Women booking for delivery between 1982 and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7069.1358
更新日期:1996-11-30 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-07-08 00:00:00
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doi:
更新日期:1994-01-29 00:00:00
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doi:10.1136/bmj.313.7052.270
更新日期:1996-08-03 00:00:00
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更新日期:1996-08-10 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of 4% dimeticone lotion for treatment of head louse infestation. DESIGN:Randomised controlled equivalence trial. SETTING:Community, with home visits. PARTICIPANTS:214 young people aged 4 to 18 years and 39 adults with active head louse infestation. INTERVENTIONS:Two app...
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-06-18 00:00:00
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doi:10.1136/bmj.318.7190.1035
更新日期:1999-04-17 00:00:00
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更新日期:2000-07-15 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.298.6684.1350
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pub_type: 杂志文章,meta分析
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更新日期:2012-08-07 00:00:00
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更新日期:2019-07-10 00:00:00
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更新日期:2020-10-07 00:00:00
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doi:10.1136/bmj.319.7208.483
更新日期:1999-08-21 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1988-10-29 00:00:00
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更新日期:2020-12-09 00:00:00
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更新日期:1999-10-09 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2016-11-01 00:00:00
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更新日期:1992-05-23 00:00:00
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更新日期:1989-10-21 00:00:00