The death rate from poisoning among children ages 14 and under has declined 27 percent from 1987 to 1997. This decline has been due to child-resistant packaging, product reformulation, heightened parental awareness, and appropriate interventions by poison control centers and health professionals.

Children continue to be at significantly greater risk from unintentional poisoning death and exposure than adults because they are smaller, have faster metabolic rates, and are less able to physically handle toxic chemicals. In addition, their natural curiosity and desire to put everything in their mouths increase their poisoning risk.

Children are poisoned by household and personal care products, medicines, vitamins, lead and carbon monoxide (CO). The exposure risk to a child is associated with a product’s toxicity, packaging, accessibility, availability and formulation.

DEATHS AND INJURIES

— In 1997, 81 children ages 14 and under were fatally poisoned. Children ages 4 and under accounted for nearly half of these deaths.

— In 1998, more than 1.1 million unintentional poisonings among children ages 5 and under were reported to U.S. poison control centers.

WHEN AND WHERE POISONING DEATHS AND INJURIES OCCUR

— Calls to poison control centers peak between 4 p.m. and l0 p.m.

— More than 90 percent of all poison exposures occur in homes.

Medicine and Household Product Poisoning

— Each year, more than 35 children ages 4 and under die from unintentional exposure to household products and medicines.

— Among children ages 5 and under, 60 percent of poisoning exposures are by non-pharmaceutical products such as cosmetics, cleaning substances, plants, foreign bodies and toys, pesticides, art supplies and alcohol; 40 percent are by pharmaceuticals.

— Of the oral prescription drugs ingested by children ages 4 and under, 23 percent belong to someone who does not live with the child; 17 percent belong to a grandparent or great-grandparent.

— From 1986 through 1997, more than 218,000 children ages 5 and under ingested iron preparations, and 46 died.

— When dispensing over-the-counter medications to their children, only 30 percent of caregivers are able to accurately measure a correct dosage.

Lead Poisoning

— It is estimated that 890,000 children ages I to 5 have elevated blood lead levels high enough to affect intelligence, growth and development. Children ages I to 2 are at the greatest risk from lead poisoning.

— Ingesting dust from deteriorating lead-based paint is the most common cause of lead poisoning among children. Currently, more than 80 percent of public and privately owned housing units built before 1980 contain some lead-based paint.

— Children are more likely to suffer elevated blood lead levels if they are low-income, black, Mexican-American, living in large metropolitan areas or living in older housing.

— Children receiving Medicaid are three times as likely to have harmful blood lead levels as those no receiving Medicaid.

COPoisoning

— Each year, approximately 26 children ages 14 and under are fatally poisoned by CO, a colorless, odorless gas.

— In 1998, more than 2,300 cases of CO poisoning among children ages 5 and under were reported to poison control centers.

— The majority of CO exposures occur in the winter months and the most common sources of residential CO-related poisoning are unvented supplemental heaters.

WHO IS AT RISK

— In general, children ages 5 and under are at greatest risk for nonfatal poisoning, accounting for the majority of all poisoning exposures. Children ages 2 and under are especially vulnerable.

— Male children are more likely than female children to suffer from poisoning fatalities and exposures.

— Black children ages 5 and under have a poisoning death rate that is approximately four times that of white children.

POISONING PREVENTION LAWS AND REGULATIONS

— The Poison Prevention Packaging Act (1970) authorizes the U.S. Consumer Product Safety Commission to require the use of child-resistant packaging for toxic substances used in and around the home.

— The Food and Drug Administration regulates the labeling and packaging of all iron-containing drugs and supplements to protect children from unintentional poisoning.

— The Lead-Based Paint Prevention Act (1971) and the Residential Lead-Based Paint Hazard Reduction Act (1992) are designed to reduce childhood lead poisoning by restricting sources of lead in the environment.

— The state of West Virginia and some local jurisdictions, including Chicago, St.Louis and Kingston, NY, have passed legislation requiring the use of CO detectors in the home.

POISONING PREVENTION EFFECTIVENESS

— Child-resistant packaging of prescription medications is effective in reducing the poisoning mortality rate among children ages 4 and under. An estimated 460 deaths among children ages 4 and under were prevented from 1974 through 1992, a 45 percent reduction in the mortality rate from levels predicted without child-resistant requirements.

— Poison control centers are effective in handling poison exposures. Seventy-five percent of cases reported to poison control centers are managed in a non-health care facility (e.g., site of exposure, the patient’s home).

— Ipecac syrup and activated charcoal, when used under medical advice, can reduce the likelihood of severe poisoning, decrease the costs of a poisoning incident, and prevent the need for a hospital emergency room visit.

— The removal of lead from gasoline, paint and soldered cans has contributed to the substantial decline in blood lead levels. In the 15 years following intensive efforts to reduce lead in these consumer products, a nearly 80 percent decline in the prevalence of elevated blood lead levels among children ages 1 to 5 was observed.

— CO detectors are effective in preventing residential CO poisoning. It is estimated that CO detectors may prevent half of such deaths.

PREVENTION TIPS

— Store all household products and medications locked out of sight and out of reach of children. Never leave potentially poisonous household products unattended while in use.

— List poison control center and emergency medical service numbers near every telephone. Keep ipecac syrup on hand to be used only on the advice of a poison control center or a physician. Check with your local poison control center to see if they recommend that you keep activated charcoal in the home as well.

— Always read labels, follow directions and give medicines to children based on their weights and ages and only use the dispenser that comes packaged with children’s medications.

— Test children for lead exposure, and test homes built before 1978 for lead-based paint. Cover lead paint with a sealant or hire a professional abatement company to remove the paint. Frequently wash children’s hands and faces as well as toys and pacifiers to reduce the risk of ingesting lead-contaminated dust.

— Install CO detectors in your home in every sleeping area, and on the ceiling at least 15 feet from fuel-buming appliances. Ensure that space heaters, furnaces, fireplaces and wood-buming stoves are vented properly and inspected annually.