Rodenticide poisoning among children

We aimed to determine the nature, extent and sequence of events of accidental childhood poisoning with rodenticides and identify potential intervention strategies. Subjects were identified prospectively from callers to the Victorian Poisons Information Centre and those presenting to the Emergency Departments of hospitals participating in the Victorian Injury Surveillance System from 1 April to 31 December 1993. The events preceding rodenticide ingestion were examined via telephone questionnaire involving 128 parents or guardians of children under five years exposed to rodenticides. Rodenticides are not leading agents for severe poisoning but are a frequent and increasing cause of less severe poisoning. Most children (90 per cent) had obtained the rodenticide from the site at which it had been laid, usually by the caregiver (67 per cent), in the kitchen, lounge room or laundry, inside cupboards or wardrobes. In 69 per cent of these cases, respondents thought the site would not normally allow access to children. Only 13 per cent of children were admitted to hospital, although 41 per cent sought medical attention. Most caregivers (90 per cent) were aware of some dangers associated with rodenticides. Children usually ingest insufficient amounts of rodenticide to cause serious effects. However, medical assessment and monitoring of prothrombin times is often indicated, with a consequent cost to the healthcare system. Potential countermeasures, focusing on packaging and positioning of rodenticide baits, product reformulation, and the distribution of management guidelines for health workers, were identified. Implementation of the identified countermeasures was initiated by a workshop involving stakeholders from industry, research and health professions.