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Published Online First: 12 March 2008. doi:10.1136/adc.2007.133686
Archives of Disease in Childhood 2008;93:599-608
Copyright © 2008 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

Original articles

Effect of education and safety equipment on poisoning-prevention practices and poisoning: systematic review, meta-analysis and meta-regression

D Kendrick1, S Smith1, A Sutton2, M Watson3, C Coupland1, C Mulvaney4, A Mason-Jones5

1 Division of Primary Care, University Park, Nottingham, UK
2 Department of Health Sciences, University of Leicester, Leicester, UK
3 School of Nursing, University of Nottingham, Nottingham, UK
4 Broxtowe and Hucknall Primary Care Trust, Hucknall Health Centre, Nottingham, UK
5 Western Cape Department of Health, Cape Town, Republic of South Africa

Professor D Kendrick, Division of Primary Care, Floor 13, Tower Building, University Park, Nottingham NG7 2RD, UK; denise.kendrick{at}nottingham.ac.uk

Objective: To assess (a) the effect of home safety education and the provision of safety equipment on poison-prevention practices and poisoning rates, and (b) whether the effect of interventions differs by social group.

Data sources: Medline, Embase, Cinahl, ASSIA, Psychinfo, Web of Science, plus other electronic sources and hand searching of conference abstracts and reference lists. Authors of included studies were asked to supply individual participant data.

Review methods: Randomised controlled trials, non-randomised controlled trials and controlled before-and-after studies, with participants aged <=19 years, providing home safety education with or without free or subsidised safety equipment and reporting poison-prevention practices or poisoning incidents were included. Pooled odds ratios and pooled rate ratios were estimated, and meta-regression estimated intervention effects by child age, gender and social variables.

Results: Home safety interventions increased safe storage of medicines (OR 1.57, 95% CI 1.22 to 2.02) and cleaning products (OR 1.63, 95% CI 1.22 to 2.17), the possession of syrup of ipecac (OR 3.34, 95% CI 1.50 to 7.41), and having poison control centre numbers accessible (OR 3.67, 95% CI 1.84 to 7.33). There was a lack of evidence on poisoning rates (rate ratio 1.03, 95% CI 0.78 to 1.36) and no consistent evidence that intervention effects differed by child age, gender or social group.

Conclusions: Home safety education and the provision of safety equipment improve poison-prevention practices, but the impact on poisoning rates is unclear. Such interventions are unlikely to widen inequalities in childhood poisoning-prevention practices.


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