Vol. 9 Issue 28
Watching the Aisles
Community health issue discovered in the aisle of local grocery store
While shopping at Food Lion in 2005, I noticed they were stocking low dose aspirin with other fever reducers in the infant aisle of the grocery store. This concerned me because as an emergency department nurse I have noticed a disturbing number of parents who are treating children's fever with aspirin. Parents have told me they don't understand because the box say's children's aspirin, so they believe it is safe to give their children.
Seeing the aspirin, I voiced my concern to the cashier explaining the association between aspirin and Reye's syndrome. She said she was required to place the aspirin where it is but did not understand my concern because she also treats her children with aspirin when they have fevers.
When I treated a 9-year-old boy in 2004 who was diagnosed with Reye's syndrome a deadly disease which affects all organ systems and is thought to be caused by aspirin in children the mother told me, "The box read children's aspirin, I thought it was OK." I could only imagine how many parents are picking up the box of aspirin and assuming it is safe to give to children not only because the box says "children's aspirin" but also because the aspirin is located with the pediatric fever reducers in the infant aisle of the grocery store. Parents are assuming it is safe to give children and the packaging is reinforcing this belief.
After leaving multiple messages for the store manager, calling the corporate office and contacting the quality assurance specialist and the category manager, I finally received a note from the category manager which stated:
"We place these items in locations that are safe and conveniently located to aid the consumers in finding the items they need and want to purchase. The aisle in general contains products that are not just for infants, but for toddlers and very young children. We work diligently to locate products in the safest way possible. When you look for pain relief in the HBA aisle, you will notice the infant and children's products are located on the bottom shelf. This is done to assure a child does not open or accidentally swallow products intended for adults.
I will factor this info into my thinking when this category is reviewed and reset."
This letter was confusing and frustrating since I provided information about the dangers of children taking aspirin, so I decided I needed to take further action.
I e-mailed and sent letters to the FDA, Maryland Board of Pharmacy and the Consumer Protection Division. The Maryland board also took action and I received a copy of the letter they sent to Food Lion. This letter stated:
"Maryland Board of Pharmacy strongly recommends that Food Lion move all aspirin products to areas of the store that are intended for treatment of adult patients. The Maryland Board of Pharmacy further intends to include this topic in an upcoming newsletter to notify all pharmacy permit holders that aspirin products should not be located near baby or children's products in their stores."
Remembering the child I helped treat in the ED triggered my concern for the lack of education about Reye's Syndrome in my community, and perhaps in other areas. I am shocked by the number of people I have talked with who are not aware of the risks. Most do not know that children should not be medicated with aspirin without a doctor's instruction. It is critical children with viral illnesses not be treated with aspirin. I am equally disappointed at the lack of response from Food Lion. Despite the letter from Maryland Board of Pharmacy, Food Lion continues to stock the product neatly with the other antipyretics for children. Furthering the danger, these generic boxes of low dose aspirin still say "children's aspirin." I am hoping the Maryland Board of Pharmacy's newsletter motivates retailers to relocate the low dose aspirin away from other children's medications.
Parents and caregivers need to be made aware of the risks associated with medicating children with aspirin. Manufacturers must also be held accountable for proper labeling and retailers must be held responsible for appropriate placement of products in stores. Education is the best prevention, especially with a disease which is so easily avoided.
Jennifer Folkes, RN, is an IV therapy nurse at Upper Chesapeake Health System in Harford County, MD.