Intended for healthcare professionals

Practice Practice Pointer

Toxic household exposures in children

BMJ 2024; 385 doi: (Published 03 May 2024) Cite this as: BMJ 2024;385:e077046
  1. Kate King, head of department1,
  2. Rachel Smith, consultant paediatrician2,
  3. Graham Johnson, consultant in emergency/paediatric emergency medicine; honorary associate professor3 4
  1. 1Academic Department of Military General Practice, Defence Medical Services, ICT Centre, Birmingham Research Park, Birmingham B15 2SQ, UK
  2. 2Department of Paediatrics, West Cumberland Hospital, Whitehaven CA28 8JG, UK
  3. 3University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
  4. 4Medical School, University of Nottingham, Lenton, Nottingham NG7 2UH, UK
  1. Correspondence to: K King kate.king22{at}

What you need to know

  • Poisoning is the third most common cause of injury related hospital admission in children aged under 5 years

  • Most ingestions are not harmful, but access to suitable poisons information is required

  • Intentional ingestion of household products is usually more hazardous than accidental ingestions

Poisoning is a leading cause of unintentional injury in children worldwide accounting for 11% of all unintentional injuries in children under 15 years old.1 Fatal poisoning rates are four times higher in low and middle income countries compared with high income countries.1 Across Europe, agents most commonly ingested include medications and household products.2 In the UK, poisoning is the third most common cause of injury related admission to hospital, equating to around 4000-5000 admissions per year (box 1).1011 Most children ingesting poisonous substances do not require hospital admission, and many can be managed at home or in the community.11 However, these decisions require adequate clinical assessment and access to appropriate information on the chemicals involved. This article offers an approach to assessing a child with suspected exposure to toxic household chemicals for those working in community settings.

Box 1

Rise in poisoning from household exposures during the covid-19 pandemic

In the UK, there was a steady and significant fall in the incidence of poisoning episodes from 2000 to the start of the covid-19 pandemic with a 23% reduction in admissions of preschool children between 2000 and 2011.3 The drop probably resulted from better accident prevention information and legislative changes, such as child resistant containers, that engineered much of the risk away.12

Covid-19 produced a dramatic reversal of this decline. Reports from France, Italy, and the US suggested up to a 20% increase in calls to national poisons centres, many attributed to misuse of cleaning products used to counteract the virus.456 Sales of bleaches, hand sanitisers, and …

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