· Poisoning is the third leading cause of pected poisoning – over 26,000 of these
unintentional injury death in the WHO were under five years old7. About 20% of
European Region. Each year 3,000 those who presented were admitted to
young children aged 0 to 14 die of acute hospital, a very high proportion of admis-
poisoning1. Children 5 years and under sions when compared with other types of
account for the majority of all poison accidents. The agent involved in the
exposures with children up to two years poisonings was a medication 69% of the
old especially vulnerable2. time – a quarter of those being commonly
used drugs such as analgesics. In the
· The term poisoning is used when cells same year 6 children died of accidental
are injured or destroyed by inhalation, poisoning.
ingestion, injection or absorption of a
toxic substance. · A study of 100 cases of unintentional
poisoning involving children in Athens,
· Curiosity and the desire to put everything Greece who were brought to the emer-
in their mouths place young children at gency clinics of the two children’s hospi-
considerably greater risk for poison tals also showed that medicinal products
exposure than adults. Children will eat or were implicated in the majority of acci-
drink anything regardless of how it tastes. dental poisonings (58%)8. A surprising
They like things that smell good and are finding in the same study was that chew-
drawn to attractive packaging and the ing and swallowing cigarettes was re-
colourful substances of many of the sponsible for 15% of the childhood poi-
products found around the home3. soning injuries with the risk of poisoning
increasing when one or both of the par-
ents were smokers.
· When exposed to poison, children are
more likely to suffer serious conse-
quences because they are smaller, have · A study found that 23% of the oral pre-
faster metabolic rates and their bodies scription drugs that were ingested by
are less capable of neutralising toxic children under 5 belonged to someone
chemicals3. who did not live with the child. Overall,
17% of the medicines ingested belonged
to a grandparent or great-grandparent6.
· More than 90% of all poisonings occur
within the home environment and many
common household products can poison · Products to watch out for 9:
children, including cleaning supplies,
alcohol, plants, pesticides, medicines, · Pills, medicine: Aspirin and other pain
and cosmetics4. Cigarettes and tobacco or cold medications, prescription medi-
can also cause sickness if eaten and cines, vitamins, diet pills, and diet sup-
should be kept well out of the reach of plements.
young children. · Bathroom: Cleaners, sprays, perfume,
cologne, hairspray, and mouthwash.
· Most poisonings occur when the product · Household products: Cleaners, pol-
is being used5. ishes, solvents, and products with lye
· Garage, work room: Insect sprays,
· Every year in the Netherlands a child
lamp oil, kerosene, lighter fluid, turpen-
between the ages of 0 to 5 dies from
tine, paint, glue, batteries, tire fluid and
poisoning and 1,600 children in this age
group are admitted to a hospital due to
· Laundry room: Detergents, bleach,
serious cases of poisoning6. Almost all of
fabric softeners, and pet products.
the poisonings occur in the home and a
· Outdoors: Fertilizers, pesticides,
caregiver was present in 94% of inci-
plants, and berries.
dents. In the majority of the cases the
child was under limited supervision due to
· While poisoning incidents are often
circumstances or other duties being
perceived as mainly due to unintentional
performed by the caregiver at the time of
ingestion by young children, a significant
number of poisonings are also due to
adolescent suicide attempts, via over-
· In 2002 in the United Kingdom almost doses of narcotics and psychodysleptics
31,500 children under 15 years of age (hallucinogens)3.
went to the hospital because of a sus-
· Carbon monoxide, an odourless and carbon monoxide poisoning to its pres-
colourless gas that is produced during any ence. Persons with these detectors are
combustion process, is also a cause of less likely to become symptomatic from
poisoning. The symptoms of carbon the exposure than those who do not have
monoxide poisoning are similar to early these detectors in the home15.
signs of the flu and include: fatigue, chest
pain in people with heart disease, head- · Poison Control Centre and Hotline – in
ache, nausea, dizziness, confusion, and the United States it has been shown that
impaired vision and coordination. Carbon for every dollar spent on poison control
monoxide poisoning can be fatal at high services an estimated $7 was saved in
concentrations and it is estimated that in medical care payments by reducing the
the United Kingdom carbon monoxide number of medically treated poisonings11.
from furnaces and heaters is responsible The savings per poisoning call were $175.
for almost a death a week in the winter10.
Recommended Policy Actions
· Total medical spending for the treatment
of poisonings in the United States is Legislation
estimated at $3 billion a year with an
average of $925 spent per case11. · For the European Commission to monitor
and enforce European Union policy requir-
Prevention Effectiveness ing Member States to adopt and enforce
the compulsory use of child resistant
There is increasing evidence that the follow- packaging for pharmaceutical products
ing measures to prevent poisonings in such as children’s aspirin and paraceta-
children should be implemented, enforced mol preparations, as well as for non-
and communicated to the European public: pharmaceutical products.
