Demographic and clinical characteristics of hospitalised unintentional poisoning in Aboriginal and non-Aboriginal preschool children in New South Wales, Australia: a population data linkage study

• Published in: BMJ open 2019-01, Vol.9 (1), p.e022633
• Main Authors: Lee, Caroline, Hanly, Mark, Larter, Natasha, Zwi, Karen, Woolfenden, Susan, Jorm, Louisa
• Format: Article
• Language: English
• Subjects: Age Distribution; Child, Preschool; Children & youth; Childrens health; Clinical Coding - statistics & numerical data; Clinical outcomes; Female; Hospitalization - statistics & numerical data; Humans; Infant; Infant, Newborn; Information Storage and Retrieval; Injury prevention; Logistic Models; Male; Mental health; Mortality; Native peoples; New South Wales - epidemiology; Paediatrics; Pediatrics; Pharmaceuticals; Poisoning; Poisoning - epidemiology; Poisoning - mortality; Poisons; Population; Preschool children; Qualitative research; Retrospective Studies; Risk factors; Sex Distribution; Socioeconomic Factors; Systematic review
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2018-022633

ObjectivesTo investigate differences in demographic and clinical characteristics of Aboriginal and non-Aboriginal children aged 0–4 years hospitalised for unintentional poisoning in New South Wales (NSW), Australia.Design and settingRetrospective whole-of-population cohort analysis of linked hospital and mortality data for 2000–2014.ParticipantsAll children (Aboriginal and non-Aboriginal) under the age of 5 years who were born in a hospital in NSW from 2000 to 2009.OutcomesThe primary outcome was hospitalisation for unintentional poisoning. Logistic regression was used to estimate odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children. Poisoning agents and clinical outcomes were compared by Aboriginality.ResultsThe cohort included 767 119 children, including 28 528 (3.7%) Aboriginal children. Aboriginal children had approximately three times higher rates of hospitalised poisoning (1.34%) compared with non-Aboriginal children (0.41%). Poisoning incidence peaked at 2–3 years of age. Male sex, socioeconomic disadvantage and geographical remoteness were associated with higher odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children, but associations with disadvantage and remoteness were statistically significant only for non-Aboriginal children. Most (83%) poisonings were caused by pharmaceutical agents. Few Aboriginal and non-Aboriginal children had repeat admissions for poisoning; most had a length of stay of 1 day or less. Only 8% of poisoning admissions involved contact with a social worker.ConclusionCommonly used medications in the general population contribute to poisonings among both Aboriginal and non-Aboriginal preschool-aged children. This study highlights a need to develop culturally safe poisoning prevention strategies and policies.