POISONING

Preventable poisonings are a significant cause of both unintentional and intentional injuries, often resulting in hospitalization

For Canadians aged 1-4 years, 15% of unintentional injury hospitalizations are poisonings 1

OVERVIEW

Poisoning in Young Children

Medication is the leading cause of poisoning in children. Products that can be poisonous to children include:

  • Prescribed and over-the-counter medications
  • Alcohol
  • Household cleaners (detergent pods, bleach)
  • Personal hygiene products (mouthwash, nail polish)
  • Garden products
  • Car fluids (windshield fluid, oil)
  • Cannabis products (oils, edibles)
Poisoning in Teenagers and Adults

Both unintentional and intentional poisonings are common injuries among Canadian teenagers and adults. Common substances involved include:

  • Acetaminophen and ibuprofen
  • Opioids and illicit drugs
  • Alcohol
  • Antidepressants
  • Cannabis products
Poisoning in Older Adults

Unintentional poisoning among older adults typically involves:

  • Prescribed or over-the-counter medications
  • Consuming the wrong medication or incorrect dose
  • Alcohol

Intentional poisoning may also occur, commonly involving:

  • Pain medication
  • Sedatives

Poisoning is a leading cause of both unintentional and intentional injury deaths in BC.5 Any substance consumed in excess can result in poisoning. Substances that result in a poisoning, and the populations at risk of poisoning, vary greatly by intent and lethality. Alcohol, drugs, or medicinal agents are the predominant substances that result in over 90% of unintentional poisoning deaths and 85% of poisoning hospitalizations

Recently, poisonings involving detergent pods have become more common among young children, particularly toddlers. Consumption of these colourful, sweet-scented and highly concentrated packets of laundry or dishwasher detergent often result in hospitalization, and in extreme cases, death. These events are preventable, with best practices including keeping the pods out of reach and sight of children, as well as locking cabinets that contain these cleaning supplies.3

Among Canadians aged 10-17 years, 87% of self-inflicted injury hospitalizations are poisonings 2

RESEARCH

Poisoning Study: The relationship between injury, opioid prescribing and overdose and overdose death

Using a large linked administrative dataset from PopDataBC, we are looking to understand the pathway and risk factors between an injury and an illicit drug overdose event. Specifically, this project aims to determine whether opioid prescription, opioid agonist therapy, whether the injury was work-related, and the profession affected the risk of overdose. Read more on the PopDataBC website.

BC Children’s Hospital CHIRPP Program Substance Use Project

The Substance Use Project aims to capture all intentional and unintentional pediatric poisonings observed in the emergency department at BC Children’s Hospital. Topics covered include alcohol and cannabis-related poisonings in 2016-2018; alcohol and illicit drug-related poisonings in 2019; and trends in pediatric poisonings during the COVID-19 pandemic. This project is ongoing and is funded by the Public Health Agency of Canada.

Fentanyl-related deaths in BC increased from 0.3 per 100,000 people in 2012 to 12.1 per 100,000 people in 2016 (a 40-times increase), resulting in the declaration of an ongoing public health emergency in April 2016 8

PREVENTION

Current evidence suggests the following best practices to prevent poisoning-related events or reduce their effects:

  • Keep products in their original containers. Make sure they are clearly labeled.
  • Install Canadian-certified CO detectors in your home and have gas appliances serviced regularly.
  • Have a Poison Control emergency number handy in case of emergency. BC DPIC: 1-800-567-8911 toll-free in B.C. or 604-682-5050 in Greater Vancouver
  • Do not try to make the person vomit if you suspect poisoning unless advised do to so by poison control or a medical professional.6

To Protect Young Children:

  • Keep dangerous products out of sight and out of reach of children.
  • Place safety latches on all drawers or cabinets containing harmful products, including medicine, alcohol and cannabis products, and cleaning products.
  • Be mindful of where cannabis products are stored – especially edibles or cannabis-infused foods that imitate sweets, candies, or baked goods. Always ensure that any unconsumed cannabis is returned to its child-resistant packaging and not left on surfaces easily accessible to children.
  • Use products that have child-resistant safety caps. Be aware that child-resistant caps are not child-proof.
  • Avoid the use of cleaning products when children are close by.
  • Do not take medicine in front of a child and never call medicine “candy.”
  • Keep all cigarettes, butts, and ashtrays away from children.
  • Ensure that visitors to your home place their purses and bags out of reach of children.
  • Identify poisonous household plants, label each plant with its exact name, and keep plants off the floor and out-of-reach from young children.

Negative effects have been found regarding the use of warning labels—colourful stickers placed on the containers of hazardous substances to warn and deter children from handling or ingesting the contents. Evidence suggests either no effect of the intervention or an increase in children’s handling of labeled medicine. Warning stickers are not a good deterrent for children and may in fact serve as an attraction.

While typically not fatal, cannabis poisoning can require urgent medical attention, especially for children 4

News

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1. Yanchar, N.L., Warda, L.J., Fuselli, P., Canadian Paediatric Society, Injury Prevention Committee. (2012). Position Statement: Child and youth injury prevention: A public health approach. Available from: https://www.cps.ca/documents/position/child-and-youth-injury-prevention

2. Canadian Institute for Health Information. (2014). Self-Harm and Assault: A Closer Look at Children and Youth. Available from: https://www.cihi.ca/en/document/self-harm-and-assault-a-closer-look-at-children-and-youth

3. Government of Canada. (2015). Laundry Detergent Packets. Available from: https://www.canada.ca/en/health-canada/services/household-products/laundry-detergent-packets.html

4. Government of Canada. (2019). Cannabis in Canada: Get the facts. Available from: https://www.canada.ca/en/services/health/campaigns/cannabis.html

5. BC Vital Statistics Agency, Retrieved from Injury Data Online Tool (iDOT), BC Injury Research and Prevention Unit. 2014-2017.

6. HealthLinkBC. (2018). Poisoning. Available from: https://www.healthlinkbc.ca/health-topics/poins#tw9579

7. Goldman, J. M. (2018). Is the Label “not Recommended for Children” a Deterrent or Dangerous Attraction for Teenagers? Council on Injury, Violence, and Poison Prevention Program. https://doi.org/10.1542/peds.141.1_meetingabstract.70

8. Baldwin, N. et al. (2018). Fentanyl and heroin contained in seized illicit drugs and overdose-related deaths in British Columbia, Canada: An observational analysis. Drug Alcohol Depend. 185, 322–327.