Ozanne-Smith J, Day L, Parsons B, Tibballs J, Dobbin M
Monash University Accident Research Centre, Clayton, Victoria, Australia.
J Paediatr Child Health. 2001 Jun;37(3):262-5. doi: 10.1046/j.1440-1754.2001.00654.x.
To investigate the circumstances and means of access to six poisoning agents by children under 5 years of age and to make recommendations for countermeasures and strategies for implementation.
A case series study of access to six poisoning agents was conducted. Cases were identified prospectively through a poisons information centre and hospital emergency departments. Interviews were conducted with 523 parents and caregivers using a structured questionnaire.
The majority of children (94.1%) accessed the agent in their own home or another home and, in 38% of cases (excluding mistakes in administration), the parent or caregiver was present in the immediate area at the time of the incident. In cases in which the child was alone in the room, caregivers were frequently involved in household duties (51%), with only 10% undertaking leisure activities and 8% on the telephone. The span of unsupervised time reported was 5 min or less in 79.5% of these cases. The means of access was generally during periods of use of the agent (75.3%), including just purchased, rather than when agents were in their usual storage place.
There is little scope for improved supervision as a major intervention. Design and regulatory changes such as local safe storage for bench tops and while travelling, improved labelling and packaging, improved child-resistant packaging and its more general application are required. These and agent-specific interventions, including child-resistant bait stations for rodenticides and well covers for vaporizers, are more likely to prevent poisoning. The recent identification of childhood poisoning prevention as a national priority may lead to coordinated action to implement these and other preventive measures.
调查5岁以下儿童接触六种中毒剂的情况及途径，并提出应对措施和实施策略的建议。
对六种中毒剂的接触情况进行了病例系列研究。通过毒物信息中心和医院急诊科前瞻性地确定病例。使用结构化问卷对523名家长和照顾者进行了访谈。
大多数儿童（94.1%）在自己家中或其他家庭接触到中毒剂，在38%的病例中（不包括用药错误），事件发生时家长或照顾者就在附近。在孩子独自在房间的情况下，照顾者经常从事家务（51%），只有10%进行休闲活动，8%在打电话。在这些病例中，79.5%报告的无人监管时间跨度为5分钟或更短。接触途径通常是在使用中毒剂期间（75.3%），包括刚购买时，而不是在中毒剂通常存放的地方。
作为主要干预措施，加强监管的空间不大。需要进行设计和监管方面的改变，如在台面和旅行时进行本地安全储存、改进标签和包装、改进儿童防开启包装及其更广泛的应用。这些以及针对特定中毒剂的干预措施，包括用于杀鼠剂的儿童防开启诱饵站和用于蒸发器的井盖，更有可能预防中毒。最近将预防儿童中毒确定为国家优先事项可能会导致采取协调行动来实施这些及其他预防措施。
