Analysis of the calls made to the Malta National Poisons Centre

Abstract

Background: The Malta National Poisons Centre (MNPC) commenced operations in October 2023, initially serving Healthcare Professionals (HCP) before extending access to the public in May 2024. Poison centres serve as critical epidemiological resources providing essential data on poisoning incidents while offering expert clinical consultation for exposure management. The centre provides telephone consultation services to both HCP and the public for toxicological emergencies. Aim: To analyse the nature and characteristics of all toxicological exposure calls received by the MNPC during its first months of operation, from October 2023 to May 2025, and examine insights regarding poison types and severity in Malta. Methods: A retrospective quantitative analysis was conducted using anonymised call-log data from the MNPC database. The study included all 654 toxicology-related calls meeting inclusion criteria. Data encompassed caller demographics, patient characteristics, exposure circumstances, substance categories, clinical severity using the Poisoning Severity Score (PSS), and documented outcomes. Statistical analysis employed descriptive methods and chi-square tests using SPSS version 29. Results: HCP constituted 76.6% of callers, with 23.4% from the public. Patient gender distribution was balanced (50.8% male, 48.9% female). The largest age groups exposed were 30-39 years (17.4%) and children under 5 years (16.4%). Accidental exposures predominated (40.1%), followed by deliberate exposures (36.2%). Pharmaceutical agents comprised most exposures, with paracetamol-containing analgesics being most frequently reported (15.1%); 59.6% of paracetamol cases involved deliberate poisoning. Most exposures occurred in domestic settings (85.5%) via oral route (84.4%). PSS distribution showed 34.6% asymptomatic, 40.2% minor, 16.8% moderate, 8.3% severe, and 0.2% fatal outcomes. Hospital admission was required in 52.4% of cases, with 60.7% involving clinical toxicologist consultation. Non-Maltese residents comprised 28.3% of cases, with disproportionate representation in workplace exposures (58.3% of occupational cases). Conclusions: The MNPC has successfully integrated into Malta's healthcare system, demonstrating appropriate utilisation and effective outcomes. The epidemiological profile reveals distinct age-related intentionality patterns requiring targeted prevention strategies. Paracetamol prominence in deliberate exposures and significant non-Maltese representation in occupational exposures indicate specific risk factors requiring public health intervention. These findings provide essential baseline data for evidence-based prevention strategies and clinical protocol optimisation.