27.6 POISONING IN CHILDREN
Poisoning is a common medical emergency and important cause of death in children. Unlike adults, most cases of childhood poisoning are accidental in origin and usually seen in toddlers due to their inquisitive and exploratory nature.
Intentional poisoning, e.g. suicidal attempts, are not uncommon in adolescents, while intentional homicidal poisoning is rare but does occur.Accidental exposure to unwanted substances is common in young children, though most of these
TABLE 27.25: Epidemiological risk factors for poisoning
• Younger age (lt; 3 years)
• Male sex
• Large family size
• Illiterate or working parents
• Overcrowded dwellings e.g. slums
• Mentally handicapped or hyperactive child
• Seasonal: CO (winter), pesticides (harvesting)
• Domestic/household industries
• Child labor in hazardous industries
• Family events: House-painting, change of residence
CO: Carbon monoxide poisoning
substances are non-poisonous. While the pattern of accidental poisonous exposures depends on family environment, some common poisons in Indian children, in order of the frequency of exposure, are: (a) hydrocarbons, e.g. kerosene, (b) drugs and medications, (c) insecticides/pesticides, (d) detergents, and (e) others. The pattern of poisoning also differs in urban vs. rural population.
Accidental childhood poisoning is more common in males and ~75% cases occur in first 3 years of life, with maximum risk (40%) during second year. Common epidemiological risk factors for poisoning are given in Table 27.25.
27.6.1