Despite advances improving packaging safeguards in recent years, unintentional child poisonings remain an important public health concern. From 2001 to 2008, more than half a million children 5 or younger visited an emergency room in the U.S due to possible poisoning by medication. Data reported by the Centers for Disease Control and Prevention (CDC) in their latest report (2013) further suggests that among children, ED visits for medication poisonings are most common in children under 6 years of age. To limit childrens' exposure to drugs and other household items that may cause harm, the US government has required "special packaging" on specified products since the early 1970s. Our study attempts to extend early stage processing (i.e. capture a child's attention in an area of the package away from the closure system) to extend the time before opening. To do so, we applied a lenticular graphic, or a "visual distracter," to pharmaceutical vials and blisters. Distracters alternated between a frowning facial icon and the words "keep away" as the packages were moved. Two hundred and seven children between the ages of 24 and 51 months were tested in pairs. Each pair was provided one of the four treatment conditions (pharmaceutical vials with and without distracter and walleted blisters with and without distracters). Given that only 7 out of 99 subjects open the blisters successfully, no evidence for any effect of treatment on the probability of opening blisters (P=0.6522) or the time to successful opening (P=0.8196) was found. However, the results for the vials suggest the presence of a visual distracter to be a promising approach for prolonging time to opening (P=0.0375 ; Treatments that contained distracters [ME= 103.05 seconds SE 26.10]; Plain Treatment [ME=36.64 seconds SE 20.34]) and may be particularly effective in preventing younger children (24 to 40 months of age) (P=0.0356) from successfully opening vials (LSM=0.085 CI [0.0246, 0.2538]) as compared to their counterparts 42-51 months (LSM=0.2414 CI [0.0813, 0.5337] ).
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