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Paracetamol poisoning – impact of pack size restrictions


N. J. Langford, West Midlands Centre for Adverse Drug Reaction Reporting, City Hospital, Dudley Road, Birmingham B18 7QH, UK. Tel.: 0121 554 3801; fax: 0121 507 5585; e-mail:


Background:  Pack sizes of paracetamol available to the public were reduced by legislation in 1998.

Objective:  To study the effect of the legislation on paracetamol poisoning related admissions to an accident and emergency department and to a tertiary referral liver unit.

Method:  Data were obtained from the University Hospitals, Birmingham, UK (UHB) Trust Information Service and the Queen Elizabeth Hospital liver unit records on (a) the number of patients admitted to hospital because of paracetamol overdose and (b) the number of patients admitted to the liver unit with parcetamol-induced hepatotoxicity.

Results:  Prior to legislation, an average of 360 people a year were admitted to UHB. However, following the change in legislation the number of admissions has fallen to an average of 250 people per year. This represents a reduction of 31%. Prior to legislation, an average of 76 people per year were admitted to the liver unit. Post-legislation this number has dropped to an average of 38 per year representing a reduction of 50%.

Conclusion:  Legislation restricting paracetamol pack-size reduced the incidence and severity of poisoning.