Ingestion of Illicit Substances by Young Children Before and During the COVID-19 Pandemic

Raffa, Brittany J.; Schilling, Samantha; Henry, M. Katherine; Ritter, Victor; Bennett, Colleen E; Huang, Jeannie S.; Laub, Natalie

doi:10.1001/jamanetworkopen.2023.9549

Cited by 11 publications

(19 citation statements)

References 27 publications

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“…We analyzed the KYRBS data to investigate the national trends in hand and oral hygiene behaviors during the past 15 years in the context of before and after the pandemic. Interrupted time series analysis was performed using an ordinary least-squares model (linear regression), logistic regression, and estimate of adjusted odds ratio (OR) to investigate immediate and sustained changes in hand and oral hygiene behaviors before and during the pandemic . We conducted sex and age standardization and adjustment for sex, grade, BMI, current alcohol use, current smoking status, highest educational level of parents, household economic level, and school performance.…”

Section: Methodsmentioning

confidence: 99%

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

Oh,

Lee,

Lee

et al. 2023

JAMA Netw Open

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ImportanceOnly a few studies have examined the long-term trends of hand and oral hygiene, especially among adolescents.ObjectiveTo investigate the 15-year trends in frequency of handwashing and toothbrushing and examine the factors associated with hand and oral hygiene, particularly during the COVID-19 pandemic.Design, Setting, and ParticipantsThis cross-sectional study, performed from January 1, 2008, to December 31, 2022, used general population–based data from 963 644 individuals in a national representative survey (Korea Youth Risk Behavior Web-based Survey [KYRBS]).ExposureCOVID-19 pandemic.Main Outcomes and MeasuresTrends in hand and oral hygiene practices were measured by how frequently adolescents washed their hands and whether they fulfilled the recommended guidelines for toothbrushing. An interrupted time series analysis using linear and logistic regression models was performed to assess any associations with the COVID-19 pandemic. Hand and oral hygiene behaviors before and during the pandemic in each sociodemographic subgroup were also compared.ResultsIn the 963 644 adolescents (495 697 [51.4%] male; mean [range] age, 15.01 [12-18] years) who participated in the KYRBS from 2008 to 2022, a 73.3% (95% CI, 59.4%-97.4%; P &lt; .001) immediate increase was seen in overall hand hygiene behavior at the onset of the COVID-19 pandemic compared with the prepandemic period, with a sustained decrease thereafter (β = −0.018; 95% CI, −0.022 to −0.015; P &lt; .001). Meanwhile, no immediate increase was observed in terms of overall oral hygiene behavior (0.1%; 95% CI, −0.9% to 1.1%; P = .82); however, there was a sustained decrease during the pandemic (β = −0.018; 95% CI, −0.020 to −0.016; P &lt; .001). Older age, female sex, nonsmoking status, alcohol use, low household economic level, and poor school performance were significantly associated with poor hand hygiene during the pandemic.Conclusions and RelevanceIn this cross-sectional study of South Korean adolescents, an increase in the prevalence of hand hygiene was observed during the early pandemic; however, this prevalence decreased over time. Meanwhile, the decrease in the prevalence of oral hygiene was more pronounced during the pandemic. This study recommends stronger guidelines for adolescent health coaches, such as teachers or public health advisers, regarding hygiene behaviors, even after the COVID-19 pandemic ends.

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Section: Methodsmentioning

confidence: 99%

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

Oh,

Lee,

Lee

et al. 2023

JAMA Netw Open

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“…Children who reside in homes where adult drug use is occurring are at risk of accidentally ingesting those substances . Recent research indicates that there has been a 26% increase in illicit drug ingestions in children since the onset of COVID-19 and pediatric hospitalizations for cannabis poisoning has doubled in areas with recreational legalization . Young children often ingest these drugs through exploratory means as they are unaware of the dangers; caregivers who are using substances may be less able to monitor their children’s behavior …”

