Q. What is National Poison Prevention Week?
A. Public Law 87-319 authorizes the President to designate annually the third week in March as National Poison Prevention Week. This act of Congress was signed into law on September 16, 1961, by President Kennedy, after which the Poison Prevention Week Council was organized to coordinate this annual event. Congress intended this event as a means for local communities to raise awareness of the dangers of unintentional poisonings and to take such preventive measures as the dangers warrant.
Q. Is there a special theme for National Poison Prevention Week?
A. Yes, our basic theme is "Children Act Fast...So Do Poisons!" This means that parents must always be watchful when household chemicals or drugs are being used. Many incidents happen when adults are using a product but are distracted (for example, by the telephone or the doorbell) for a few moments. Children act fast, and adults must make sure that household chemicals and medicines are stored away from children at all times.
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.
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.
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 victim's 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.
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.
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.
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.
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.
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.
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.
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).
Deaths of Children under Age 5 Involving Household Products
|Deaths from All Medicines and Household Chemicals|
Source: National Center for Health Statistics (mortality files)
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.
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.
Q. Are there any good housekeeping rules I can use to prevent poisonings?
- Use child-resistant packaging properly by closing the container securely after use.
- Keep all chemicals and medicines locked up and out of sight.
- Call the poison center (800-222-1222) immediately in case of poisoning. Keep on hand a bottle of ipecac syrup but use it only if the poison center instructs you to induce vomiting.
- When products are in use, never let young children out of your sight, even if you must take the child or product along when answering the phone or doorbell.
- Keep items in original containers.
- Leave the original labels on all products, and read the label before using.
- Do not put decorative lamps and candles that contain lamp oil where children can reach them because lamp oil is very toxic.
- Always leave the light on when giving or taking medicine. Check the dosage every time.
- Avoid taking medicine in front of children. Refer to medicine as "medicine," not "candy."
- Clean out the medicine cabinet periodically, and safely dispose of unneeded medicines when the illness for which they were prescribed is over. Pour contents down drain or toilet, and rinse container before discarding.
Q. Is the poinsettia still considered to be extremely toxic?
A. The poinsettia was blamed for a death in 1919; however, recent studies indicate that the plant is not as highly toxic as was thought at that time. It is unlikely that ingestion of a poinsettia would be fatal, although it may cause some gastric irritation and burning in the mouth. Many other plants are toxic also. If any indoor or outdoor plants are ingested, the Poison Control Center should be contacted or medical advice should be sought.
Q. Is lead in paint a serious problem if a child should ingest it?
A. In the past, paints could - and did - contain much higher levels of lead than they do now. Since 1971, however, the permissible amount of lead in consumer paint products has been reduced through a series of federal laws and regulations. This reduction also applies to paints or coatings on toys or articles intended for use by children. Children can still become lead poisoned from ingesting chips or breathing dust from old, heavily-leaded paint that is still present on walls and other surfaces in older houses and buildings. Workers and entire families face the same hazard when older homes and buildings are rehabilitated and sanding raises dust as leaded paint is removed from walls, floors, and ceilings.
Q. Can miniature "button" batteries present a risk of childhood poisoning?
A. These tiny batteries (used in watches, calculators, cameras, and hearing aids) usually pass through the person without any problem. However, miniature batteries may cause poisoning if swallowed and they can cause internal burns if they become lodged in the esophagus or intestinal tract. If a miniature battery is swallowed, you should contact your Poison Control Center, your physician, or the National Button Battery Ingestion hotline at 202-625-3333. In order to prevent ingestion of miniature batteries, consumers should keep the batteries out of children's reach and throw away old batteries, securely wrapped, after they have been removed from the appliance.
Q. Are adults also at risk when they swallow medicines and household chemicals?
A. Yes, poisonings happen to adults - especially older people - who cannot read labels or who fail to follow instructions. Some people may confuse one medicine for another, especially if the light is not on when they reach for a medicine at night. Others may take too much of a medicine or may mix medicine with alcohol or other substances. Adults should take precautions to avoid poisonings:
- Turn on a light at night and put on your glasses to read the label when you need to take a medicine.
- Always read the label and follow instructions when taking medicines. If any questions arise, consult your physician.
- Never mix medicines and alcohol, and never take more than the prescribed amount of medicine.
- Never "borrow" a friend's medicine or take old medicines.
- Tell your doctor what other medicines you are taking so you can avoid adverse drug interactions.
Q. What can consumers do to protect themselves and their families from medicines that have been tampered with?
A. Although most medicines are packaged in tamper-evident packaging, they are not tamper-proof. Each consumer must be alert for the packaging to be protective. Here's how you can help protect yourself and your family:
- Read the label. Over-the-counter medicines tell you on the label what tamper-evident features you should look for on the package.
- Inspect the outer packaging. Look before you buy!
- Inspect the product itself when you open the package. Look again before you take it! If it looks suspicious, be suspicious.
- Look for tablets or capsules that are different in any way from others in the package.
- Don't use any medicine from a package that shows cuts, slices, tears, or other imperfections.
- Never take medicine in the dark.
- Read the label and look at the medicine every time you take a dose.
- Whenever you suspect something wrong with a medicine or its packaging, take it to the store manager.
- Tamper-evident packaging can help protect you if you are alert!
Q. What can consumers do to protect children from pesticide-related poisonings?
A. A recent survey by the U.S. Environmental Protection Agency regarding pesticide use in and around the home revealed that almost half (47%) of all households with children under the age of 5 had at least one pesticide stored in an unlocked cabinet, and less than 4 feet off the ground (i.e., within reach of children). The survey also found that 75% of households without children under the age of 5 also stored one pesticide within reach of children. This number is especially significant because 13% of all pesticide poisonings occur in homes other than the child's home. Adults should take the following steps to safeguard children from exposures to pesticides:
- Always store pesticides away from children's reach, in a locked cabinet or garden shed.
- Read the label first and follow the directions to the letter, including all precautions and restrictions.
- Before applying pesticides (indoors and outdoors), remove children and their toys from the area and keep them away until it is dry or as recommended by the label.
- Never leave pesticides unattended when you are using them - not even for a few minutes.
- Never transfer pesticides to other containers - children may associate certain containers with food or drink.
- Use child-resistant packaging properly by closing the container tightly after use.
- Alert others to the potential hazard, especially grandparents and caregivers.
Q. Where can I get more information on preventing poisonings?
A. The list can be obtained from Secretary, Poison Prevention Week Council, PO Box 1543, Washington, D.C. 20013 and is posted at www.poisonprevention.org