title: Unsuspected cocaine exposure in young children.
abstract: 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.
authors.affiliation: Department of Pediatrics, Boston (Mass) City Hospital 02118.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kharasch
authors.forename: D
authors.initials: D
authors.lastname: Glotzer
authors.forename: R
authors.initials: R
authors.lastname: Vinci
authors.forename: M
authors.initials: M
authors.lastname: Weitzman
authors.forename: J
authors.initials: J
authors.lastname: Sargent
mesh_terms: 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
chemical_list: D003042:Cocaine