ACCIDENTAL POISONING OF CHILDREN AND THE EFFECT OF CHILD-RESISTANT PACKAGES

Objective: Annually in the Netherlands (15.9 million inhabitants), approximately 1850 children, aged zero to five years need to be hospitalized and 1200 children need treatment at a First Aid and Emergency department following an accidental intoxication. Despite the introduction in the Netherlands of guidelines on childproof packaging of household chemicals (1986) and medicines (1990), intoxications still occur with child-resistant products. The aim of this study is to increase insight into the causal factors of accidental intoxications of children aged zero to five years in the Netherlands and to assess the role of child-resistant packages. The results will be used to formulate recommendations, which can help to improve the policy regarding child-resistant packages. Methods: An analysis of the database of the National Poisons Control Centre on poisonings was performed in order to assess the product groups which are most frequently involved in causing exposure in children. After this analysis a telephone inquiry was carried out among parents/guardians of children aged 0-6 years, who had been exposed to these product groups and consulted a general practitioner. Results: Medicines (39%), household products (21%) and cosmetics (7%) are most frequently involved in causing exposure in children. Pesticides are less frequently involved but are potentially very hazardous. In total 600 telephone inquiries with parent/guardians were held in the period May-November 1999. The average age of the children was 25.4 months (1.7 years). Practically always someone was present to watch over the child (94%). However, most accidents occurred when the parent or guardian left the room where the child was (54%). The product was often readily available for the child (77%), mostly due to the fact that the product was in use (37%) or had not been put away (21%). At the time of the accidents, only a quarter of the products were stored properly. At the time of the accidents, 55% of the products were in a closed container only 8% of which had a childproof closure. The majority (60%) of these childproof products could be opened by the children in the correct manner. In addition, another 11% of the child-resistant closures were malfunctioning or broken. Conclusion: The product was often readily available for the child, because most of the time it was being used. In order to reduce the number of intoxications in these children, attention should be focused on general public information regarding the use and easy availability of these consumer products in housekeeping. Furthermore, products that legally require childproof closures should be sold in properly designed packages. Vriend I(1), Hertog PC den(1), Vriesman MF(2), Vries I de(2), Zoelen GA van(2), Mulder S(1), Meulenbelt J(2) (1) Consumer Safety Institute, PO Box 75169, 1070 AD Amsterdam, The Netherlands (2) National Institute of Public Health and the Environment, National Poisons Control Centre, PO Box 1, 3720 BA Bilthoven, The Netherlands