Effect of education and safety equipment on poisoning-prevention practices and poisoning: systematic review, meta-analysis and meta-regression.

Abstract

To assess (a) the effect of home safety education and the provision of safety equipment on poison-prevention practices and poisoning rates, and (b) whether the effect of interventions differs by social group. Medline, Embase, Cinahl, ASSIA, Psychinfo, Web of Science, plus other electronic sources and hand searching of conference abstracts and reference lists. Authors of included studies were asked to supply individual participant data. Randomised controlled trials, non-randomised controlled trials and controlled before-and-after studies, with participants aged </=19 years, providing home safety education with or without free or subsidised safety equipment and reporting poison-prevention practices or poisoning incidents were included. Pooled odds ratios and pooled rate ratios were estimated, and meta-regression estimated intervention effects by child age, gender and social variables. Home safety interventions increased safe storage of medicines (OR 1.57, 95% CI 1.22 to 2.02) and cleaning products (OR 1.63, 95% CI 1.22 to 2.17), the possession of syrup of ipecac (OR 3.34, 95% CI 1.50 to 7.41), and having poison control centre numbers accessible (OR 3.67, 95% CI 1.84 to 7.33). There was a lack of evidence on poisoning rates (rate ratio 1.03, 95% CI 0.78 to 1.36) and no consistent evidence that intervention effects differed by child age, gender or social group. Home safety education and the provision of safety equipment improve poison-prevention practices, but the impact on poisoning rates is unclear. Such interventions are unlikely to widen inequalities in childhood poisoning-prevention practices.