26 août, 2005 17:01
Tots Often Foil Child-Resistant Drug Packaging
http://www.familypracticenews.com/article/PIIS0300707305715255/fulltext
Volume 35, Issue 16, Page 10 (15 August 2005)
Tots Often Foil Child-Resistant Drug Packaging
CHRISTINE KILGORE (Contributing Writer)
WASHINGTON — Warning: Do not rely on child-resistant medication tops to prevent accidental ingestions.
The reason is simple: Too many young children can open them, said Monisha Shah, M.D.
When Dr. Shah and her colleagues gave young children 5 minutes to open "child-resistant," over-the-counter medicine bottles, they were surprised at how many children figured out how to open them.
The Poison Prevention Packaging Act (PPPA) of 1972 defines child-resistant packaging as packaging that 85% of children less than 5 years of age cannot open within 5 minutes or, conversely, packaging that fewer than 15% can open within 5 minutes.
But in Dr. Shah's study of 213 children, 16% of 3-year-olds and 20% of 4-year-olds were able to open squeeze-off bottle tops (squeeze opposite sides and turn). Even more—43% of 3-year-olds, and 63% of 4-year olds—were able to open twist-off tops (push down and turn).
"[Our] anticipatory guidance should focus on limiting access … [not] reliance on safety packaging," Dr. Shah said at the annual meeting of the Pediatric Academic Societies.
When she looked specifically at children aged 42–51 months—the age range covered in testing done for the PPPA—Dr. Shah found that 48% of children were able to open twist-off tops, and 24% were able to open the squeeze-off kind.
This means that two of the three main types of safety caps on over-the-counter drugs do not meet PPPA standards, said Dr. Shah of New York-Presbyterian Hospital-Weill Cornell Medical College in New York.
Pop-off bottle tops (align arrows and flip off) were the only type that met the standard of the protective law: only 5% of 3-year-olds and 11% of 4-year-olds were able to open these, she reported.
And when it came to 2-year-olds, all cap types met the PPPA criteria, though 8% still could open the twist-off caps.
Despite a decline in the late 1970s in the number of accidental ingestions, poison control centers still receive more than a million calls each year about ingestions by children.
Poisonings caused by prescription and over-the-counter medications account for more than 50% of deaths from accidental ingestion, according to Dr. Shah.
"Pharmaceutical companies may need to re-evaluate safety packaging," she added.
The job isn't simple, however, since 85% of adults over 50 years have to be able to open "child-resistant" packaging, she noted.
The children in the study were randomly tested in an urban pediatric emergency department and clinic.
The investigators excluded any child with emergent status, severe developmental delay, upper extremity injury, or altered mental status.
