Poisoning is a serious but often unintentional health issue among children. There are approximately 1 million poison exposures among children younger than 6 in the United States each year. This number drops to around 130,000 among children aged between 6 and 12. The majority of poisoning cases occur in the home and are unintentional.
The symptoms of poisoning in young children are usually minor and are rarely fatal. In 2019, there were 13 exposure-related deaths in children younger than 6, and the same number of deaths for children aged between 6 and 12.
This article explains common causes and risk factors associated with poisoning in children. It also offers information on how to prevent poison exposure and ingestion in children.
Table of contents
Ingested substances such as cosmetics, personal care products, household cleaning products, pain medications, foreign bodies/toys, and dietary supplements are responsible for most cases of poison exposure in children under the age of 5.
The categories of substances that most often involve fatalities in children younger than 5 are:
- Fumes, gases, and vapors (e.g. carbon monoxide)
- Analgesics (painkillers)
Commonly ingested substances include
- Over-the-counter cough and cold preparations (although ingestions have declined since warning labels were added advising against use in children younger than 4)
- Diphenhydramine (E.g. Benadryl, Nytol)
- Electronic cigarettes
- Iron supplements
- Cardiovascular medications
- Methyl salicylate
Some substances are more dangerous than others, and certain products have been identified as causing severe symptoms and even death in very small amounts. These include:
- Sulfonylureas (used to treat type-2 diabetes)
- Calcium channel blockers (used to treat high blood pressure and cardiac arrhythmias)
- Toxic alcohols (e.g. ethanol, methanol, ethylene glycol, isopropyl)
- Clonidine (used to treat high blood pressure, ADHD, drug withdrawal, etc.)
- Liquid nicotine
There are certain factors that can increase the likelihood of poisoning in a particular child. These include developmental and environmental factors, as well as factors related to age and sex.
- When young children and toddlers become more mobile, learn to walk and explore, and develop their fine motor skills, they gain easier access to substances and objects that were previously out of reach.
- Young children will also develop a keen sense of curiosity about their surroundings without yet understanding the concept of poisoning and the danger of ingesting substances they encounter.
- Among adolescents, the risk of poisoning is increased by peer pressure, desire for independence, pressure to conform, and personal issues relating to mental health.
- Adolescents may intentionally overdose on medication as a suicide attempt.
- Over 90 percent of poisonings happen at home.
- Potentially dangerous substances can be found in any normal household and can include cleaning products for the kitchen, bathroom, and garage. These substances pose a serious health risk to children if they are stored on low shelves or anywhere that children can access them.
- Adults can neglect to appreciate the danger associated with products and substances that they use on a daily basis and may forget to keep them stored away securely.
- Medicines may be momentarily left unattended and come within a child’s reach, even if they are usually stored away safely.
- The packaging and overall appearance of medicines and cleaning products often look inviting to children because of their similarity to food packaging, thus making children more likely to ingest them.
- The majority of poisonings occur in children aged below 6, which has between 171,000 and 177,000 poison exposures each year. The developmental factors listed above help to explain the increased incidence in these age groups.
- In preadolescents, the majority of poisonings occur in males. In adolescents, however, approximately 60 percent of poisoning victims are female.
What to do if your child is poisoned
Poisoning cases should be dealt with by a poison control center specialist. It is best to take an affected child to a poison control center rather than the emergency room, as these centers can provide specialized mechanisms and support for managing poisonings.
They can also reduce unnecessary emergency room visits, expedite referrals to appropriate health care facilities, decrease the length of hospital stays, and lessen healthcare spending. They also save time and reduce parental anxiety.
Parents can effectively prevent their children from being poisoned by taking simple measures at home. Preventing poisoning in the home involves eliminating exposure to toxic substances and reducing the risk of ingestion.
The following tips are useful for parents who want more information on how to keep their child safe from toxic substances:
- Regularly survey your home for hazards and consider whether certain toxic substances are necessary.
- Safely and securely store any substances that are deemed necessary and keep them out of children’s reach.
- Ensure that any house your child visits has the same precautions in place and has no dangerous substances accessible to children. This is especially important when visiting a grandparent’s house, as there may be pills or other medication left out for easy access.
- Try to purchase the least toxic substances needed for household tasks and only purchase them in small amounts. Discard toxic substances when they are no longer needed.
- Keep the relevant universal poison control telephone number (1-800-222-1222 in the United States) posted near all phones in the house and keep it in your phone’s contacts list.
- Never call medicine “candy” or anything similarly misleading in an attempt to make it more appealing for children.
- Keep medicines and substances in their original containers and never put them in food or drink containers.
- Do not take medicine in front of children as this can encourage copycat behavior.
- Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, Rivers LJ, Pham NPT, Ryan ML. 2019 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 37th Annual Report. Clin Toxicol (Phila). 2020 Dec;58(12):1360-1541. doi: 10.1080/15563650.2020.1834219. PMID: 33305966.
- Mazer-Amirshahi M, Reid N, van den Anker J, Litovitz T. Effect of cough and cold medication restriction and label changes on pediatric ingestions reported to United States poison centers. J Pediatr. 2013 Nov;163(5):1372-6. doi: 10.1016/j.jpeds.2013.04.054. Epub 2013 Jun 12. PMID: 23769500.
- Lovegrove MC, Weidle NJ, Budnitz DS. Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004-2013. Pediatrics. 2015 Oct;136(4):e821-9. doi: 10.1542/peds.2015-2092. Epub 2015 Sep 7. PMID: 26347435; PMCID: PMC4651433.
- Michael JB, Sztajnkrycer MD. Deadly pediatric poisons: nine common agents that kill at low doses. Emerg Med Clin North Am. 2004 Nov;22(4):1019-50. doi: 10.1016/j.emc.2004.05.004. PMID: 15474780.
- Committee on Injury and Poison Prevention, American Academy of Pediatrics. Injury prevention in and around the home. In: Injury Prevention and Control for Children and Youth, American Academy of Pediatrics, Elk Grove Village, IL 1997. p.47.
- King WD, Palmisano PA. Poison control centers: can their value be measured? South Med J. 1991 Jun;84(6):722-6. PMID: 2052960.
- Poison prevention tips from the American Academy of Pediatrics https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Poison-Prevention-Tips-from-the-American-Academy-of-Pediatrics.aspx.