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

Caroline Lee; Mark Hanly; Natasha Larter; Karen Zwi; Susan Woolfenden; Louisa Jorm

doi:10.1136/bmjopen-2018-022633

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

BMJ Open. 2019 Jan 30;9(1):e022633. doi: 10.1136/bmjopen-2018-022633.

Authors

Caroline Lee¹, Mark Hanly¹, Natasha Larter², Karen Zwi², Susan Woolfenden², Louisa Jorm¹

Affiliations

¹ Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
² Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.

Abstract

Objectives: To 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 setting: Retrospective whole-of-population cohort analysis of linked hospital and mortality data for 2000-2014.

Participants: All children (Aboriginal and non-Aboriginal) under the age of 5 years who were born in a hospital in NSW from 2000 to 2009.

Outcomes: The 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.

Results: The 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.

Conclusion: Commonly 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.

Keywords: aboriginal; child, preschool; data linkage; poisoning; unintentional injury.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Age Distribution
Child, Preschool
Clinical Coding / statistics & numerical data*
Female
Hospitalization / statistics & numerical data*
Humans
Infant
Infant, Newborn
Information Storage and Retrieval
Logistic Models
Male
Native Hawaiian or Other Pacific Islander / statistics & numerical data*
New South Wales / epidemiology
Poisoning / epidemiology*
Poisoning / mortality
Retrospective Studies
Sex Distribution
Socioeconomic Factors