The effects of COVID-19 on poisonings in the paediatric emergency department

Abstract

Objectives The purpose of this study is to describe the impact of the pandemic on poisoning in children under 18 years presenting to a tertiary care paediatric emergency department (ED) in Canada. Methods We utilized the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) surveillance data to identify children presenting to the Hospital for Sick Children for poisonings during two time periods: pre-pandemic (March 11 to December 31, 2018 and 2019) and pandemic (March 11 to December 31, 2020). Primary outcomes investigated the change in proportion for total poisonings, unintentional poisonings, recreational drug use, and intentional self-harm exposures over total ED visits. Secondarily, we examined the change in proportion of poisonings between age, sex, substance type, and admission requirement pre-pandemic versus during pandemic. Results The proportions significantly increased for total poisonings (122.5%), unintentional poisonings (127.8%), recreational drug use (160%), and intentional self-harm poisonings (104.2%) over total ED visits. The proportions over all poisoning cases also significantly increased for cannabis (44.3%), vaping (134.6%), other recreational drugs (54.5%), multi-substance use (29.3%), and admissions due to poisonings (44.3%) during the pandemic. Conclusion Despite an overall decrease in ED visits, there was a significant increase in poisoning presentations to our ED during the pandemic compared with pre-pandemic years. Our results will provide better insight into care delivery and public health interventions for paediatric poisonings.

The Effect of the COVID-19 Lockdown on the Frequency of Acute Poisoning Presentation to Adult and Pediatric Emergency Departments

“…This might be explained by the increase of laws and restrictions that were implemented during the lockdown to limit the rate of the disease spread. In contrast, Zhang et al and Raffee et al showed an increase in poisoning cases during the pandemic [ 11 - 12 ].…”

Accidental child poisoning and the impact of the COVID-19 pandemic at a referral Children’s Hospital in Greece

“…Notably, French data state that gel dispensers often are close to children's faces leading to corneal lesions [18].Furthermore, South Africa highlighted a 60% increase in calls regarding exposure to antiseptics compared to pre-pandemic time [19]. A rise in poisonings has also been seen in Canada, probably associated with the school closure and homestay during the lockdown [12]. An Italian study highlighted that the most frequent poisons during the pandemic were medications and hand sanitizers [20].…”

Pediatric Hospitalizations for Unintentional Cannabis Poisonings and All-Cause Poisonings Associated With Edible Cannabis Product Legalization and Sales in Canada

“…8 However, the introduction of edible cannabis in Canada coincided closely with the COVID-19 pandemic when there were large changes in pediatric health care visit patterns, including reports of increases in pediatric poisoning events. 9,10 Consequently, whether pediatric poisonings have increased primarily as a result of the legalization of recreational cannabis in general, an increase in children's access to ready-to-consume commercially produced legal cannabis edibles, COVID-19-related factors, or a combination of factors is unclear. Also unclear is how temporal trends in cannabis poisonings differ from all-cause pediatric poisonings and the relative burden of cannabis on poisoning events in children.…”

“…Recent studies from Canada found that ED visits and hospitalizations for cannabis poisonings in children increased after legalization of recreational cannabis, particularly when legal cannabis edibles were introduced . However, the introduction of edible cannabis in Canada coincided closely with the COVID-19 pandemic when there were large changes in pediatric health care visit patterns, including reports of increases in pediatric poisoning events . Consequently, whether pediatric poisonings have increased primarily as a result of the legalization of recreational cannabis in general, an increase in children’s access to ready-to-consume commercially produced legal cannabis edibles, COVID-19–related factors, or a combination of factors is unclear.…”