Poisoning in Children from an Educationally and Economically Advanced Urban Area of South India

Poisoning, a major cause of morbidity among children may be accidental or deliberate. This study was undertaken to assess the factors associated with poisoning in children in a south Indian city with high levels of education and health care facilities. The study included all children 18 years and below, admitted with poisoning during a four year period at the PSG institute of medical science and research, Coimbatore. The relevant data including the substance(s) consumed, time interval at presentation to the casualty, Poisoning Severity Score (PSS) and outcome were noted on a pre-designed questionnaire. There were 121 cases of poisoning, constituting 0.5% of total pediatric admissions. Among them, 86 (70.2%) children consumed poison for Deliberate Self Harm (DSH) and in 35 (29.8%) it was accidental. In 31 of the 35 children with accidental poisoning, easily available household items (drugs, insecticides, cleaning solutions) were responsible. The median age of children with accidental poisoning was 2 years, while in DSH it was 16 years. One third of children with DSH had an underlying psychiatric disorder. A majority (75%) of children were brought to hospital within six hours. The poison severity score was none or mild in 91 (75.2%), while 17 had moderate and 10 had severe poisoning. The overall mortality was only 2.5%. Poisoning is usually accidental in young children and its prevention requires educating the public regarding safe storage of drugs, pesticides, floor cleaners etc., In older children, DSH is the commonest reason for poisoning. All children with DSH should have a psychiatric evaluation. Most children with poisoning have low PSS and the prognosis is good.