An Autopsy Based Review of Poisoning Related Deaths in a Tertiary Health Care Center in Himachal Pradesh

Background:: Poisoning remains a major public health, forensic and medicolegal concern in India, especially in rural regions where agricultural chemicals are widely used by the farmers. This study investigates and highlights the toxicological profiles, temporal patterns and seasonal variations in poisoning-related deaths reported at a tertiary care center in Northern India over a three-year period. Methods:: A retrospective analysis of 284 autopsy-confirmed poisoning-related fatalities between October 2021 and November 2024 was done. Data were extracted from medico-legal autopsy reports, toxicological findings, case histories and police inquests. Parameters included type of poison, season/climate and time of incident and quarter-wise case distribution. Results:: Aluminum phosphide poison were the most frequently implicated agents, followed by organophosphate poisons. Blood alcohol was detected in 13.5% of cases, often as a co-ingestant with another poison, particularly pesticide/weedicide. The fatal poisonings peaked during the monsoon season (28.5%) and the poison was taken most commonly in the afternoon and evening (36.27%) time of the day. Quarter-wise Quarter-II of 2023 recorded the highest incidence (13.2%) of poisoning deaths. Rare and composite toxic exposures, including industrial and psychoactive substances, reflect evolving toxicological profiles. Conclusion:: Agrochemical poisoning in rural settings underscores the influence of temporal and seasonal factors. These findings call for enhanced community awareness, regulatory measures on hazardous agents and improved toxicovigilance infrastructure.