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Severe and fatal pharmaceutical poisoning in young children in the UK
Mark Anderson1, Leonard Hawkins2, Michael Eddleston3
1Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK Newcastle Unit, National Poisons Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Insights
Methadone is the leading pharmaceutical causing fatal accidental poisoning in young children in the UK. It is also a common cause for pediatric intensive care unit admissions due to pharmaceutical poisoning.
Area of Science:
- Pediatric Toxicology
- Public Health Surveillance
- Pharmaceutical Safety
Background:
- Accidental poisoning in young children is a significant concern.
- Severe or fatal poisoning events, while rare, require thorough investigation.
- Identifying causative agents is crucial for prevention strategies.
Purpose of the Study:
- To determine the incidence of severe and fatal pharmaceutical poisonings in young children in the UK.
- To identify the specific medications most frequently implicated in these events.
Main Methods:
- Analysis of national mortality data (Office of National Statistics).
- Review of Paediatric Intensive Care Audit Network admissions data.
- Examination of National Poisons Information Service and Hospital Episode Statistics for implicated agents.
Main Results:
- From 2001-2013, 28 deaths in young children (≤4 years) in England and Wales were linked to pharmaceutical poisoning.
- Methadone accounted for 57% (16 cases) of these fatal poisonings.
- Between 2002-2012, 201 children (≤4 years) were admitted to UK pediatric intensive care units for pharmaceutical poisoning, with benzodiazepines (19%) and methadone (17%) being most common.
Conclusions:
- Methadone is identified as the primary pharmaceutical agent responsible for fatal poisonings in young children across the UK.
- Methadone is also a frequent cause of pediatric intensive care unit admissions due to accidental pharmaceutical poisoning.
Objective:
Accidental poisoning in young children is common, but severe or fatal events are rare. This study was performed to identify the number of such events occurring in the UK and the medications that were most commonly responsible.
Design:
Analysis of national data sets containing information relating to severe and fatal poisoning in children in the UK.
Data Sources:
Office of National Statistics mortality data for fatal poisoning; Paediatric Intensive Care Audit Network admissions database and the National Poisons Information Service for severe non-fatal poisoning; Hospital Episode Statistics for admission data for implicated agents.
Results:
Between 2001 and 2013, there were 28 children aged 4 years and under with a death registered as due to accidental poisoning by a pharmaceutical product in England and Wales. Methadone was the responsible drug in 16 (57%) cases. In the UK, 201 children aged 4 years and under were admitted to paediatric intensive care with pharmaceutical poisoning between 2002 and 2012. The agent(s) responsible was identified in 115 cases, most commonly benzodiazepines (22/115, 19%) and methadone (20/115, 17%).
Conclusions:
Methadone is the most common pharmaceutical causing fatal poisoning and a common cause of intensive care unit admissions in young children in the UK.