CHILDHOOD POISONING INVOLVING TRANSDERMAL NICOTINE PATCHES

Objective. To describe the circumstances, medical complications, and o utcomes of children exposed to a transdermal nicotine patch (TNP). Des ign. Prospective case series; postmarketing surveillance study over a 24-month period. Setting. Thirty-four United States poison centers. Pa tients. Children 0 to 15 years old exposed to a TNP. Interventions. No ne. Outcome Measures. Exposure circumstances, symptoms and signs of to xicity, complications, disposition, and hospital length of stay. Resul ts. Reports were received concerning 36 exposures to TNP in children y ounger than 16 years old (mean: 3 years old). Eighteen of these TNP ex posures were dermal; 18 additional children had bitten, chewed, or swa llowed part of a patch. All four commercial brands of TNP were represe nted; no brand was associated with more symptoms or an increased sever ity of illness. Fourteen children (39%) developed symptoms, including gastrointestinal distress (nausea, vomiting, diarrhea, abdominal pain) , weakness, dizziness, or localized rashes. Occurrence of symptoms aft er a dermal exposure to a TNP was associated with an estimated nicotin e dose .10 mg (.01 mg/kg body weight). Ten children were seen in the e mergency department; two were admitted overnight. All recovered fully. Conclusions. In this series, unintentional exposures to TNPs among yo ung children usually involved used patches, were transient (<20 minute s duration), and required only skin decontamination and supportive car e. Continued monitoring of inadvertent childhood exposures to TNPs is recommended to confirm these observations.