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Journal Article

Citation

Pilgrim JL, Jenkins EL, Baber Y, Caldicott D, Drummer OH. Addiction 2016; 112(4): 627-639.

Affiliation

Victorian Institute of Forensic Medicine, Victoria, Australia.

Copyright

(Copyright © 2016, John Wiley and Sons)

DOI

10.1111/add.13669

PMID

27766705

Abstract

BACKGROUND AND AIMS: Fatal poisonings in children comprise a small proportion of cases investigated by an Australian coroner; however, they present a major opportunity for death prevention. This study aimed to examine fatal child poisonings in Australia to 1) estimate the rate of acute poisoning deaths in children; 2) describe the key characteristics of the cohort; and 3) describe the outcomes of coronial recommendations made as a death prevention measure.

DESIGN: Retrospective case series. SETTING: The National Coronial Information System (NCIS), a database of cases reported to an Australian coroner. PARTICIPANTS: 90 poisoning deaths reported to an Australian coroner between January 2003 and December 2013 involving children (≤16 years of age). MEASURES: Logistic regression, Pearson's Correlation coefficient and descriptive statistics were used to examine the significance of associations. The primary outcome measures were poisoning type and cause of death. Covariates included age and mental illness.

FINDINGS: There were marginally more males (52.2%) (CI = 44.4-45.6) in the cohort and most occurred in the 13 to 16 years age group (58.9%) (CI = 7.5-12.5). Deaths were typically unintentional (61.1%) (CI = 17.9-27.1) and occurred in the home (68.9%) (CI = 6.8-15.7). The most common form of poisoning was due to opioids (24.4%), followed by carbon monoxide (20%), and volatile substances (18.9%) (CI = 18.5-19.6). Males had slightly higher odds of dying from prescription opioids compared with females (OR = 1.9, CI = 0.7-5.1), but this was not statistically significant. A recommendation was made by a coroner in 12 cases, of which 10 related to poisons (including drugs). Of these, 8 recommendations were implemented.

CONCLUSIONS: In Australia between 2003 and 2013 there were on average 8 acute poisoning deaths in children each year, most commonly involving prescription opioids and adolescents. There was a downward trend in mortality since 2003. These cases generatedmore than twice as many recommendations for public safety compared with other Australian coroners' cases.

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Language: en

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