Claudet Isabelle, Mouvier Sébastien, Labadie Magali, Manin Cécile, Michard-Lenoir Anne-Pascale, Eyer Didier, Dufour Damien
Service d'Accueil des Urgences Pédiatriques, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse and Inserm, UMR 1027, Université Paul Sabatier Toulouse III, Toulouse, France;
Urgences Enfants, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Pediatrics. 2017 Sep;140(3). doi: 10.1542/peds.2017-0017. Epub 2017 Aug 14.
In France, cannabis consumption is illegal. The health impact of its increasing use and higher tetrahydrocannabinol (THC) concentrations is still poorly documented, particularly that of unintentional pediatric intoxications. We sought to evaluate the French national trend of admissions for unintentional cannabis intoxication in children over an 11-year period (2004-2014).
A retrospective, national, multicenter, observational study of a pediatric cohort. All children aged <6 years admitted to a tertiary-level pediatric emergency department (PED) for proven cannabis intoxication (compatible symptoms and positive toxicological screening results) during the reference period were included.
Twenty-four PEDs participated in our study; 235 children were included, and 71% of the patients were 18 months old or younger. Annual admissions increased by a factor of 13. Hashish resin was the main form ingested (72%). During the study period, the evolution was characterized by a national increase in intoxications, younger intoxicated children (1.28 ± 0.4 vs 1.7 ± 0.7 years, = .005), and more comas ( = 38) ( = .05, odds ratio 3.5 [1.02-11.8]). Compared with other intoxications, other PED admissions, and the same age population, cannabis-related admissions were greater. There was a potential link between the increased incidence of comas and increased THC concentration in resin seized in France over the period.
Children are collateral victims of changing trends in cannabis use and a prevailing THC concentration. Intoxicated children are more frequent, are younger, and have intoxications that are more severe. This raises a real issue of public health.
在法国,大麻消费是非法的。其使用增加以及四氢大麻酚(THC)浓度升高对健康的影响仍记录不足,尤其是儿童意外中毒方面。我们试图评估11年间(2004 - 2014年)法国儿童意外大麻中毒的全国性入院趋势。
对一个儿科队列进行回顾性、全国性、多中心观察性研究。纳入参考期间因确诊大麻中毒(症状相符且毒理学筛查结果呈阳性)而入住三级儿科急诊科(PED)的所有6岁以下儿童。
24个PED参与了我们的研究;纳入235名儿童,71%的患者年龄在18个月及以下。年入院人数增加了13倍。大麻脂是主要摄入形式(72%)。在研究期间,其演变特点为全国中毒人数增加、中毒儿童年龄更小(1.28±0.4岁对1.7±0.7岁,P = 0.005)以及昏迷情况增多(P = 0.05,优势比3.5[1.02 - 11.8])。与其他中毒、其他PED入院情况以及同年龄人群相比,与大麻相关的入院人数更多。在此期间法国查获的树脂中THC浓度增加与昏迷发生率增加之间可能存在关联。
儿童是大麻使用趋势变化和普遍存在的THC浓度的附带受害者。中毒儿童更常见、年龄更小且中毒情况更严重。这引发了一个真正的公共卫生问题。