Saturday, September 17, 2011

Drug Poisoning in Children on the Rise

A recent study published in the Journal of Pediatrics blames greater availability of prescription medications in the household for a rise of accidental drug poisonings in children. The large majority of these accidents which lead to serious poisonings, hospitalizations and even death are from young children finding and ingesting drugs by themselves. Failure to poison-proof a household may play a role. The larger problem is simply the increased use and availability of prescription medications including pain medications, narcotics, sedatives for sleep, muscle relaxants for injury and cardiovascular prescriptions. Dosing mistakes for pediatric patients account for only a very small portion of the problem. Past emphasis by FDA and other professionals has minimized therapeutic mistakes and does not account for the rise of serious drug poisoning in children. The offending medications are often not even drugs that are commonly used for children.

The most recent surveys show that 55% of adults have taken a prescription medication within the last week and 11% have taken five or more prescription drugs within the preceding week. The use of over-the-counter medications such as common anti-inflammatory products and acetaminophen has increased and created more prevalence in the home. However the largest increase in poisonings remains from prescription medications. Therefore there are more adult medications around that are toxic to toddlers and young children. Medications of seniors or grandparents were estimated to be involved in these accidents only 10 to 20% of the time. These products are often stored in containers or pill reminders that are not child resistant. The rise of more serious admissions for accidental poisonings and the types of drugs ingested, point to the greater availability of medications in the child’s environment, without adequate precautions for protected access.  

Some experts believe there are limitations to education about prevention and poison-proofing the home for toddlers and young children. The consensus among experts in behavior is that the best efforts in childproofing will result in prevention 90% of the time. Even that would be improvement over the status quo. The typical pattern for accidental ingestion is during the period of time that the medications are in use by an adult. They are probably left out for convenience without recognizing the hazard they present to a curious young child. Medication in locked cabinets is generally considered inconvenient which limits the accessibility especially when needed two or three times a day. The recent information sheds light on the prevalence of prescription medications in a household and the serious risks of self ingestion by children. Some experts have suggested new types of packaging that would restrict the access to medication by limiting the amount. This means flow restrictors for liquid medications and containers that would dispense only one tablet at a time. Such changes would have to be applied to both adult and pediatric products to have any beneficial effect.

Renewed education for all consumers about where the risks are that may be overlooked is an important first step. More thoughtful storage and access to prescription medications is necessary to restrict access to young children. In general the situation gives one reason to pause and consider society’s overall increased use of powerful medications such as opiates and sedatives which have clearly been on the rise. In turn, it has indirectly increased the risks to our children. Preventive measures need to take steps to decrease the immediate risks while evaluating the larger picture of a society that emphasizes appropriate use of therapeutic prescription drugs.

Wednesday, September 7, 2011

Food Storage Tips

Seventy to eighty million people a year in the United States get food poisoning resulting in over 100,000 hospitalizations and numerous deaths. Only 20% are attributed to restaurants and food workers. Many cases are somewhat self-inflicted by poor handling and storage of food in the home. Whether it is summer picnics, cookouts or holiday dinner season, proper food handling and storage is critical to keeping your family safe and enjoying your celebrations with food.

Handling your food properly as soon as purchased means prompt and proper storage until it is ready for consumption. Raw meat products are a common source where it is important to avoid cross contamination with other products. Separate clean packaging in plastic until it can be promptly refrigerated or frozen is important in avoiding the spread and proliferation of harmful bacteria. Effective refrigerator temperature is 40 degrees Fahrenheit and freezers at 0 degrees to ensure safe storage. Carefully store meats in clean leak-proof bag, double wrapped tightly with suitable freezer wrap or plastic. Storing on the bottom shelf of the refrigerator will avoid possible dripping on other foods. Fresh meats or fish should be consumed within 1-3 days. Five days can still be satisfactory for some whole products such as a roast or chops. On average, frozen meat products should be consumed within six months, sooner for products like ground beef. Some whole roasts can be safely frozen for up to 10-12 months. Even if safe, this pushes the limits of food product integrity. Monitor the temperatures in your refrigerator and freezer to ensure no temperature fluctuations are occurring due to mechanical malfunctions or weather conditions.

Check use-by or sell-by dates on food packages. Remember, these dates do not apply once the package is open even if restored properly. Best-if-used-by dates provide the most reliable information. They take into account normal handling and use of the product. Any package new or leftover can get lost in the refrigerator. You cannot safely judge a food product by the appearance, smell or taste. If in doubt, please throw it out! It is not worth the risk of consuming tainted food. Condiments often remain open in the refrigerator for long periods and are easily forgotten. Storage of condiments on the door is a suitable location in the refrigerator by design. Even the few acidic condiments that may be safe for longer will lose integrity of quality and taste; they still should be replaced after two months. Fresh eggs should always be stored in a protective carton in a more consistently cool area. Do not store on the door where they are subject to temperature fluctuations and breakage. Fresh produce should be stored in perforated bags that allow air circulation and evaporation of moisture. Do not wash them before storage. The moisture will speed decay and decrease shelf life dramatically. Except for selected items like a hard aged salami or cheese that contain natural mold that can be trimmed or even safely consumed, moldy or questionably appearing products should be discarded.

Cleaning the refrigerator/freezer more regularly is important to avoid excess build up of bacteria. Clean spills as soon as they occur with a weak cleaning solution that will sanitize. Bananas, potatoes and onions should be stored in a cool dry place, not refrigerated. Store leftovers of any kind, in a clean airtight container. Food you prepare should be refrigerated within 2 hours after cooking to avoid spoilage and development of excess bacteria.

Enjoy cooking and family celebrations but stay safe. Remember when in doubt throw it out!