By Kerry Grens
NEW YORK (Reuters Health) - Injuries from gasoline, lamp oil and similar chemicals have dropped considerably among small children in the last decade, according to a new study.
"It seems to decline right around 2000, 2001. That's when the Consumer Products Safety Commission mandated products be placed in child-resistant packaging," said Dr. Heath Jolliff, the study's lead author and associate medical director of the Central Ohio Poison Center at Nationwide Children's Hospital in Columbus.
Summertime, however, brings extra risk for exposure to these types of poisonings, especially among toddlers.
"The kind of gasoline (used) with the lawnmowers, (fuel for) tiki torches and that sort of thing - because of the access, (children) get the exposure," said Dr. Jennifer Lowry, chief of Clinical Toxicology at Children's Mercy Hospital in Kansas City, Missouri.
Fuels such as lamp oil for tiki torches, kerosene for camping stoves and gasoline, as well as turpentine and some lubricants are all hydrocarbons - a category of dangerous liquids that is the third leading cause of children's poisoning deaths, Jolliff and his colleagues write in the journal Pediatrics.
"We had had a child in our hospital who had been exposed to a hydrocarbon and was very ill. And I said, 'let's look at this subcategory since they tend to be very dangerous,'" Jolliff told Reuters Health.
To get a sense of broader trends in injuries resulting from these chemicals, the researchers gathered information from two large databases spanning the 10 years from 2000 through 2009.
One database includes emergency department records from about 100 hospitals across the U.S. The other has phone calls made to 57 regional poison control centers.
The researchers narrowed down the records to only those involving hydrocarbons and children five years old and younger - which totaled more than 40,000 patients treated in an emergency room and more than 65,000 phone calls to poison control.
They found that emergency room visits dropped over the study period, from roughly 19 out of every 100,000 kids in 2000 to about 14 of every 100,000 in 2009.
Similarly, calls to poison control centers also fell, from 34 calls for every 100,000 kids in 2000 to about 21 of every 100,000 in 2009.
Injuries were most common among one- and two-year-olds, and kerosene, lamp oil and lighter fluids resulted in the most serious injuries and hospitalizations. Lamp oil was linked to the highest percentage of deaths.
Although the researchers could not determine why poisonings appeared to become less frequent over the 10-year study period, Lowry, who didn't participate in the research, thinks that child-resistant caps on poisonous containers likely helped.
In 2001, the Consumer Product Safety Commission required that all household products containing hydrocarbons be sealed with child-resistant packaging.
In addition, "there was a big educational push in the early 2000s on hydrocarbons and how dangerous they were," Lowry told Reuters Health.
Although injuries declined over time, summertime each year brought a slight bump in cases.
Nearly 32 percent of emergency room visits and poison control calls came during the summer months, compared with 19 percent of emergency room visits and 17 percent of poison control calls during the winter.
Gasoline was the most common hydrocarbon involved in an injury, Jolliff's team found.
Nearly 32 percent of emergency department visits and 27.6 percent of poison control center calls concerned gasoline.
When the researchers looked through the medical records at the hospitals, they found a surprising cause.
"The number one reason was parents allowing their kids outside the automobile at the gas station, and kids pulled the hose out of the car and got splashed with it," said Jolliff.
What happens then is that because the liquid becomes a gas so quickly, the children inhale it into their lungs.
"It's very unsafe for children five and under to be out there helping to pump gas," said Lowry.
Jolliff said that although child-resistant packaging helps keeps kids out of dangerous chemicals, there is no such thing as child-proof containers.
Another recent study found that prescription drug poisonings among children is on the rise (see Reuters Health story of September 16, 2011 here: http://reut.rs/qIUKP9).
"We have to do better education on placement. One of the poison center mottos is 'up and away.' Keep them out of reach of children," said Lowry.
SOURCE: http://bit.ly/16d4isN Pediatrics, online May 6, 2013.