Epidemiological Study of Acute Toxicity in Children Admitted to Poison Control Center, Ain Shams University Hospitals during the Year 2012 -A Retrospective Study

Acute poisoning represents a major cause of morbidity and mortality among children. The pattern of incidence and risk factors for acute poisoning in children change with time and differ from country to country.  Thus, specific epidemiological studies for each country are necessary for determination of the extent and characteristics of the problem, accordingly appropriate preventive measures can be taken.
Aim of the study: This is an epidemiological retrospective study aimed to determine the pattern of acute poisoning in children admitted to PCC, Ain Shams University Hospitals during the year 2012.
Methods: The collected data about the cases included demographic data (age, gender and residence), circumstances of poisoning (substance of exposure; place, time, mode and route of exposure and co-ingestion of other agents) and cases’ outcome (recovery and discharge or death).
Results: This study included 1,521 children; adolescents represented the most frequent age group (55.6%), followed by toddlers (21.9%). Female gender was more frequent than male (67.8% versus 32.2%). The majority of admitted pediatric cases were resident in Greater Cairo governorates. Drugs were more common cause of poisoning in the included cases than non-medicinal agents (57.1% vs 42.9%) and theophylline was the most frequent drug. Pesticides were the most frequent non-medicinal agent in all age groups, except for toddlers where chemicals (kerosene and corrosives) were the most frequent agent. Intentional poisoning was more frequent than unintentional poisoning (55.5% vs 44.5%). While unintentional poisoning occurred in all age groups, intentional poisoning (mainly suicidal) occurred exclusively in older age groups (school age group and adolescents).
The house was the site of exposure to poisons in all cases. The winter was the season of greatest frequency of poisoning by pesticides, gases and drugs while the summer was the season of greatest frequency of animal, food, fish and plant poisoning as well as poisoning by chemicals. Ingestion was the most common route of exposure in all age groups (1484 cases, 97.4%) and it was the only route of exposure in infants. About 3.5% of the included cases (59 cases) were presented with co-ingestion of other substances; most of them were in the adolescent group. The percentage of mortality of the admitted cases was 2.2% (33 cases). Iatrogenic/ therapeutic poisoning had the highest mortality ratio (25%) followed by accidental poisoning (2.8%) and suicidal poisoning (1.4%).
Conclusion: The greatest frequency of poisoning in children was in adolescents, followed by toddlers. Oral route was the most common route of exposure.  Poisoning in children may occur unintentional (in all age group) or intentional (only in older age groups). Suicidal poisoning was the main manner of exposure in adolescents. The percentage of mortality was 2.2%.
Recommendations: Appropriate injury prevention strategies, such as safe storage of medicines and cleaning supplies should be implemented. Also, more restrictive measures on the use and storage of pesticides should be taken.
Further studies on the risk factors of deliberate self-poisoning in adolescents are recommended as it was found as a major manner of exposure to poisoning in this stage.