Poisoning Epidemiology, Clinical Outcomes and Management Decisions for General Public Calls: A Cross-Sectional Analysis of a Nationwide Telehealth Toxicology Consultation Service Data in Saudi Arabia.

Abstract

Background: Poisoning represents a major global public health burden with significant regional variations in epidemiology and management. The Saudi Toxicology Consultation Service (TCS) provides nationwide remote consultation through a public hotline, enabling systematic data collection and analysis of poisoning patterns. However, contemporary data on poisoning epidemiology and telehealth services in Saudi Arabia is lacking.

Objectives: This study aimed to analyze national TCS data originating from public calls, in order to systematically characterize community-based poisoning epidemiology and clinical profiles. Specific goals included determining sociodemographic, seasonal, and geographic distributions, identifying common agent categories and their associated clinical profiles, and analyzing management decisions across different toxic exposure categories.

Methods: We conducted a retrospective analysis of all public calls to the national TCS hotline between January 1 and December 31, 2023. Data collected included poisoning cases demographics, geographic location, agent category, symptoms, and management decisions. Descriptive statistics characterized the study population. Chi-square tests assessed associations between variables with significance set at p < 0.001.

Results: Among 39,142 consultations analyzed, children aged 1-<3 years had the highest consultation rate (157.59 per 10,000). Females showed higher utilization than males (15.41 vs. 10.10 per 10,000). The Central region demonstrated the highest consultation rate (19.13 per 10,000). Medications were the most common agent category (49.37%), followed by household products (26.32%) and health supplements (22.99%). Most cases were asymptomatic (97.19%) and managed through home observation (74.53%). However, bites/stings and substance abuse cases more frequently required hospital referrals (70.56% and 61.97% respectively) despite being predominantly asymptomatic.

Conclusions: This first comprehensive analysis of the epidemiology of national toxicology consultations data reveals children 1-<3 years old as the highest risk group for poisonings in Saudi Arabia, with medications as the predominant exposure. The large proportion of cases safely managed by the TCS demonstrates the feasibility and healthcare value of expanding remote toxicology services to improve efficiency and reduce costs. Data-driven insights could inform preventative initiatives, clinical guidance development, and strategic policies to curb poisoning incidence by targeting highest-risk demographics.