Acute severe poisonings
This surveillance study aimed to determine the incidence of accidental poisoning; identify trends in severe poisonings that might inform public health interventions; describe the demographics of presenting populations; and calculate the severity of the poisoning event as determined by the EAPCCT poisoning severity score. The study was led by Dr Elizabeth Starkey, winner of the Sir Peter Tizard Bursary 2014-15.
Overview
Poisoning occurs when someone is exposed to a substance that can affect his or her health. Accidental or unintentional poisonings involve people poisoning themselves or others without wanting to cause harm. Accidental poisoning in children is a common reason for attendance at healthcare providers. Young children, especially those under five, have an inquisitive nature, and frequently put things found in their environment into their mouths. Teenagers involved in taking illicit drugs or alcohol are also in danger of poisoning themselves unintentionally because of their risk-taking behaviour.
Serious consequences are rare after an accidental poisoning and most children are either discharged or observed for a few hours. Child-resistant containers for medicines and other dangerous substances have contributed significantly to a reduction in serious harm. However, a number of children continue to suffer significant harm, with between 5 and 10 deaths each year and around 50 children admitted to intensive care within the UK. In particular, there are a number of medications in which a single adult dose unit is potentially fatal to a toddler. The majority of these are packaged in blister packs, which are not subject to current child resistant closure legislation. Accidental poisoning is essentially an avoidable problem and, as a result, remains an important public health issue.
There is very little detailed data regarding serious poisoning in children in the UK. This study, for the first time, will determine the incidence and identify the circumstances surrounding severe accidental poisoning in children under 15 years in the UK and Republic of Ireland resulting in death, or signs and symptoms of poisoning defined as needing significant monitoring or support.
Accidental poisoning is an avoidable problem and remains an important public health issue. It is well recognised that blanket approaches to public health campaigns are often ineffective. By identifying specific trends in severe poisonings, in particular including specific substances that frequently cause significant harm, it is hoped that these can be subsequently be targeted.
Published paper
King C, Anderson M, Agarwal A, Fakis A, Parry CM, Lynn RM, et al. Severe accidental poisonings in children: a British Paediatric Surveillance Unit nationwide prospective study. Arch Dis Child. 2025;110(8):597–602. doi:10.1136/archdischild-2024-328196.
Investigators
Dr Elizabeth Starkey
Derbyshire Children’s Hospital
Uttoxeter Road
Derby DE22 3DE
Email: elizabeth.starkey@nhs.net
Duration
July 2018 – July 2019