Epidemio-toxicological Profile of Autopsy-confirmed Poisoning Deaths in Himachal Pradesh: A Three-year Retrospective Study

Poisoning continues to be a major public health concern in India, with regional variations in agents, intent and demographics. This retrospective descriptive–analytical autopsy-based study reviewed 284 poisoning-related deaths from October 2021 to November 2024 at the Department of Forensic Medicine, Himachal Pradesh. Demographic, circumstantial, autopsy and toxicology data were analysed using descriptive statistics, Student’s t-test and Pearson’s chi-square test. Males accounted for 65% of cases and were significantly older than females (mean age 40.6 ± 16.1 vs. 34.9 ± 15.3 years; p = .004). Most incidents occurred at home (83%) and were classified as accidental (61.6%). Among cases with confirmed forensic science laboratory toxicology reports (n = 180), aluminium phosphide was the most common agent (56.1%), followed by organophosphates (20.0%). Among 45% women and 17.25% men committed suicide (p = .002), and blood alcohol detection was almost exclusively male (16.8% vs. 1.0%; p < .001). Submucosal haemorrhages were present in 56% and visceral organ congestion in 97% of all 284 cases. Pesticide-related deaths predominate in this sub-Himalayan agricultural region. Stricter regulatory measures, safe storage practices and strengthened mental health and poison-prevention strategies are essential to reduce preventable mortality.