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PubMed2004

Trends in age-specific human poisoning exposures reported to a regional poison control center, 1997-2001.

This study examined age-specific trends in the annual incidence rates of poisoning exposures reported to a regional poison control center over a 5-y period. Data from the poison control center's 1997-2001 computerized case records were combined with age-specific population estimates from the US Census Bureau. Incidence rates of reported poisoning exposures were calculated and evaluated for the following age groups: < 6 y; 6 to 12 y; 13 to 19 y; 20 to 35 y; 36 to 65 y; and > 65 years. Ordinary linear regression analysis revealed a statistically significant decreasing trend in the annual crude incidence rate of poisoning exposures/1.000 population (r2 = .87, slope = -.33 p = .02). Different patterns were observed in the rates of reported poisoning exposures between the 6 age groups. While there was a significant decrease in the rate of reported poisoning exposures in children < 6 y of age or less, and for adults 20-35 and 36-65 y-old, the incidence rate among children 6-12 y, adolescents, and people > 65 y-old showed no significant decreasing trend.

Adolescent↗
PubMed1990

Treated vs reported toxic exposures: discrepancies between a poison control center and a member hospital.

Statistics accumulated by Poison Control Centers (PCC) are routinely used on the local, regional and national levels by governmental agencies to set policy and direct funding. Incomplete reporting by member hospitals is recognized by PCC as a factor contributing to discrepancies in epidemiological estimates; however little emphasis is classically placed by the PCC on expanding reporting from member hospitals. A 1y retrospective review of patients with toxic exposure presenting to an urban Emergency Medicine Department (EMD) was performed to quantify the lack of concordance between treated and reported toxic exposures. 470 toxic exposures presented over the study period, of which only 123 (26%) were relayed to the regional PCC. Inhalation exposures were least likely to be referred for PCC consultation (3%); whereas PCC consultation was obtained for 33% venomous snake bite cases, and 95% of the cyclic antidepressant ingestions. Clusters of similar exposures resulted in fewer PCC consultations. Understanding each hospital's "profile" for handling toxic exposures, and individualized advertisement by the PCC to their member hospital may increase their data reporting. The statistical significance of their epidemiological studies as well as their revenue may increase.

Environmental Exposure↗
PubMed1996

Re-engineering regional poison control center services.

In summary, I propose a model of poison control service delivery to replace poison control centers. A handful of financially self-sustaining poison consult centers would remain. All other services would be provided by health plans to their members, including those covered under State-funded managed care. The need for continued fundraising efforts would be eliminated. Rather than devoting large sums of money to consolidate the State's 6 centers into 1 large center, I encourage Blue Cross of California to fund the protocol development process that will drive a true restructuring effort for poison control services. In our hearts, if our goal is to ensure continued service provision, then let's take the initiative to re-engineer the way we do business. The risks of doing nothing more than seek continued funding for the existing service delivery model should be painfully obvious by now. If your individual goals include survival for your center, then there's great news. The demand for call centers providing a wide range of advice services is approaching a critical level. Most health and hospital systems are moving to a managed care environment. Health care delivery is quickly moving out of the hospital to ambulatory services. Telemedicine is here--and growing very quickly. Distance learning technology is knocking at the door. There is plenty to do. With sound strategic development, your center will survive--it just won't look or feel the same as its does today. Survival the way it used to be ...uh, except for the computers and stuff.

California↗
PubMed1992

Effects of a major earthquake on calls to regional poison control centers.

We retrospectively evaluated the effect of the Loma Prieta earthquake on calls to 2 designated regional poison control centers (San Francisco and Santa Clara) in the area. In the immediate 12 hours after the earthquake, there was an initial drop (31%) in call volume, related to telephone system overload and other technical problems. Calls from Bay Area counties outside of San Francisco and Santa Clara decreased more dramatically than those from within the host counties where the poison control centers are located. In the next 2 days, each poison control center then handled a 27% increase in call volume. Requests for information regarding safety of water supplies and other environmental concerns were significantly increased. The number of cases of actual poisoning exposure decreased, particularly poison and drug ingestions in children. Most calls directly related to the earthquake included spills and leaks of hazardous materials and questions about water and food safety. Regional poison control centers play an essential role in the emergency medical response to major disasters and are critically dependent on an operational telephone system.

Disasters↗
PubMed2003

Effects of a videotape to increase use of poison control centers by low-income and Spanish-speaking families: a randomized, controlled trial.

