Patterns of Clinical Toxicologist Referrals at the New South Wales Poisons Information Centre

BACKGROUND: The four Australian Poisons Information Centres handle over 200,000 calls annually, with 1.5%-4.1% referred to clinical toxicologists. However, the types of drug poisonings most frequently referred and how these patterns change over time remain unclear. This study aims to analyse referral patterns to clinical toxicologists by the New South Wales (NSW) Poisons Information Centre. METHODS: This retrospective study examined referral patterns to clinical toxicologists at the NSW Poisons Information Centre. Calls involving human exposure were included; duplicate entries and recalls were excluded. Demographic and clinical data were analysed using descriptive statistics. RESULTS: Between 2017 and 2022, the NSW Poisons Information Centre received 657,072 calls. Of these, 12,475 (1.9%) were referred to clinical toxicologists. Referrals rose from 1527 of 99,772 calls (1.5%) in 2017 to 2196 of 117,280 calls (1.9%) in 2022, averaging 1.9% annually. The median age was 32 years (IQR: 17-51), 53.7% were female (n = 6700) and 53.4% (n = 6665) involved deliberate self-poisoning. There was a notable rise in cases with moderate Poisoning Severity Scores (34.5% in 2018 vs. 45.0% in 2022). Paracetamol was the most frequently reported substance in referred calls (13.7%), followed by quetiapine (7.8%) and snake bites (6.0%). Most common categories of drug poisonings included non-opioid analgesics (21.9%), antidepressants (19.8%), atypical antipsychotics (13.5%), and opioids (8.1%). CONCLUSIONS: This study highlights a steady increase in Poisons Information Centre call volumes, accompanied by a rise in referral rates to clinical toxicologists and the number of cases with moderate Poisoning Severity Scores.