RECENT INCREASES IN NUMBERS AND RISK OF FATALITIES IN YOUNG-CHILDREN INGESTING IRON PREPARATIONS

Iron preparations are the most frequent cause of pediatric ingestion f atalities. The purpose of this study was to quantify the impression of an increase in iron deaths in young children and to postulate on the reasons. Using the data provided by the American Association of Poison Control Centers, overall annual mortality rate from iron preparations and among children <6 y was calculated and changes in incidence were recorded. Between 1983 and 1991, there was a 2 to 3-fold increase in t he numbers of reported ingestions of iron preparations by toddlers. In the general population the annual mortality rate/100 exposures to iro n preparations increased from 0.05 during 1983-1990 to 0.116 in 1991 ( p<0.01). A similar trend was noted in children <6 y with a rate of 0.0 04 in 1983-1990 compared with 0.12 in 1991 (p<0.01). Hence the Increas e in mortality was beyond what would be predicted from the increased n umber of ingestions noted. It is likely that increased awareness of pr egnancy-induced anemia results in abundant use of iron pills. These pi lls have the appearance of candies, which should be changed immediatel y by legislation. During this period, the volume of iron preparations prescribed increased only marginally (16%), suggesting that over-the-c ounter use of iron pills increased substantially. In addition to warni ng labels and child-resistant packaging, an aggressive educational pla n directed at the general population and physicians should he institut ed immediately.