Child Resistant Packaging: Regulations and Effectiveness, 1980–2002

Poisoning from household substances has been and continues to be a hazard to children under 5 years of age. In an effort to address this problem, the Poison Prevention Packaging Act (PPPA) of 1970 was enacted as of December 30, 1970. This act is a federally preemptive piece of legislation covering an ever expanding group of substances. The test methods used to establish compliance with the PPPA do not address the range of substances covered (e.g. liquids); the changing patterns of use of household substances such as increased use of liquid medications for children; or repeated access to and multiple reclosures of containers, as seen in the home situation. To examine the effectiveness of the PPPA in addressing actual poisonings in children under 5, national databases from 1980 through March 13, 2002 were examined. Reports mentioning the use of a CRC (child resistant container) were then analyzed. Assisted Access incidents involved an older child gaining access to the contents of a CRC and giving those contents to the younger victim. Transfer of Contents incidents involved ingestion of a substance that was originally packaged in a CRC and was transferred to a non-CRC The average age of children seen in hospitals is under 2, and fatalities due to Assisted Access and Transfer of Contents incidents were seen in children averaging under one year of age. These age ranges are below those of children used in CRC testing (3.5 to 4.25 years). More importantly, the average body weights — directly related to the susceptibility to poisoning injury — of children seen in hospitals is less than the 25 pound weight used to set toxicity thresholds by the PPPA. Training for children, the elderly, and parents would help increase awareness of Transfer of Contents and Assisted Access poisonings, which are disproportionately represented in fatal poisoning incidents of young children.