Poison Centers, Poison Prevention, and the Pediatrician

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Frederick H. Lovejoy ◽  
William O. Robertson ◽  
Alan D. Woolf
Keyword(s):  
The United States ◽  
Poison Control ◽  
Poison Center ◽  
Department Of Health ◽  
Household Products ◽  
Prevention Model ◽  
Poison Centers ◽  
History Of ◽  
Poison Prevention ◽  
Remarkable Progress

The first poison centers were established in the United States in the early 1950s, stimulated by an American Academy of Pediatrics' survey of office-based pediatric practices which ascertained that its members had no place to turn for ingredient information on medications and household products.1 With the help of the Academy, pediatrician Dr. Edward Press, the Illinois Department of Health, and several community hospitals, the first poison center emerged. Over the subsequent 40 years, remarkable progress has occurred in the fields of clinical toxicology, poison control, and poison prevention. Yet despite these accomplishments, challenging clouds are appearing on the horizon which threaten these gains. This commentary, by the authors who have viewed and participated in a large part of the history of this progress, will focus on these major accomplishments with an emphasis on (a) poison prevention utilizing the pre-event (primary prevention), (b) the event (secondary prevention), and (c) the postevent (tertiary prevention) model.2

MOTHER FIGHTS TO RUIN THE TASTE OF POISON

PEDIATRICS ◽  
1989 ◽  
Vol 84 (4) ◽  
pp. A42-A42
Author(s):  
J. F. L.
Keyword(s):  
Public Service ◽  
Executive Director ◽  
The United States ◽  
Public Television ◽  
Small Children ◽  
Nail Polish ◽  
Household Products ◽  
Promising Area ◽  
Poison Prevention ◽  
Flavoring Agent

On March 6, a mother in Oregon watched a public television report about British companies that were discouraging children from eating poisonous household products by lacing them with Bitrex, the world's bitterest flavoring agent. The woman, Lynn Tylczak, who has two small children and lives in Albany, 60 miles south of Portland, began a letter-writing campaign that is focusing attention on poison prevention. She may also be speeding Bitrex's journey to supermarket shelves in products like detergents, nail-polish removers, rodenticides and antifreeze. "Mrs. Tylczak has already achieved a certain victory by bringing national attention to this issue," said Linda Golodner, executive director of the National Consumers League in Washington. "She has shown that a single consumer can make a difference." Now she is encouraging manufacturers to add Bitrex to their products by sharing with them letters of support that are sent to her group, the Poison-Proff Project (4384 S.E. Ermine Street, Albany, Ore. 97321). `A Very Promising Area' Consumer and safety organizations in the United States are beginning to notice. On May 5, the National Safety Council, a 13,000-member public-service organization, called on manufacturers to use Bitrex in all appropriate household products. "Bitrex is the most bitter substance known to man," according to the Merck Index. In 1982, some British companies began using Bitrex in household products to deter inquisitive children, but the practice did not grow until two years ago, when the Royal Society for the Prevention of Accidents endorsed its use.

Poison Prevention Education

PEDIATRICS ◽  
1984 ◽  
Vol 74 (5) ◽  
pp. 964-969
Author(s):  
Anthony R. Temple
Keyword(s):  
Life Support ◽  
First Aid ◽  
Poison Control ◽  
Poison Center ◽  
Prevention Education ◽  
Control Center ◽  
Support Measures ◽  
Poison Prevention ◽  
Household Chemicals ◽  
Epidemiologic Characteristics

Physicians can significantly decrease the frequency and severity of poisoning by educating parents and families in poison prevention. Appropriate strategies for poison prevention education require an examination of epidemiologic characteristics of exposures and potential intervention techniques. Parents should be taught immediate first-aid steps, such as initiating basic life-support measures and irrigation and dilution, that can be taken before seeking medical assistance. Other consumer actions, such as inducing emesis, require medical supervision. The poison control center is the best source for information and advice on treating poisoning. To decrease the frequency of poisoning, parents should be taught to purchase, store, and handle potentially toxic products appropriately. The purchase of household chemicals and drugs in child-resistant safety packaging should be encouraged. To decrease the severity of poisoning, parents should post the phone number of the local poison center, be able to initiate first-aid measures, and keep ipecac syrup on hand. Ideally, a physician should establish a preventive education schedule and discuss poison prevention with parents at regular well-child visits, beginning when the child is very young.

