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Poison Center Issues

Unproven ingestion: An unrecognized bias in toxicological case series

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Pages 946-949 | Received 07 Sep 2006, Accepted 04 Jan 2007, Published online: 20 Jan 2009
 

Abstract

Background. Case series of ingestion in preschool children may include patients without significant exposure if the substance is not measured. Methods. In order to evaluate the unproven ingestion bias, we conducted, between January 2000 and June 2004, a retrospective analysis of a poison control center-based series of children <6 years old with a history of toxic methanol or ethylene glycol ingestion. Results. Over the 54 month period, 115 children were referred to obtain a level. Of these, 102 children, aged 25 ± 10 months, actually had a level analyzed. Only 21 patients had positive levels measured a median of 90 minutes post-ingestion. Conclusion. Our findings suggest that a significant fraction of purported cases were not confirmed. When a study aims at determining the toxicity of the substance, measurements of the xenobiotic should be required in any case series involving preschool aged children in order to decrease the unproven ingestion bias.

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