Evaluation of factors associated with intentional non-pharmaceutical poisoning in Iran
AI Summary
Intentional non-pharmaceutical poisoning accounted for 67.3% of cases, predominantly male (65.3%) and aged 20 to 40 (62.1%).
Previous suicide attempts (OR 14.48) and self-harm history (OR 7.81) were the strongest predictors of intentional poisoning.
Psychiatric disorder, addiction, and smoking raised risk; five or more children were protective. Recommend psychiatric triage, addiction services, smoking cessation, community education.
J Forensic Leg Med. 2026 Apr 27;120:103155. doi: 10.1016/j.jflm.2026.103155. Online ahead of print.
ABSTRACT
BACKGROUND: Intentional poisoning is frequently observed in low and middle-income countries contributing to the global burden of injuries. However, there is limited comprehensive analysis of factors specifically associated with intentional non-pharmaceutical poisoning. This study provides one of the first analytical comparisons distinguishing intentional from accidental non-pharmaceutical poisoning in Iran, offering a practical risk profile to support early psychiatric triage, targeted intervention, and public health planning.
METHODS: This retrospective cross-sectional study was conducted at a referral poisoning center in Iran. Medical records of patients admitted between January 2015 and December 2019 with nonpharmaceutical poisoning were reviewed. Binary logistic regression was used to assess factors associated with intentional poisoning.
RESULTS: A total of 1547 patients were included. Among the participants, 1041 patients (67.3%) experienced intentional poisoning. Males accounted for 65.3% of intentional cases. The most common age group for intentional poisoning was 20-40 years old (62.1%). The strongest predictors of intentional poisoning were previous suicide attempts (OR: 14.48, 95% CI 6.73-31.17), and self-harm history (OR: 7.81, 95% CI 3.12-19.57). Other significant risk factors included psychiatric disease (OR: 3.60, 95% CI 2.39-5.42), addiction(OR: 1.97, 95% CI 1.56-2.48), and smoking habits(OR: 2.50, 95% CI 1.27-4.91). Having five or more children was found to be protective (OR: 0.45, 95% CI 0.23-0.89) in intentional poisoning compared to accidental poisoning.
CONCLUSION: With the high prevalence of intentional poisoning, targeted preventive strategies are crucial. These strategies should include early psychiatric evaluation for individuals with prior suicide attempts or self-harm, addiction-focused support services, smoking cessation interventions, and community-based education on the toxicity of non-pharmaceutical substances. Reinforcing family-centered support and screening high-risk young adults may further reduce intentional poisoning.
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