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Am J Epidemiol 2003; 157:273-278.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health

PRACTICE OF EPIDEMIOLOGY

Methodological Issues in the Surveillance of Poisoning, Illicit Drug Overdose, and Heroin Overdose Deaths in New Mexico

Michael G. Landen1,, Stuart Castle1, Kurt B. Nolte2, Mary Gonzales3, Luis G. Escobedo4, Barbara F. Chatterjee1, Karen Johnson1 and C. Mack Sewell1

1 Office of Epidemiology, New Mexico Department of Health, Santa Fe, NM.
2 Office of the Medical Investigator, University of New Mexico School of Medicine, Albuquerque, NM.
3 Office of Vital Records and Health Statistics, New Mexico Department of Health, Santa Fe, NM.
4 Public Health Division, District III, New Mexico Department of Health, Las Cruces, NM.

New Mexico leads the nation in poisoning mortality, which has increased during the 1990s in New Mexico and the United States. Most of this increase has been due to unintentional deaths from illicit drug overdoses. Medical examiner and/or vital statistics data have been used to track poisoning deaths. In this study, the authors linked medical examiner and vital statistics records on underlying cause of death, coded using the International Classification of Diseases, Ninth Revision, to assess the extent to which these data sources agreed with respect to poisoning deaths. The authors used multiple-cause files, which are files with several causes listed for each death, to further assess poisoning deaths involving more than one drug. Using vital statistics or medical examiner records, 94.7% of poisoning deaths were captured by each source alone. For unintentional illicit drug and heroin overdose deaths, each data source alone captured smaller percentages of deaths. Deaths coded as E858.8 (unintentional poisoning due to other drugs) require linkage with medical examiner or multiple-cause records, because this code identifies a significant percentage of illicit drug overdose deaths but obscures the specific drug(s) involved. Surveillance of poisoning death should include the use of medical examiner records and underlying- and multiple-cause vital statistics records.

cause of death; coroners and medical examiners; heroin; mortality; overdose; poisoning; population surveillance; vital statistics

Abbreviations: Abbreviations: ICD, International Classification of Diseases; NCHS, National Center for Health Statistics; OMI, Office of the Medical Investigator.


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