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Iron poisoning--a preventable hazard of childhood
Insights
Iron poisoning in children is a serious risk, often from prenatal supplements. Prompt desferrioxamine treatment is crucial for survival, while safer packaging could prevent many cases.
Area of Science:
- Pediatric Toxicology
- Emergency Medicine
- Public Health
Background:
- Iron overdose is a significant cause of pediatric poisoning.
- Prenatal iron supplements, often in easy-open packaging, are frequently ingested by young children.
- Assessing the exact number of ingested tablets is challenging.
Observation:
- A retrospective study reviewed 80 pediatric cases of iron poisoning over 7.5 years.
- Nearly half of the children experienced severe poisoning.
- Iron tablets intended for pregnant women were the primary source of ingestion.
Findings:
- Parenteral desferrioxamine administration upon presentation resulted in survival for all 29 children treated.
- A delay in desferrioxamine therapy led to mortality in 3 out of 51 children.
- Long-term effects like brain damage and intestinal strictures were not evaluated.
Implications:
- Strip-packaging of iron tablets could prevent numerous childhood poisoning incidents.
- Immediate parenteral desferrioxamine administration is recommended for suspected iron overdose in children.
- Enhanced safety measures for iron supplements are critical for child safety.
Abstract:
We retrospectively studied the records of all patients with poisoning due to excessive iron ingestion admitted to a children's hospital during a 7 1/2-year period. There were 80 such children, aged between 0,6 and 3,93 years. Almost half were severely poisoned. Most children took iron tablets intended for their mothers or aunts as a supplement during pregnancy. These were packed in easy-to-open plastic packets. Estimates of the number of tablets taken were unreliable. All 29 children who received parenteral desferrioxamine (Desferal; Ciba) on presentation survived, whereas 3 of the 51 children in whom desferrioxamine therapy was delayed died. Late morbidity from brain damage and intestinal strictures was not assessed. Many cases of iron poisoning in childhood could be prevented by strip-packaging of iron tablets. Parenteral desferrioxamine should be given without delay whenever a child is suspected of having swallowed excessive iron tablets.