Table 3.

Recommendations and sources of the evidence for preventing poisoning

Recommendations	Guidelines and/or institutions recommending the intervention	Source of the evidence
Remove the toxic agent	- WHO 2008; European region [1] - RCPCH 2019 [2]	- Flanagan 2005; cohort study [51] - Roberts 2003; cohort study [52]
Packaging - Pass and enforce legislation requiring child-resistant packaging of medicines and poisons - Packaging drugs in non-lethal quantities	- WHO 2008; European region [1] - EuroSafe 2006 [13]	- Flanagan 2005; cohort study [51] - European laws and regulations 2008 [53]
Poison control centres - Establishing poison control centres - Having a poison control centre sticker available - Know the nationwide poison control centre phone number	- WHO 2008; European region [1] - PrevInfad 2011 [42] - CDC 2019 [16] - EuroSafe 2006 [13]	- IPCS INTOX Programme [48] - WHO resources for poisons centre [54] - Kendrick 2013; Cochrane systematic review [50] - Kendrick 2012; Cochrane systematic review [45] - Bateman 2002; cohort study [55]
Secure storage Lock away medicines and other toxic substances	- WHO 2008; European region [1] - PrevInfad 2011 [42] - RCPCH 2019 [2] - CDC 2019 [16] - EuroSafe 2006 [13]	- Kendrick 2013; Cochrane systematic review [50] - Kendrick 2012; Cochrane systematic review [45] - Turner 2011; Cochrane systematic review [49]
Remove or regulate availability of toxic substances that are easily mistaken for edible items	- WHO 2008; European region [1]	(See original documents)
Teach children to avoid poisonous substances	- WHO 2008; European region [1]	(See original documents)
Attractiveness of medications and poisons - Reduce the attractiveness of medications and poisonous products - Do not call medicine ‘candy’	- WHO 2008; European region [1] - CDC 2019 [16]	(See original documents)
Provide home safety education and safety equipment	- WHO 2008; European region [1]	- Kendrick 2013; Cochrane systematic review [50] - Turner 2011; Cochrane systematic review [49]
Safe use of syrup of ipecac Routine administration of ipecac at the site of ingestion or in the emergency department should be avoided	- PrevInfad 2011 [42]	- Kendrick 2012; Cochrane systematic review [45] - Höjer 2013; systematic review [56]

Abbreviations:CDC Centers for Disease Control and Prevention, PrevInfad PrevInfad workgroup from the Spanish Association of Primary Care Pediatrics, RCPCH Royal College of Paediatrics and Child Health, WHO World Health Organization