The research team, led by Lin-fei Li and colleagues in the hospital’s Department of Emergency, extracted records from the hospital information system using the keyword “poisoning” and applied strict inclusion and exclusion criteria. Of 1,202 collected cases, 932 met the validity threshold, an effective rate of 77.54 percent. Cases involving metabolic or respiratory acid-base disorders, diabetic ketoacidosis, toxic encephalopathy, and envenomation from insect or snake bites were deliberately excluded to keep the analysis focused on true toxic exposures. Records with missing core variables that could not be traced back to original files were also dropped, and outliers were screened using the interquartile range method before being verified against source documents.

The demographic breakdown upends assumptions drawn from European and North American studies, where children under five account for the vast majority of poisonings. In Zunyi, nearly seven in ten patients — 645 cases, or 69.21 percent — were aged 12 to 18. Toddlers and preschoolers, the dominant group elsewhere, made up a comparatively small share: 109 cases among children aged 3 to 6 and 100 among those aged 1 to 3. Girls and young women bore the heaviest burden, with 574 female patients against 358 male. The gender gap was driven almost entirely by drug poisoning, which affected 433 females and 208 males.

That drug poisoning dominated the case mix is the study’s central finding. Pharmaceuticals accounted for 641 cases, roughly 69 percent of all valid exposures, far outpacing pesticides at 131 cases, chemicals at 85, and food poisoning at 75. Applying the Pareto principle, the authors note that drugs, pesticides, and chemicals together accounted for a cumulative 92 percent of cases, comfortably exceeding the 80 percent threshold that marks the principal high-risk categories. The concentration of drug poisoning among female adolescents aligns with a growing body of evidence linking adolescent mental health deterioration — depression, academic pressure, family conflict — to intentional overdose, and with findings that females experience higher rates of mood disorders during adolescence.

The temporal patterns are equally revealing. Cases climbed every single year of the study: 40 in 2021, 139 in 2022, 184 in 2023, 240 in 2024, and 329 in 2025. The authors connect this rebound to the relaxation of COVID-19 public health measures. During the pandemic years, movement restrictions, closed schools, and strained medical access suppressed both exposures and visits. Once normal social activity resumed, pent-up demand for care was released, and the psychological strains of returning to regular life added new triggers. The researchers are careful to note that as a retrospective observational study, no causal inference can be drawn, and the trend should be interpreted with caution.

Seasonality matters too. Spring was the peak season, with 240 cases representing 25.75 percent of the total, followed by summer at 19.74 percent, autumn at 14.91 percent, and winter at 4.29 percent. Drug and pesticide poisoning predominated in spring, a pattern the authors attribute partly to intensified agricultural pesticide use during the spring farming season and partly to the academic stress that accompanies the start of a new semester. Summer and autumn were dominated by drugs and food poisoning, while winter cases leaned toward drugs and chemicals.

The weekly and daily rhythms offer practical guidance for emergency planners. Drug poisoning visits peaked on Mondays, with 104 cases, and Wednesdays, with 106 — a pattern the study links to the academic stress cycle, with anxiety at the start of the school week and midweek fatigue triggering emotion-related incidents. Reduced adult supervision on workdays also raises accidental ingestion risk for younger children. Across shifts, the afternoon window from 4:00 p.m. to 11:00 p.m. received the largest volume, 392 cases, with the Wednesday afternoon shift alone logging 78 patients, followed by Sunday afternoon with 70. Night shifts were quietest, since most minors are asleep and have limited access to toxic substances.

Clinical severity varied sharply by poison type, and this is where the study carries its most urgent warning. The overall ICU admission rate was 7 percent, consistent with the 3 to 8 percent range reported in the United States National Poison Data System and with a 5 percent pediatric intensive care rate reported from Italy. But pesticide poisoning was an outlier of a different order: 73 percent of those patients required admission to a general ward and 13 percent needed intensive care, reflecting the potent cytotoxicity of agricultural chemicals, which can rapidly precipitate respiratory and circulatory failure, neurological damage, and multi-organ dysfunction. By contrast, drug and food poisoning cases more often ended in observation or follow-up, and drug poisoning carried the highest rates of discharge against medical advice at 20 percent and emergency observation at 24 percent — a signal, the authors suggest, that some families underestimate delayed adverse reactions and comply poorly with treatment.

The authors frame their findings as a call for layered, targeted prevention. At the family level, they recommend storing drugs, chemicals, and pesticides in locked, elevated cabinets with original packaging retained and clearing out expired products regularly. At the school and community level, they advocate age-stratified safety education, routine psychological screening for female adolescents on campus, training for parents and clinicians to recognize poisoning risk, and stricter prescription management of psychotropic medications. They also propose a three-dimensional protection network spanning schools, families, and hospitals, alongside a 24-hour poison consultation hotline and dedicated emergency green channels for poisoning patients.

The study’s limitations are candidly acknowledged. All data come from a single hospital, raising the possibility of selection bias, and the retrospective design meant that poisoning routes, inducements, and toxic doses were unavailable — only broad categories were recorded, without specific drug names, a gap the authors say should prompt better documentation practices. No risk prediction model was built, and no long-term follow-up was performed. Still, the epidemiological signal is hard to dismiss: in this region, the face of pediatric poisoning is not a curious toddler but a stressed teenage girl with access to medicine cabinet pharmaceuticals, arriving most often on a spring or midweek afternoon. Emergency departments, the authors argue, should staff accordingly — reinforcing afternoon coverage while maintaining baseline night capacity — and public health campaigns should aim their sharpest messages at adolescents and the households that keep medications within their reach.

Subject of Research: Epidemiology and clinical characteristics of acute poisoning among children and adolescents presenting to an emergency department in China, 2021–2025

Article Title: Clinical characteristics of emergency visits for acute poisoning among children and adolescents: a single-center retrospective study (2021–2025) in China

Article References: Li, L.-F., Gou, X.-J., He, J., Luo, L.-J., Yang, L., Chen, M., & Tian, W.-Y. (2026). Clinical characteristics of emergency visits for acute poisoning among children and adolescents: a single-center retrospective study (2021–2025) in China. Frontiers in Pediatrics, 14, Article 1939513. https://doi.org/10.3389/fped.2026.1939513

Image Credits: AI Generated

DOI: 10.3389/fped.2026.1939513

Keywords: acute poisoning, pediatrics, emergency department, adolescents, drug poisoning, pesticide poisoning, epidemiology, China, mental health, ICU admission, seasonal trends, retrospective study