But he also said that child-resistant containers were not as effective as they could be. He pointed out that the 45 percent reduction in the child mortality rate was less than might be expected given that the containers were supposed to be impossible for 80 percent of all children under 5 to open. He offered two explanations.

First, as many as 40 percent of accidental poisonings of young children involve drugs packaged in containers that are not child-resistant. Federal law allows people to request conventional containers when having a prescription filled. The law was intended to help elderly and handicapped people who find the child-resistant tops too hard to open. Second, Dr. Rodgers estimates that perhaps 10 percent of child poisonings occur when medicine that was dispensed in the protective containers is left outside of those containers.

Dr. Rodgers believes that child-resistant packages will save an even greater number lives in the near future because they are being redesigned to be easier for adults to use, but no easier for children to open. The redesign is the result of changes in testing protocols made by the Consumer Products Safety Commission in response to complaints that child-resistant containers are too difficult to open. The change, which will affect all medicine packaged after Jan. 21, 1998, is an effort to get more elderly people, especially grandparents of small children, to use child-resistant containers.

Rose Ann Solloway, administrator for the American Association of Poison Control Centers in Washington was encouraged by the study results as well as by the pending redesign of child-resistant containers. "It's very important that older adults be able to use the packaging," she said, "because the medicines that they take, especially cardiovascular drugs, diabetes drugs and analgesics, can be fatal to children in small doses."

She added that in addition to using child-resistant packages, parents and others who care for children should put medicines in places where children cannot reach them.