Accidental poisoning of young children by ingestion of medicines and other substances is a relatively common reason for attendance at hospital in the UK, but infrequently results in significant harm. There is limited data regarding which substances cause major morbidity and mortality. This study aimed to identify which medicines and other substances are associated with death and serious illness in pre-school children.
The Office of National Statistics (ONS) was contacted and provided data relating to deaths in children due to poisoning between 2000 and 2010. The UK Paediatric Intensive Care Audit network (PICANet) was contacted and provided data relating to children admitted to intensive care as a result of poisoning between 2002 and 2012. Where possible, demographic data and the individual substance or class of drug was extracted.
21 deaths of children aged under 5 years occurred where the primary cause was poisoning due to medication between 2000 and 2010. Methadone was responsible for 9 of these deaths. 214 children (124 male:90 female) aged under 5 years were admitted to PICU between 2002 and 2012 as a result of poisoning with a median length of stay of 1 day (range 0.1 – 17.2 days). The causative medicine was often not recorded and admissions due to therapeutic misadventure or idiosyncratic drug reactions were included within these numbers. The commonest medicines, where recorded, were benzodiazepines (24 admissions) and methadone (19 admissions). 4 children died (2 methadone, 1 benzodiazepine and 1 caustic alkali).
Existing databases are useful sources of data relating to poisoning in children but are limited, and it is not possible to differentiate easily between exploratory poisoning and therapeutic misadventure. However, the data available suggest that methadone is a significant danger to young children. It is vital that the presence of young children in the households of those on methadone programmes are taken into account, and alternatives are explored. More robust and systematic data collection might help identify other substances associated with significant risk and assist with targetted prevention measures.