According to a paper published in the Journal of the American Medical Association for September 22/29, from paediatricians at Johns Hopkins school of medicine in Baltimore, more than one million children younger than six years are poisoned each year in the United States. The main categories of substances involved are cosmetics and personal care products, cleaning agents, analgesics, plants and cough and cold remedies. Deaths from accidental poisoning have significantly declined since the introduction of new formulations, child-resistant containers, increased parental awareness of the hazards, intervention by poison information centres, and special training of health professionals. More than half the fatalities of under-sixes are caused by pharmaceutical products.
Among serious pharmaceutical hazards have been iron-deficiency preparations, tricyclic antidepressants, cardiovascular medications, hypoglycaemic agents, narcotic analgesics and antimalarials, with iron supplements high on the list. It is estimated that the child-resistant packaging of aspirin and other oral medications has saved the lives of many thousands of children since the mid-1970s.
Among household products contributing materially to the picture of child poisoning are alcohols and glycols, hydrocarbons, solvents and paint-strippers, strong acids and alkalis, pesticides, nail products and food flavouring additives.
Treatments for poisoning are largely controversial. It is no longer recommended to keep ipecacuanha syrup available in the home, since it may impair the efficacy of activated charcoal and other oral antidotes. Home administration of activated carbon is recommended both in the US and in Europe. Gastric lavage is now regarded as obsolete, since it is traumatic and of non-proven efficacy. Cathartics are no longer advised as routine antidosis. Irrigation with balanced polyethyleneglycol solutions is useful to decontaminate the gut. There are now specific antidotes which are precise and highly effective when the nature of the intoxication is known.