EFFECTIVENESS OF CHILD-RESISTANT PACKAGING ON TOXIN PROCUREMENT IN YOUNG POISONING VICTIMS

The objective of this study was to determine how often and how childre n <5 y-of-age involved In unintentional poisonings gained access to th ose poisons by opening properly secured child-resistant packages. From June 1994 through February 1995 we surveyed caretakers of children <5 y-of-age presenting with the chief complaint of ingestion, inhalation , or ocular or dermal exposure of potential or perceived toxins. Exclu ded were exposures to plants, bites or stings, or patients inadvertent ly overdosed by a caretaker. The survey was administered to caretakers of 168 patients. Mean age was 26 mo (range 9 mo to 56.9 mo). The toxi n was In its original container In 71% and transferred to another cont ainer or found outside of its container in 29% of cases; 33% involved a child-resistant closure. The child gained access by opening a proper ly closed child-resistant closure in 20% of the exposures and in 18.5% by opening a properly closed non-child-resistant closure. Child-resis tance did not ensure child impenetrability. This suggests the need to reevaluate child-resistant closure testing protocols or retest current ly used closures. Packaging misuse, including improper closure use or transferring medications or household products from the original conta iner accounts for a large percentage of pediatric toxin exposures, thu s emphasizing the importance of poison prevention education.