The aim of this study was to investigate the incidence and nature of paediatric poisonings and poisoning deaths in Finland.
The study was based on four databases. First, using the Tampere University Hospital Information System the incidence and distribution of emergency department (ED) visits due to poisonings among 0–15 years old children during 2002–2006 were analysed. Second, the incidence of hospital admissions due to poisoning among Finnish children and adolescents during 1971–2005 was studied. This study was based on the information from the National Hospital Discharge Register (NHDR) and aimed to describe the secular trend of hospitalisations due to poisoning in 0–19 years old children and adolescents. Third aim was to investigate the incidence, nature and secular trend of poisoning deaths in Finland. The incidence of poisoning deaths was studied in all age groups during 1971–2005. This part of the study was based on the Official Cause-of-Death Statistics (OCDS) in Finland. Finally, the aim was more specifically describe poisoning deaths among Finnish children including the causes and distribution of substances involved in fatal poisonings. This part of the study was based on copies of the death certificates of all Finnish children aged 0–15 years who died from poisoning between 1969 and 2003.
This thesis showed that acute paediatric poisonings are relatively common in Finland. The incidence of ED visits due to poisonings among 0-15 years old children was 8.1 per 10,000 person-years during 2002–2006 within the catchment area of the Tampere University Hospital. Nonpharmaceutical agents were suspected to cause 60% and pharmaceuticals 31% of the intoxications. The most common single agent in poisonings was alcohol. Overall mortality in ED visits due to poisonings was 0.3%, indicating that poisoning may still today represent a life-threatening problem.
Annually about 1,000 children and adolescents are admitted to hospital in Finland due to poisoning. During 1971–2005 there were altogether 41,862 hospitalisations due to poisoning among 0 to 19 years old Finnish children and adolescents. The incidence of hospitalisations declined from 91 admissions per 100,000 person-years in boys and 105 in girls in 1971 to 65 and 84 in 2005, respectively. In the 0–4- year age group, admissions declined by 51%. On the other hand, hospitalisations for alcohol poisoning increased 1.7-fold among boys and 2.4-fold among girls. Of all children and adolescents hospitalised due to poisoning up to 1% has died in subsequent poisoning later (until the end of year 2005).
When investigating the whole population by means of OCDS it was seen that poisoning deaths increased in Finland during 1971–2005. In 1971, the incidence of all poisoning deaths was 12.2 per 100,000 person-years among men and 2.1 in women. In 2005, the corresponding figures were 23.6 and 7.4. Alcohol poisonings comprised the majority of poisoning deaths in Finland during the 35-year study period. Men’s risk was markedly higher than women’s, but in later years, women’s risk was increasing.
During 1969–2003 altogether 121 children aged 0 to 15 years died from poisoning in Finland. Among 0–4-year-olds the incidence of poisoning deaths declined to practically zero by the beginning of 1980s. Most of these deaths were unintentional poisonings. Among 5–15-year-olds the incidence of poisoning deaths varied during the study period. At this age the majority of the poisonings were intentional. Girls predominated in suicides while substance abuse was more common among boys.
In conlusion, paediatric poisonings remain a relatively frequent problem in Finland. In spite of child-resistant packaging, heightened parental awareness, and other protective measures, such as interventions by the Finnish Poison Information Centre and specially trained healthcare professionals, paediatric poisonings occur in Finland. Moreover, despite the declining secular trend seen in paediatric poisoning deaths, the risk of death from both intentional and unintentional poisoning persists in children. Health promotion programmes should be continued and improved especially to promote the well-being of families and to prevent unintentional poisonings among young children, teenage suicides and substance abuse, collateral suicides and chemical assaults.
