The epidemiology of acetaminophen (paracetamol) poisoning in Hong Kong

The prince of Wales Hospital is in a unique position for the study of the actual incidence of acetaminophen poisoning in Hong Kong because it is the sole general teaching hospital in the New Territories East and the age and sex distribution of the population in the region are readily available. Between 1991 and 1994, the rate of admission in subjects aged > or = 15 years slightly increased from 5.7 to 7.3/100,000. In both 1991 and 1994, the highest rates in women were in the 15-19 age group (from 22.8 to 53.0/100,000) and in men in the 25-29 age group (from 10.5 to 6.0/100,000). The rates of admission with toxic plasma acetaminophen concentrations were higher in 1994 than in 1991 (10.8 vs 0.6/100,000). The annual incidence of acetaminophen-induced liver damage remained unchanged (0.3/100,000). None of the patients with liver damage developed fulminant liver failure. There were no deaths. Thus, acetaminophen poisoning appears to cause less fulminant liver failure and deaths in Hong Kong than in other Western societies. Reasons for such differences need to be better understood.