Accidental Poisoning in Children and Adolescents Admitted to a Referral Toxicology Department of a Brazilian Emergency Hospital

Abstract

Objective: To describe the profile of children and adolescents admitted for exogenous unintentional poisoning in the emergency room and analyze factors associated with subsequent in-hospital admissions. Methods: This is a cross-sectional study based on hospital records of all subjects up to 19 years-old admitted in 2013 at a specialized toxicology service on a major public emergency hospital due to unintentional intoxication (as reported). Accidents with poisonous animals and insects were excluded. Percentages and frequencies were calculated for the qualitative variables, and measures of central tendency and dispersion for the continuous quantitative variables. Multivariate analysis was performed using binary logistic regression to identify variables associated with subsequent in-hospital admissions. Results: In 2013, 353 cases were reported. Poisonings were more frequent in children 0-4 years-old (72.5%) and in boys (55%). The vast majority was of dwellers of the Metropolitan Region of Belo Horizonte (83%), and 90% of the accidental poisonings occurred at home. 82.7% of the poisonings occurred by oral ingestion, especially of medicinal (36.5%) and cleaning products (29.4% of all poisonings). Only 12.2% of the cases resulted in hospitalization, and only one resulted in death. Residing outside Belo Horizonte (OR=5.20 [95%CI 2.37-11.44]) and poisoning by two or more products (OR=4.29 [95%CI 1.33-13.82]) were considered risk factors for hospitalization. Conclusions: Accidental poisonings occurred most frequently by ingestion of household medications and cleaning products, especially among children under 4 years-old. Preventive strategies should be primarily directed for this prevalent profile.

Dialogic educational practices in the context of child intoxication: an approach based on Paulo Freire

“…Professionals mentioned little involvement in activities to prevent child intoxication and were unaware of the reality of the families concerning intoxication, as the third thematic category showed. Considering these premises, child intoxication has been discussed as an event where the values and beliefs of a family are important causal factors -the existence of toxic plants around the houses to "protect the family", the use of highly toxic cleaning products to diminish the personal effort spent in cleaning, the self-medication and storage of drugs at home (4,27) .…”

“…The home can be especially unsafe for children, since it contains objects and materials that offer risk in all of its rooms. This is especially true with regard to the diversity of chemical products, which favor intoxication and are mostly stored in places that the child can easily access (3)(4) .…”

Poisoning in Children and adolescents assisted during the COVID-19 pandemic at the Toxicological Information and Assistance Center in Federal District, Brazil (CIATOX -DF): Descriptive, Cross-sectional, and Analytical study with 1.037 patients

“…In pediatrics, they are listed as one of the most common causes in emergency care (Oliveira & Suchara, 2014) (Farnaghi et al, 2016) and are the second most common cause of child death in these scenarios, second only to car accidents (Farnaghi et al, 2016). Therefore, accidental poisoning is a worldwide public health problem, corresponding to approximately 45 thousand annual deaths with an incidence of 1.8 per 100 thousand inhabitants (Vilaca et al, 2020).…”

“…Considering the prevalence of poisoning in the home environment (90%) (Vilaca et al, 2020), the social isolation as a consequence of the current situation of the COVID-19 pandemic raises concerns about the possibility of an increase in accidental poisoning among children during this period, since they spend most of their time at home. Therefore, the present study aims to evaluate data on exogenous poisoning in children under ten years of age and adolescents aged 11 to 20 years old from February to September 2020, during the COVID-19 pandemic period, and demonstrating its relevance for possible prevention intervention.…”

Availability and Storage of Hazardous Products in Households in the Metropolitan Region of Manaus: A Population-Based Survey, 2015

“…9 In 2013, 73% of the patients treated for poisonings in a Brazilian Poison Control Center were children aged ≤5; cleaning products were the second most frequent cause of poisonings, which mostly occurred at home. 10 Childhood poisonings show higher lethality in low-and middle-income countries, because they are associated with poverty and weaker market regulations. 11 Illegal products, with hazardous substances in their formulations, also play a role in poisoning exposures among children, leading to systemic symptoms and high number of hospital admissions.…”