Acute Poisoning among Children Admitted to a Regional University Hospital in Northern Greece

Article excerpt

SUMMARY

Objectives: The aim of our study was to elucidate the current pattern of acute poisoning among children admitted to a regional University Hospital in the prefecture of Evros in Northern Greece. We also compared the obtained findings with those of two previous studies performed in the same region.

Methods: Demographic and clinical data, management, and outcome of children with acute poisoning were recorded in our region, during the past 5-years (2005-2009, period C) and compared to similar studies carried out in the periods 1985-1989 (period A) and 1995-1999 (period B).

Results: Comparison between the three periods showed that in period A the lower incidence of children's acute poisoning (CAP) was observed. Also this revealed a 20%-reduction in the frequency of poisoning over the past 5-years (period C) compared to period B (p=0.219), a significant increase in tobacco intoxication over the years (in the order A-C; p<0.001 for comparisons of periods A and B, and periods B and C), while poisoning from insecticides-pesticides decreased (p<0.001). The incidence of poisoning via salicylates significantly reduced from 9.7% in period A to 6.2% in period B, and further to 4.7% in period C (p=0.016), whereas during the same periods poisoning via paracetamol increased from 2.3% to 5.1% and then to 10.4%, respectively (p<0.001). A trend toward a higher incidence of suicide attempt via poisoning was found during the three periods (from 3.0% in period A to 4.7% and 6.6%, in periods B and C, respectively; p=0.049).

Conclusions: The frequency of acute poisoning among children has decreased over the past 5 years. The incidences of poisoning via paracetamol and tobacco, and attempted suicide have increased in recent years. Targeted and continuous educational preventive programs are mandatory.

Key words: child, emergency medicine, medication, poisoning, toxic substances

INTRODUCTION

Acute poisoning among children remains a major health problem (1,2). Although there are educational programs and public campaigns designed to prevent children's acute poisoning (C AP), it continues to be a common medical emergency in the pediatric population (3). The pattern of incidence and the risk factors for CAP change with time and differ from country to country (4-6), and between geographical areas within the same country (7, 2). Two studies of CAP have already been undertaken at our institution (8, 9). The incidence of CAP was evaluated in both of these studies, in the first during the period 1985-1989 (period A) and in the second during the period 1995-1999 (period B). As the lifestyle of our society has altered over recent years, it is reasonable to suppose that the pattern of CAP has also changed. We have therefore completed a new prospective study, which covers the period 2005-2009 (period C), to assess the current pattern of CAP in the prefecture of Evros, and compared this with the two aforementioned studies (periods A and B).

METHODS

Children up to 14 years old who were admitted with acute poisoning to the Department of Pediatrics of Alexandroupolis University Hospital, a regional general and children's Hospital in the region of Thrace in Northern Greece, between January 2005 and December 2009 (period C) were enrolled in this study. The geographical target area was the prefecture of Evros, and the number of children aged up to 14 years according to the 2001 census was 20.809. The total prevalence of parental education level in the population of our region according to the same census was 21.1%, 42.0% and 36.9% for elementary, secondary education, and tertiary education respectively. The Department of Pediatrics is the only primary pediatric department in the prefecture of Evros so this paper represents the pattern of CAP among children in this region.

The information about each case was recorded on standardized forms, and a chart review survey was performed. …