Accidental Poisoning in Childhood: A Multicentre Survey. 2. The Role of Packaging in Accidents Involving Medications

Abstract

<jats:p> 1 To assess the effectiveness of child-resistant closures (CRCs) and unit dose packaging in preventing childhood poisoning with medications, a survey by 14 hospitals of accidental suspected poisoning in children under 5-years-old, was compared with a survey of a representative sample of households with children under 5 living in the catchment areas of the hospitals. </jats:p><jats:p> 2 Nine hundred and thirty-eight medications thought to have been ingested by 877 children were compared with 5827 medications found in households with children. The relationship between availability of packs or medications in the home and their involvement in accidents was quantified by means of an Accident Association Index (AAI). A low AAI indicated that the involvement of a pack or medication was less than expected from availability and therefore safe. A high AAI indicated that involvement was greater than expected and therefore unsafe. </jats:p><jats:p> 3 Medications involved in suspected poisoning were most frequently packed in containers without CRCs (63%) or transparent blisters (20%); both had high AAIs. CRCs, strips, sachets and opaque blisters had low AAIs. </jats:p><jats:p> 4 Analgesics, expectorants and gastrointestinal medications, had low AAIs, while oral contraceptives, hypnotics, sedative/tranquillizers, antidepressants, anticonvulsants, anti-emetics, and anti-infectives had high AAIs. Prescription medications were more frequently involved in accidents than over-the-counter (OTC) medications and had a higher AAI. </jats:p><jats:p> 5 Comparison of the AAIs of different kinds of medication in each of their various pack types showed that safe packaging reduced the risk from medications which had a high average AAI. </jats:p><jats:p> 6 Only 40% of medications were in their normal storage place at the time of the accident. Medicine and bathroom cabinets, and kitchen cupboards and drawers were the safest places to store medications. Handbags, fridges, and shelves or ledges in the bathroom were the most unsafe places. No pack had a low AAI when stored on open shelves indicating that safe packaging cannot compensate for unsafe storage. </jats:p><jats:p> 7 Other factors which influenced the involvement of medications in accidents were the intended user and the duration of storage. </jats:p><jats:p> 8 The results of the study have important implications for design of packaging for medications and for education of the public. </jats:p>

Childhood poisoning in Warri, Niger Delta, Nigeria: A ten year retrospective study

“…21 The drugs found as culprits in our study are used on a long-term bases by adults who carelessly keep the drugs in easy reach of children. It is not surprising that drugs result in poisoning within our environment because the Accident Association Index as enunciated by a study in Britain 24 , is high in Warri, as most drugs are not packaged in child resistant packs and come in transparent packs. Drugs are more likely to be stored in handbags and refrigerators as noted in our study, making them easily accessible to children.…”

Children’s acetaminophen exposures reported to a regional poison control center

“…17 Health care professionals can influence safe practices at home and should call attention to the use of child-resistant containers and secure storage to reduce the availability of medications to children. 18 Another essential part of poison prevention education is creating awareness about PCCs. 11 PCCs play important roles in poison prevention education, as well as in the management of poisonings.…”

Essential oil poisoning: N-acetylcysteine for eugenol-induced hepatic failure and analysis of a national database

“…The large number of cases in children under 3 years is partly explained by the explorative nature and lack of taste discrimination in children of this age group, exacerbated by easy access to medicines and distracted parents [2]. More than 50% of accidental childhood poisonings occur when the main carer is involved in household duties [11] or when medications are not in their normal storage place [15].…”