ABSTRACT
Scores for severity grading of childhood poisoning may be useful in comparing different causes of poisoning, in order to identify the main risks and their changes over time. The Multicentre Study of Poisoning in Children score is based on four levels of severity (1-mild, 2-moderate, 3-severe, 4-very severe) involving nine target groups: seven relating to organ systems (gastrointestinal, nervous, respiratory, circulatory, renal, hepatic, skin), one to metabolic abnormalities and one to injuries from corrosive substances. Each patient is classified by the highest level attributed to any one of the nine groups. The score has been prospectively tested in 644 symptomatic children, aged 0-13 years, admitted to six pediatric hospitals of Northern Italy from January 1, 1991 to December 31, 1993. Poisoning was categorized as mild (1) in 357 children (53.8%), moderate (2) in 285 (42.9%), severe (3) in 18 (2.7%) and very severe (4) in 4 (0.6%). No deaths occurred. Severity grading according to The Multicentre Study of Poisoning in Children score confirms the prevalence of mild and moderate poisonings in children; the score seems to be an objective method suitable for epidemiological studies in different countries. Its clinical usefulness deserves more investigation.
Subject(s)
Poisoning/classification , Severity of Illness Index , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Prospective StudiesABSTRACT
Epidemiological and clinical aspects of 233 children below 14 years of age with acute carbon-monoxide poisoning are presented. Patients were recorded in the retrospective part of the M.S.P.C. (Multicentre Study of Poisoning in Children) at Genova, Torino and Trieste pediatric hospitals during 1975/90. Carbon-monoxide poisoning resulted to be a main toxic risk in children by considering its frequency and the severity of symptoms; three cases of death occurred. In particular, differences between symptoms in small children (under the age of 4 years) and adults are emphasised. This poisoning has to be suspected even in the presence of minor symptoms; the blood carboxyhemoglobin assay confirms the diagnosis and is useful to avoid further exposure.
Subject(s)
Carbon Monoxide Poisoning/epidemiology , Age Factors , Carbon Monoxide Poisoning/diagnosis , Carboxyhemoglobin/analysis , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Italy/epidemiology , Male , SeasonsABSTRACT
The risk associated with poisonings in children was assessed on 6175 subjects admitted to the pediatric hospitals of 3 regions of Northern Italy between 1975 and 1990. The frequency of exposures and the severity of sequelae allowed high- and low-risk substances to be identified. Risks were studied separately in the 0-4, 5-9 and 10-13 y age group to determine age-related differences. A decrease in drug-related poisonings and an increase of those caused by household products, particularly in the first 2 y of life, were observed in 1983-90 as against 1975-82 in association with the introduction of safety caps and containers for drugs. Our study points out the need to strengthen active primary prevention through health education and parental and adolescent information, and to improve passive prevention through the extension of safety closures to household products.
Subject(s)
Poisoning/epidemiology , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Italy/epidemiology , Male , Poisoning/mortality , Poisons , Risk FactorsABSTRACT
Child abuse by toxic substances is not easy to identify due to both the lack of signs of physical violence and the high incidence of accidental poisonings. Twelve cases of documented abuse, out of 6175 poisonings in children aged 0-13 years, were registered during 1975-1990 at Genova, Torino and Trieste Children Hospitals. In other 139 children the suspicion of abuse couldn't be confirmed. An early suspicion of abuse, is needed to prevent abuse and help the child and his family.