BACKGROUND: Poison control centers (PCCs) reduce health care costs for childhood poisonings by providing telephone advice for home management of most cases. Past research suggests that PCCs are underutilized by low-income minority and Spanish-speaking parents because of lack of knowledge and misconceptions about the PCC. A videotape intervention was designed to address these barriers to PCC use. OBJECTIVE: To evaluate the effectiveness of a videotape intervention (videotape, PCC pamphlet, and PCC stickers) in improving knowledge, attitudes, behaviors, and behavioral intention regarding use of the PCC in a low-income and predominantly Spanish-speaking population in Northern California. METHODS: Two hundred eighty-nine parents of children <6 years of age, attending educational classes at 2 Women, Infant, and Children (WIC) clinics participated in a randomized, controlled trial. WIC classes were randomized to receive the video intervention (video group) or to attend the regularly scheduled WIC class (control group). Participants completed a baseline questionnaire and 2 to 4 weeks later, a follow-up telephone interview. Changes from baseline to posttest were compared in the treatment and control groups using analysis of variance. RESULTS: Compared with the control group, the video group showed an increase in knowledge about the PCC's function, its hours of operation, and staff qualifications; was more likely to feel confident in speaking with and carrying out recommendations made by the PCC; was less likely to believe the PCC would report a mother for neglect; was more likely to have the correct PCC phone number posted in their homes; and when presented with several hypothetical emergency scenarios, was more likely to correctly answer that calling the PCC was the best action to take in a poisoning situation. CONCLUSIONS: This videotape intervention was highly effective in changing knowledge, attitudes, behaviors, and behavioral intentions concerning the PCC within this population. As a result, use of this video may help increase use of the PCC by low-income and Spanish-speaking families.

Adult↗
PubMedDate not supplied

Implication of dispensing cups in dosing errors and pediatric poisonings: a report from the American Association of Poison Control Centers.

OBJECTIVE: To characterize reports to poison centers involving liquid medication errors associated with the use of dispensing cups. DESIGN: Case series reported by 16 US poison centers over an eight-day period. SETTING: Calls to poison control centers, predominantly but not exclusively from homes. PATIENTS: Children and adults. RESULTS: Of 34 reported cases, most (79 percent) involved a two- to threefold dosing error, and most (94 percent) involved an error in a single dose of medication. Cough and cold preparations were implicated in 65 percent; acetaminophen elixirs in 18 percent. Three major causes of dosing errors were identified, including teaspoon/tablespoon confusion, assumption that the dispensing cup was the unit of measure, and assumption that the full dispensing cup was the actual dose. CONCLUSIONS: Dispensing cup markings should use a single unit of measure, and a uniform labeling system should be implemented. Teaspoon/tablespoon abbreviations should be avoided, and dispensing cup lettering should be more legible. Consumer education is essential to correct the misimpression that the full cup is always the recommended dose.

Child↗
PubMed2004

Trends in child and teen nonprescription drug abuse reported to a regional poison control center.

PURPOSE: Trends in child and teen nonprescription drug abuse reported to a regional poison control center over a 10-year period were examined. METHODS: Human exposures to toxic substances reported to the Utah Poison Control Center between January 1990 and December 1999 were reviewed. Cases were selected for analysis if the exposure involved a nonprescription drug, the patient was 6-19 years old, and the reason for exposure was intentional abuse. Frequencies and cross-tabulations were calculated to identify trends in nonprescription drug abuse. RESULTS: There were 2214 reports of intentional drug abuse among children and teenagers 6-19 years old. Of those, 844 (38.1%) involved nonprescription drugs. The percentage of exposures Involving nonprescription products varied every year and declined over time. Exposures were slightly more common In males (51.7%). The site of exposure was a residence in 65% of cases and a school in 10% of cases. The majority of patients with exposures (68.4%) were treated In a health care facility. The most common types of nonprescription medications abused were drugs with anticholinergic properties, caffeine, dextromethorphan, and nonprescription stimulants. CONCLUSION: Reports of the Intentional abuse of nonprescription drugs by children and teenagers were common at a regional poison control center. There was significant variation in the type of nonprescription medication most commonly abused. The knowledge of these trends may assist public health policymakers, physicians, pharmacists, and child educators in their attempts to curb nonprescription drug abuse. drugs.

Adolescent↗
PubMed1998

The present and future of poison control center in Taiwan.

The PCC-Taiwan was founded in July 1985 under the auspices of the Department of Health, Executive Yuan, and the Veterans General Hospital-Taipei, Republic of China. It has served a population of 21 million inhabitants on a 24-hours basis. It has also served as a referral center for treating poisoning cases nationwide, a training center for physicians and consultants, and a center for Analytical Toxicology. The average annual volume of telephone inquires to PCC is more than four thousand in recent few years and continue to increase annually. The present and future prospective of the PCC-Taiwan which have to be accomplished are: 1. to propagate public education of poisoning prevention and increase the utility of PCC before events of intoxication, 2. to establish, computerize and improve the database and network of domestic poisonous products or natural toxins, including herbs, 3. to establish an nationwide referral network for severely poisoned patients or cluster poisoning events, 4. to build up a global collaborative work with other poison centers.

