CINCINNATI -- Pharmaceutical poisoning
remains a common childhood injury, despite years of concerted prevention
efforts, such as improved safe guards on packaging. Over half a
million children are exposed to pharmaceuticals each year. A new study
soon to be published in The Journal of Pediatrics attempts to
understand this growing problem to aid in the progress of reducing the
number of childhood injuries due to pharmaceutical poisoning.
Dr. Randall Bond and colleagues from Cincinnati Children''s Hospital
Medical Center and the University of Cincinnati gathered information
about 544,133 children 5 years of age and younger who had visited the
emergency department (ED) because they may have been poisoned by
medication. The data was gathered from all cases reported to the
American Association of Poison Control Centers between 2001 and 2008.
In an attempt to find a focus for continued poison prevention methods,
the authors organized the data according to medication type and whether
the exposure was caused by the child self-ingesting the medication or by
a dosing error.
"We need to know the medications and ingestion circumstances that
contribute most to ED visits, hospitalization, and harm," Dr. Bond
explains. The authors found that 95% of ED visits resulted from
self-ingestion. Prescription drugs accounted for 55% of the ED visits,
76% of hospital admissions, and 71% of significant injuries. The
biggest impact came from opioid-containing pain medications (eg,
oxycodone, morphine, codeine), sedative hypnotics (eg, muscle relaxants,
sleep aids), and cardiovascular medications. "The problem of pediatric
poisoning in the U.S. is getting worse, not better," Dr. Bond asserts.
Overall, there was a 22% increase in the exposure for this age group,
although the number of children in the U.S. under the age of 5 years
increased only 8% during the study period.
The authors attribute this increase to a greater availability of,
and access to, medications in the child''s home. They also note that
effective "poison proofing" may have plateaued or declined in recent
years. "Prevention efforts of parents and caregivers to store medicines
in locked cabinets or up and away from children continue to be crucial.
However, the largest potential benefit would come from packaging
design changes that reduce the quantity a child could quickly and easily
access in a self-ingestion episode, like flow restrictors on liquids
and one-at-a-time tablet dispensing containers," Dr. Bond suggests. He
goes on to recommend that such changes should be applied to both adult
and pediatric products and to over-the-counter and prescription