By Titilola Afolabi, Pharm.D., BCPS, BCPPS
Safeguarding is a continuous process of ensuring that children grow and develop in a safe and effective environment. Standard childproofing solutions such as cabinet and toilet locks and electrical outlet plugs immediately come to mind, yet many people fail to recognize that safeguarding must also include constant vigilance to prevent toxic exposure. For example, have you ever thought that your child could be endangered simply by reaching into a purse while you are not looking?
In 2015, the American Association of Poison Control Centers reported more than 1.3 million exposures to dangerous substances for children 19 years and younger. Children under age six have the highest risk of toxic exposure, accounting for nearly 47% of all toxic exposures across all age ranges. The top substances causing more than 50% of exposures in children under six included: cosmetics/personal care products; cleaning substances; analgesics; foreign bodies/toys; topical preparations; and vitamins; however, any substance can be toxic, depending on amount, concentration, or circumstance of exposure. Many household dangers are easily accessible in purses, garages, laundry rooms, bedrooms, or bathrooms. Children can be harmed through accidentally ingesting, inhaling or touching these substances—the very behaviors through which babies naturally experience the world.
Three principles in safeguarding the home include safe use, safe storage, and safe environment. Safe use requires carefully following product directions and cautions to prevent misuse and potential toxic exposure. Additional ways to implement safe use include: never call medications “candy”; teach children to ask an adult before tasting anything; and use a syringe or measuring cup when administering medications. The safe use principle also applies to household products. For example, use laundry detergent pods only as directed. Detergent pods, which contain caustic concentrations of detergent in a water-soluble membrane, should be placed into the empty washer before adding water and clothes. If pods are placed on clothes before adding water, their contents may be deposited on clothes, with dermal exposure to caustic detergent when the clothes are worn.
Safe storage is also essential and reduces the risk of exposure by preventing access. Keep products in their original containers, and always return them to secure storage immediately after use. Potentially toxic substances should be stored in childproof or child-resistant containers. Use the phrase “up, up and away” as a reminder, placing products far out of reach. Products should also be properly secured to prevent accidental access. For example, avoid placing bleach or ammonia on top of a running washer or dryer, which may cause spillage from the machine’s vibrations. Laundry detergent pods, which come with colorful, candy-like designs that are very attractive to kids, should also be stored safely out of reach of children. In 2015, more than 12,000 reports were made to U.S. poison control centers of children age five and under ingesting, inhaling, or getting detergent on eyes and skin, often with serious medical consequences including hospitalization and mechanical ventilation. Electronic (e-) cigarettes are another example of devices easily accessed in purses that should be kept out of reach of children. E-cigarettes are filled with concentrated nicotine that can cause toxic exposure through dermal, ocular or oral routes.
Ensuring a safe environment is important to safeguarding your home, and the best way to secure any environment is to always keep children within sight. Even a few seconds out of sight could be potentially dangerous for a crawling toddler, with children between the ages of one and four having the highest risk of drowning. Install security measures such as pool fences, covers, alarms or self-closing doors. Routinely check for expiration dates and dispose of expired products and medications. Eliminate toxic plants from homes and gardens, or keep them out of reach. Hearing aid batteries that can be found in purses are another potential hazard for ingestion.
Finally, all people who interact with children should learn cardiopulmonary resuscitation or basic life support skills and have an action plan of steps to take in the event of a suspected toxic exposure. If an individual is unconscious or not breathing, immediately call 911. If the individual is conscious and breathing, call the poison control national hotline at 1.800.222.1222.
It takes continuous vigilance and effort to safeguard your surroundings and prevent toxic exposure. Maintain a childproofing checklist, stay alert and aware, and continuously apply safeguarding principles to create a safe environment for children’s healthy growth and development.
Titilola Afolabi, Pharm.D., BCPS, BCPPS, is an Assistant Professor in the Department of Pharmacy Practice at the Midwestern University College of Pharmacy–Glendale. Her research interests include general pediatric care, pediatric infectious disease, and pediatric pain and palliative care. Dr. Kimduy Nguyen, College of Pharmacy–Glendale Class of 2017 and Razelle Hernandez, third-year student at the College of Pharmacy–Glendale, also contributed to this article.