Section: Introductionmentioning

confidence: 99%

“…A previous study that examined drug exposure beyond the neonatal period using hospital data from 2006 to 2008 found that only 4% of cases were reported to CPS and reporting rates varied by substance type . Given increases in child ingestion rates, and the legalization of cannabis in many states, understanding both reporting practices and CPS responses by drug type when a child tests positive is important …”

Section: Introductionmentioning

confidence: 99%

Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Rebbe,

Malicki,

Siddiqi

et al. 2024

JAMA Netw Open

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ImportanceYoung children are ingesting illicit drugs at increased rates, but it is unknown what the associated child protection system (CPS) responses are when a child tests positive.ObjectiveTo document the child protection system involvement and the characteristics of children who test positive for illicit substances.Design, Setting, and ParticipantsThis retrospective cross-sectional study linked medical discharge and child protection system administrative data. The setting was Rady Children’s Hospital San Diego, a free-standing pediatric hospital in California. Participants included all emergency department and inpatient medical encounters involving children aged 12 years or younger with a positive urine drug test between 2016 and 2021. Statistical analysis was performed from February 2023 to January 2024.ExposureDrug type, including amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, fentanyl, opiates, and phencyclidine.Main Measures and OutcomesCPS responses associated with the medical encounter including reports, substantiations, case openings, and out-of-home placements.ResultsA total of 511 emergency department and inpatient medical encounters involving children had a positive drug test (262 [51.3%] were female; 309 [60.5%] were age 6 years or younger; fewer than 10 [&lt;3.0%] were American Indian or Alaska Native; 252 [49.3%] were Hispanic [any race], 20 [3.9%] were non-Hispanic Asian, 56 [11.0%] were non-Hispanic Black, 143 [28.0%] were non-Hispanic White, 36 [7.0%] had other or unknown race and ethnicity; 233 [43.6%] had a CPS report prior to the medical encounter). Following the positive screen, 244 (47.7%) were reported to child protection, and 61 (11.9%) were placed out-of-home within 30 days. Mean (SD) quarterly counts of encounters with positive drug tests doubled after the COVID-19 pandemic onset (32.9 [9.8]) compared with prior to the pandemic onset (16.5 [4.7]); for encounters positive for cannabis, mean (SD) quarterly counts were 3 times as high after the pandemic onset than prior (16.6 [4.7] vs 5.7 [2.9]). Encounters for children under age 1 were significantly more likely to have associated child protection reports (relative risk [RR], 2.91 [95% CI, 2.21-3.83]) and child protection case openings (RR, 1.71 [95% CI, 1.07-2.72]) than encounters involving older children.Conclusions and RelevanceIn this cross-sectional study of emergency department and inpatient medical encounters, less than half of children with positive urine drug screens were reported to CPS; out-of-home placements were uncommon. With increased encounters for positive drug tests, it is unclear what services these children and families are receiving.

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“…This role is especially important now because the COVID-19 pandemic saw an increase in ingestion of illicit substances among young children. 10 Clinicians treat patients after unintentional exposures, including those resulting in hospitalizations. Clinicians also in-teract with patients and have the opportunity to discuss responsible cannabis use, namely keeping cannabis out of children's reach.…”

mentioning

confidence: 99%

“…Health care professionals are on the front line of this issue and play an invaluable role as educators of the potential dangers posed by unregulated, untested, and unlicensed cannabis that targets minors. This role is especially important now because the COVID-19 pandemic saw an increase in ingestion of illicit substances among young children . Clinicians treat patients after unintentional exposures, including those resulting in hospitalizations.…”

mentioning

confidence: 99%

Unintentional Pediatric Ingestion of Cannabis—Addressing a Growing Public Health Risk

Tobin,

Xie,

George

2023

JAMA Pediatr

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Ingestion of Illicit Substances by Young Children Before and During the COVID-19 Pandemic

Cited by 11 publications

References 27 publications

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Unintentional Pediatric Ingestion of Cannabis—Addressing a Growing Public Health Risk

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