Accidental and intentional poisonings in Colombia (2015-2023): Social and territorial inequalities affecting public health.

OBJECTIVE

To analyze the epidemiological and spatial differences in accidental and intentional poisonings in Colombia between 2015 and 2023, with an emphasis on social and territorial inequalities.

METHODOLOGY: An observational, retrospective, and analytical study was conducted using records from the Public Health Surveillance System (Sivigila, event 365). Cases classified as accidental and intentional (suicide) poisonings were included. Frequencies, incidence rates, and associations were estimated using chi-square tests and odds ratios (OR) with 95% CI. Additionally, spatial analysis was performed using the Global Moran's Index and LISA to identify patterns of autocorrelation and geographic clústers. Data processing was performed in RStudio (v4.4.3).

RESULTS

A total of 237,926 cases were analyzed, of which 70,405 were accidental and 167,521 were intentional. Accidental poisonings were primarily associated with other chemicals and pesticides, while intentional poisonings were dominated by medications, revealing distinct patterns depending on the substance group involved. Accidental poisonings were more prevalent among children and showed a heterogeneous geographic distribution, while intentional poisonings predominated among adolescents and adults. Significant associations were found with gender, age, marital status, type of health insurance, and ethnic group (p < 0.05). Men were more likely to experience accidental poisonings (OR = 2.53), while adolescents had a higher risk of intentional poisoning compared to children (OR = 137.4). Spatial analysis revealed positive autocorrelation in intentional poisonings (Moran's coefficient = 0.20; p = 0.017), with clústers in Cauca and Tolima, while accidental poisonings did not show a significant overall spatial pattern.

CONCLUSION

Chemical poisonings in Colombia exhibit distinct patterns depending on intent, with clear social, demographic, and territorial disparities. These findings highlight the need to strengthen prevention strategies by regulating highly hazardous pesticides, especially in areas where agricultural activities predominate and these products are more widely available, as well as to promote the safe storage of medications and mental health interventions with a territorial and life-cycle approach.