Humans↗
PubMed2006

Clinician validation of Poison Control Center (PCC) intentional exposure cases involving prescription opioids.

Poison Control Center (PCC) cases involving intentional ingestion, injection or inhalation of prescription opioids are a potentially valuable source of information on the abuse and misuse of these products. This study sought to validate PCC classifications of prescription opioid intentional exposure cases against clinical diagnostic criteria. 4,321 cases were reviewed. PCC-clinician concordance was good to excellent for Withdrawal, Abuse, and Suicide (kappa statistics: 0.73, 0.53, 0.48, respectively), but poor for Misuse and Intentional Unknown (Specific motive not known). Interrater reliability among clinicians was good (weighted kappa range: 0.56-0.68). Results demonstrate the degree of compatibility between PCC and standard nosologic classifications.

Drug Evaluation, Preclinical↗
PubMed1995

The production model as a basis for conducting economic evaluations of regional poison control centers.

To identify the significant inputs, activities, and outputs of a regional poison control center, a production model is described and its potential application to the conduct of economic evaluations delineated. The model can help the researcher identify the significant inputs (costs) incurred through the provision of poison control center services. These inputs directly influence the activities that the poison center is capable of undertaking. Activities undertaken by a poison center are intermediate steps between the inputs and outputs, and serve to convert the various inputs into associated outputs. They form the basis for determining the outputs produced by the poison center services. The outputs derived from poison center services provide the conceptual framework for assessing the effectiveness of a poison center in an economic analysis. Also described are potential applications of the production model in conducting poison center cost-effectiveness and cost-benefit analyses.

Cost-Benefit Analysis↗
PubMed1992

Case reports of lead poisoning in dogs from the National Animal Poison Control Center and the Centre National D'Informations Toxicologiques, Veterinaires: anecdotes or reality?

This paper presents case reports of lead toxicoses from 2 major animal poison control centers in Europe and North America, gathered from 1985 through 1989. All results examined here involved cases assessed as "toxicosis" or "suspected toxicosis" by the National Animal Poison Control Center (NAPCC) or the Centre National d'Informations Toxicologiques Veterinaries (CNITV). 537 cases were reported to the NAPCC, most of them concerning dogs (59%). In France, most of the 362 cases involved cattle (57.2%). There was an increased number of cases reported during late summer and early fall, and a decreased number of cases in November and December, in both centers. Dogs intoxicated were predominantly young animals (60% were less than 2 years old). No sex difference was noted. Pure bred dogs appeared more often involved than mixed-breed ones, but the breed distribution closely resembles dog breed distribution in the US. The source of lead was usually unknown and, when information was available, paint seemed to be the most common cause of poisoning. Clinical signs reported to the animal poison control centers involved the CNS and GI tract. Results from the French and the American database showed similar trends. They are compared to data from veterinary clinics and veterinary colleges in the US and Australia. In each case, data are very similar to what was reported to the CNITV and the NAPCC. It is concluded that animal poison control centers databases can provide a useful tool for better knowledge of animal poisoning. They can also help identify unexpected toxicologic problems related to drug administration or pesticide use.

Age Factors↗
PubMed2000

Poisoning mortality in the United States: comparison of national mortality statistics and poison control center reports.

STUDY OBJECTIVE: To determine whether the distributions of age and poisoning categories for poisoning deaths are similar in death certificates as compiled by the National Center for Health Statistics (NCHS) and US poison control centers as reported by the Toxic Exposure Surveillance System (TESS). METHODS: Data from both databases for 1994 were examined. Mortality data from NCHS were identified by applicable E-codes of the International Classification of Diseases-ninth revision (ICD-9). All fatalities described in the TESS report were coded to conform to the ICD-9 system. RESULTS: A total of 16,527 poisoning deaths were recorded by NCHS; 766 deaths were reported by TESS. For NCHS and TESS, respectively, the age distribution of unintentional drug poisonings (N=7,823; 155) and unintentional non-drug poisonings (N=1,234; 102) differed (P <.001), whereas those for intentional poisonings (N=5,320; 413) did not differ significantly. In the NCHS and TESS data sets, respectively, the relative distribution of death circumstances differed (P <.001) for unintentional drug poisonings (47% versus 20%), unintentional non-drug poisonings (8% versus 14%), intentional poisonings (32% versus 54%), and unknown or other circumstances (13% versus 12%). The distributions of poisoning circumstances and age categories were dependent on the data source (P <.001). There was no statistical agreement between the data sets in rankings of the 12 most frequent ICD-9 codes and toxins associated with poisoning deaths. CONCLUSION: Deaths reported in TESS represent 5% of the poisoning deaths tabulated by NCHS. Differences observed in the 2 data sets may lead to differing health policies to address poisoning hazards.

Accidents↗