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

Denise Kendrick ^1*, Sherie Smith ¹, Alex Sutton ², Michael Craig Watson ¹, Carol Coupland ¹, Caroline Mulvaney ³ and Amanda Mason-Jones ⁴

¹ University of Nottingham, United Kingdom
² University of Leicester, United Kingdom
³ Broxtowe and Hucknall Primary Care Trust, United Kingdom
⁴ Western Cape Department of Health, South Africa

^* To whom correspondence should be addressed. E-mail: denise.kendrick{at}nottingham.ac.uk.

Accepted 18 February 2008

Abstract

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: We included randomised controlled trials (RCTs), non-RCTs 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. 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), having syrup of ipecac (OR 3.34, 95% CI 1.50 to 7.41) and poison control centre numbers accessible (OR 3.67, 95% CI 1.84 to 7.33). There was a lack of evidence in relation to poisoning rates (rate ratio 1.03, 95% CI 0.78, 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.