In Western Australia there were 557 DEATHS DUE TO POISONING YRS MORE INJURIES OCCUR IN

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1 In Western Australia there were 557 DEATHS DUE TO POISONING WHERE AGE RANGE 57.5 KIMBERLEY HOSPITALISATIONS MALE / FEMALE % ,758 COST % MALE WHEN YRS 45.2 PILBARA 59.5 MIDWEST APPROX ,431 BED DAYS $5,721,811 FOCUS In Western Australia Aboriginal people make up 3.8% of the population, however between 2008 and % of Poisoning hospitalisations were Aboriginal People. MORE INJURIES OCCUR IN APR, NOV & JAN 50.2 NORTH METRO 47.6 SOUTH METRO 46.5 SOUTHWEST 59.8 WHEATBELT 48.4 GOLDFIELDS 54.4 GREAT SOUTHERN Age-standardised hospitalisation rates expressed per 100,000 person years.

2 Definition of Poisoning Poisoning occurs when people unintentionally drink, eat, breathe, inject, or touch enough of a hazardous substance (poison) to cause illness or death. 1 Impact of Poisoning on Western Australia WHO DOES IT IMPACT? In Western Australia between 2007 and 2011, there were 557 deaths due to accidental poisoning. 2 In Western Australia between 2008 and 2012 there were: 5,758 hospitalisations due to accidental poisoning % of hospitalisations for accidental poisoning were males. 3 people aged had the highest incidence of accidental poisoning. 3 In Western Australia Aboriginal People make up 3.8% of the population, however between 2008 and % of poisoning hospitalisations were Aboriginal People. 3 All data for poisoning includes unintentional poisonings by nonopiod analgesics, antipyretics and antiheumatics; antiepileptic, sedative-hypnotic, anti-parkinsonism and psychotropic drugs; narcotics and hallucinogens; other and unspecified drugs, medicaments and biological substances; and by other and unspecified chemicals and noxious substances. WHEN DOES IT OCCUR? In Western Australia between 2008 and 2012, hospitalisations from poisoning were greater in April (9%), November (9%) and January (8.9%). 2 WHERE DOES IT OCCUR? In Western Australia, between 2008 and 2012, the three regions with the highest age-standardised rate for hospitalisations for burns and scalds, were the Wheatbelt (59.8), Midwest (59.5) and Kimberley (57.5). 3 The age-standardised hospitalisation rates are standardised with the Australian 2001 population and expressed per 100,000 person years.

3 IMPACT ON THE HEALTH SYSTEM In Western Australia in 2012, there were 1,369 hospitalisations for poisoning, consuming an estimated 2,431 bed days at an approximate cost of $5,721, Determinants of Poisoning (Risk / Protective Factors) SOCIAL DETERMINANTS PEER PRESSURE AND RISK TAKING Peer pressure and risk taking behaviour can lead to the misuse of alcohol or illicit drugs, which can increase the risk of poisoning, especially among teenagers. 4 ENVIRONMENTAL, COMMUNITY AND ORGANISATIONAL DETERMINANTS STORAGE OF POISONS The storage of poisons out of reach of children, in the original packaging and the correct use of childresistant closures on poison containers are important protective factors towards reducing the risk of poisoning incidents in children. 4 BEHAVIOURAL AND INDIVIDUAL DETERMINANTS AWARENESS OF POISON SAFETY A lack of knowledge about the safe storage of poisons, appropriate medicine intake and the services offered by the poison information centre all pose as risk factors for accidental poisoning. 4 AGE Young children are closer to the ground and are very curious often touching objects and attempting the put objects into their mouths. As children grow they become more mobile increasing their ability to reach objects but lack the awareness of what could place them in harm, putting them at an increased risk of poisoning. 4 Effective Interventions LEGISLATION, POLICIES, STANDARDS AND CODES OF PRACTICE LABELLING OF POISONS LEGISLATION Legislation surrounding the promotion of storing poisons in a safe place has proven effective. This includes ensuring that the phrase keep out of reach of children is easily visible on the packaging and instructions outline the appropriate use of the poison. 4 Page 2

