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Poison prevention practices and medically attended poisoning in young children: multicentre case–control study

Abstract

Introduction Childhood poisonings are common, placing a substantial burden on health services. Case–control studies have found inconsistent evidence about modifiable risk factors for poisonings among children aged 0–4 years. This study quantifies associations between poison prevention practices and medically attended poisonings in children aged 0–4 years.

Methods Multicentre case–control study conducted at hospitals, minor injury units and family practices from four study centres in England between 2010 and 2013. Participants comprised 567 children presenting with unintentional poisoning occurring at home and 2320 community control participants matched on age, sex, date of event and study centre. Parents/caregivers provided data on safety practices, safety equipment use, home hazards and potential confounders by means of self-completion questionnaires. Data were analysed using conditional logistic regression.

Results Compared with community controls, parents of poisoned children were significantly more likely not to store medicines out of reach (adjusted OR (AOR) 1.59; 95% CI 1.21 to 2.09; population attributable fraction (PAF) 15%), not to store medicines safely (locked or out of reach (AOR 1.83; 95% CI 1.38 to 2.42; PAF 16%) and not to have put all medicines (AOR 2.11; 95% CI 1.54 to 2.90; PAF 20%) or household products (AOR 1.79, 95% CI 1.29 to 2.48; PAF 11%) away immediately after use.

Conclusions Not storing medicines out of reach or locked away and not putting medicines and household products away immediately after use increased the odds of secondary care attended poisonings in children aged 0–4 years. If associations are causal, implementing these poison prevention practices could each prevent between 11% and 20% of poisonings.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Correction notice This article has been corrected since it was published Online First. In Table 3, the values in the ‘Cases’ and ‘Community controls’ columns have been updated for rows ‘Medicines’ – ‘All put away immediately after use4’ and ‘Household products’ – ‘All put away immediately after use4’.

  • Contributors DK, CC, MH and RR designed the study and GM-N, PB, CT, TG and AH contributed to study design. DK and RR supervised the study. GM-N, PB, CT, TG and AH collected data. DK, GM-N, PB, CC and CT analysed data and all authors interpreted data. DK, GM-N, PB and CT drafted sections of the manuscript. All authors critically reviewed the manuscript and approved the final manuscript.

  • Funding This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (RP-PG-0407-10231). The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Ethics approval Nottinghamshire research ethics committee 1 (09/H0407/14).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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