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Biomedical subjects

M Dobbin

Publications and source records attributed to M Dobbin.

5 recordsLinked to original sources
PubMed2001

Childhood poisoning: access and prevention.

OBJECTIVES: To investigate the circumstances and means of access to six poisoning agents by children under 5 years of age and to make recommendations for countermeasures and strategies for implementation. METHODOLOGY: A case series study of access to six poisoning agents was conducted. Cases were identified prospectively through a poisons information centre and hospital emergency departments. Interviews were conducted with 523 parents and caregivers using a structured questionnaire. RESULTS: The majority of children (94.1%) accessed the agent in their own home or another home and, in 38% of cases (excluding mistakes in administration), the parent or caregiver was present in the immediate area at the time of the incident. In cases in which the child was alone in the room, caregivers were frequently involved in household duties (51%), with only 10% undertaking leisure activities and 8% on the telephone. The span of unsupervised time reported was 5 min or less in 79.5% of these cases. The means of access was generally during periods of use of the agent (75.3%), including just purchased, rather than when agents were in their usual storage place. CONCLUSIONS: There is little scope for improved supervision as a major intervention. Design and regulatory changes such as local safe storage for bench tops and while travelling, improved labelling and packaging, improved child-resistant packaging and its more general application are required. These and agent-specific interventions, including child-resistant bait stations for rodenticides and well covers for vaporizers, are more likely to prevent poisoning. The recent identification of childhood poisoning prevention as a national priority may lead to coordinated action to implement these and other preventive measures.

Australia↗
PubMed1997

Eucalyptus oil poisoning among young children: mechanisms of access and the potential for prevention.

We studied unintentional paediatric eucalyptus oil poisoning to identify potential intervention strategies. The epidemiology of paediatric eucalyptus oil poisoning in Victoria was determined by analysis of four databases. The sequence of events preceding ingestion was examined by a telephone survey involving 109 parents or guardians of children under five years involved in an actual or suspected ingestion of eucalyptus oil. Such children were identified prospectively from all callers during a nine-month period to the Victorian Poisons Information Centre and those presenting to the emergency departments of the participating hospitals of the Victorian Injury Surveillance System. Eucalyptus oil was a leading agent associated with hospitalisation for poisoning among Victorian children aged under five years. In the telephone survey, 90 incidents were found to involve vaporiser solutions, 15 eucalyptus oil preparations, and the remainder other eucalyptus-oil-containing products of a medicinal nature. Regardless of the type of product, 74 per cent gained access via a home vaporiser unit, most frequently placed at ground level. Although amounts ingested are usually small, the reported range of toxic doses is wide, necessitating at least a medical assessment following ingestion. Potential countermeasures identified in a consultative workshop included: discontinuing the use of eucalyptus oil as a therapeutic agent; confirmation that vaporiser-well residues are nontoxic; removal of barriers to product reregistration following safety-related modifications; improved child-resistant closures; discouraging vaporiser use for respiratory infections among young children; and development and dissemination of protocols for treatment of suspected ingestion.

Child, Preschool↗
PubMed1996

Rodenticide poisoning among children.

We aimed to determine the nature, extent and sequence of events of accidental childhood poisoning with rodenticides and identify potential intervention strategies. Subjects were identified prospectively from callers to the Victorian Poisons Information Centre and those presenting to the Emergency Departments of hospitals participating in the Victorian Injury Surveillance System from 1 April to 31 December 1993. The events preceding rodenticide ingestion were examined via telephone questionnaire involving 128 parents or guardians of children under five years exposed to rodenticides. Rodenticides are not leading agents for severe poisoning but are a frequent and increasing cause of less severe poisoning. Most children (90 per cent) had obtained the rodenticide from the site at which it had been laid, usually by the caregiver (67 per cent), in the kitchen, lounge room or laundry, inside cupboards or-wardrobes. In 69 per cent of these cases, respondents thought the site would not normally allow access to children. Only 13 per cent of children were admitted to hospital, although 41 per cent sought medical attention. Most caregivers (90 per cent) were aware of some dangers associated with rodenticides. Children usually ingest insufficient amounts of rodenticide to cause serious effects. However, medical assessment and monitoring of prothrombin times is often indicated, with a consequent cost to the healthcare system. Potential countermeasures, focusing on packaging and positioning of rodenticide baits, product reformulation, and the distribution of management guidelines for health workers, were identified. Implementation of the identified countermeasures was initiated by a workshop involving stakeholders from industry, research and health professions.

Accident Prevention↗
PubMed1992

Randomised trial of three approaches for marketing smoking cessation programmes to Australian general practitioners.

OBJECTIVE: To compare three approaches for marketing a quit smoking intervention kit to general practitioners. DESIGN: Randomised trial of (a) personal delivery and presentation by an educational facilitator with a follow up visit six weeks later; (b) delivery to the receptionist by a friendly volunteer courier with a follow up phone call six weeks later, or (c) postal delivery with a follow up letter six weeks later. SETTING: Melbourne, Australia. SUBJECTS: 264 randomly selected general practitioners. DATA COLLECTION: A research assistant visited each doctor four months after delivery and measured use of components of the kit. A questionnaire measuring perceptions of aspects of the kit and its delivery was completed by doctors. Costs of each approach were calculated. RESULTS: Doctors receiving the educational facilitator approach were significantly more likely than those receiving the other two approaches to have seen the kit, to rate the method of delivery as engendering motivation to try the kit, to have used one of the "intensive intervention" components from the kit, to report that they found the kit less complicated, and to report greater knowledge of how to use the kit. There were no significant differences in use of "minimal intervention" components of the kit, ratings of overall acceptability of delivery, perceptions of cultural and structural barriers to using the kit, and ratings of the overall acceptability of the kit. The cost of the educational facilitator approach ($A142/doctor) was 24 times that of the mailed approach. The volunteer courier approach ($A14) was twice the cost of the mailed approach. CONCLUSION: Educational facilitators and volunteer couriers do not seem to be cost effective strategies for distributing smoking interventions.

Adult↗