Citation

Mintegi S, Azkunaga B, Prego J, Qureshi N, Dalziel SR, Arana-Arri E, Acedo Y, Martinez-Indart L, Urkaregi A, Salmon N, Benito J, Kuppermann N. Pediatr. Emerg. Care 2019; 35(1): 50-57.

Affiliation

From the *Pediatric Emergency Department, Cruces University Hospital, University of the Basque Country, Bilbao, Basque Country, Spain; †Research in European Paediatric Emergency Medicine (REPEM), London, UK; ‡Departamento de Emergencia Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay; §Cardinal Glennon Children's Hospital, St Louis University, St Louis, MI; ∥Children's Emergency Department, Starship Children's Hospital, and Liggins Institute, University of Auckland, Auckland, New Zealand; ¶Paediatric Research in Emergency Departments International Collaborative (PREDICT), Parkville, Victoria, Australia; #Clinical Epidemiology Unit, Cruces University Hospital, BioCruces Health Research Institute, Basque Country, Spain; **University of the Basque Country, Leioa, Spain; ††Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA; and ‡‡Pediatric Emergency Care Applied Research Network (PECARN), Rockville, MD.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0000000000001031

PMID

28121975

Abstract

BACKGROUND AND OBJECTIVE: Identifying international differences in the epidemiology of acute poisonings in children may help in improving prevention. We sought to evaluate the international epidemiological differences in acute poisonings in children presenting to emergency departments (EDs) from 8 different global regions.

METHODS: This was an international multicenter cross-sectional prospective study including children younger than 18 years with acute poisonings presenting to 105 EDs in 20 countries was conducted. Data collection started at each ED between January and September 2013, and continued for 1 year.

RESULTS: During the study period, we registered 363,245 pediatric ED presentations, of which 1727 were for poisoning (0.47%; 95% confidence interval, 0.45%-0.50%), with a significant variation in incidence between the regions. Full data were obtained for 1688 presentations. Most poisonings (1361 [80.6%]) occurred at home with either ingestion (1504 [89.0%]) or inhalation of the toxin (126 [7.6%]). Nonintentional exposures accounted for 1157 poisonings (68.5%; mainly in South America and Eastern Mediterranean region), with therapeutic drugs (494 [42.7%]), household products (310 [26.8%]), and pesticides (59 [5.1%]) being the most common toxins. Suicide attempts accounted for 233 exposures (13.8%; mainly in the Western Pacific region and North America), with therapeutic drugs (214 [91.8%], mainly psychotropics and acetaminophen) being the most common toxins. Significant differences between regions were found in both types of poisonings. Recreational poisonings were more common in Europe and Western Pacific region. No patient died.

CONCLUSIONS: There are substantial epidemiological differences in acute poisonings among children in different countries and regions of the globe. International best practices need to be identified for prevention of acute poisonings in childhood.

Language: en