title: Children at risk of medicinal and non-medicinal poisoning: a population-based case-control study in general practice.
abstract: BACKGROUND
  Preschool children have a high risk of poisoning. While medicines prescribed by primary care are potential poisoning agents, the risk factors for poisoning from medication are not well described.
  
  
  OBJECTIVE
  To identify risk factors for medicinal and  non-medicinal poisoning in preschool children.
  
  
  METHODS
  Population-based nested case-control study using The Health Improvement Network primary care database 1988-2004.
  
  
  METHODS
  Conditional logistic regression was used to identify child,  maternal, and social risk factors for medicinal (1316 cases) and non-medicinal poisoning (503 cases), using 17 709 controls matched on general practice.
  
  
  RESULTS
  Poisoning by medicines was independently associated with deprivation (test for trend P<0.001), maternal  age (P<0.001), birth order (P<0.001), maternal alcohol misuse (odds ratio [OR] = 5.44, 95% confidence interval [CI] = 1.99 to 14.91), and perinatal depression (OR = 1.54, 95% CI = 1.26 to 1.88). Living in a household with two or more adults lowered the odds of injury compared  to single-parent households (OR = 0.85, 95% CI = 0.74 to 0.96) and the odds varied by age, being highest in 2 year olds (OR = 9.61, 95% CI = 7.73 to 11.95). Non-medicinal poisoning was associated with deprivation (P = 0.001), maternal age (P<0.001), and birth order (P<0.001).  The odds were raised in 1 year olds (OR = 5.44, 95% CI = 4.07 to 7.26) and 2 year olds (OR = 5.07, 95% CI = 3.73 to 6.90) compared to those aged <1 year.
  
  
  CONCLUSIONS
  Primary care data can be used to target interventions to children at risk of poisoning. This is pertinent  when prescribing for children/family members, as prescribed medications may become poisoning agents. Prompt identification of maternal depression and alcohol misuse, and delivery of poisoning-prevention interventions at this stage may help prevent poisonings.
authors.affiliation: Church Street Medical Centre, Eastwood, Nottingham, United Kingdom.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Tyrrell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Orton
authors.forename: Laila J
authors.initials: LJ
authors.lastname: Tata
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
mesh_terms: D000437:Alcoholism / Q000453:epidemiology; D001722:Birth Order; D016022:Case-Control Studies; D002675:Child, Preschool; D003866:Depressive Disorder / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008423:Maternal Age; D009035:Mothers / Q000706:statistics & numerical data; D011041:Poisoning / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology