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Changes in the epidemiology of poisonings attended in Spanish pediatric emergency departments between 2001 and 2010: increase in ethanol intoxication

Azkunaga B, Mintegi S, Del Arco Arco L, Bizkarra I

Servicio de Urgencias de Pediatría, Hospital Universitario de Cruces, Bilbao, Spain.

Objective: To analyze changes in the epidemiology of poisonings attended in Spanish
pediatric emergency departments in the last decade.
Methods: Comparative study with historical control group. The characteristics of poisoning cases
were extracted from the records of hospital emergency departments participating in the working
group on poisonings of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). We
studied 2 groups comprised of cases from 2 periods: January 2001 to December2002 (data from
the paper records of 17 departments) and October 2008 to September 2010 (data from the
computerized records of 38 departments).
Results: The frequency of poisoning among all emergencies attended was higher in the
second period (0.33%) than in the first (0.28%) (P=.0076). In both periods around 75%
of poisonings occurred in children aged 6 years or under (78.3% in the first period and
73.8% in the second). Medicines were the substances most often involved (54.7% and
51.6% in the first and second periods, respectively). The individual substances most
often ingested were paracetamol in 2001-2002 and ethanol in 2008-2010. Ethanol
poisonings increased from 7.5% of all cases in the first period to 16% in the second
(P<.00001); abuse of illegal drugs (mainly cannabis) was associated with alcohol
poisoning in nearly 9% of the cases. A third of the patients were discharged after initial
evaluation and treatment.
Conclusions: Involuntary ingestion of a medicine by a child under the age of 6 years
continues to be the main cause of acute poisoning in Spanish pediatrics, although
poisoning due to recreational use of alcohol has increased significantly. Ethanol is now
the main single toxic substance implicated in cases of acute poisonings attended by
Spanish pediatric emergency departments.

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