Characterizing risk factors for pediatric lamp oil product exposures

Abstract

Poisonings from lamp oil ingestion continue to occur worldwide among the pediatric population despite preventive measures such as restricted sale of colored and scented lamp oils. This suggests that optimal prevention practices for unintentional pediatric exposures to lamp oil have yet to be identified and/or properly implemented. Objective To characterize demographic, health data, and potential risk factors associated with reported exposures to lamp oil by callers to poison centers (PCs) in the US and discuss their public health implications. Study design . This was a two part study in which the first part included characterizing all exposures to a lamp oil product reported to the National Poison Data System (NPDS) with regard to demographics, exposure, health, and outcome data from 1/1/2000 to 12/31/2010. Regional penetrance was calculated using NPDS data by grouping states into four regions and dividing the number of exposure calls by pediatric population per region (from the 2000 US census). Temporal analyses were performed on NPDS data by comparing number of exposures by season and around the July 4th holiday. Poisson regression was used to model the count of exposures for these analyses. In the second part of this project, in order to identify risk factors we conducted a telephone-based survey to the parents of children from five PCs in five different states. The 10 most recent lamp oil product exposure calls for each poison center were systematically selected for inclusion. Calls in which a parent or guardian witnessed a pediatric lamp oil product ingestion were eligible for inclusion. Data on demographics, exposure information, behavioral traits, and health were collected. A descriptive analysis was performed and Fisher’s exact test was used to evaluate associations between variables. All analyses were conducted using SAS v9.3. Results Among NPDS data, 2 years was the most common patient age reported and states in the Midwestern region had the highest numbers of exposure calls compared to other regions. Exposure calls differed by season (p<0.0001) and were higher around the July 4th holiday compared to the rest of the days in July (2.09 vs. 1.89 calls/day, p<0.002). Most exposures occurred inside a house, were managed on-site and also had a “no effect” medical outcome. Of the 50 PC-administered surveys to parents or guardians, 39 (78%) met inclusion criteria for analysis. The majority of ingestions occurred in children that were 2 years of age, that were not alone, involved tiki torch fuel products located on a table or shelf, and occurred inside the home. The amount of lamp oil ingested did not appear to be associated with either the smell (p = 0.19) or the color of the oil (p = 1.00) in this small sample. Approximately half were asymptomatic (n = 18; 46%), and of those that reported symptoms, cough was the most common (n = 20, 95%) complaint. Conclusions Lamp oil product exposures are most common among young children (around 2 years of age) while at home, not alone and likely as a result of th...

Predictors of Clinical Decision Rule in Hydrocarbon Intoxicated Cases Admitted to Poison Control Center Ain Shams University Hospitals during 2015-2016

“…The highest rates of morbidity and mortality result from accidental ingestion by children younger than 5 years in US (Makrygianni et al, 2016). Sheikh et al (2013), found that upon ingestion in US, 35-54% of children are symptomatic. This is because hydrocarbon aspiration may cause death secondary to respiratory failure in this pediatric population.…”

“…Among hydrocarbons those with low viscosity and surface tension, such as kerosene, lighter fluid, lamp oil, and naphtha, are frequently associated with clinically significant effects on the respiratory system. Chemical pneumonitis, respiratory distress, and a variety of air-leak syndromes may occur (Sheikh et al, 2013). In a study made by Makrygianni et al (2016) in US, aspiration pneumonitis occurred in approximately 15% of ingestions, and evolves over the first 6-8 hours Chest radiographic abnormalities develop by 4-8 hours after ingestion, but they are not always predictive of clinical pneumonitis.…”

Social determinants of health associated with childhood accidents at home: An integrative review

“…It is found that, in general, accidents are less frequent among children under one. In the context of the AH caused by a specific cause, the poisonings or intoxications were also analyzed from the age of the child in seven surveys (18,21,(26)(27)30,32,41) . The same analysis was performed in cases of accidental drowning/submersion injuries in childhood (33) and television falling on the child (37) .…”

“…Behavioral factors, especially those related to the lack of adult supervision, were identified in a large part of the articles analyz ed (18,23,(25)(26)(28)(29)(30)(31)(32)(33)(36)(37)39,41,43,48) . The main AHs that were related to this determinant were: intoxications; falls and burns (18,21,26,30,32,41,48) . In such contexts, direct adult supervision is one of the protective factors to prevent childhood accidents.…”

“…In the third theoretical category, "Distal Social Determinants of Health", 27 articles referred to aspects of living and working conditions, general socioeconomic, cultural and environmental conditions identified in the employment of the father/ mother (18,20,(22)(23)(30)(31) , housing (18)(19)(21)(22)(23)(28)(29)(30)(32)(33)(35)(36)(37)39,43,47) , access to health services (19,(21)(22)38) , cultural factors (18,28,30,41,43) , living conditions (19)(20)(22)(23)28,(39)(40)44) , social factors (18)(19)22,26,36,(39)(40)(42)(43) , economic factors (18)…”