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Child-resistant closure: yesterday, today and tomorrow
  1. Milton Tenenbein
  1. Correspondence to Dr Milton Tenenbein, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A1S1, Canada; mtenenbein{at}

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This is the 50th anniversary of the first child-resistant closure (CRC), the Palm N’ Turn, which was patented in 1967.1 This gives pause for reflection upon the strengths and shortcomings of this poison prevention intervention.

The CRC is the cornerstone of the US Poison Prevention Packaging Act (PPPA) of 1970.2 Within the PPPA is a schedule of hazardous substances (drugs and consumer products) requiring a CRC. Over the years, drugs and consumer products have been added to this schedule. The criteria for certification as a CRC are precise and are defined in the PPPA. Its thrust is that opening the container within a defined period of time must be significantly difficult for children less than 5 years old but not difficult for normal adults.

The CRC is Canada’s gift to injury prevention. Henri Breault MD, the director of the poison control centre in Windsor Ontario was disillusioned by 10 years of failure of education to reduce exploratory ingestion (formerly referred to as accidental ingestion or unintentional ingestion) by young children.3 The concept of a CRC had been discussed in the literature4 5 but had not gained traction. In 1964, Dr Breault founded the Ontario Association to Control Poisonings (OACP), an advocacy group consisting of physicians, pharmacists, industry and poison prevention advocates. The purpose of the OACP was to develop a CRC for medication containers.

They raised US$1500 which was used as prize money for a contest requesting CRC designs. There were over 200 submissions and the winner was Peter Hedgewick’s Palm N’ Turn. Mr Hedgewick had considerable expertise with custom plastic moulding and was a designer and manufacturer of unique tools for the automobile parts industry. He patented the Palm N’ Turn in 1967.1

Dr Breault then undertook a study of this CRC. The pharmacists …

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  • Contributors MT is the sole contributor of this commentary.

  • Competing interests None declared.

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