This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
Researchers examined hospital admissions for children (aged 0 - 11 years) poisoned with medicines between 1998 and 2018. The vast majority of poisonings in this age group are known to be unintentional. The team found that admissions for poisoning by paracetamol increased, while those for poisoning by prescribed drugs (such as antidepressants or opioids) decreased.
Compared with children living in the least deprived areas, those living in the most deprived areas:
- were more likely to be admitted to hospital for any medicinal poisoning (30% more)
- were twice as likely to be admitted for poisoning by a prescribed drug.
The researchers hope their findings will encourage more public health campaigns and targeted messages about medicinal safety, especially for those living in more deprived areas. They stress that deprivation status was derived from the address of a child’s GP and might not reflect individual households.
More information about poisoning can be found on the NHS website.
The issue: how often are children admitted to hospital because of medicinal poisoning?
Accidental poisoning of children by medicines is dangerous and preventable. Between April 2023 and April 2024, around 1426 children aged 0 to 9 years were admitted to hospital as a result, according to NHS England. Previous research found that children in the most deprived areas were most at risk.
In recent years, over-the-counter medicines (such as aspirin, ibuprofen, anti-congestion remedies and sore throat lozenges) have become more widely available, and more prescriptions of prescribed medicines have been issued. This could have increased avoidable poisonings. Equally, the introduction of child-proof caps and packaging, along with other public health interventions, might have reduced the risk.
This research assessed the risk of accidental poisoning by different medicines among young children, and explored the link between deprivation and risk.
What’s new?
Researchers examined electronic health records of almost 1.5 million children aged 0 to 11 years registered at 399 general practices in England. The main outcome was hospital admission from medicine poisoning between 1998 and 2018.
The 3 most common categories of medicine poisoning account for most (60%) of all poisonings. They are:
- paracetamol
- drugs with dependency or withdrawal risk (including opioids such as codeine, antidepressants and antianxiety drugs)
- over-the-counter pain relief and anti-cold drugs that do not contain paracetamol.
The study found that the incidence of children’s admissions due to these 3 categories of medicines combined did not change over the study period. Overall, 3,621 children experienced 3,685 hospital admissions. Young children (aged 2 - 4 years) were much more likely (90% more likely) to be admitted to hospital than older children (aged 5 - 11 years).
Over the course of the study, hospital admissions for:
- paracetamol increased by 43% over the study period (and accounted for 33% of all poisoning admissions)
- drugs with dependency or withdrawal risk decreased by 33% (and accounted for 14% of all poisoning admissions)
- over-the-counter drugs did not change over the study period (and accounted for 13% of all poisoning admissions).
Compared with children in the least deprived areas, those from the most deprived:
- were at greater risk of poisoning from drugs in all 3 categories (30% more risk)
- were almost twice as likely to be admitted because of poisonings from drugs with a risk of dependency or withdrawal.
Why is this important?
Overall, childhood hospital admissions for poisoning by the 3 categories of drug in this study did not change between 1998 and 2018. Admissions for paracetamol poisoning increased. But admissions for drugs with a risk of dependency or withdrawal decreased, even though prescriptions for opioids increased between 2000 and 2012.
The researchers say that messages around safe storage of medicines have led to positive changes in behaviour with prescribed medication. However, people may consider easily available medicines such as paracetamol less dangerous. The researchers stress that these drugs should be stored safely, in a raised, locked cupboard out of reach of children, in the same way as prescribed medicines.
More drugs with a risk of dependency or withdrawal are prescribed to adults in the most deprived areas, which is reflected in the increased risk to children living there. More targeted messaging about storing medicines safely could help people living in more deprived areas, the researchers say. The findings strengthen the argument for measures such as home safety assessments as recommended by the National Institute for Health and Care Excellence (NICE).
Deprivation status, derived from the address of the general practice where children were registered, might not reflect households’ actual status. The study focused on hospital admissions; findings might therefore not be generalisable to less serious poisonings.
What’s next?
The researchers have shared their results with the Royal Society for the Prevention of Accidents and KidRapt (a UK company that works with charities and local authorities to prevent children's accidents at home).
You may be interested to read
This is a summary of: Tyrrell E, and others. Patterns and trends of medicinal poisoning substances: a population-based cohort study of injuries in 0-11 year old children from 1998-2018. Archives of Public Health 2024; 82: 50.
Information about what to do if a child has swallowed a medicine accidentally from the Royal College of Paediatrics and Child Health.
The research team’s website: Injury Epidemiology and Prevention Research
Funding: This study was funded by the NIHR School for Primary Care Research.
Conflicts of Interest: No relevant conflicts were declared. Full disclosures are available on the original paper.
Disclaimer: Summaries on NIHR Evidence are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that the views expressed are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.
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