title: Acute ethanol toxicity from ingesting mouthwash in children younger than age 6, 1989-2003.
abstract: OBJECTIVE
  The purpose of this study was to analyze American Association of Poison Control Centers (AAPCC) reports of suspected overingestion of mouthwash by children under age 6 and examine the effect of a 1995 Consumer Product Safety Commission (CPSC) rule requiring child-resistant packaging for mouthwashes containing at least 3 g (0.11 oz) of ethanol per package.
  
  
  METHODS
  The volume of ethanol ingested per kg of body weight was computed for children at the 5th, 50th, and 95th percentiles. The potentially toxic and potentially lethal volumes of 100% ethanol at each weight were also determined. The authors used segmented regression to test the difference in slopes between 1989 to 1996 (preintervention) and 1996 to 2003 (postintervention).
  
  
  RESULTS
  Incidence of overingestion rose from a low of 12.7 per 100,000 (1991) to 20.7 (1996). The increase ended with the adoption of the CPSC rule, declining to 16.8 per 100,000 in 2001 and rising to 17.9 in 2003.
  
  
  CONCLUSIONS
  This study's analysis suggests that the CPSC rule requiring child-resistant packaging on containers of mouthwash containing 3 g or more of ethanol has been successful in reducing AAPCC's reports of mouthwash overingestion. Health care providers should take a more active role by informing parents of the dangers associated with accidental ingestion of ethanol-containing mouthwash. Manufacturers should print warnings about the potential hazard of high ethanol concentrations on labels more prominent and they should stop producing mouthwashes with such high concentrations of ethanol. Moreover, they should also consider discontinuing packaging mouthwash in large containers.
authors.affiliation: Department of Public Health Sciences, Baylor College of Dentistry, The Texas A&M University System Health Science Center, Dallas, USA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Massey
authors.forename: Jay D
authors.initials: JD
authors.lastname: Shulman
mesh_terms: D000061:Accidents, Home / Q000706:statistics & numerical data; D000891:Anti-Infective Agents, Local / Q000506:poisoning*; D001835:Body Weight; D002675:Child, Preschool; D003257:Consumer Product Safety; D003679:Deglutition; D004348:Drug Labeling; D004349:Drug Packaging; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009067:Mouthwashes / Q000506:poisoning*; D011041:Poisoning / Q000453:epidemiology; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D000431:Ethanol