Severe accidental poisonings in children: a British Paediatric Surveillance Unit nationwide prospective study.

Background: Poisoning in children and young people is common. Understanding the incidence, causes and circumstances of severe accidental poisonings, requiring admission and medical intervention, may help healthcare professionals and shape public health interventions.

Methods: A prospective, population-based surveillance study using the British Paediatric Surveillance Unit (BPSU)'s active surveillance methodology (July 2018-July 2019) in the UK and Ireland. Inclusion criteria were as follows: all children aged <15 years; accidental poisoning requiring intervention; Poisoning Severity Score (PSS) score ≥2 (moderate or severe). Intentional poisonings were excluded.

Results: 116 cases of poisoning were reported, and 31 cases met the inclusion criteria. The overall incidence of reported severe accidental poisoning was 2.4 cases per million children (3.2 per million in male, 1.6 per million in female), with 7.3 cases per million in children under 2 years. On PSS scoring, 14 (45%) cases were classified as moderate, 16 (52%) cases severe and 1 (3%) case fatal. The frequency of fatal poisonings reported was 0.08 per million children. Prescription medications were the most common substance implicated (n=13, 42%), with opioids (n=6, 19%) being the most common medication group. Common non-medication causes were illicit drugs or alcohol (n=12, 39%), household or industrial products (n=5, 16%), and carbon monoxide (n=1, 3%). The most cited circumstance was 'the substance being left unattended' (n=8, 26%).

Conclusion: Severe accidental poisoning remains a significant problem for children, but the most common causes have changed, underscoring the importance of updating public health initiatives.