Unsuspected cocaine exposure in young children.
OBJECTIVE
To determine the prevalence of cocaine exposure among preschool children with clinically unsuspected signs and/or symptoms.


METHODS
Prevalence study.


METHODS
Pediatric emergency department in an inner-city hospital.


METHODS
250 children aged 2 weeks to 5 years who underwent urine assays for cocaine prior to discharge from the emergency department.


METHODS
None.


RESULTS
Six (2.4%) of the 250 urine assays (95% confidence interval, 0.5% to 4.3%) were positive for benzoylecgonine, the major urinary cocaine metabolite. Four of the positive urine assays were from children younger than 1 year and all children with positive urine assays were younger than 24 months. None of these children presented with a complaint or was identified as having clinical problems currently associated with childhood exposure to cocaine. Possible exposure routes include breastfeeding, intentional administration, accidental ingestion of cocaine or cocaine-contaminated household dust via normal hand-to-mouth activity, and passive inhalation of "crack" vapors.


CONCLUSIONS
Among the inner-city children served by this hospital, significant numbers of infants and young children are being exposed to cocaine, and this exposure occurs in a clinically unsuspected population.
Kharasch
S J
SJ
Department of Pediatrics, Boston (Mass) City Hospital 02118.
Glotzer
D
D
Vinci
R
R
Weitzman
M
M
Sargent
J
J
D002675:Child, Preschool; D003042:Cocaine / Q000652:urine; D004630:Emergencies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000652:urine; D014505:Urban Population
D003042:Cocaine