2024-07-03 13:30:06
This article is reproduced from dialogue sous licensed under Creative Commons. liraOriginal article.
We continue to regret the accidental poisoning of too many children, especially those under 6 years of age. Cleaning and maintenance product poisoning, drug poisoning and carbon monoxide poisoning are the three most common and serious poisoning incidents. Marijuana intoxication or ingestion of tie batteries should also be cause for concern. However, by taking the right precautions, these poisonings can be avoided. Here we review the top tips to follow at home, on holiday or anywhere else.
Generally speaking, to avoid the annual deaths from accidental poisoning of children, care must be taken to keep small items and dangerous items out of the reach of children. This vigilance must be maintained at home, but also on vacation, with friends, or anywhere else.
Table: The most common and serious accidental poisonings in children (Source: Anses, 2023. Accidental exposure to toxic substances in children. Study of data from multiple health care use sources between 2014 and 2020, Reference No. 2020-SA-0084)
Who should I contact in case of emergency?
If life is in danger (loss of consciousness, difficulty breathing, etc.): Please dial 15 or 112 (if you are deaf or hard of hearing, please dial 114).
In all other cases, if poisoning is suspected in a child, even if there are no symptoms: Call immediately poison control center.
Poison Control Center emergency phone, available 24/7: 01 45 42 59 59 (single number)
At the request of the Directorate-General for Health and the Directorate-General for Competition, Consumption and Fraud Control (DGCCRF), the Agency for Health Security (Anses), with the help of the French Ministry of Health, analyzed different health databases to describe the number of children under 15 years of age between 2014 and 2020. Accidental poisoning of children: data from the Réseau des poison control centergo to the emergency room (Osku Network), Hospitalization (PMSI) and mortality rate (CépiDc).
The study of data from these diverse sources is unprecedented on this topic and allows us to provide a comprehensive overview of benign to severe accidental pediatric poisonings.
Better closure and storage of laundry boxes, unlockers and other cleaning agents
According to Poison Control Center records, cleaning and maintenance products were the leading cause of accidental poisonings (29%) in children under 15 between 2014 and 2020.
Nearly half of these poisonings (45%) were caused by laundry products (liquid detergents including pods, fabric softeners, stain removers, etc.), followed by dish or surface cleaning products (floors, etc.) (32%), indoor Air fresheners (8%), swimming pool maintenance products (4%), etc.
If cleaning and maintenance products most often cause mild poisoning, there are two categories of products that pose a greater risk of serious poisoning.
The first are laundry beads, which are more toxic than traditional liquid detergent at the same dose and whose shapes and colors are particularly attractive to children. If “false” conditions occur, they may cause difficulty breathing or, if ocular projection occurs, damage to the cornea.
However, with the use of pods, pod poisoning has been reduced Europe has made preventive measures mandatory since 2015 (opaque boxes, reinforced closures, prevention pictograms, bitter products in capsules, etc.).
In addition to these precautions, you should not remove the container from the box and place it on a table or floor while waiting for the manufacturing machine.
Duct unclogging products come in second because they can cause corrosive digestive damage if accidentally ingested by children. There Regulation Require safety caps to be used to enclose hazardous products, including pipe uncloggers. Therefore, you must be careful to close products with safety caps.
Tips to remember when using cleaning and maintenance products:
Close and store cleaning products immediately following use
Keep them out of the reach of children, high up or in a closed cupboard
Avoid opening packaging: When household products are transferred to bottled water, soda, or juice, children (such as adults) may accidentally drink it
Special attention must be paid to laundry detergent boxes and pipe uncloggers, which are more likely to cause serious accidents
Don’t underestimate the high risk of drug poisoning
According to the Poison Control Center, drugs are the second leading cause of poisonings in children under 15 (16 percent) and the No. 1 cause of serious cases (34 percent). Nervous system drugs (painkilleranti-anxiety medications, etc.) are most commonly involved, followed by dermatological treatments (antiseptics, disinfectants), then respiratory treatments (antihistamines).
Opioid pain relievers (tramadol, morphine) are particularly dangerous, as are cardiovascular medications (such as beta-blockers) and medications that treat:hypertension (calcium channel blocker).
