Perspectives in Disease Prevention and Health Promotion Unintentional Poisoning Among Young Children -- United States

The Poison Prevention Packaging Act of 1970* provides that certain potentially hazardous drugs and household products be sold in child-resistant containers. Since this act has been implemented, reported incidents of children ingesting regulated products, such as aspirin and aspirin substitutes, lighter fluids, oven cleaners and other lye preparations, and antifreeze, have declined (1).

From 1974 to 1981, U.S. Consumer Product Safety Commission (CPSC) estimates of regulated products ingested by children under 5 years of age that prompted emergency room (ER) visits decreased from 48,000 (2.9/l,000 population under 5 years) to 34,000 (2.0/1,000).** During the same period, estimated ER visits for children under 5 years old prompted by ingestion of unregulated products increased from 51,000 (3.2/1,000) to 56,000 (3.3/1,000) (2).

Morbidity and mortality data from unintentional ingestions of aspirin and aspirin substitutes, often used to measure the effect of child-resistant containers (3), have dramatically decreased. Such ingestions by young children as reported by poison control centers have declined 65% since the act was introduced (1); mortality among children under 5 years old declined from 58 in 1970 to 18 in 1978--a 69% reduction (2,4).

Despite these advances, unintentional poisoning remains a significant public health concern. In 1981, an estimated 90,000 children under 5 years old received ER care because of ingested hazardous substances (2). *Administered by the U.S. Consumer Product Safety Commission. **These estimates are based on data from 73 representative U.S. hospital emergency rooms, which comprise CPSC's National Electronic Injury Surveillance System.

Unintentional carbon monoxide (CO) intoxication remains a major environmental hazard for all age groups (5), and for reasons not fully understood, CO-related fatalities have increased among young children. CO deaths among children under 5 years old increased 143% from 1973 to 1978 (from 14 to 34 cases); during the same period, CO deaths among persons over 5 years old increased 5% (from 1,235 to 1,295 cases) (2,6).

Pediatric lead poisoning is still a problem in the United States. In fiscal year 1981, over 500,000 children were reportedly screened for this condition, and nearly 22,000 (4.1%) had lead toxicity. Medical care and environmental intervention were required to identify and reduce the sources of lead exposure for these children (7). Reported by Southeastern Regional Office, US Consumer Product Safety Commission; Environmental Health Svcs Div, Center for Environmental Health, CDC.

Editorial Note

Editorial Note: March 20-26, 1983, is National Poison Prevention Week (PPW). This campaign, held annually since Congress mandated it in 1962, alerts Americans to the problem of unintentional poisoning among children. PPW is sponsored by the PPW Council, a nonprofit group of trade associations, health and safety groups, and federal agencies that provides educational programs and materials for health professionals and the public designed to reduce unintentional poisonings among children.

Although unintentional ingestions and deaths have dropped significantly since child-resistant packaging was introduced, many preventable ingestions and deaths still occur among young children. Causes include failure to correctly use child-resistant packaging, improper storage of poisonous substances, and ignorance of proper emergency steps to take when ingestion of hazardous substances occurs.

Members of the PPW Council are currently involved in the following major activities:

1. CPSC held a public hearing in Washington, D.C., on March 10, 1983, concerning proposed changes in tests for child-resistant closures.

2. CPSC Regional Offices are holding seminars for pharmacists and physicians to emphasize the importance of using child-resistant closures in compliance with the Poison Prevention Packaging Act. Seminars will take place in Ft. Mitchell and Midway, Kentucky, on March 29 and April 26, respectively. Additional seminars are being scheduled in Georgia during April and in other states in the future.

3. The American Association of Poison Control Centers is promoting the message "Know Your Poison Control Center Number." There are more than 600 Poison Control Centers in the United States, which are equipped to provide quick and accurate instructions for dealing with poisoning incidents. Phone numbers for these centers are generally listed with other emergency numbers in the white pages of the phone book.

4. Through workshops, school programs, and the media, many PPW Council agencies are providing information to consumers on proper storage of hazardous substances, the importance of child-resistant packaging, and the services of local poison control centers.

References

1. Steorts NH. National poison prevention week announcement. Washington D.C.: U.S. Consumer Product Safety Commission, February 1983.

2. National Safety Council. Accident facts, 1982. Chicago: National Safety Council 1982.

3. Garrettson LK. The child resistant container: a success and a model for accident prevention (editorial). Am J Public Health 1977;67:135-6.

4. National Safety Council. Accident facts, 1974. Chicago: National Safety Council 1974.

5. CDC. Carbon monoxide intoxication--a preventable environmental health hazard. MMWR 1982;31:529-31.

6. National Safety Council. Accident facts, 1975. Chicago: National Safety Council 1975.

7. CDC. Lead poisoning. In: Annual summary 1981: reported morbidity and mortality in the United States. MMWR 1982;30:112-3.

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