Calls to poison centers involving liver injuries caused by medications, supplements, alcohol and other substances\u00a0jumped\u00a0nearly 400%\u00a0between 2000 and 2024,\u00a0according to a new study from UVA Health.\u00a0<\/p>\n
Researchers led by UVA’s Christopher P. Holstege, MD, looked at liver damage called by “xenobiotics,” foreign substances not naturally found in the human body. This category includes drugs, food\u00a0additives, alcohol\u00a0and environmental pollutants.\u00a0<\/p>\n
More than 80% of the\u00a0liver injuries required\u00a0inpatient care, with the majority of cases stemming from medications. Acetaminophen was the most frequently implicated substance.\u00a0<\/p>\n
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Xenobiotic-induced liver injuries reported to U.S. poison centers have steadily increased. The public should be aware of potential liver injury with various substances that are readily available to consumers.”<\/p>\n
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Christopher P. Holstege, director of UVA Health’s Blue Ridge Poison Center<\/p>\n
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Liver injury causes<\/p>\n
Holstege and his colleagues identified\u00a0a total of 220,160 cases of xenobiotic liver injury over the 24 years reviewed. Population-adjusted exposure rates skyrocketed from 10.9 per million people to 52.9 per million people.\u00a0<\/p>\n
The researchers found that exposures\u00a0from\u00a0acetaminophen-containing drugs\u00a0decreased significantly\u00a0\u2013\u00a0by 60%-85%\u00a0\u2013\u00a0after the U.S. Food and Drug Administration imposed a cap on the amount of acetaminophen allowed in combination prescription products. By\u00a0contrast, potentially harmful exposures to acetaminophen by itself\u00a0increased steadily over the 24-year period,\u00a0indicating\u00a0that regulatory action successfully reduced\u00a0liver damage\u00a0from combination products, while acetaminophen\u00a0alone\u00a0remains\u00a0a leading contributor to liver injuries reported to poison centers.\u00a0<\/p>\n
Females had higher rates of acetaminophen-associated liver injury than males,\u00a0and\u00a0suspected suicide was the most common reason for exposure in both sexes, the study found.\u00a0<\/p>\n
“Liver injuries reported to poison centers has increased substantially over the past 25 years, with acetaminophen emerging as a growing contributor,” Holstege said. “Our study findings highlight the important role poison centers play in toxico-surveillance.”<\/p>\n
Alcohol was a distant second in the top causes of liver injuries. This was seen more frequently in men than women, but injuries increased in both sexes during the COVID-19 pandemic.<\/p>\n
The researchers also identified increases in liver injuries caused by stimulants and street drugs, herbal and dietary supplements and environmental toxins, but these were far less common than the injuries caused by acetaminophen and alcohol.<\/p>\n
“Medications should always be taken as directed by clinicians and per pharmaceutical label instructions,” Holstege said. “Care must also be taken in consuming emerging substances that are unregulated. More studies are warranted to determine if specific populations are more at risk of liver injury.”<\/p>\n
UVA Health’s Blue Ridge Poison Center is available to answer questions about potential poison exposures 24 hours a day, seven days a week. The center can be reached at 1.800.222.1222. There is no charge for the service.<\/p>\n
Findings published\u00a0<\/p>\n
The researchers have\u00a0published their findings\u00a0in\u00a0Clinical Gastroenterology and Hepatology. The research team consisted of\u00a0Eleanor Blair Towers, Holstege, Scott\u00a0Schmalzried\u00a0and Rita Farah. The scientists have no financial interest in the work.<\/p>\n
Source:<\/p>\n