Non-opioid painkillers such as ibuprofen, aspirin and paracetamol…are responsible for 10% of poisoning hospitalizations in children under six.
Severe poisoning requiring resuscitation is usually due to Benzodiazepines (7.5%), specifically medications prescribed for anxiety disorders, psychiatric medications (Antidepressants, anti-anxiety drugs…) for 6% and calcium channel blockers for the treatment of hypertension (2%).
Finally, seven of the 23 deaths of children under 15 recorded by the CépiDc between 2014 and 2017 were due to drugs, without detailing the medical specialty responsible for the deaths.
Children under one year old are often poisoned due to mistakes (dosing or medication errors) made by those around them when giving them medications, while children between one and five years old are often given medications alone.
Advice to remember when taking medications:
Store all medications high up or in a closed medicine cabinet, whether they are for children, family members, or pets
Make sure medication is not available outside your primary residence (e.g. grandparent’s house, etc.)
Do not leave medications in handbags, tables, etc.
Do not open the packaging of solid medicines (tablets, capsules) before taking them
Special case of carbon monoxide, a colorless, odorless, non-irritating gas
Carbon monoxide is a colorless, odorless, non-irritating toxic gas known to cause collective (usually household) poisoning, most commonly in the winter.
During the analysis period, carbon monoxide poisoning was the leading cause of hospitalization for poisoning in children under 6 years of age (11%) and the second leading cause of admission to the intensive care unit (21%). They especially affect children under one year old.
Note that carbon monoxide is the leading cause of death in the CépiDc data (9 out of 23 deaths).
Tips to remember when working with carbon monoxide:
Regular inspection of heating and hot water production equipment (boilers, water heaters, furnaces, etc.), preferably before winter
Ventilate your home regularly
Keep ventilation systems in good condition and do not block them
Do not use simple heating equipment (braziers, barbecue grills, generators, etc.) at home
Make sure smoke detectors, Mandatory for all accommodation since 2010in working condition.
Marijuana, a serious and increasing risk
Marijuana intoxication is the leading cause of poisoning in ICU admissions for children under 6 years old, accounting for 23%.
During the time period analyzed, these poisonings became more frequent, especially among children under one year old (increasing from 9% of hospitalizations due to poisoning in 2014 to 16% in 2020), and they became increasingly severe. This trend can also be observed in other fields study.
Tips for preventing marijuana intoxication:
Do not discount cannabis consumption by parents or those around their children (friends, acquaintances, etc.)
Inform parents of the serious risks of children ingesting resin (drowsiness, breathing problems, etc.)
In case of accidental ingestion, seek medical attention immediately even if you suspect it.
Danger of foreign objects such as button batteries
Children, especially those under 6 years old, are attracted to objects that are easy to hold, put in the mouth, or are attractive because of their size, appearance, and color, such as button batteries, remote controls or toys, or water used for decoration Beads or supports for plants.
Foreign bodies account for only 1% of poisonings recorded by poison control centers but account for 6% of serious cases. Between 2014 and 2020, they were responsible for two deaths.
One child died from a perforation of the esophagus and aorta, and another died from digestive complications caused by ingesting a bolus of water. In both deaths, the ingestion of foreign objects was not noted at the time of the accident, thus delaying medical attention.
Recommendations for limiting children’s access to these small objects:
Keep tie batteries out of the reach of children, even if they have been used or are still in the packaging
Do not let young children play with remote controls, keys, etc., or any objects that may contain connected batteries.
Make sure the product’s battery compartment is secure and cannot be opened by children (screws tightened, closure system activated, etc.)
Remember, any suspicion that a child has ingested a button battery must be treated as a potential ingestion and require medical attention.
In summary, this study demonstrates that accidental poisonings in children, although diverse, remain frequent and severe.
This requires strengthening communication with the public, especially young parents and childcare professionals, so as not to underestimate certain risks and reduce the occurrence of accidents. Their prevention is an important public health issue.
The authors would like to thank Christine Tournoud, clinical toxicologist at the Center for Poison Control and Poison Vigilance East, Nancy University Hospital, for proofreading the manuscript.
This article was written by Sandra Sinno-Tellier, a public health physician specializing in epidemiology and toxicology at ANSES.
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