Poisoning in Children 4 Years Old and Younger in Kansas

BACKGROUND:  

During the creation of a burden report on poisoning it was noticed that there was a very large number of poisoning related emergency department visits (EDV) in children 4 years old and younger. This study examines the demographics of this group of children, what poisons they are ingesting and the possible mechanisms for ingestion.

METHODS:  

Cases are defined based on first valid e‐code a criteria defined by the CDC’s Instructions for Preparing State Injury Indicators Report 2007-2009. Poisoning drug type was defined by the new Safe State Injury Surveillance Workgroup Consensus Recommendations for National and State Poisoning Surveillance (ISW7). This first valid e‐code is then scanned using the ISW7 matrix for ICD9‐CM codes. Secondary fields are not included in this analysis.

2007-2009 Emergency Department Visit data were provided by the Kansas Hospital Association. Only children 4 years old and younger were included in this analysis.

RESULTS:  

From 2007 to 2009, 21 percent of all poisoning related EDV, occurred among those ages four years and younger (N= 1,453 of 7,035). Nearly equal percentages of poisoning related EDV occurred in males (53%, n=776) and females (47%, n=677) ages four years and younger. Among those four years and younger, the poisoning related EDV rate per 100,000 population was highest among one year olds (379.2, 95% CI: 345.6-415.2 n=467) and two year olds (425.1, 95% CI: 389.1-463.5 n=513) compared to children younger than one (111.0, 95% CI: 93.2-131.1 n=138), three year olds (189.5, 95% CI: 165.5-216.0 n=224), and four year olds (94.4, 95% CI: 77.6-113.6 n=111).

Nearly all of these poisonings were unintentional (97%, N=1,416). Most of these poisonings are occurring due to children unintentionally ingesting drugs. More than half (69%) of poisonings among those four years and younger were drug related.

CONCLUSIONS:  

Younger children are at higher risk for all injuries due to their limited strength, small size, and lack of understanding of risk. Children four years and younger had the highest unintentional rate of poisoning compared to all other age groups in Kansas. Most of these unintentional poisonings in children ages 4 years old and younger are drug related.

Safe Kids Kansas and the Kansas Injury Prevention Program have been using this information to inform stakeholders and parents about this issue. Work has been done on educating parents about storing medication safely and being aware of using the poison control center.