Acute lethal poisonings in children: a 10-year retrospective study of the Moscow Region, Russia.

Abstract

Background: Poisoning is a critical public health problem. Toxic substances differ across time, region and age. Little is known about poisoning in Russia, and even less is known about lethal poisoning in children in Russia. We aimed to describe the characteristics of cases of lethal poisoning in children and adolescents.Design and methods: Our retrospective study was based on autopsy reports from archives of the Moscow Region Bureau of Forensic Medical Examination for the period of 2009 to 2018.Results: A total of 438 lethal poisoning cases were recorded. The average age of the poisoned children was 11.3 years. Deaths predominantly occurred in boys, mostly due to the higher frequency of poisoning with household and technical chemicals (P<0.01). Accidental deaths were also higher in males (P<0.01). Therapeutic drug poisoning (P<0.01) and suicide (P<0.01) were more frequent in females. The leading cause of lethal poisoning in children was exposure to carbon monoxide, especially in children aged 5 to 9 years (P<0.01) and 1 to 4 years (P<0.01). Carbon monoxide poisoning occurred more often in winter (P<0.01). Regarding the structure of poisoning with household and technical chemicals, the most frequent was poisoning by a mixture of utility gases.Conclusion: Our study shows that carbon monoxide poisoning is a serious problem in the region. This may be associated with the ongoing use of individual heating systems. A significant increase in the frequency of fatal poisoning by chemicals, especially by propane-butane gas mixtures while sniffing, has become a disturbing trend. Significance for public health Lethal poisoning in children plays a major role in mortality. While clinical toxicologists have worked with live persons and seen the tip of the iceberg, forensic experts have worked with children who died before being admitted to the hospital. It is only by analyzing both sources that we can obtain a comprehensive picture. This paper is an epidemiological study based on autopsy reports and shows another part of the problem.