The Initiative, The Referendum, and The Recall: Recent Legislation in the United States

1907 ◽  
Vol 2 (1) ◽  
pp. 32-42 ◽  
Author(s):  
Margaret A. Schaffner
Keyword(s):  
United States ◽  
Social Organization ◽  
Political Institutions ◽  
Social Evolution ◽  
The United States ◽  
Representative Government ◽  
State Legislation ◽  
Gradual Process ◽  
History Of ◽  
Remarkable Progress

To make representative government more representative is the problem of today. The gradual process of social evolution has changed the industrial basis upon which our political institutions rest, and the increased complexity of our social organization has made the expression of the popular will more difficult. As readjustment to changing conditions is the requisite for any advancing type of life, so political progress becomes impossible unless new agencies are developed to be retained or discarded as experience may warrant.Among the agencies for political expression, few have made more remarkable progress in the history of recent legislation than the initiative, the referendum, and the recall. State wide referendums for the adoption of State constitutional, and local referendums for local affairs, are familiar institutions in the United States, but it is only within recent years that our States have begun to adopt the initiative and the referendum for State legislation.

Bibliometric analysis of poison center-related research published in peer-review journals

2015 ◽  
Vol 35 (7) ◽  
pp. 705-712 ◽  
Author(s):  
MB Forrester
Keyword(s):  
United States ◽  
Peer Review ◽  
Medical Toxicology ◽  
The United States ◽  
Poison Center ◽  
Related Research ◽  
Pubmed Database ◽  
Poison Centers ◽  
Number Of Publications ◽  
Advance Knowledge

Poison centers advance knowledge in the field of toxicology through publication in peer-review journals. This investigation describes the pattern of poison center-related publications. Cases were poison center-related research published in peer-review journals during 1995–2014. These were identified through searching the PubMed database, reviewing the tables of contents of selected toxicology journals, and reviewing abstracts of various national and international meetings. The following variables for each publication were identified: year of publication, journal, type of publication (meeting abstract vs. other, i.e. full article or letter to the editor), and the country(ies) of the poison center(s) included in the research. Of the 3147 total publications, 62.1% were meeting abstracts. There were 263 publications in 1995–1999, 536 in 2000–2004, 999 in 2005–2009, and 1349 in 2010–2014. The publications were in 234 different journals. The journals in which the highest number of research was published were Clinical Toxicology (69.7%), Journal of Medical Toxicology (2.2%), and Veterinary and Human Toxicology (2.1%). The research was reported from 62 different countries. The countries with the highest number of publications were the United States (67.9%), United Kingdom (6.5%), Germany (3.9%), France (2.5%), and Italy (2.4%). The number of publications increased greatly over the 20 years. Although the publications were in a large number of journals, a high proportion of the publications were in one journal. While the research came from a large number of countries, the preponderance came from the United States.

"SUICIDE" AS SEEN IN POISON CONTROL CENTERS

PEDIATRICS ◽  
1971 ◽  
Vol 48 (6) ◽  
pp. 914-922
Author(s):  
Matilda S. McIntire ◽  
Carol R. Angle
Keyword(s):  
Mental Health ◽  
United States ◽  
Behavior Problems ◽  
Suicide Attempts ◽  
The United States ◽  
Poison Control ◽  
Age Group ◽  
Abrupt Increase ◽  
Poison Control Centers ◽  
History Of

Of 1,103 cases of poisoning, ages 6 to 18, admitted to 50 poison control centers during 1 year, 13% were considered unintentional, 13% "trips," 26% suicide attempts, and 48% suicide gestures or affect reactions. The youngest age group, 6 to 10, is 63% male, 40% Negro, and about one-half give a history of precipitating stress or current or prior referral for behavior problems. The abrupt increase in self-poisoning in girls at age 12 peaks at age 16, while male paisonings continue to increase with age. An admittedly immature concept of death was retained by 16% of the 17 to 18-year-olds. In the five deaths (mortality 1: 220 hospitalized self-poisonings), lethality of intent was presumed low with death the result of a toxicologic mishap. The estimate of about 115,000 self-poisonings annually in the United States, ages 6 to 18, defines a mental health problem of the first magnitude, but open to epidemiologic analysis by relatively simple techniques.

