Objective: What are the circumstances, medical complications, and outcomes of children exposed inadvertently to a transdermal nicotine patch(TNP)?

Design: Post-marketing surveillance series:consecutive sample over 24 mos

Setting: 34 United States poison centers

Patients: Children 0-15 yrs old exposed to a TNP

Outcome Measures: Exposure circumstance,toxicity,management,hospital length of stay,calculated dose(based on size of TNP × delivery rate × estimated time)

Results: 36 exposures in children (mean:3 yrs old): 18 dermal& 18 who bit, chewed, or swallowed part of a TNP.Only 8/28 (29%) children exposed to a used TNP had symptoms as opposed to 6 of 8 (75%) children exposed to a new TNP (p=0.02). Symptoms included gastrointestinal (nausea, vomiting, diarrhea, abdominal pain), weakness, dizziness, or localized rashes. For the 18 dermal exposures,children with symptoms had higher calculated nicotine doses (×3.368 vs 0.096mg; p=0.03): Table Ten children were seen in the ED;2 (dermal exposures) admitted. All recovered.

Table 1
Full size table

Conclusions: 3 variables in pediatric TNP exposures were associated with low order of toxicity: oral route (mouthing,chewing,biting a TNP), TNP that had already been used therapeutically,& brief exposure duration (calculated nicotine dose < 0.9mg). This research funded, in part, by Lederle Laboratories.