In this issue of the journal, the study by Adams et al1 reminds us that a large proportion of acute pesticide exposures are reported in children. This is important data, which should inform the general public and direct both clinical and regulatory decisions.

Pesticides are a heterogeneous group of substances with differing toxicological properties. These range from the very high, acute toxicity of insecticides such as organophosphates to the relatively low toxicity of herbicides such as glyphosate. Pesticides are used for various purposes (eg, for crop protection, wood preservation, human and veterinary medicine) and are applied in a variety of ways (eg, as sprays, baits, soil injections, dips and drenches). Thus, the pesticide exposures experienced by people depend on many factors and are highly variable. In the UK, pesticides rarely cause serious ill health or death. The agricultural sector in this country is relatively small, and for the population at large, toxic pesticide exposures are rare. In other countries, particularly ones with developing economies, pesticide exposures are far higher and are accompanied by significant morbidity and mortality.2 In general, the highest exposures occur after deliberate self-poisoning and during occupational use.

This study highlights the frequent reported exposure of young children to those products used in domestic settings, such as rodenticides, slug killers and treatments for head lice. Particular risks arise from these because they remain in the environment for long periods and at high concentrations—for example, as laid baits.

The paper showed that a large proportion of suspected exposures involved children under the age of 5 years. In these, the most common scenario was exposure after application of pesticide or because of poor storage. Intuitively, these situations would be expected to be important points of risk control in young children, related to their innate curiosity, impulse to place …