Salicylate Poisoning

Abstract

Medications are the most common substances accidentally ingested by children less than 5 years of age. In 1972, 62% of fatal ingestions reported to the National Clearinghouse for Poison Control Centers were due to drugs.1 The leading categories for fatal reported ingestions are drug combinations, analgesics, nonbarbiturate sedatives, and psychopharmacologic agents. The effectiveness of child resistant containers (CRCs) in reducing the incidence of childhood accidental poisonings from medications has been demonstrated by the experience at Madigan General Hospital and in Essex County, Ontario. Scherz2 speculates a 75% reduction in childhood poisoning could be achieved by this measure alone. The Poison Prevention Packaging Act of 1970 (Public Law 91-601) permitted the Consumer Product Safety Commission to develop and administer safety packaging regulations for salicylates. Salicylates, generally considered the most important drug hazard for the preschool child,3 are currently available in both safety and non-safety containers. By law, each manufacturer can produce for retail use one size container with a noncomplying package. Therefore the risk of salicylate poisoning can be expected to continue from noncomplying packaging, the misuse of safety packaging by adults, and misuse of salicylates as therapeutic agents. The widespread use of safety packaging for children's aspirin has been accompanied by a steady decline in poisoning in preschool children from this source since 1970. However, salicylates remain the single substance most frequently accidentally ingested by preschool children; and there were eight reported fatalities in 1972.1 Although accidental ingestion is a frequent problem, over one half of hospitalized cases of salicylism in children have been due to chronic ingestion associated with therapeutic misuse.