Adolescent poisoning: a comparison of accidental and intentional exposures

The fact that intentional drug and toxic substance use/abuse by adolescents has dramatically increased during the past 2 decades often overshadows the knowledge that adolescents also suffer accidental poisonings as well. A 1-year retrospective analysis of 1,879 poison exposures involving children 13 to 17 years of age revealed 894 (47.6%) were due to accidental circumstances and 945 (50.2%) were intentional in nature. Nonpharmaceuticals were involved in 63.5% of all accidental adolescent poisonings versus 36.5% involving various drugs. Intentional nonpharmaceutical exposures were 17.5% compared to total intentional adolescent poisonings, while 82.5% involved drugs. Site of exposure was the child's own home in 1,252 (66.7%) cases, school in 201 (10.8%), the workplace in 35 (1.9%), and other/unknown sites accounted for 387 (20.6%) poisonings. Poisoning by ingestion accounted for 1,408 (74.9%) of the adolescent exposures, inhalations 147 (7.8%), ocular 219 (11.5%), and dermal 110 (5.8%). Management at the nearest health care facility (HCF) was necessary in 1,252 (66.6%) of the poisonings versus 627 (33.4%) who were treated in non-HCF environments. Regional poison centers must be cognizant that accidental as well as intentional poisoning can occur with adolescents. Distinct viable prevention strategies should be developed to address these problems.