Structure of acute lethal poisonings in children: a retrospective study in the Moscow Region, Russia

Abstract

Abstract Background Poisonings are of major public health concern - they cause sickness and death in many children. The clinical case series are non-informative about the very severe intoxications. The objective of this study was to describe the spectrum of toxic substances leading to the death of children, and analyze the time trends and age differences. Materials and Methods We analyzed autopsy reports from the archives of the Bureau of Forensic Medical Expertise of the Moscow Region over a 10-year period. Results Of total children's deaths in age 0 to 19 (n = 3873), unnatural death accounted for 71% of cases (n = 2750). In the structure of unnatural deaths, poisoning accounted for 15.56%. The average age of dead children is 11.2 ± 6.10 years (X + SD). Deaths of boys dominates (at least 60% in age older one year), mostly due to the higher frequency of poisoning with chemical/technical agents (p < 0.01). Age groups are different by the causes of death (p < 0.01): higher frequency of poisoning by carbon monoxide (p = 0.036) in younger children and in older children - by illicit drugs (p = 0,026). There was significant increase in frequency of fatal poisoning by therapeutic drugs and chemical-technical agents in 2016-2018 compared with the previous time interval (p < 0.01). Conclusions The most common cause of Russian children's death is the exposition to the carbon monoxide. The improvement in living conditions and heating technology is a major preventive measure. In the group of therapeutic drugs, the leading toxicant is drotaverine, and among technical substances - natural gas (as a recreational self-poisoning). Key messages Unnatural deaths a numerous in Russian children, and intoxication is one of the leading causes. Dangerous heating of the houses is a major and preventable cause of death by CO intoxication.