To estimate the number of acetaminophen‐associated overdoses in the United States and identify possible risk factors for intervention.

The investigators obtained estimates of acetaminophen‐associated overdoses using different national databases. Two emergency room databases, a hospital discharge database, a national mortality file, and a poison surveillance database were used to identify cases. The FDA's spontaneous reporting system was searched to identify possible root causes for overdoses.

Analysis of national databases show that acetaminophen‐associated overdoses account for about 56 000 emergency room visits and 26 000 hospitalizations yearly. Analysis of national mortality files shows 458 deaths occur each year from acetaminophen‐associated overdoses; 100 of these are unintentional. The poison surveillance database showed near‐doubling in the number of fatalities associated with acetaminophen from 98 in 1997 to 173 in 2001. AERS data describe a number of possible causes for unintentional acetaminophen‐associated overdoses.

Each year a substantial numbers of Americans experience intentional and unintentional acetaminophen‐associated overdoses that, in severe cases, lead to serious illness and possible death. This summary of a series of analyses highlights the need for strategies to reduce this public health burden. Copyright © 2005 John Wiley & Sons, Ltd.