International Epidemiological Differences in Acute Poisonings in Pediatric Emergency Departments
Santiago Mintegi, Beatriz Azkunaga, Javier Prego1
1Departamento de Emergencia Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
Insights
Acute childhood poisonings vary significantly worldwide, with different causes and regional patterns observed in emergency departments. Identifying these international differences is crucial for developing effective prevention strategies.
Area of Science:
- Pediatric Emergency Medicine
- Global Public Health
- Toxicology
Background:
- Acute poisonings in children represent a significant global health concern.
- Understanding regional epidemiological variations is essential for targeted prevention efforts.
Purpose of the Study:
- To evaluate international epidemiological differences in acute poisonings among children presenting to emergency departments (EDs).
- To identify variations across 8 distinct global regions.
Main Methods:
- International multicenter cross-sectional prospective study.
- Inclusion of children under 18 years presenting to 105 EDs in 20 countries.
- Data collected over a 1-year period starting between January and September 2013.
Main Results:
- 1727 poisonings (0.47%) were recorded among 363,245 pediatric ED presentations, with significant regional incidence variation.
- Non-intentional exposures (68.5%) were common, primarily involving therapeutic drugs and household products.
- Suicide attempts (13.8%) and recreational poisonings showed distinct regional patterns, particularly in the Western Pacific and Europe.
Conclusions:
- Substantial global epidemiological differences exist in pediatric acute poisonings.
- International collaboration is needed to identify best practices for childhood poisoning prevention.
Background And Objective:
Identifying international differences in the epidemiology of acute poisonings in children may help in improving prevention. We sought to evaluate the international epidemiological differences in acute poisonings in children presenting to emergency departments (EDs) from 8 different global regions.
Methods:
This was an international multicenter cross-sectional prospective study including children younger than 18 years with acute poisonings presenting to 105 EDs in 20 countries was conducted. Data collection started at each ED between January and September 2013, and continued for 1 year.
Results:
During the study period, we registered 363,245 pediatric ED presentations, of which 1727 were for poisoning (0.47%; 95% confidence interval, 0.45%-0.50%), with a significant variation in incidence between the regions. Full data were obtained for 1688 presentations. Most poisonings (1361 [80.6%]) occurred at home with either ingestion (1504 [89.0%]) or inhalation of the toxin (126 [7.6%]). Nonintentional exposures accounted for 1157 poisonings (68.5%; mainly in South America and Eastern Mediterranean region), with therapeutic drugs (494 [42.7%]), household products (310 [26.8%]), and pesticides (59 [5.1%]) being the most common toxins. Suicide attempts accounted for 233 exposures (13.8%; mainly in the Western Pacific region and North America), with therapeutic drugs (214 [91.8%], mainly psychotropics and acetaminophen) being the most common toxins. Significant differences between regions were found in both types of poisonings. Recreational poisonings were more common in Europe and Western Pacific region. No patient died.
Conclusions:
There are substantial epidemiological differences in acute poisonings among children in different countries and regions of the globe. International best practices need to be identified for prevention of acute poisonings in childhood.
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