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Severe accidental poisonings in children: a British Paediatric Surveillance Unit nationwide prospective study
Charlotte King1, Mark Anderson2, Abhishek Agarwal3,4
1Department of Women and Child's Health, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Insights
Severe accidental poisonings in children are a significant concern. Prescription medications and illicit substances are now leading causes, highlighting the need for updated public health strategies.
Area of Science:
- Pediatric Toxicology
- Public Health Surveillance
- Accidental Injury Prevention
Background:
- Poisoning is a common issue among children and young people.
- Understanding severe accidental poisonings is crucial for healthcare professionals and public health initiatives.
Purpose of the Study:
- To determine the incidence, causes, and circumstances of severe accidental poisonings in children under 15 years old.
- To inform public health interventions by analyzing recent trends in pediatric poisoning.
Main Methods:
- Prospective, population-based surveillance study conducted in the UK and Ireland from July 2018 to July 2019.
- Utilized the British Paediatric Surveillance Unit (BPSU) active surveillance methodology.
- Included accidental poisonings with a Poisoning Severity Score (PSS) of ≥2, excluding intentional cases.
Main Results:
- 31 cases of severe accidental poisoning were reported, with an incidence of 2.4 cases per million children.
- Prescription medications (42%) and illicit drugs/alcohol (39%) were the most common causes.
- The primary circumstance reported was 'substance left unattended' (26%).
Conclusions:
- Severe accidental poisoning remains a significant pediatric health problem.
- The leading causes of poisoning have shifted, necessitating updated public health campaigns.
- Surveillance data is vital for adapting prevention strategies to current risks.
Background:
Poisoning in children and young people is common. Understanding the incidence, causes and circumstances of severe accidental poisonings, requiring admission and medical intervention, may help healthcare professionals and shape public health interventions.
Methods:
A prospective, population-based surveillance study using the British Paediatric Surveillance Unit (BPSU)'s active surveillance methodology (July 2018-July 2019) in the UK and Ireland. Inclusion criteria were as follows: all children aged <15 years; accidental poisoning requiring intervention; Poisoning Severity Score (PSS) score ≥2 (moderate or severe). Intentional poisonings were excluded.
Results:
116 cases of poisoning were reported, and 31 cases met the inclusion criteria. The overall incidence of reported severe accidental poisoning was 2.4 cases per million children (3.2 per million in male, 1.6 per million in female), with 7.3 cases per million in children under 2 years. On PSS scoring, 14 (45%) cases were classified as moderate, 16 (52%) cases severe and 1 (3%) case fatal. The frequency of fatal poisonings reported was 0.08 per million children. Prescription medications were the most common substance implicated (n=13, 42%), with opioids (n=6, 19%) being the most common medication group. Common non-medication causes were illicit drugs or alcohol (n=12, 39%), household or industrial products (n=5, 16%), and carbon monoxide (n=1, 3%). The most cited circumstance was 'the substance being left unattended' (n=8, 26%).
Conclusion:
Severe accidental poisoning remains a significant problem for children, but the most common causes have changed, underscoring the importance of updating public health initiatives.
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