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Emergency Care for Pediatric Medication Poisoning More Likely in Poor, Rural Areas

PITTSBURGH – How many toddlers and infants in your ED for medication poisoning is correlated to the ED’s location and level of economic disadvantage in the area around it.

A study published online by the journal Clinical Toxicology finds that children younger than 5 years of age who live in economically disadvantaged rural areas had a greater risk of medication poisoning that resulted in referral to a healthcare facility than others.

The study team, led by researchers from the University of Pittsburgh Graduate School of Public Health and the University of California, San Diego, noted that these areas tended to be rural and have high unemployment, as well as lower rates of high school graduation and reduced household income.

Study authors noted that their analysis of Pittsburgh Poison Center data offers some insight into potential geographic targets for poison prevention outreach.

"Understanding where there are geographic clusters of kids being exposed to medications that could hurt them gives us the opportunity to effectively intervene," explained senior author Anthony Fabio, PhD, MPH, of Pitt Public Health. "It also could help emergency clinicians ask the right questions and perhaps zero in on a medication exposure when a child comes in with unexplained symptoms."

For the study, researchers analyzed 26,685 Pittsburgh Poison Center records of pharmaceutical drug exposures in children under 5 years of age from 2006 through 2010, distinguishing between those where home treatment was recommended, as opposed to a recommendation to seek medical evaluation.

That revealed "exposure" and "referral" clusters throughout western and central Pennsylvania. Researchers suggested that the exposure clusters tended to be in urban areas where parents and caregivers might have been more familiar with the Pittsburgh Poison Center's hotline and, therefore, more likely to call and deal with the problem at home.

Referral clusters, meanwhile, were generally in more rural areas characterized by high unemployment. In fact, in those areas, the study found that that the risk of a child under 5 years of age referred to a healthcare facility for a medication exposure was 3.2 times greater than elsewhere.

"More study is needed to determine exactly why this is, but we believe it could be related to fewer resources for child supervision -- whether at home or at daycare centers in the community -- increasing the likelihood of a small child finding and swallowing medication," Fabio said in a Pitt press release.

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