Unsafe storage of poisons in homes with toddlers

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Abstract

Background

The objective of this project was to assess the current nature and level of preventive actions that parents take to avoid unintentional poisoning among toddlers (11–18 months old).

Methods

In 2004, we conducted a cross-sectional observational survey with self-administered questionnaires among parents with toddlers (n = 1722). Data were obtained on storage locations of medicines and cleaning products and supervision of children.

Results

Overall, 50.1% of the toddlers were exposed to unsafe storage of possible poisonous products in the home. Parents were more likely to store medicines safely than cleaning products, and products were most often stored unsafely in the kitchen, where children were left unattended most often (69%). Households with one child were associated with unsafe storage of both medicines and cleaning products. Lower educational level of the mother and unemployment of the mother were both associated with safe storage of medicines. Mother's ethnicity, the child's ability to walk, and the education level of the father were associated with storage of cleaning products.

Conclusions

The results of this study are an important first step for the development of effective interventions to reduce unintentional poisoning in toddlers’ homes.

Introduction

Unintentional injury is the leading cause of death and long-term disability in pre-school children in Europe and the United States. Injuries from poisonings are a major cause of non-fatal injuries in children 0–24 months old (Vincenten, 2004). More than 1.1 million unintentional poisonings among children aged 5 and under are reported to U.S. poison control centers each year. In 2003, 49.6% of all the reported poisonings in the U.S. occurred among the children aged 4 and under (Watson et al., 2004). Poisoning, which mostly takes place in the home, may be caused by many common household products, such as cleaning products, medicines, plants, and cigarettes (Vincenten, 2004, Watson et al., 2004). Guidelines concerning the prevention of childhood poisoning include the use of child-resistant packaging, child-safe storage of potentially poisonous products, and extra attention and supervision when the possible hazardous products are in use (Azizi et al., 1994, Hoy et al., 1999, Petridou et al., 1996, Rodgers, 2002, Vincenten, 2004, Woolf et al., 1992). However, using only one of the preventive measures may not be sufficient; they should always be combined.

With regard to the details of exposure of children 0–24 months old, who are at the highest risk for poisoning, only limited information is available from household surveys considering detailed information on storage of possible poisonous products in the home and supervision of the child. To reduce the number of accidental poisonings, it is important to know which preventive actions parents take to prevent poisoning (Roberts, 2001, van Beeck, 2004). More information is required on the possible factors related to adequate protection of toddlers against unintentional injuries in the home (Kendrick et al., 2003, Kendrick et al., 2005, Runyan et al., 2005). The objective of this study was to assess the current nature and level of preventive actions that parents take to avoid unintentional poisoning, due to medicines and cleaning products, among toddlers (11–18 months old) and the differences in (un)safe storage as they relate to household and child characteristics.

The study was focused on children aged 11–18 months old, since the incidence of poisoning in this age group is 3 per 1000 children per year, which is much higher compared to other age groups; e.g. the relative risk of poisoning in 1 year olds compared to 4 year olds is 6 (LIS, 2003). Furthermore, ideally parents should take measures to prevent poisonings before the risk is highest, and these preventive actions should be continued over time. By focusing upon this specific age group we were able to evaluate whether parents take preventive measures before, respectively during this critical period. This study was targeted at medicines and cleaning products (like detergent, chloride, and other cleaners) as most cases of poisoning in this age group, in the Netherlands occur with these products (LIS, 2003).

Section snippets

Study design and participants

All families (2470) with at least one child aged 11–18 months old who were part of the caseloads of six preventive youth healthcare providers in the Netherlands, scattered over the whole country, were asked to participate in a postal questionnaire in 2004. The parents were informed that the study was about home safety issues in order to improve safety information provided by preventive youth healthcare at ages 11–18 months old. Participants from both urban and rural areas were included. Up to

Questionnaire response and participant characteristics

Response was 70.1%; nine questionnaires (0.5%) were excluded from analyses because they had been incorrectly completed (n = 4) or because the questionnaire was not completed for the selected child but for an older sibling (n = 5); thus, 1722 questionnaires were used in the analysis. The mean age of the respondents was 32.4 years (range 16–60; S.D. 4.5) the 60 years old respondent was a grandmother who completed the questionnaire together with the child's mother, they lived together in the same

Discussion

This explorative study, with a high response rate from a large sample of parents of toddlers 11–18 months old, specifically addressed young children's exposure to poisoning hazards associated with unsafe storage of medicines and cleaning products inside their homes at the stage at which they start crawling and walking independently.

Medicines are reported more often as having been stored in a child-safe manner compared to cleaning products. In this study, the kitchen was the location in the home

Conclusions

Information on childhood exposure to safety hazards, as provided in this study, is necessary to enhance both current safety promotion initiatives in pediatric practices and preventive child health care at the community level. Specific information on various types of hazards in the home might contribute more to the prevention of unintentional injuries among young children in the home compared to information about general applied safety practices. Based on this study, there is ample opportunity

Acknowledgment

This study was funded by the Netherlands Organization for Health Research and Development (ZonMw Grant # 22000143).

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