Preventing Childhood Poisoning

by Food and Drug Administration (FDA)

Most people regard their home as a safe haven, a calming oasis in an often stormy world.

But home can be a dangerous place when it comes to accidental poisoning, especially accidental poisoning of children. One tablet of some medicines can wreak havoc in or kill a child.

Childhood poisonings caused by accidental overdoses of iron-containing supplements are the biggest concern of poison control experts, consumer protection groups, and health-care providers. Iron-containing supplements are the leading cause of pediatric poisoning deaths for children under 6 in the United States. According to the American Association of Poison Control Centers, from 1986 to 1994, 38 children between the ages of 9 months and 3 years died from accidentally swallowing iron-containing products. The number of pills consumed by these children varied from as few as five to as many as 98.

In the Jan. 15, 1997, Federal Register, FDA published final regulations that will make it harder for small children to gain access to high-potency iron products (30 milligrams of iron or more per tablet). FDA has also taken steps to ensure that health-care providers and consumers are alerted to the dangers associated with accidental overdoses of iron-containing products, including pediatric multivitamin supplements that contain iron.

Although iron poisoning is the biggest concern when it comes to childhood poisoning, there is also concern about other drugs.

"Over-the-counter diet pills have the potential to be lethal to children, as do OTC stimulants used to keep you awake and decongestant tablets," says George C. Rodgers, M.D., Ph.D., medical director of the Kentucky Regional Poisoning Center. "Tofranil [imipramine], an antidepressant drug also used for childhood bedwetting, and Catapres [clonidine], a high blood pressure medicine, can be very hazardous because it takes very little to produce life-threatening problems in children. One tablet may do it.

"Antidepressant drugs have a high degree of toxicity," he continues. "They are cardiac and central nervous system toxins, and it doesn't take much of them to do harm, particularly in children. They are prescribed fairly ubiquitously. One of the things we look at when we get kids' poisonings is who had the medicine, and why."

Rodgers also urges extra caution when antidepressant drugs are prescribed for teenage patients who may have behavioral or emotional problems.

"Antidepressant drugs are commonly given to adolescents with behavioral problems, and often a month or two-month supply is prescribed. Teens should not be given more than a week's supply to begin with, and parents need to monitor their usage," he says.

The marketing of pediatric vitamins is also a cause of concern for Rodgers.

"Because they're marketed to look like candy or cartoon characters, it looks like candy and doesn't seem like medicine," he explains.

In addition, children frequently mimic the behavior of their parents. Children who watch their parents take pills may want to do it, too — with potentially fatal results.

Poison-Proofing Your Home

Poison-proofing your home is the key to preventing childhood poisonings. In the case of iron-containing pills or any medicine:

• Always close the container as soon as you've finished using it. Properly secure the child-resistant packaging, and put it away immediately in a place where children can't reach it.
• Keep pills in their original container.
• Keep iron-containing tablets, and all medicines, out of reach — and out of sight — of children.
• Never keep medicines on a countertop or bedside table.
• Follow medicine label directions carefully to avoid accidental overdoses or misdoses that could result in accidental poisoning.

For other substances, buy the least hazardous products that will serve your purposes. When buying art supplies, for example, look for products that are safe for children. For hazardous products such as gasoline, kerosene, and paint thinners that are often kept on hand indefinitely, buy only as much as you need and safely get rid of what you don't use. Never transfer these substances to other containers. People often use cups, soft-drink bottles, or milk cartons to store leftover paint thinner or turpentine. This is a bad idea because children associate cups and bottles with food and drink.

The kitchen and bathroom are the most likely unsafe areas. (Medicines should never be stored in the bathroom for another reason: a bathroom's warm, moist environment tends to cause changes or disintegration of the product in these rooms.) Any cabinet containing a potentially poisonous item should be locked.

"Bathrooms with medicines, kitchens with cleaning products, even cigarette butts left out, can be toxic to kids," Rodgers explains. "And remember that child-resistant caps are child-resistant, not childproof. The legal definition is that it takes greater than five minutes for 80 percent of 5-year-olds to get into it: that means 20 percent can get in in less time! Kids are inventive, and can often figure it out. And leftover liquor in glasses on the counter after parties? Don't do it!"

Alcohol can cause drunkenness as well as serious poisoning leading to seizures, coma, and even death in young children. Children are more sensitive to the toxic effects of alcohol than are adults, and it doesn't take much alcohol to produce such effects. Alcohol-laced products, such as some mouthwashes, aftershaves or colognes, can cause the same problems.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.