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

Angalakuditi, Mallik; Coley, Kim C.; Krenzelok, Edward P.

doi:10.2146/ajhp050227

Cited by 9 publications

(4 citation statements)

References 13 publications

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“…Another possible scenario of unintentional exposure are dosing errors by parents or caregivers, as was the case in 6 % of our cases. This is similar to the 8 % reported in the USA for children aged 0–6 years overdosed with paracetamol ( 18 ). Most of these dosing errors were associated with the liquid form, and only a few cases were owed to parents giving children tablets intended for adults.…”

Section: Discussionsupporting

confidence: 87%

Characteristics of unintentional ingestion of oral non-steroidal anti-inflammatory drugs and analgesics in preschool children

Babić

Kordić

Rešić

et al. 2021

Archives of Industrial Hygiene and Toxicology

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We characterised accidental ingestion of non-steroidal anti-inflammatory drugs and non-opioid analgesics in children aged 0–5 years between 2009 and 2019 by analysing records of telephone consultations with the Croatian Poison Control Centre (CPCC) and cases treated at the Children’s Hospital Zagreb (CHZ). Among the total of 466 identified cases (411 from CPPCC records and 55 from CHS hospital records), the most frequently ingested drugs were ibuprofen (47 %), paracetamol (20 %), ketoprofen (15 %), and diclofenac (11 %). In 94 % of the cases unsupervised children ingested the drug left within their reach. The remaining 6 % were dosing errors by parents or caregivers and involved liquid formulations as a rule. Our findings can serve as real-life examples informing preventive measures.

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Section: Discussionsupporting

confidence: 87%

Characteristics of unintentional ingestion of oral non-steroidal anti-inflammatory drugs and analgesics in preschool children

Babić

Kordić

Rešić

et al. 2021

Archives of Industrial Hygiene and Toxicology

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“…Similar studies have been conducted for nonprescription medications [35], [36], [37], [38], [39]. Our primary finding is that poison center data may be used as a predictive tool for methadone poisoning deaths, due to their more rapid availability than national vital statistics data.…”

Section: Discussionmentioning

confidence: 55%

Using Poison Center Exposure Calls to Predict Methadone Poisoning Deaths

et al. 2012

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Purpose There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC). In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdose mortality. Methods We used PC call counts for methadone that were reported to the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System in 2006 and 2007. US death certificate data were used to identify deaths due to methadone. Linear regression was used to quantify the relationship of deaths and poison center calls. Results Compared to decedents, poison center callers tended to be younger, more often female, at home and less likely to require medical attention. A strong association was found with PC calls and methadone mortality (b = 0.88, se = 0.42, t = 9.5, df = 1, p<0.0001, R 2 = 0.77). These findings were robust to large changes in a sensitivity analysis assessing the impact of underreporting of methadone overdose deaths. Conclusions Our results suggest that calls to poison centers for methadone are correlated with poisoning mortality as identified on death certificates. Calls received by poison centers may be used for timely surveillance of mortality due to methadone. In the midst of the prescription opioid overdose epidemic, electronic surveillance tools that report in real-time are powerful public health tools.

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“… 16 - 18 Acetaminophen has become the most frequent modality of choice for adolescents when attempting suicide. 19 Without implying causality, we observed a drastic increase in the proportion of acetaminophen self-harm ingestion admissions in our health care system during the pandemic lockdown. In fact, the odds of an APAP ingestion admission increased by 28% each year ( P = .006) from 2016 to 2020, whereas there was no such significant trend with all-cause self-harm admissions.…”

Section: Discussionmentioning

confidence: 76%

“…The novel coronavirus disease 2019 (COVID- 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has not only had a detrimental physical toll on the population, but an emotional one as well. The COVID-19 pandemic has caused unprecedented disruptions to the lives of children and adolescents, including the closing of schools.…”

Section: Introductionmentioning

confidence: 99%

Increase in Rate of Hospitalizations for Pediatric Intentional Acetaminophen Ingestion at a Single Center During the COVID-19 Pandemic

Moss

Hertzberg

Person

et al. 2022

Clin Pediatr (Phila)

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Objectives: Social disruption due to COVID-19 has detrimentally affected American adolescents’ emotional well-being. Within our system, pediatric acetaminophen ingestions increased in 2020, compared with previous years. We sought to evaluate the rate of hospitalizations for acetaminophen self-harm ingestions and self-harm of adolescents during the COVID-19 pandemic. Study Design: We identified patients (aged 0-23) from billing data with diagnosis of acetaminophen ingestion with self-harm intent (ICD-10 code T391X2A), from a multicenter urban, quaternary health care system. We performed retrospective chart review from 2016 to 2020 and performed statistics using a generalized estimating equation (GEE) logistic regression model. Results: From 2016 to 2020, there were 25 790 discharges of adolescents with 65 acetaminophen self-harm ingestion and 148 self-harm discharges. Of the 65 acetaminophen patients, 75% identified as female and 54% identified as non-white; 71% with Medicaid insurance. The proportion of acetaminophen ingestion and self-harm admissions increased from 0.13% in 2016 to 0.46% by 2020 and 0.42% in 2016 to 0.73% by 2020, respectively. The odds of acetaminophen ingestion admission increased by 28% each additional year (odds ratio = 1.28; 95% confidence interval: 1.08, 1.53; P = .006). There was not enough evidence to conclude that the log-odds of a self-harm ingestion were linearly related to time ( P = .06). Conclusions: Acetaminophen ingestion for self-harm has significantly increased, while overall self-harm has increased to a lesser, nonsignificant degree. Primarily females of color and those with Medicaid insurance are affected. It is important to note this growing, disturbing trend, and to continue to screen for depression in our adolescent community and ensure access to mental health resources.

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

Abstract: Most acetaminophen exposures reported to an RPCC occurred in children less than six years of age and were unintentional, whereas exposures in children over 12 years were more likely to be intentional overdoses.

Cited by 9 publications

References 13 publications

Characteristics of unintentional ingestion of oral non-steroidal anti-inflammatory drugs and analgesics in preschool children

Characteristics of unintentional ingestion of oral non-steroidal anti-inflammatory drugs and analgesics in preschool children

Using Poison Center Exposure Calls to Predict Methadone Poisoning Deaths

Increase in Rate of Hospitalizations for Pediatric Intentional Acetaminophen Ingestion at a Single Center During the COVID-19 Pandemic

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