Acetaminophen toxicity is one of the most common causes of poisoning worldwide

(Gunnell et al., 2000). Currently paracetamol is the most common cause of acute liver failure in
both United States and United Kingdom, with a trend to increasing incidence in the United States.
About 50 million people use acetaminophen or acetaminophen-combination products each week
in the United States. Toxicity may occur during self-medication for pain or following intentional
overdose (Kaufman et al., 2002).
In a study by the World Health Organization, it was reported that lower income was
associated with increased mortality resulting from poisoning. The probable reason explained in
that report was that people with lower income may have limited access to medical resources and
a lower standard of living. The drug is easily available in market, and lay people commonly
underestimate its toxicity which may have contribute to higher risk of death after poisoning.
Moreover, acetaminophen is one of the most frequently used drugs in intentional
overdose, particularly in young people. The American Association of Poison Control Centers'
National Poison Data System reported 49,417 exposure cases involving acetaminophen alone
(Gumin et al., 2017). In the Philippines, few epidemiologic data are available about
acetaminophen toxicity. However, in a study conducted by the University of the Philippines
Manila, paracetamol/acetaminophen was one of the most common poisoning related to suicide
(Tolabing, 2010).

Kaufman DW, Kelly JP, Rosenberg L, et al. Recent patterns of medication use in the ambulatory adult population
of the United States: the Slone survey. JAMA. 2002 Jan 16;287(3):337-44

Gunnell D, Murray V, Hawton K (2000) Use of paracetamol (acetaminophen) for suicide and
nonfatal poisoning: worldwide patterns of use and misuse. Suicide Life Threat Behav 30: 313-
326.
Gummin DD, Mowry JB, Spyker DA, et al. 2016 annual report of the American Association of Poison C
Centers' National Poison Data System (NPDS): 34th annual report. Clin Toxicol (Phila). 2017 Dec;55(10)
1252.

Tolabing MC. (2010). Associate Professor of Epidemiology, University of the Philippines, Personal
communication. 2010.