Accidental childhood poisoning: influence of the type of caretaker on etiology and risk.

The primary audience of poison prevention programs is the parent(s) of children less than 6 years of age. Literature review reveals few references assessing other caretakers as risk factors in childhood poisoning. The frequency and severity of calls to the poison center by nonparental caretakers was studied. A total of 4,205 poisoning cases involving children under 6 years of age were analyzed. In 11.9% of the cases the caretaker at the time of exposure was someone other than the parents and the site of the exposure was other than the child's home. Of the 3,702 cases where the exposure occurred while the child was supervised by the parents in their home, 90.2% were treated in the home and 72.4% required dilution only. Grandparents represented 39.6% of caretakers other than the parents. In these cases 44.6% required treatment beyond dilution, indicating more serious exposures in this group. Ingestion of cardiovascular drugs occurred in 12.3% of calls from grandparents as opposed to 0.7% of calls initiated by parents. Poisoning exposures involving children under six years of age, where the caretaker is other than the parents, and the site is other than the child's home, are often more serious. Poison prevention information programs are needed to reduce the risk factors among this group.