OBJECTIVES: This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States. METHODS:Data from the National Poison Data System for 2000 through 2015 were analyzed. RESULTS:Poison control centers received reports of 188 468 prescription opioid exposures among children aged <20 years old from 2000 through 2015. The annual number and rate of exposures increased early in the study period, but declined after 2009, except for buprenorphine exposures, which increased during the last 3 study years. Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years (odds ratio [OR]: 2.86; 95% confidence interval [CI]: 2.78-2.94) or children aged 6 to 12 years (OR: 6.62; 95% CI: 6.06-7.02). Teenagers also had greater odds of serious medical outcomes than did children aged 0 to 5 years (OR: 3.03; 95% CI: 2.92-3.15) or children aged 6 to 12 years (OR: 4.59; 95% CI: 4.21-5.00). The rate of prescription opioid-related suspected suicides among teenagers increased by 52.7% during the study period.CONCLUSIONS: Prescription opioid-related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.
OBJECTIVE: To investigate out-of-hospital medication errors among young children in the United States. METHODS: Using data from the National Poison Database System, a retrospective analysis of out-of-hospital medication errors among children <6 years old from 2002 through 2012 was conducted. RESULTS: During 2002–2012, 696 937 children <6 years experienced out-of-hospital medication errors, averaging 63 358 episodes per year, or 1 child every 8 minutes. The average annual rate of medication errors was 26.42 per 10 000 population. Cough and cold medication errors decreased significantly, whereas the number (42.9% increase) and rate (37.2% increase) of all other medication errors rose significantly during the 11-year study period. The number and rate of medication error events decreased with increasing child age, with children <1 year accounting for 25.2% of episodes. Analgesics (25.2%) were most commonly involved in medication errors, followed by cough and cold preparations (24.6%). Ingestion accounted for 96.2% of events, and 27.0% of medication errors were attributed to inadvertently taking or being given medication twice. Most (93.5%) cases were managed outside of a health care facility; 4.4% were treated and released from a health care facility; 0.4% were admitted to a non–critical care unit; 0.3% were admitted to a critical care unit; and 25 children died. CONCLUSIONS: This is the first comprehensive study to evaluate the epidemiologic characteristics of out-of-hospital medication errors among children <6 years of age on a national level. Increased efforts are needed to prevent medication errors, especially those involving non–cough and cold preparations, among young children.
This study describes the epidemiology of rare-earth magnet ingestion by children by retrospectively analyzing 72 cases of magnet ingestion collected from Saferproducts.gov and the US Consumer Product Safety Commission from 2000 through 2012. The mean child age was 6.4 years. Patients ingested between 1 and 40 magnets, most often 1 to 4 magnets. Unique circumstances of ingestion included faux piercing (19.4%) and mistaking magnets for candy (6.9%). Surgery was required in 69.7% of cases where treatment was reported. Fifty-three patients were hospitalized (73.6%), and the length of hospital stay was reported in 58.5% of those cases, ranging from 1 to 54 days. Approximately half (50.7%) of the magnets causing injury were products intended for use by adults. Study findings demonstrate that pediatric ingestion of rare-earth magnets can cause serious gastrointestinal injury. Establishing a performance standard that limits the attraction force of these magnets offers the best prevention solution to this important pediatric public health problem.
This study investigates marijuana exposures among children <6 years old in the United States using data from the National Poison Data System. From 2000 through 2013, there were 1969 marijuana exposures among children <6 years old and an exposure rate of 5.90 per million children. The mean age of an exposed child was 1.81 years (median = 1.58 years). The majority of the children were exposed through ingestion (75.0%), and 18.5% of exposures required admission to a health care facility. The rate of marijuana exposure was significantly (2.82 times) higher in states where its use was legalized prior to 2000 compared with states where its use is not legal. Because more states are likely to pass legislation legalizing medical and recreational use of marijuana, increased efforts to establish child-focused safety requirements regarding packaging of commercially sold marijuana products are needed to help prevent more children from being exposed to this schedule I substance.
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