Prevent Child Poisoning
1. Q. If my child eats or drinks a substance that might be a poison, where can I find information on treatment?
A. If you think someone has been poisoned from a medicine or household chemical, call 800-222-1222 for your Poison Control Center. This new national toll-free number works from anyplace in the U.S. 24-hours-a-day, 7-days-a-week. Keep the number on your phone. There are currently some 65 Regional Poison Control Centers in the United States that maintain information for the doctor or the public on recommended treatment for the ingestion of household products and medicines. They are familiar with the toxicity (how poisonous it is) of most substances found in the home or know how to find this information.
2. Q. If I find my youngster playing with a bottle of medicine or some household product, how can I tell if he or she has swallowed some and what should I do?
A. Reactions vary, depending on the product. Sometimes the child may vomit; or he or she may appear to be drowsy or sluggish. Some of the substance may remain around the child’s mouth and teeth. There may be burns around the lips or mouth from corrosive items; or you may be able to smell the product on the child’s breath. Some products cause no immediate symptoms. If a household chemical has been ingested, call the Poison Control Center (800-222-1222) or follow the first aid instructions on the label. Even if you suspect, but don’t know for sure, that your child has ingested a potentially hazardous product, call your Poison Control Center, emergency department, or doctor. Keep these telephone numbers on your phone.
3. Q. Are there some first aid measures I can take when an ingestion takes place?
A. Remain calm. Not all medicines and household chemicals are poisonous, and not all exposures necessarily result in poisoning. For medicines, call the Poison Control Center or doctor immediately. For household chemical products, call the Poison Control Center or follow the first aid instructions on the label. If unable to contact them, call your local emergency number (911 in most areas) or the operator. Keep emergency numbers listed near the phone before an emergency arises. When you contact the Poison Control Center or other emergency personnel, be prepared to give the facts (described below) to the expert on the other end of the phone. Have the label ready when you call the expert. The label provides information concerning the product’s contents and advice on what immediate first aid to perform. This will be useful when giving first aid and when you call the Poison Control Center. Tell the expert:
- The victims age
- The victim’s weight
- Existing health conditions or problems
- The substance involved and how it contacted the person. For example, was it swallowed, inhaled, absorbed through skin contact, or splashed into the eyes? How long ago did they swallow or inhale the substance?
- Any first aid which may have been given
- If the person has vomited
- Your location, and how long it will take you to get to the hospital
If medicine has been swallowed, do not give anything by mouth until advised by the Poison Control Center. If chemicals or household products have been swallowed, call the Poison Control Center or follow the first aid instructions on the label. Always keep on hand at home a one-ounce bottle of ipecac syrup for each child or grandchild under age 5 in the home. Use only on advice of the Poison Control Center, emergency department, or doctor.
4. Q. Why are so many poisonings related to children under 5 years of age?
A. Children under the age of 5 are in stages of growth and development in which they are constantly exploring and investigating the world around them. This is the way they learn. It is a normal characteristic and should not be discouraged. Unfortunately, what children see and reach, they usually put in their mouths. It is this behavior to which parents must be alerted. As the youngsters’ mobility, ingenuity, and capabilities increase, they can reach medicines and household chemicals wherever stored. For instance, when children are crawling, they can find such products as drain cleaners stored under the kitchen sink or on the floor. As soon as they are able to stand, they can reach such products as furniture polish on low-lying tables, as well as medications in purses on beds. When they start to climb, they can reach medicine on countertops or open the medicine cabinet and get to the medicine. These products should be locked up where possible, out of the child’s reach – even when safety packaging is used. Adults should never leave a medicine or household chemical product unattended while in use; children act fast and can get hold of a product and swallow it during the short time while the adult is answering the telephone or doorbell. Advise the caregiver to take the child (or product) with them to answer the phone or doorbell.
5. Q. Why do we need child-resistant packaging?
A. Although labeling requirements and educational programs have had some effect in reducing the number of childhood ingestions, significant numbers of children are still being poisoned by ingesting household products that can be hazardous, such as medicines (sometimes brought into the child’s home by grandparents or other visitors or accessed by a child visiting a home), cleaning products, and solvents. Child-resistant packaging, if used properly, provides an additional barrier to help prevent ingestions.
6. Q. As a parent, how certain can I be regarding the effectiveness of this kind of packaging?
A. While child-resistant packaging provides an increased element of protection, children are going to investigate several different ways of opening a container. If their fingers won’t work, their teeth might. It would be impossible to manufacture a package or a closure that would prevent every single child from getting into the contents under all possible circumstances. Therefore, the Poison Prevention Packaging Act requires that packages be difficult for children under 5 years of age to open or otherwise obtain a toxic amount within a reasonable time. For example, U.S. Consumer Product Safety Commission (CPSC) regulations require that aspirin, and other products, be packaged in special containers that would prevent at least 80% of those children tested from opening the container during a 10-minute test. This requirement means that some children may still be able to open a container or otherwise obtain a toxic amount. So, keep poisonous substances locked up, even if they are in child-resistant packaging.
