Suspected paediatric pesticide poisoning in the UK. II--Home Accident Surveillance System 1989-1991

Accidental Childhood Poisoning in Enugu, South-East, Nigeria

Background:

Accidental childhood poisoning is one of the recognized causes of morbidity and mortality in children under the age of 5 years worldwide. The prevalence and type of substance ingested vary from place to place and over time.

Aim:

This study was conducted with the aim of ascertaining the frequency and pattern of accidental childhood poisoning in Enugu.

Subjects and Methods:

This retrospective study was conducted at the Emergency Paediatric Unit of the University of Nigeria Teaching Hospital, Enugu, South-East, Nigeria from January 2003 to December 2012 (10 years). All the cases of childhood accidental poisoning that presented within the period were reviewed and important information extracted.

Results:

Sixty-five cases of childhood poisoning were recorded during the 10-year period, giving an incidence rate of 442 per 100,000 children. The mean age was 22.15 ± 11.7 months. Male:female ratio was 1.5:1. The prevalence was higher among those with low socioeconomic background. Kerosene poisoning was the most common agent. The overall mortality rate was 3.1% (2/65).

Conclusion:

Accidental childhood poisoning is common in Enugu, with appreciable mortality, with kerosene being the most common agent. We advocate regulatory policy on proper ways of storing kerosene and other harmful household chemicals and medications.

Homicidal poisoning by injection of methidathion: The first ever report

We present the first ever case of homicidal poisoning due to injection of methidathion, an organophosphate insecticide. Case: A 4-month-old baby presented to the emergency department with chief complaints of unconsciousness and irregular respiration. A bitter odour and an injection site with a greenish blue colouration and two bullaous lesions were noticed by the emergency department physicians. Postmortem examinations revealed a wide shiny blue colouration of the antecubital region with oedematous muscular fascia and focal liquefaction necrosis. Blood and tissue levels were positive for methidathion. Our case report emphasizes the necessity of a detailed crime scene investigation and postmortem examination for the possibility of homicide in such cases. Although injection sites may be the expected results of medical treatment, dermal lesions also may be associated with injections of toxic substances.

Socio-demographic characteristics of UK families using pesticides and weed-killers

Pesticides are widely used in the home and garden to kill insects, weeds and other unwanted pests. There is mounting evidence that this usage may also have health consequences particularly on children. Using the ALSPAC cohort of 13,391 families with self-reported usage data up to age 4 years of the study child, the main users of pesticides appeared to be older, Caucasian, better educated, have higher incomes and more likely to own their home or to belong to non-manual social classes compared to less frequent users. There was some suggestion that different factors may affect weed-killer compared to other pesticide use. In particular, income appeared unrelated to other pesticide use. This may reflect different attitudes to indoor compared to garden applications. Alternatively, it may reflect whether the main user was the mother or the partner. Some authorities are currently encouraging domestic users to consider other non-chemical means of pest control before using pesticides. These results may help in targeting particular groups if further reductions in pesticide usage are desired. They have also helped in identifying the important confounders for adjusting future analyses on the potential health consequences of pesticides and weed-killers.

Childhood and adolescence poisoning in NSW, Australia: an analysis of age, sex, geographic, and poison types

OBJECTIVE

This study aims to investigate whether there is any association between the types of poison substances and geographic locations for different age groups and sex.

DESIGN

This is a population based epidemiological study utilising routinely collected inpatient statistics.

SETTING

Data are collected as part of the routine vital health information system via all hospitals in New South Wales (NSW), Australia.

PATIENTS

All patients aged between 0-19 years who were admitted to a hospital because of poisoning by the four major types of substances that were defined in the study in NSW in 2000.

MAIN RESULTS

The standardised incidence ratios of poisoning related hospitalisation between metropolitan and rural areas varied across different poison types when compared with the NSW average. While there are few differences between metropolitan and rural areas for analgesic and chemical related poisoning admissions across different age groups and sex, differences in the standardised incidence ratios between geographic locations for psychotropic and venom related poisoning admissions were found. No significant difference in standardised mortality ratios were found between metropolitan and rural areas except for females in the 10-14 years age group (standardised mortality ratio 3.24, 95% confidence interval 1.69 to 6.21).

CONCLUSIONS

The results obtained in this study, on the whole, provide some evidence for an association between poison types and geographic locations for psychotropic and venom related poisoning.

Childhood poisoning in Queensland: an analysis of presentation and admission rates

OBJECTIVE

To determine the presentation rates for paediatric poisoning by ingestion and the determinants of hospital admission.

METHODOLOGY

Cross-sectional survey using an injury surveillance database from emergency departments in South Brisbane, Mackay and Mt Isa, Queensland, from January 1998 to December 1999. There were 1516 children aged 0-14 years who presented following ingestional poisoning.

RESULTS

The presentation rates for poisoning were 690, 40 and 67 per 100000 population aged 0-4, 5-9 and 10-14 years, respectively. The admission rates to hospital for poisoning were 144, 14 and 22 per 100000 population aged 0-4, 5-9 and 10-14 years, respectively. Although presentation rates for poisoning were higher in the rural centres the admission rates were disproportionately high for the 0-4 years age group. The agents most frequently ingested were paracetamol, Dimetapp, rodenticides and essential oils.

CONCLUSION

There is a need to design and implement interventions aimed at reducing poison exposures and unnecessary hospital admissions in the 0-4 years age group.