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Unsuspected Cocaine Exposure in Young Children
Sigmund J. Kharasch, MD;
Deborah Glotzer, MD;
Robert Vinci, MD;
Michael Weitzman, MD;
James Sargent, MD
Am J Dis Child. 1991;145(2):204-206.
Abstract
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• Objective
To determine the prevalence of cocaine exposure among preschool children with clinically unsuspected signs and/or symptoms.
Design
Prevalence study.
Setting
Pediatric emergency department in an inner-city hospital.
Participants
250 children aged 2 weeks to 5 years who underwent urine assays for cocaine prior to discharge from the emergency department.
Interventions
None.
Measurements/Main Results
Six (2.4%) of the 250 urine assays (95% confidence interval, 0.5% to 4.3%) were positive for benzoylecgonine, the major urinary cocaine metabolite. Four of the positive urine assays were from children younger than 1 year and all children with positive urine assays were younger than 24 months. None of these children presented with a complaint or was identified as having clinical problems currently associated with childhood exposure to cocaine. Possible exposure routes include breast-feeding, intentional administration, accidental ingestion of cocaine or cocaine-contaminated household dust via normal hand-to-mouth activity, and passive inhalation of "crack" vapors.
Conclusion
Among the inner-city children served by this hospital, significant numbers of infants and young children are being exposed to cocaine, and this exposure occurs in a clinically unsuspected population.
(AJDC. 1991;145:204–206)
Author Affiliations
From the Department of Pediatrics, Boston (Mass) City Hospital, and Boston University School of Medicine.
Footnotes
Accepted for publication September 4, 1990.
Presented in part at the 30th Annual Meeting of the Ambulatory Pediatric Association, Anaheim, Calif, May 10, 1990.
Reprint requests to the Department of Pediatrics, Talbot 106, Boston City Hospital, 818 Harrison Ave, Boston, MA 02118 (Dr Kharasch).
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