4 Under the Commonwealth Therapeutic Goods Act 1989 manufacturers of drugs and poisons must comply with the Commonwealth requirements for the labelling and packaging of poisons that are outlined in the Standard for the Uniform Scheduling of Drugs and Poisons. 4 CHILD-RESISTANT CLOSURES STANDARDS The introduction of child-resistant closures in Australia in the early 1980 s has proved to be successful in reducing the rates of death and hospitalisation from accidental poisoning. 4 The Australian Standard AS Child Resistant Packages includes the requirements of Child- Resistant Closures on poisons such as oils, alkaline salts and acids. 4 This includes requirements around non-enclosable packaging that medicines are usually packaged in, to make sure that the packaging acts as a physical barrier, that medicines cannot leak and that they will show signs of tampering. 4 ACCESS TO POISONS LEGISLATION As a primary intervention, the regulation of the sale of poisons and drugs aims to prevent poisoning by restricting access to poisonous substances. 4 The Poisons Prevention Act 1964 aims to regulate and control the possession, sale and use of poisons in Western Australia, by regulating the licensing and authorisation of people who can sell and produce poisons. 4 ENVIRONMENTAL, COMMUNITY AND ORGANISATIONAL INITIATIVES POISONS INFORMATION CENTRES In the event of poisoning or suspected poisoning, Poisons Information Centres allow for easy access to emergency first-aid information over the phone. This service helps prevent unnecessary burden on hospital emergency departments, while their expert advice contributes to decreasing the morbidity and mortality of poisoning. 4 The Western Australian Poisons Information Centre is a government funded telephone information service that provides information about poisoning to the general public and health professionals. 4 In the event of poisoning or suspected poisoning the centre is able to provide advice to callers about further actions to take and follow up treatment advice, phone CHILD SAFETY CENTRES Community based initiatives that promote a child safety centre have proven effective in increasing the awareness of poison hazards in the home and improving home safety practices. 4 Child safety centres have information and products relating to home safety and increase consumers access to discounted safety devices. Page 3

5 The Safety Demonstration Home, run by Kidsafe WA, showcases a safe home environment, including awareness raising of poisons hazards around the home and improving home safety practices. 4 Kidsafe also run a seasonal childhood injury prevention program, with poisoning prevention being the primary focus in spring. PARENTAL SAFETY CAMPAIGNS Education campaigns that target families with children under five have proven to be effective at reducing the risk of poisoning, educational campaigns advocate for the safe storage of poisons, explain what type of substances can be poisonous, outline appropriate actions to take when disposing poisons and promote the services offered by the Poisons Information Centre. 4 RESTRICTING ACCESS TO POISONS PROGRAMS Research into initiatives that aim to reduce access to potential poisons around the home have supported the association between access to potential poisons around the home and cases of poisoning. 4 The Return Unwanted Medicines project operates through pharmacies and is backed by funding from the Australian Department of Health and Aged Care, providing a free disposal service for out of date and unwanted medicines. 4 This project aims to reduce the likelihood of poisoning from medical products and operates on the principle that reducing the amount of poisons near young children in the home will reduce the chance of poisoning. 4 GROUP AND INDIVIDUAL INITIATIVES STORAGE OF POISONS Storing poisons out of reach of children and pets, in appropriate places, in the original packaging and disposing of poisons safely reduces the likelihood of poisoning occurring. 5 INDIVIDUAL ACTIONS Knowing which plants in your garden are poisonous, keeping the poisons hotline handy and reading poison labels and instructions prior to use reduce the likelihood of poisoning occurring. 5 EDUCATION PROGRAMS Studies have indicated that education programs are effective in changing attitudes and behaviours, but future research is needed to determine if they decrease the poisons hospitalisation rate. 4 Planet Think-Safe is run by The Department of Consumer and Employment Protection and Worksafe WA to provide resources that develop skills, knowledge and safe habits at school, home and in the community. 4 As part of the program Think-Safe Sam encourages children to spot the hazard, assess the risk and make the change, and includes the storage of medicines and poisons. Page 4

6 Key stakeholders in Western Australia Department of Health WA Poisons Information Centre Department of Health Injury Prevention Department of Health WA Country Health Service Kidsafe WA National Return and Disposal of Unwanted Medicines Ltd Poisons Information Centre St John Ambulance The Department of Consumer and Employment Protection For more information download Injury Prevention in Western Australia: A Review of Statewide Activity for Selected Injury Areas References 1 World Health Organisation. (2014). Poisoning. Retrieved from 2 Department of Health, Western Australia. (2015). Health condition overview. External causes of mortality deaths Western Australia State. 3 Department of Health, Western Australia. (2015). Specific health condition analysis. Accidental poisoning hospitalisations by external cause (injury and poisoning) Western Australia State. 4 Arena, G., Cordova, S., Gavine, A., Palamara, P. & Rimajova, M. (2002). Injury in Western Australia: a review of best practice, stakeholder activity, legislation and recommendations. Perth: Injury Research Centre, The University of Western Australia. 5 Kidsafe WA. (2008). Take the time to spring clean for poisons. Retrieved from archresult&searchid= &objectid=300876&objecttype=55 Acknowledgement Know Injury would like to thank the Western Australian Department of Health, Chronic Disease Prevention Directorate and Epidemiology Branch for providing content for these fact sheets Page 5