Alcohol in Mouthwash

1985 ◽  
Vol 7 (1) ◽  
pp. 11-26
Keyword(s):  
United States ◽  
Lethal Dose ◽  
The United States ◽  
Absolute Ethanol ◽  
Poison Center ◽  
Accidental Death ◽  
Small Child ◽  
National Poison ◽  
Poison Centers ◽  
At Home

Poisoning is an important cause of accidental death in children less than 5 years of age. The most frequently ingested poisons are those that are commonly available at home in pleasant-colored containers and are easily accessible. They are usually in containers that are not child-proof. Mouthwash contains varying concentrations of ethanol ranging from a high of 26.9% (53.8 proof) to 14% (28 proof). A potentially lethal dose of absolute ethanol is approximately 3 g/kg (3.8 mL/kg) in a small child. [See Table in the PDF] During an 18-month period, reports of 422 cases of mouthwash ingestions by children less than 6 years of age were collected by The National Poison Center Network from its member poison centers in selected areas of the United States (unpublished data, 1979).

Comparison of Pediatric Poisoning Hazards: An Analysis of 3.8 Million Exposure Incidents A Report from the American Association of Poison Control Centers

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 999-1006
Author(s):  
Toby Litovitz ◽  
Anthony Manoguerra
Keyword(s):  
Poison Control ◽  
Over The Counter ◽  
Research Areas ◽  
Poison Centers ◽  
Life Threatening ◽  
Cardiovascular Medications ◽  
Poison Prevention ◽  
Frequent Exposure ◽  
Clinical Advances ◽  
Hazard Factor

This analysis of life-threatening and fatal pediatric poisonings was conducted to aid poison prevention educational efforts, guide product reformulations and aversive agent use, reassess over-the-counter status for selected pharmaceuticals, and identify research areas for clinical advances in the treatment of pediatric poisonings. A hazard factor was devised to assess more objectively the pediatric poisoning hazard posed by pharmaceutical and nonpharmaceutical products. By considering the frequency and extent of injury following actual exposures, the hazard factor reflects more than the acute toxicity of individual ingredients and is also influenced by such variables as packaging, accessibility, availability (as a reflection of marketing), formulations, and closure types. Of the 3 810 405 exposures involving children younger than 6 years of age reported to poison centers in 1985 through 1989, 2117 patients experienced a major outcome (life-threatening effect or residual disability) and an additional 111 fatalities occurred. The three most commonly implicated substance categories, accounting for 30.4% of reported exposures, include cosmetics and personal care products, cleaning substances, and plants. All had low hazard factors, with significant hazards being limited to a small number of products identified herein. Thus this analysis of hazard factors demonstrates that frequent exposure does not imply toxicity. Iron supplements were the single most frequent cause of pediatric unintentional ingestion fatalities, accounting for 30.2% of reported pediatric pharmaceutical unintentional ingestion fatalities reported over an 8-year period. Antidepressants, cardiovascular medications, and methyl salicylate follow in frequency of pediatric pharmaceutical deaths. Hydrocarbons (including five lamp oil deaths) and pesticides were each implicated in 12 pediatric ingestion fatalities during the 8-year period. Selenious acid-containing gun bluing was involved in four deaths. These data allow a more informed approach to poison prevention efforts in the 1990s.

Redotex ingestions reported to Texas poison centers

2010 ◽  
Vol 29 (9) ◽  
pp. 789-791
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Minor Effect ◽  
Poison Center ◽  
Clinical Effects ◽  
Clinical Factors ◽  
Poison Centers ◽  
Moderate Effect

