Objective  To analyze the trends of mortality and disease burden of accidental poisoning among young and middle-aged adults (aged 20 to < 60 years) in Chongqing, thus providing suggestions for poisoning prevention and control in this population.

Methods  Death cases of accidental poisoning from 2012 to 2024 were obtained from the Chongqing Resident Death Surveillance System. SPSS 25.0 and Excel 2010 were used to calculate indicators including the mortality, age-standardized mortality rate (ASMR), age-specific mortality, rate of years of life lost (YLL), and average years of life lost (AYLL). Chi-square test was conducted to compare the mortality between different genders and regions. Joinpoint regression was employed to calculate the average annual percent change (AAPC) for the trends of the rates.

Results  In Chongqing, the mortality and ASMR of accidental poisoning among young and middle-aged adults decreased from 3.55/100 000 and 3.41/100 000 in 2012 to 1.30/100 000 and 1.18/100 000 in 2024, with the AAPCs of −8.34% and −9.13%, respectively (both P < 0.05). The mortality of accidental poisoning in males was consistently higher than that in females (all P < 0.05). The mortality and ASMR of accidental poisoning decreased by 7.45% and 8.11% annually in males and by 10.79% and 11.66% annually in females, respectively (all P < 0.05). The mortality of accidental poisoning in rural areas was higher than that in urban areas (all P < 0.05). The mortality and ASMR of accidental poisoning decreased by 11.58% and 11.41% annually in urban areas and by 7.23% and 8.19% annually in rural areas, respectively (all P < 0.05). The rate of YLL and AYLL of accidental poisoning among young and middle-aged adults in Chongqing decreased from 1.61‰ and 45.29 years in 2012 to 0.57‰ and 44.34 years in 2024, with the AAPCs of −8.69% and −0.30%, respectively (both P < 0.05). The top four causes of death due to accidental poisoning were pesticide poisoning, alcohol poisoning, drug poisoning, and organic solvent/gas poisoning in 2012. And in 2024, they were organic solvent/gas poisoning, alcohol poisoning, pesticide poisoning, and drug poisoning. From 2012 to 2024, the proportions of pesticide poisoning and drug poisoning decreased annually by 11.05% and 4.64%, while those of organic solvent/gas poisoning and alcohol poisoning increased annually by 12.78% and 2.26%, respectively (all P < 0.05).

Conclusions  The mortality and disease burden of accidental poisoning among young and middle-aged adults in Chongqing show a downward trend. Males and rural residents are the key populations at risk of death due to accidental poisoning. Organic solvent/gas poisoning and alcohol poisoning are the main causes of death. Targeted interventions should be implemented for key populations and different causes of accidental poisoning.