7. Q. How can I use child-resistant packaging properly?
A. Remember these steps: (1) Read the instructions to make it easier to open the packaging. (2) If using cap and vial packages, be sure to resecure the closure tightly. Blister cards will not have to be resecured. But if the blister cards are contained in an outer package, make sure the package is closed properly. Never transfer the contents to other containers. (3) Do not leave loose pills anywhere. (4) Keep medicines and household products (even those with safety caps) locked up and out of sight. Use locks or child-resistant latches to secure storage areas. The pharmacist or merchant from whom the product was purchased can teach you how to open and close the packaging, if you have difficulty. Opening and closing becomes easier with practice. While it may take a few additional seconds of your time, those few seconds may save the life of a child who is very dear to you.
8. Q. What kind of products can I expect to find in child-resistant packaging?
A. Aspirin and aspirin-substitutes (acetaminophen), oral dosage prescription drugs, iron-containing drugs and dietary supplements, ibuprofen, loperamide (an anti-diarrhea medicine), preparations containing lidocaine and dibucaine (anesthetic medicines), mouthwash containing 3 grams or more of ethanol (alcohol), naproxen, ketoprofen, certain types of liquid furniture polish, oil of wintergreen, drain cleaners, oven cleaners, lighter fluids, turpentine, paint solvents, windshield washer solutions, automobile antifreeze, fluoride-based rust removers, minoxidil, methacrylic acid, and hydrocarbons are among the substances required to be in child-resistant packaging. The Environmental Protection Agency requires that most pesticides be in child-resistant packaging.
9. Q. There are no small children in my home. Do I have to use child-resistant packaging?
A. In general, all adults should use child-resistant packaging because young children may visit the adult’s home. To assist people who are elderly or handicapped, the Poison Prevention Packaging Act allows a manufacturer to offer a regulated non-prescription product in one size or package that does not comply with the safety packaging standard and that bears the label statement “This package for households without young children,” if that manufacturer also offers the same product in popular-sized child-resistant packages. Additionally, if a prescription is involved, the purchaser or prescribing physician can request regular, non-child-resistant packaging. However, such requests should be kept to a minimum, since they increase the danger of childhood poisonings. Poisonings have happened when youngsters have visited homes where no children live. Little ones have been poisoned after finding medicine containers left in purses or on bedside tables. Poisonings have happened when older persons carried medicines into homes that have small children. A study conducted for the U.S. Consumer Product Safety Commission (CPSC) by the American Association of Poison Control Centers found that 23% of the oral prescription drugs that were ingested by children under 5 belonged to someone who did not live with the child. Overall, 17% of the medicines ingested belonged to a grandparent or great-grandparent. This percentage varied from city to city: in Salt Lake City, 9% of the medicines ingested belonged to a grandparent, but in Shreveport, Louisiana, 24% of the medicines ingested belonged to a grandparent. The data suggest that grandparents – and all adults – need to use child-resistant packaging and keep medicines properly secured, away from young children. CPSC requires that child-resistant packaging be “adult-friendly” so that adults can open it more easily. This will encourage adults of all ages to keep their medicines in their original child-resistant packaging and not be tempted to leave the tops off medicine.
10. Q. Is there any evidence that deaths from child poisonings have decreased since child-resistant packaging began to be used?
A. Yes. The staff of the U.S. Consumer Product Safety Commission (CPSC) estimates that child-resistant packaging for aspirin and oral prescription medicine has saved the lives of about 900 children since the requirements went into effect in the early 1970s. CPSC staff analyzed child fatality data for unintentional ingestions of aspirin and oral prescription medicines. The death rate for these medicines declined even after taking account of the overall decline in the unintentional child death rate from all causes and changes in per capita product consumption. The CPSC staff study showed that child-resistant packaging for aspirin and oral prescription drugs reduced the child death rate by over 2 deaths per million children under age 5. This represents a fatality rate reduction of up to 45 percent from levels that would have been projected in the absence of child-resistant packaging requirements. The estimate of about 900 lives saved relates to aspirin and oral prescription medicines only and does not include additional lives that may have been saved by child-resistant packaging on other products.
There has been a reduction in deaths with all medicines and household chemicals since 1972 (when child-resistant packaging was first required).
However, the number of ingestions or exposures to household medicines and chemicals continues to be high. The American Association of Poison Control Centers reports that in 2001 there were 1,169,478 children age 5 and under exposed to potentially poisonous substances.
11. Q. Why is it dangerous to use cups or soft-drink bottles to hold paint thinner, turpentine, gasoline, or other household chemicals?
A. Children associate cups, soft-drink bottles, and drinking glasses with food and drink. For example, fatalities have been reported when lighter fluid intended for outdoor barbecue fires was poured into such containers and subsequently swallowed by children.