Health Authority, and Azeem Majeed, National Statistics

Paracetamol can cause fatal liver disease if taken, either intentionally or unintentionally in too high a dose. Using a newly developed database of deaths from overdose and poisoning, we examined the mortality associated with paracetamol in England and Wales between 1993–97. In total, there were 2,499 deaths during this period in which preparations containing paracetamol were among the drugs taken, an average of about 500 deaths per year and about 20 per cent of all deaths from overdose and poisoning. Paracetamol was the only drug taken in 873 deaths, an average of about 175 deaths per year; this figure probably provides a better estimate of the true mortality associated with paracetamol than all deaths from overdose and poisoning in which paracetamol was taken. There were 488 deaths in which liver failure was specifically mentioned. The most commonly used preparations of paracetamol were paracetamol alone (1,451 deaths) and coproxamol (991 deaths). The study confirms that paracetamol is one of the important causes of deaths from overdose and poisoning and shows the value of the new database for monitoring trends in these deaths