· Child resistant packaging - introduction · For the European Commission to encour-
of regulations enforcing the compulsory age the adoption of modified building code
use of child resistant packaging for all regulations in Member States to require
children’s aspirin and paracetamol prepa- new buildings to provide a lockable stor-
rations led to a dramatic fall in the number age cabinet in each apartment or home,
of children admitted to hospital with unin- as well as carbon monoxide monitors.
tentional poisoning as a result of these
medications in England, The Netherlands EU Collaboration
and the United States. This type of pack-
aging would also be beneficial for specific · For the European Commission to support
non-pharmaceutical products12. a European campaign on the topic of child
poisoning prevention which delivers key,
· Safe storage - placing household clean- consistent messages across Europe about
ers, chemicals and medications in a the use of and safe storage of cleaners
locked storage cabinet or using child and chemicals in convenient and lockable
protective products to lock the cupboards units, the importance of child resistant
and drawers have been an effective packaging, as well as improve the com-
means of preventing poisoning13. munity’s awareness of poison dangers.
· Education - a school and parent educa- · For poison centres in Europe to standard-
tion campaign to make toxic household ise and link their data on poisoning inju-
products less accessible to children, ries in order to make recent statistics
accompanied by media to promote pur- available and detailed.
chasing and using safer products and
locked cabinets resulted in a 66% de- · For industry to have child poisoning pre-
crease in admissions to the emergency vention in mind when designing products
department for 0 – 5 year olds compared so that products are not attractive to
with two pre-intervention years and to children and are more resistant to access
control comparison sites14. by children.
· Monitoring of air quality - carbon mon-
oxide detectors with audible alarms are
effective in alerting potential victims of
1. The global burden of disease: 2004 update 13. Harbourview Injury Prevention and Research
Geneva, World Health Organization, 2008 Center/Cochrane Collaboration, Systematic
(http://www.who.int/healthinfo/ Review Database. Seattle, University of
global_burden_disease/2004_report_update/ Washington, 2001.
en/index.html, accessed 10 November 2008).
14. Fisher L. Community based interventions-less
2. World Health Organisation, World Health Or- than perfect? Inj Prev 2004; 10:255
ganisation Mortality Database. Geneva: World
Health Organisation. Accessed May 18, 2005. 15. Krenzelok E, Roth R, Full R. Carbon monox-
http://www.who.int/whosis, 2003. ide...the silent killer with an audible solution.
Am J Emerg Med 1996; 14(5):484-6.
3. National SAFE KIDS Campaign (NSKC). Poi-
soning Fact Sheet. Washington (DC): NSKC, (Printed October 2009)
4. Confederation of European Specialists in
Paediatrics. EURECAAP survey: European
Evaluation of Children’s and Adolescents’
Accidents Prevention Policies. Luxembourg,
5. Consumer Safety Institute, Warning: - Poison-
ing Factsheet 0-5 year olds. Amsterdam: Con-
sumer Safety Institute. Accessed September
20, 2005. http://www.childsafetyeurope.org/
6. Northeast Injury Prevention Network Poison
Data Book, Children's Safety Network Eco-
nomics and Data Analysis Resource Center,
7. Child Accident Prevention Trust, 2004, Fact-
sheet: Poisonings. London: Child Accident
Prevention Trust. Accessed May 22, 2005.
8. Petridou E, Polychronopoulou A, Kouri N, et
al. Childhood poisonings from ingestion of
cigarettes. Lancet. 1995 Nov 11;346
9. D'Alessandro D, Huth L, 2002, Pediatrics
Common Questions, Quick Answers. How to
Prevent Poisoning. Virtual Children’s Hospital.
Accessed May 21, 2005. http://www.vh.org/
10. Royal Society for the Prevention of Accidents,
1998, Press Release Carbon Monoxide Warn-
ing For Winter. Accessed May 21, 2005.
11. Miller T, Lestina D. Costs of poisoning in the
United States and savings from poison control
centers: a benefit-cost analysis. Ann Emerg
Med 1997; 29(2):239-45.
12. Vincenten J, Farquhar B. A guide to child
safety regulations and standards in Europe.
Amsterdam, ECOSA, 2003.
The European Child Safety Alliance is a Programme of EuroSafe and is hosted by the Consumer Safety Institute in the Netherlands
PO Box 75169 1070 AD Amsterdam The Netherlands Tel. +31 20 511 45 13 Fax +31 20 511 45 10