Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based casecontrol study.

Hamideh Feiz Disfani,Kazem Rahmani,Seyed Mohammad Mousavi,Sayyed Majid Sadrzadeh,Roohie Farzaneh,Mostafa Kamandi,Najme Doolabi

doi:10.4178/epih.e2019016

Abstract

OBJECTIVESSince poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODSThis hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTSGastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONSAddiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

Highlights

The main causes of poisoning in children include the use of various drugs, exposure to hydrocarbons such as petroleum products, bleaching agents, detergents and disinfectants, plant pesticides, insecticides, and the use of cosmetics, alcohol, and narcotics; more than 75% of poisoning cases occur as a result of consuming poisonous substances [13,14]
Given the impact of factors related to acute childhood poisoning and the lack of sufficient evidence on the epidemiology of these factors in Iran, the present study aimed to identify risk factors for acute childhood poisoning, focusing both on incidence and mortality
The odds ratios (ORs) and 95% confidence intervals (CIs) of the risk factors associated with the incidence of childhood poisoning were calculated using a univariate logistic regression model

Summary

Introduction

Poisoning is a major public health problem and a significant cause of mortality and morbidity in children, accounting for approximately 3.0% of all patients admitted to emergency departments (EDs) [1,2,3]. Approximately 45,000 children and adolescents under the age of 20 die from poisoning, and it has been reported that the death rate from poisoning in people under the age of 20 is 1.8 per 100,000 worldwide [4,5]. It is well established that increased access to and use of chemicals for various purposes such as medicine, agriculture, and industry, accompanied by changes in individuals’ lifestyle, social behaviors, and economic factors, have led to increases in the rate of poisoning and mortality due to poisoning throughout the world [13,15,16]

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