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Paracetamol availability and recent changes in paracetamol poisoning: is the 1998 legislation limiting availability of paracetamol being followed?
  1. S L Greene1,
  2. P I Dargan1,
  3. P Leman2,
  4. A L Jones1
  1. 1Guy’s and St Thomas’s Poisons Unit, Guys and St Thomas’s NHS Foundation Trust, London, UK
  2. 2Emergency Department, Royal Perth Hospital, Perth, Australia
  1. Correspondence to:
 Dr S L Greene
 Guy’s and St Thomas’s Poisons Unit, Avonley Road, New Cross, London SE14 5ER UK; Shaun.Greene{at}


Objective: To determine the degree of adherence to legislation introduced in 1998 restricting the availability of over the counter paracetamol.

Design: A prospective observational study.

Setting: An emergency department in an inner city London teaching hospital. Pharmacy and non-pharmacy outlets in south London.

Main outcome measures: (1) The source of paracetamol ingested by 107 patients presenting with an acute paracetamol overdose (2001–2003) and (2) the ability to purchase paracetamol from pharmacy and non-pharmacy outlets in a manner contravening paracetamol pack size legislation (2004).

Results: Potentially toxic amounts of paracetamol in excess of pack size restrictions were purchased in 70% (17 of 24) of outlets. Forty six per cent of patients who had ingested a potentially toxic dose of paracetamol obtained the tablets in a manner contravening the 1998 legislation.

Conclusion: Legislation limiting the availability of over the counter paracetamol is not being adhered to in south London. A significant number of patients ingesting a potentially toxic dose of paracetamol report purchasing the tablets in a manner contravening the legislation. Studies that attempt to assess the impact of the legislation need to be interpreted in the context of these results. Measures to enforce current legislation may help to reduce the severity of paracetamol poisoning in the UK.

  • legislation
  • paracetamol
  • pack size
  • overdose

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  • Contributors

    SG, PD, PL, and AJ designed the study and collected study data. SG and PD conducted data analysis. SG wrote the draft report and PD, PL, and AJ reviewed and finalised the report. All four authors will act as guarantors.

  • Funding: this study did not receive any funding.

  • Competing interests: AJ and PD have acted as scientific advisors and have received funding to attend scientific meetings from Glaxo Smith Kline.

  • Ethics: this observational study was not considered by the local hospital ethics committee. Information obtained from patients is part of the standard toxicology history taken by the Clinical Toxicology team at St Thomas’s Hospital. The clinical toxicology database has been discussed with the local research ethics committee.