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Home Safety Practices for Prevention of Poisoning in Young Children
1.0 INTRODUCTION
Poisoning in young children is defined as unintentional ingestion of medication and common household products J. Nixon et al. 2004.
Poisoning in young children is a preventable cause of mortality and morbidity Laffoy M., 1997. Poisonings account for 2 of the accidental deaths in developed countries and for
5 in developing countries Nadarajah P., 2004.
Most poisoning accidents occur in children aged between 1 to 4 years 48.5 in the study by Sibel E. and Sukran S. 2006 and 60.3 according to FDA’s Poisoning Surveillance and
Epidemiology Branch 1981.
Around 80-85 poisoning accidents occur in the home B. Jacobson et al. 1989. Children under the age of 5 are in a stage of development where they constantly explore
their home environment. This is a normal characteristic and should not be restricted. Unfortunately they usually put whatever they see or reach in their mouth A. W. Craft,
1990.
Most of the poisoning accidents 49.5 stemmed from storing of drugs within the reach of children. Out of these accidents, 49.5 were due to drugs, 17.5 due to cleaning agents
and 16.5 due to insecticidespesticides Sibel E. et al. 2006.
In a study on home safety in the United States, although most families reported locked storage of medications, 77 had unlocked storage of medication documented during
home observation Kimberly E. et al. 2007.
Medications involved in suspected poisoning were most frequently packed in containers without Child Resistant Containers CRC 63 or transparent blisters 20. However safe
packaging cannot compensate for unsafe storage. Bathroom and kitchen cabinets and drawers are the safest place to store medication H. M. Wiseman et al. 1987.
The concept of CRC is widely supported by parents as an important mechanism for protecting children from toxic products. However the support for CRCs was often based
on the notion that they were childproof rather than child resistant. As a result some parents were more likely to store products unsafely if they were in CRCs L. Gibbs et al. 2005.
CRC is defined by the Poison prevention Packaging Act to be packaging that is “difficult for children under age of 5 years to open” but “not difficult for normal adults to use properly”.
US Consumer Product Safety Commission CPSC regulations require that certain drugs be packaged in special containers that would prevent at least 80 of those children younger
than 5 years old from opening the container within 10 minutes CPSC Federal Register 1983. Oral prescription drugs became subject to Child Resistant Packaging requirements
since 1974 in the US. Introduction of CRC resulted in 47 reduction in the incidence of
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Home Safety Practices for Prevention of Poisoning in Young Children
paraffin poisoning in the study community compared to the control community Krug et al. 1994.
Safe storage of toxic products should be in a locked cabinet or cupboard out of reach if possible in the kitchen or bathroom L. Gibbs et al. 2005. Safe disposal according to the
National Drug Control Policy Federal Guidelines Washington DC for unneeded or expired prescription drug should be taken out of their original container and thrown into the
trash, returned to a community pharmaceutical take back program or flush down the toilet if the label instructs so.
Other implementation measure, besides safe storage and disposal practices and CRC, is parental education and improved supervision by parents. In rendering the child’s
environment safe, the family’s education especially that of the mother is vital Stewart J., 2001. 67 of the children involved in a poisoning accident were under the supervision
of their mothers at the time of the accident Sibel E. et al. 2006. 69 of mothers claimed to have taken measures to prevent future poisoning accidents in their homes however
there was no mention at all of basic precautions such as storage in locked cupboards which are out of reach of children. This proves the necessity for educational measures in
the families Sibel E. et al. 2006.
In summary, a combination and not a single home poison safety strategy is needed to reduce accidental poisoning in young children. The strategies are:
1. Safe storage practices.
2. Efficacious CRC and Child Safety Devices.
3. Safe disposal practices.
4. Parent education.
5. Responsible supervision of children by caregiver at all times.
1.1 Problem Statement
The number of cases of accidental poisoning admitted to government hospital is static with no reduction over the years. There are no available local studies assessing
the knowledge of caregivers or home poison safety practices. There is also no CRC or Child Safety Device in regular use in our local setting.
Based on international data, only 20 of homes are safe in terms of preventing an accidental poisoning and we assume this is the case in our setting as well.
Here is a table showing the number of admissions to government hospitals in Malaysia due to poisoning by drugs, medicaments and biological substances in the
1-4 years age group. Data was obtained from Admissions and Deaths in Government Hospitals due to Injury in Malaysia 1999-2002.
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