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Paediatric poisoning exposures in schools: reports to Australia’s largest poisons centre
  1. Jennifer Ly1,2,
  2. Jared A Brown2,3,
  3. Nicholas A Buckley1,2,
  4. Rose Cairns2,4
  1. 1 Faculty of Medicine and Health, School of Medical Sciences, Discipline of Pharmacology, The University of Sydney, Sydney, New South Wales, Australia
  2. 2 New South Wales Poisons Information Centre, Children's Hospital at Westmead, Westmead, New South Wales, Australia
  3. 3 Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
  4. 4 Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Rose Cairns, Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia; rose.cairns{at}health.nsw.gov.au

Abstract

Objective To describe poisoning exposures occurring at school in a large sample of Australian children.

Design A population-based retrospective cohort study.

Setting Cases reported to the New South Wales Poisons Information Centre (NSWPIC), Australia’s largest poisons information centre, taking 50% of the nation’s poisoning calls.

Patients Poisoning exposures occurring in children and adolescents while at school were included, over a 4.5-year period (January 2014 to June 2018).

Main outcome measures Time trends in poisonings, demographics, exposure characteristics, substances involved, disposition.

Results There were 1751 calls relating to exposures at school made to NSWPIC. Most calls concerned accidental exposures (60.8%, n=1064), followed by deliberate self-poisonings (self-harm, 12.3%, n=216). Over a quarter of cases were hospitalised (n=468), where the call originated from hospital or patients referred to hospital by NSWPIC. Disposition varied by exposure type, and hospitalisation was highest with deliberate self-poisonings (92.6%, n=200), recreational exposures (57.1%, n=12) and other intentional exposures (32.6%, n=45). The median age was 12 (IQR 8–15 years), and 54.7% were male (n=958). The most common pharmaceutical exposures were to paracetamol (n=100), methylphenidate (n=78) and ibuprofen (n=53), with the majority being deliberate self-poisonings. Copper sulfate was responsible for 55 science class cases, 45% of which were hospitalised. Cases may be increasing, with 81.3 (±8.2) calls per quarter, 2014–2016, and 129.3 (±24.3) calls per quarter, 2017–2018.

Conclusions Poisoning exposures occurring at school are common, with disposition and substances involved varying considerably by exposure reason. The relatively high number of referrals to hospital highlights the need for investigation into preventative measures.

  • adolescent health
  • epidemiology
  • toxicology
  • therapeutics
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Footnotes

  • Contributors JL cleaned the data and performed initial data analysis, and wrote the initial draft manuscript. JAB conceived the study, contributed to study design and data extraction, and revised the draft manuscript. NAB contributed to interpretation of data and creation of figures, and revised the draft manuscript. RC extracted the data and supervised JL, contributed to analysis and interpretation, and drafted/revised the manuscript.

  • Funding This work was supported by an NHMRC Program Grant (1055176), and a UNSW Scientia PhD Scholarship (JAB).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The conduct of this study was approved by the Sydney Children’s Hospitals Network Human Research Ethics Committee (reference: LNR/16/SCHN/44).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. No additional data about poisons centre calls are available due to privacy/confidentiality reasons.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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