Another intervention aimed at preventing
accidental poisonings is the addition of a harmless agent that would make poisonous
household liquids taste so foul and bitter that children would not continue to ingest
the substance. Denatonium benzoate (Bitrex) has been suggested as the ideal compound
for such an intervention: it is non-toxic, chemically stable, and the most bitter
substance known (50-100 ppb is sufficeint to be tasted as bitter).
While several stuides exist that examine
childrens reactions to this bittering agent,13-16 at this time, there are no studies that examine the effectiveness
of bittering agents in preventing childhood poisonings in the real world.
Review of physician-based
|Neumann et al, 2000
Study design and target population
|Ecological time series.
State of Oregon, children under 6.
|1991 Oregon law which required that
anti-freeze and windshield washer fluid must contain an aversive agent after
|Reports of poisoning to the Poison
|No significant effect on number of
Study quality and conclusions
|Poor design and small number of cases
limits conclusions which can be drawn.
Summary of bittering agent studies
The one study above did not provide any evidence for the impact of
the law. The study was a weak design with small numbers of cases and no concurrent
Recommendations for future research
Other studies should be undertaken of the Oregon Law. There is also
a need for a large RCT of bittering agents.