2024 Annual report of the National Poison Data System® (NPDS) from America's Poison Centers®: 42nd annual report.

INTRODUCTION: This is the 42nd Annual Report of America's Poison Centers® National Poison Data System®. As of 1 January, 2024, all 55 of the nation's Poison Centers uploaded case data automatically to NPDS.

METHODS: We analyzed the case data, tabulating specific indices from the NPDS. The methodology was as in previous years. Where changes were introduced, the differences are identified. Cases with medical outcomes of death were evaluated by a team of medical and clinical toxicologists using an ordinal scale of 1-6 to assess the Relative Contribution to Fatality of the exposure.

RESULTS: In 2024, 2,418,426 closed encounters were logged by the National Poison Data System: 2,092,689 human exposures, 34,919 animal exposures, 285,736 information requests, 5,054 human confirmed nonexposures, and 28 animal confirmed nonexposures. The upload interval was 4.97 [4.32, 9.32] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. Total encounters remained essentially constant with a 0.117% decrease from 2023 while human exposure cases increased by 0.578% and health care facility human exposure cases increased by 0.661%. All information requests decreased by 2.70%, medication identification (Drug ID) requests decreased by 17.0%, and medical information requests showed a 24.5% decrease. Drug Information requests showed a 0.218% increase and comprised 22.4% of all information contacts. Human exposures with less serious outcomes have decreased by 1.45% per year since 2008, while those with more serious outcomes (moderate, major or death) have increased by 4.08% per year since 2000.Consistent with the previous year, the top 5 substance classes most frequently involved in all human exposures were analgesics (10.5%), household cleaning substances (6.94%), antidepressants (5.50%), cardiovascular drugs (5.12%) and cosmetics/personal care products (4.96%). As a class, stimulants and street drug exposures increased most rapidly, by 813 cases/year (4.54%/year) over the past 10 years for cases with more serious outcomes.The top 5 most common exposures in children aged 5 years or less were household cleaning substances (9.96%), cosmetics/personal care products (9.15%), analgesics (8.85%), foreign bodies/toys/miscellaneous (7.92%), and dietary supplements/herbals/homeopathic (6.34%).The National Poison Data System documented 2,809 human exposures resulting in death; 2,271 (80.9%) of these were judged as related (Relative Contribution to Fatality of 1-Undoubtedly responsible, 2-Probably responsible, or 3-Contributory).

CONCLUSIONS: These data support the continued value of Poison Center expertise and the need for specialized medical toxicology information to manage the increasing number of more serious exposures. Unintentional and intentional exposures continue to be a significant cause of morbidity and mortality in the US. The near real-time nature of the National Poison Data System represents a national public health resource for collecting and monitoring US exposure cases and information requests. The continuing mission of the National Poison Data System is to provide a nationwide infrastructure for surveillance for all types of exposures (e.g., foreign body, infectious, venomous, chemical agent, or commercial product), and the identification and tracking of significant public health events. The National Poison Data System is a model system for the near real-time surveillance of national and global public health.