Pediatric iron poisonings in the United States.

BACKGROUND: Iron overdose is considered a leading cause of poisoning-related injury and death in young children. This report analyzes the nature, trend, and hazard patterns of unintentional pediatric iron overdoses in the United States from 1980 to 1996.

METHODS: Analyses include multiple regression and correlation analysis of national data on pediatric iron ingestion-related injuries and deaths and review of in-depth investigation case reports. Data sources include files of the US Consumer Product Safety Commission, National Center for Health Statistics, American Association of Poison Control Centers, and US Census Bureau.

RESULTS: Pediatric iron-related injuries increased 150% in 1986, from an annual average of 1,200 from 1980 through 1985 to 3,000 from 1986 through 1996. No such annual trend occurred before or after 1986. About one third of the injuries from 1980 through 1996 involved infants under 2 years old, a third involved 2-year-olds, and a third involved children 3 or 4 years old. Pediatric iron-related fatalities increased in 1986, peaked at 10 in 1991, and declined to 2 by 1995. The children often obtained the iron from a child-resistant container opened by themselves or another child or left open or improperly closed by an adult.

CONCLUSIONS: Iron overdose remains a significant public health threat to young children. The frequency of pediatric iron overdose injuries increased in 1986 and has not declined. Unit-dose packaging of potent iron supplements is expected to reduce the frequency of severe pediatric iron overdose incidents.