Public Health Agency of Canada, Ottawa, ON, Canada.
BMC Public Health. 2023 Oct 23;23(1):2067. doi: 10.1186/s12889-023-16987-9.
Cannabis poisonings among children are of public health concern. Existing evidence from the US and from four provinces in Canada (Quebec, Ontario, Alberta, British Columbia) indicate an increase in pediatric cannabis-related poisonings since the legalization of cannabis. This study evaluates trends in cannabis-related poisoning pediatric emergency department (ED) visits and hospitalizations in Canada and addresses a gap in literature by describing trends and context around cannabis edible-related poisoning cases using data from a Canadian sentinel surveillance system.
Mixed-methods using data from two administrative data sources and one injury/poisoning sentinel surveillance system to estimate age-specific rates of cannabis-related poisonings ED visits (Ontario and Alberta), edible-related events (sentinel surveillance Canada), and hospitalizations (Canada with the exception of Quebec) among children between the ages of 0 to 11 from 2015/2016 to 2021. Annual absolute changes were calculated to quantify the magnitude of change between each age-specific rate. Joinpoint regression was used for trend analysis. A thematic analysis was completed to gain a better understanding of cannabis edible-related poisoning cases in the ED.
The pediatric age-specific rates for cannabis-related poisoning ED visits (average annual percent change (AAPC) Ontario: 98.2%, 95% CI: 79.1, 119.2; AAPC Alberta: 57.4%, 95% CI: 36.7, 81.2), hospitalizations (AAPC: 63.4%, 95% CI: 42.0, 87.9) and cannabis edible-related events (AAPC: 122.8%, 95% CI: 64.0, 202.6) increased significantly from 2015 to 2021. Almost half of all pediatric edible-related events involved gummy edible products (48.8%, n = 143). Based on the thematic analysis, 88% cannabis edible-related events were attributed to inadvertent ingestion due to access to such products or lack of safe storage practices.
Age-specific rates of cannabis-related poisoning ED visits (Ontario and Alberta) and hospitalizations (Canada with the exception of Quebec) have increased since cannabis legalization, with the largest increase in rates occurring from 2019 to 2020. A similar increase in the rate of cannabis edible-related cases from sentinel surveillance data underscores the importance of monitoring this outcome. Public health messaging and national public health promotion strategies targeted towards raising awareness on the risks associated with consuming illegal cannabis and safe storage of cannabis could help mitigate cannabis poisonings among children.
儿童大麻中毒是公共卫生关注的问题。来自美国和加拿大四个省份（魁北克、安大略、艾伯塔、不列颠哥伦比亚）的现有证据表明，自大麻合法化以来，儿科与大麻相关的中毒事件有所增加。本研究评估了加拿大与大麻相关的儿科急诊（ED）就诊和住院中毒趋势，并通过使用来自加拿大监测系统的中毒数据描述了可食用大麻中毒病例的趋势和背景，填补了文献中的空白。
使用来自两个行政数据源和一个伤害/中毒监测系统的数据，采用混合方法，估计 2015/2016 年至 2021 年间 0 至 11 岁儿童的大麻中毒 ED 就诊（安大略和艾伯塔）、可食用相关事件（加拿大监测系统）和住院率（除魁北克外的加拿大）的特定年龄率。计算年度绝对变化，以量化每个特定年龄率之间的变化幅度。采用 Joinpoint 回归进行趋势分析。完成了主题分析，以更好地了解 ED 中与大麻可食用相关的中毒病例。
2015 年至 2021 年，与大麻相关的儿科中毒 ED 就诊（安大略平均年百分比变化率（AAPC）：98.2%，95%CI：79.1，119.2；艾伯塔 AAPC：57.4%，95%CI：36.7，81.2）、住院（AAPC：63.4%，95%CI：42.0，87.9）和大麻可食用相关事件（AAPC：122.8%，95%CI：64.0，202.6）的特定年龄率显著增加。几乎一半的儿童可食用相关事件涉及 gummy 可食用产品（48.8%，n=143）。基于主题分析，88%的与大麻可食用相关的事件归因于意外摄入，原因是接触此类产品或缺乏安全储存措施。
自大麻合法化以来，与大麻相关的中毒 ED 就诊（安大略和艾伯塔）和住院（除魁北克外的加拿大）的特定年龄率有所增加，2019 年至 2020 年期间增加幅度最大。来自监测数据的大麻可食用相关病例率的类似增加突显了监测这一结果的重要性。针对与食用非法大麻相关的风险和大麻安全储存提高公众意识的公共卫生信息和国家公共卫生促进策略可能有助于减少儿童大麻中毒。
