Adults Often Inadvertently Put Children at Risk of Oral Medication Poisoning, Study Finds

Active, curious children sometimes eat or drink dangerous substances in their environment, resulting in 300 poisoning-related emergency room visits and two deaths every day in the U.S.[1] Poisoning among children is not caused by household chemicals alone. Indeed, ingestion of solid oral prescription medications or over-the-counter (OTC) products (including medications, dietary supplements, vitamins and homeopathic products) in the form of capsules, pills, tablets and film strips is a common cause of poisoning among children.

A new survey study that aimed to examine the circumstances of unsupervised exposure to solid medications — including the type of containers accessed by young children and the intended recipients of these medications — found that adults frequently are to blame for this problem.[2]

The study was published in the April issue of The Journal of Pediatrics and was funded by the Centers for Disease Control and Prevention.

The new study

From Feb. 1 through Sept. 30, 2017, trained specialists in five poison control centers (that served more than 40 million people in Arizona, Florida and Georgia) asked all callers reporting unsupervised exposures of children aged five or younger to solid medications (intended for oral human use) to answer a few questions designed by the study researchers.

The researchers defined unsupervised exposures as incidents in which young children accessed solid medications without the knowledge, direction or oversight of a caregiver.

Overall, 4,496 eligible callers participated in the study (62% response rate). Ninety-three percent of these calls concerned exposures to a single solid medication, and 72% involved children aged two or younger.

Although federal law requires child-resistant packaging for nearly all prescription drugs and certain OTC medications (such as acetaminophen [TYLENOL] and aspirin [BAYER ASPIRIN, VAZALORE]),[3] 1,520 (34%) of the overall exposures involved prescription products and 1,473 (33%) involved OTC medications that require child-resistant packaging. The remaining 1,346 (30%) exposures involved OTC products that do not require child-resistant packaging.

In 644 (42%) of the exposures to prescription drugs, the children had accessed the medications from their original containers. In 783 (52%) of the prescription drug exposures, the children had accessed the prescription drugs after they had been removed from their original containers by another person. These removed prescriptions were not in any container (loose) in 34% of the 783 cases and were transferred to alternative containers (such as travel pill boxes and weekly pill minders that are not child resistant) in 17% of the 783 cases. The containers for the remaining cases were not reported.

Exposures to prescription attention-deficit-hyperactivity-disorder drugs, opioid painkillers and sedatives/sleeping pills most commonly involved ingestion of medications that were not in any container. In contrast, exposures to prescription drugs for seizure disorders and diabetes most commonly involved ingestion of medications that had been transferred to alternative containers.

Seventy-two percent of the prescription drugs involved in the reported exposures had been intended for a parent or grandparent, 10% for another adult and 9% for another child.

In 2,115 (75%) of the 2,819 exposures to any type of OTC product, the children had accessed the products from their original containers. In 433 (15%) of the OTC cases, the products were not in any container. In 153 (5%) of the OTC cases, the products had been transferred to an alternative container.

Finally, 65% of OTC medications and products involved in child exposure were intended for a parent, grandparent or other adult, and only 16% were intended for a child.

What You Can Do

To poison-proof your home and protect all children in your home, it is best to keep all prescriptions and OTC products in their original child-resistant containers until the moment that you take each pill or tablet.[4] If a weekly pill organizer is essential for remembering to take your daily medications correctly and you have children in your home, use a child-resistant organizer and keep it in a locked box or cabinet. If your medication does not come in a child-resistant container and you have children in your home, consider placing it in a child-resistant container or in a locked box or cabinet.

When you remove any medication from its container, close it securely after every use. If a pill or a capsule medication is spilled accidently, double-check to make sure that it is picked up. Put all medications up and away immediately after each use so children cannot see or get them. Instruct others (including grandparents) in your home to do the same.

Safely dispose of unused, unneeded or expired medication by taking it to a local take-back program or a drug take-back event. If that is not possible, and the medication is not an opioid, mix it with coffee grounds or kitty litter and throw it away. See the May 2016 issue of Worst Pills, Best Pills News for more details.[5]

Put the Poison Help Line number (800-222-1222) on or near every telephone in your home, and call it right away if you suspect that a child might have gotten into any medication, vitamin, supplement or chemical.

Call 911 if your child has collapsed or is not breathing due a poisoning emergency or any other reason.
 

References

[1] Centers for Disease Control and Prevention. Protect the ones you love: child injuries are preventable. Poisoning prevention. February 6, 2019. https://www.cdc.gov/safechild/poisoning/index.html. Accessed August 4, 2020.

[2] Agarwal M, Lovegrove MC, Geller RJ, et al. Circumstances involved in unsupervised solid dose medication exposures among young children. J Pediatr. 2020;219(April):188-195.e6.

[3] Consumer Healthcare Products Association. Child-resident packing. https://www.chpa.org/CRP.aspx. Accessed August 4, 2020.

[4] Centers for Disease Control and Prevention. Adults unintentionally make it easy for young children to eat dangerous pills. February 12, 2020. https://www.cdc.gov/media/releases/2020/p0212-dangerous-pills.html. Accessed August 4, 2020.

[5] Responsible disposal of prescription drugs. May 2016. Worst Pills, Best Pills News. /newsletters/view/1035. Accessed August 4, 2020.