The effectiveness of child-resistant packaging for aspirin

Arch Pediatr Adolesc Med. 2002 Sep;156(9):929-33. doi: 10.1001/archpedi.156.9.929.


Objective: To evaluate the effectiveness of child-resistant packaging in reducing the mortality rate from the unintentional ingestion of aspirin for children younger than 5 years.

Design: Estimates of the annual aspirin-related mortality rate for children younger than 5 years in the United States were developed for the 1958-1990 study period. A multivariate negative binomial regression model was then used to estimate the independent effect of the packaging requirements on the child mortality rate during the postintervention period. The analysis controlled for changes in the per capita use of aspirin, long-term safety trends, and other extraneous and potentially confounding factors that may have affected the aspirin-related child mortality rate.

Main outcome measure: Estimated percentage reduction in the child mortality rate associated with the use of child-resistant packaging.

Results: After controlling for covariates, the use of child-resistant packaging was associated with a 34% reduction in the aspirin-related child mortality rate. This mortality rate reduction equates to the prevention of about 90 child deaths during the 1973-1990 postregulatory study period.

Conclusions: Child-resistant packaging has been effective in reducing aspirin-related child poisonings. However, because its effectiveness is only partial, further poison prevention strategies should be developed and instituted.

Publication types

  • Evaluation Study

MeSH terms

  • Aspirin / poisoning*
  • Child, Preschool
  • Drug Packaging*
  • Humans
  • Infant
  • Multivariate Analysis
  • Poisoning / mortality
  • Poisoning / prevention & control
  • Protective Devices*
  • Regression Analysis
  • United States


  • Aspirin