title: A retrospective analysis of ingestion of caustic substances by children. Ten-year statistics in Galicia.
abstract: We reviewed the case histories of 743 children seen at our hospital from 1981 to 1990 for suspected ingestion of caustic substances. Mean patient age was 27 months; 85% of patients were less than 3 years old. The male-to-female ratio was about 2:1. About 53% of patients were from urban environments. All ingestions appear to have been accidental. Of the 743 children, 20% presented oesophageal burns (11.8% first-degree, 3.1% second-degree and 2.7% third-degree). Alkaline products were ingested about 11 times more frequently than acid products. The substance ingested was bleach in 73% of cases. The most dangerous substances were dishwasher liquids/powders (59% of ingestions led to oesophageal burn), caustic soda (55%) and drain cleaners (55%). The caustic product was not in its original container in 75% of cases. Most accidents (58%) took place in the home. We did not detect any reliable predictive relationship between the presence of symptoms and signs and of oesophageal burns. Of the 743 patients, 5% developed oesophageal stricture and 3% required oesophageal dilatation.
  
  
  CONCLUSIONS
  The incidence of accidents caused by the ingestion of caustic substances can only be reduced by broad-based preventive strategies, including enforcement of safe manufacturing practices and public education programmes. Most importantly, the containers for caustic household products should be cheap, small and childproof.
authors.affiliation: Servicio de Cirugía Pediátrica, Complejo Hospitalario Universitario de Santiago, Santiago of Compostela, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Bautista Casasnovas
authors.forename: E
authors.initials: E
authors.lastname: Estevez Martinez
authors.forename: R
authors.initials: R
authors.lastname: Varela Cives
authors.forename: A
authors.initials: A
authors.lastname: Villanueva Jeremias
authors.forename: R
authors.initials: R
authors.lastname: Tojo Sierra
authors.forename: S
authors.initials: S
authors.lastname: Cadranel
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data; D000293:Adolescent; D002057:Burns, Chemical / Q000150:complications / Q000453:epidemiology*; D002424:Caustics / Q000009:adverse effects*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D002940:Circadian Rhythm; D004940:Esophageal Stenosis / Q000453:epidemiology; D004947:Esophagus / Q000293:injuries; D005247:Feeding Behavior; D005260:Female; D006795:Household Products; D006801:Humans; D007223:Infant; D008297:Male; D019064:Product Packaging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
chemical_list: D002424:Caustics