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An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers

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Journal of Medical Toxicology Aims and scope Submit manuscript

Abstract

Introduction

The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA.

Methods

A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012.

Results

There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000–2002, decreased 8.8% during 2002–2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity.

Conclusions

There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.

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Abbreviations

AAPCC:

American Association of Poison Control Centers

AMA:

Against medical advice

CCU:

Critical care unit

FDA:

Food and Drug Administration

HCF:

Health care facility

NPDS:

National Poison Data System

PCC:

Poison control center

TESS:

Toxic Exposure Surveillance System

US:

United States

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Authors and Affiliations

  1. Center for Injury Research and Policy of the Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Nisha Rao, Nichole L. Hodges, Thiphalak Chounthirath, Marcel J. Casavant, Amrit K. Kamboj & Gary A. Smith

  2. The Ohio State University College of Medicine, Columbus, OH, USA

    Nisha Rao, Henry A. Spiller, Nichole L. Hodges, Marcel J. Casavant & Gary A. Smith

  3. Central Ohio Poison Center, Columbus, OH, USA

    Henry A. Spiller & Marcel J. Casavant

  4. Mayo Clinic, Division of General Internal Medicine, Rochester, MN, USA

    Amrit K. Kamboj

  5. Child Injury Prevention Alliance, Columbus, OH, USA

    Gary A. Smith

Authors
  1. Nisha Rao
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  2. Henry A. Spiller
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  3. Nichole L. Hodges
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  4. Thiphalak Chounthirath
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  7. Gary A. Smith
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Corresponding author

Correspondence to Gary A. Smith.

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Conflicts of Interest

The authors have no conflicts of interest or financial disclosures relevant to this study to disclose.

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The authors have no financial disclosures relevant to this study.

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Rao, N., Spiller, H.A., Hodges, N.L. et al. An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers. J. Med. Toxicol. 13, 227–237 (2017). https://doi.org/10.1007/s13181-017-0623-7

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  • DOI: https://doi.org/10.1007/s13181-017-0623-7

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