Keeping children safe at home: protocol for a matched case-control study of modifiable risk factors for poisoning.
BACKGROUND
Childhood unintentional and suspected poisonings are a serious public health problem. Evidence from systematic reviews demonstrates that home safety education in combination with safety equipment provision increases the safe storage of medicines and other products. There is lack of evidence that poisoning prevention practices reduce poisoning rates.


OBJECTIVE
To estimate ORs for medically attended poisonings in children aged 0-4 years for items of safety equipment, home hazards and parental safety practices aimed at preventing poisoning, and to explore differential effects by child and family factors.


METHODS
Multicentre case-control study in UK hospitals with validation of parent-reported exposures using home observations. Cases are aged 0-4 years with a medically attended poisoning occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression; unmatched analyses will use unconditional logistic regression to adjust for confounding variables. The study requires 266 poisoning cases and 1064 matched controls to detect an OR of 0.64 for safe storage of medicinal products and of 0.65 for non-medicinal products, with 80% power, a 5% significance level and a correlation between exposures in cases and controls of 0.1.


METHODS
Unintentional childhood poisoning.


CONCLUSIONS
This will be the largest study to date exploring modifiable risk factors for poisoning in young children. Findings will inform: policy makers developing poison prevention strategies, practitioners delivering poison prevention interventions, parents to reduce the risk of poisoning in their homes.
Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Gosia
G
Majsak-Newman
Division of Primary Care, School of Medicine, Nottingham, UK.
Penny
P
Benford
Division of Primary Care, School of Medicine, Nottingham, UK.
Joanne
J
Ablewhite
Division of Primary Care, School of Medicine, Nottingham, UK.
Rose
R
Clacy
DREEAM (Department of Research and Education in Emergency medicine Acute medicine and Major trauma), Nottingham University Hospitals' NHS Trust, UK.
Frank
F
Coffey
Department of Health Sciences, University of Leicester, Leicester, UK.
Nicola
N
Cooper
Division of Primary Care, School of Medicine, Nottingham, UK.
Carol
C
Coupland
Child Accident Prevention Trust, London, UK.
Mike
M
Hayes
Emergency Department, United Bristol Healthcare Trust, Bristol Royal Infirmary, Bristol, UK.
Bryony
B
Kay
Newcastle Clinical Trials Unit, The Medical School, Newcastle University, Newcastle upon Tyne, UK.
Elaine
E
McColl
Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Richard
R
Reading
Department of Health Sciences, University of Leicester, Leicester, UK.
Alex
A
Sutton
School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
Jane
J
Stewart
School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
Michael Craig
MC
Watson
Division of Primary Care, School of Medicine, Nottingham, UK.
Denise
D
Kendrick
D000056:Accident Prevention / Q000379:methods*; D000061:Accidents, Home / Q000517:prevention & control* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010290:Parents / Q000193:education; D011041:Poisoning / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D011482:Protective Devices / Q000706:statistics & numerical data; D012307:Risk Factors; D012449:Safety; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology