The successful introduction of child resistant closures for liquid paracetamol preparations

A liquid paracetamol preparation for pediatric use with a child resistant reclosable closure was recently introduced on the Swedish market. Objectives: To investigate the effect of this change on the number of poisoning incidents in children. A comparison was made between the number of inquiries to the Swedish Poison Information Centre concerning accidental overdoses of paracetamol among children before and after the introduction of the child resistant bottle. Efforts were also made to document the circumstances which led to the accidents. Results: During the three summer months of 1991, when the non child resistant bottle still was on the market, the centre received 90 questions concerning childhood poisoning incidents with liquid paracetamol. In 44% of all the cases the drug was in current use and the bottle had been removed from its normal storage place. During corresponding months in 1992, after introduction of the child resistant container, the number of relevant inquiries fell to 20. Six cases concerned children who could open the cap since it was not properly closed. Compared with 1991 the number of inquiries was reduced by more than 70%. Conclusion: Introduction of child resistant closures proved to be highly effective in reducing the frequency of poisoning accidents with liquid paracetamol in children. Such measures should be considered for any toxic drug, especially when provided in liquid form for pediatric use.