Prescribing Iron? Think Safety

William H. Crosby, MD
Arch Intern Med. 1978;138(5):766-767. doi:10.1001/archinte.1978.03630290062020.
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After aspirin, the second commonest cause of accidental poisoning among small children is iron. This actuarially predictable catastrophe is based on the following certainties:

  1. Mothers of toddlers become pregnant.

  2. Pregnant women are given iron tablets by their obstetricians, usually in bottles of 100.

  3. These bottles are left open and within reach of children.

  4. The child empties the bottle onto the kitchen linoleum. When discovered by his mother he has swallowed X numbers of the pleasantly coated tablets.

Of the total households within which the toddlers and tablets coexist, the percentage of poisonings is small: about 500 reported hospitalizations each year and ten or 12 reported deaths. These are preventable accidents, unnecessary deaths. Despite cumbersome screw caps and poison labels on the bottles, iron will continue to be a common cause of poisonings among toddlers. The only way to prevent the disasters is to provide a nonpoisonous, nonlethal dosage of iron.


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