title: International Epidemiological Differences in Acute Poisonings in Pediatric Emergency Departments.
abstract: OBJECTIVE
  Identifying international differences in the epidemiology of acute poisonings in children may help in improving prevention. We sought to evaluate the international epidemiological differences in acute poisonings in children presenting to emergency departments (EDs) from 8 different global regions.
  
  
  METHODS
  This was an international multicenter cross-sectional prospective study including children younger than 18 years with acute poisonings presenting to 105 EDs in 20 countries was conducted. Data collection started at each ED between January and September 2013, and continued for 1 year.
  
  
  RESULTS
  During the study period, we registered 363,245 pediatric ED presentations, of which 1727 were for poisoning (0.47%; 95% confidence interval, 0.45%-0.50%), with a significant variation in incidence between the regions. Full data were obtained for 1688 presentations. Most poisonings (1361 [80.6%]) occurred at home with either ingestion (1504 [89.0%]) or inhalation of the toxin (126 [7.6%]). Nonintentional exposures accounted for 1157 poisonings (68.5%; mainly in South America and Eastern Mediterranean region), with therapeutic drugs (494 [42.7%]), household products (310 [26.8%]), and pesticides (59 [5.1%]) being the most common toxins. Suicide attempts accounted for 233 exposures (13.8%; mainly in the Western Pacific region and North America), with therapeutic drugs (214 [91.8%], mainly psychotropics and acetaminophen) being the most common toxins. Significant differences between regions were found in both types of poisonings. Recreational poisonings were more common in Europe and Western Pacific region. No patient died.
  
  
  CONCLUSIONS
  There are substantial epidemiological differences in acute poisonings among children in different countries and regions of the globe. International best practices need to be identified for prevention of acute poisonings in childhood.
authors.forename: Santiago
authors.initials: S
authors.lastname: Mintegi
authors.forename: Beatriz
authors.initials: B
authors.lastname: Azkunaga
authors.affiliation: Departamento de Emergencia Pediátrica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
authors.forename: Javier
authors.initials: J
authors.lastname: Prego
authors.forename: Nadeem
authors.initials: N
authors.lastname: Qureshi
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Dalziel
authors.affiliation: Clinical Epidemiology Unit, Cruces University Hospital, BioCruces Health Research Institute, Basque Country, Spain.
authors.forename: Eunate
authors.initials: E
authors.lastname: Arana-Arri
authors.forename: Yordana
authors.initials: Y
authors.lastname: Acedo
authors.affiliation: Clinical Epidemiology Unit, Cruces University Hospital, BioCruces Health Research Institute, Basque Country, Spain.
authors.forename: Lorea
authors.initials: L
authors.lastname: Martinez-Indart
authors.affiliation: University of the Basque Country, Leioa, Spain.
authors.forename: Arantza
authors.initials: A
authors.lastname: Urkaregi
authors.forename: Nerea
authors.initials: N
authors.lastname: Salmon
authors.forename: Javier
authors.initials: J
authors.lastname: Benito
authors.forename: Nathan
authors.initials: N
authors.lastname: Kuppermann
mesh_terms: D000061:Accidents, Home / Q000706:statistics & numerical data; D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011041:Poisoning / Q000453:epidemiology*; D011446:Prospective Studies; D012042:Registries; D013406:Suicide, Attempted / Q000706:statistics & numerical data