Unintentional Poisoning Among Children in the Gulf Cooperation Council Countries: A Systematic Review of Causative Agents, Circumstances and Opportunities for Prevention

Unintentional poisoning is a leading and largely preventable cause of injury in childhood. More than 45,000 children die each year from unintentional poisoning worldwide, making it the fifth leading cause of injury-related death in children (Peden et al. 2008). The Global Burden of Disease 2021 study estimated the incidence at about 40 per 100,000 children aged under 15 years, with the highest incidence in high Socio-demographic Index countries (Wang et al. 2025). Children aged 1–5 years are most at risk, and most exposures occur at home. In the six Gulf Cooperation Council (GCC) countries — Saudi Arabia, Kuwait, Qatar, Bahrain, Oman and the United Arab Emirates — childhood poisoning has been recognized for four Protocol v1.0 — 1 decades. In 1983 it accounted for 5.6% of admissions to the main children’s hospital in Riyadh (Mahdi et al. 1983). Today, Saudi poison control centres receive more than 20,000 consultations a year, most concerning children under 6 years (Al-Mousa et al. 2021), and the national teleconsultation service handled 39,142 calls in 2023 (Alharbi et al. 2025). Evidence from the region, however, is scattered across single-centre, poison-centre and surveillance studies that identify different leading agents. Hospital series point to medicines such as paracetamol (Ahmed et al. 2015; Alghadeer et al. 2018), whereas chemical surveillance points to detergents, bleach and kerosene (Alshahrani et al. 2023; Hakami et al. 2025). Effective countermeasures exist. Home safety education increases the safe storage of medicines and cleaning products and the availability of poison-centre numbers (Kendrick et al. 2012), and child-resistant packaging reduces child poisoning deaths (Rodgers 1996). In Saudi Arabia, child-resistant packaging became mandatory for reclosable oral medicines containing high-risk substances, including paracetamol and iron, in February 2025 (Saudi Food and Drug Authority 2023). Yet existing reviews are restricted to deaths in Saudi Arabia (Almutairi et al. 2023), to all childhood injuries in Saudi Arabia (Albedewi et al. 2021), or to all age groups (Aljumaan and Alsulaibikh 2025). None has synthesized unintentional pediatric poisoning across all six GCC countries, analysed medicine exposures by therapeutic class, or translated the findings into prevention actions. This review will fill that gap and provide a baseline for targeting and evaluating prevention measures