Although the multi-component weight loss supplement Redotex is banned in the United States, the supplement can be obtained in Mexico. The intent of this report was to describe the pattern of Redotex calls received by a statewide poison center system. Cases were all Redotex calls received by Texas poison centers during 2000—2008. The distribution of total calls and those involving ingestion of the supplement were determined for selected demographic and clinical factors. Of 34 total Redotex calls received, 55.9% came from the 14 Texas counties that border Mexico. Of the 22 reported Redotex ingestions, 77.3% of the patients were female and 45.5% 20 years or more. Of the 17 ingestions involving no coingestants, 52.9% were already at or en route to a health care facility, 41.2% were managed on site, and 5.9% was referred to a health care facility. The final medical outcome was no effect in 23.5% cases, minor effect in 5.9%, moderate effect in 11.8%, not followed but minimal clinical effects possible in 47.1%, and unable to follow but judged to be potentially toxic in 11.8%. Most Redotex calls to the Texas poison center system originated from counties bordering Mexico.

scholarly journals (A349) The Role of Poison Centers in the 2010 Gulf Oil Spill Response

2011 ◽  
Vol 26 (S1) ◽  
pp. s97-s98
Author(s):  
M. Ryan
Keyword(s):  
Health Effects ◽  
Oil Spill ◽  
The United States ◽  
Poison Center ◽  
Draft Guidance ◽  
Medical Support ◽  
National Poison ◽  
Gulf Oil Spill ◽  
Poison Centers ◽  
Oil Spill Response

IntroductionThere are 60 Poison Centers in the United States that manage over 2.5 million poison exposure calls each year. A poison center can be reached 24 hours a day by dialing a national 800 hotline. Poison Centers are staffed by Specialists in Poison Information who are highly trained in clinical toxicology and are very skilled in telephone triage.DiscussionATSDR and the Poison Centers in HHS/FEMA Region 6 developed draft guidance for incorporating Poison Centers into the National Response Plan. That framework was used to incorporate Poison Centers into the gulf oil spill response of 2010. The National Poison hotline was promoted to provide medical support for those with health effects or health questions related to the spill. During the response the surveillance capabilities of the National Poison Data System (NPDS) were highlighted. The Louisiana Poison Center (LPC) and the other gulf states Poison Centers provided information on health effects related to the spill. Information was provided by the LPC to the Louisiana Department of Health and Hospitals, Office of Public Health Section of Epidemiology and Environmental Toxicology, public information officer to assist in briefing the Governor, the Louisiana Governors Office of Homeland Security and Emergency Preparedness to post to the Virtual Louisiana website, as well as ATSDR, CDC, EPA, and other agencies participating in the gulf response unified command. Poison Centers, for the first time, participated in a response on a national level, providing medical support for those with symptoms or medical questions related to the spill. In addition to assisting in the medical care of those exposed to substances related to the oil spill and the response efforts, Poison Centers also responded to questions about air and water quality and seafood safety.ConclusionPoison Centers are a valuable resource to assist in emergency response plans.

Evaluation of toxicity of topiramate exposures reported to poison centers

2005 ◽  
Vol 24 (11) ◽  
pp. 591-595 ◽  
Author(s):  
A L Lofton ◽  
Wendy Klein-Schwartz
Keyword(s):  
Case Reports ◽  
Healthcare Facility ◽  
Poison Control ◽  
Poison Center ◽  
Clinical Effects ◽  
Toxic Exposure ◽  
Asymptomatic Patients ◽  
Poison Centers ◽  
Toxic Exposure Surveillance System ◽  
Gastrointestinal Decontamination

Published literature on the toxicity of a topiramate overdose is limited to case reports. This retrospective study of poison center data was performed to examine the severity of topiramate overdoses. Data on single substance exposures to topiramate reported to the American Association of Poison Control Centers (AAPCC) Toxic Exposure Surveillance System (TESS) in 2000 and 2001 were retrospectively analysed. A total of 567 cases met the inclusion criteria, of which 39% occurred in adults over 19 years of age and 30.2% in children 5 / 4 years old. The majority of patients (62.1%) experienced no toxicity. The most common clinical effects reported were drowsiness/lethargy (15.5%), dizziness/vertigo (4.9%), agitation (4.9%), confusion (3.9%), nausea (2.6%) and vomiting (2.5%). Symptomatic patients were older than asymptomatic patients and adults were more likely to be managed in a healthcare facility (P B / 0.0001). Patients who received gastrointestinal decontamination experienced less serious outcomes than those without decontamination (P B / 0.02). It is concluded that clinicians should expect relatively mild mental status changes in adults or children with toxicity from topiramate overdose. Serious toxic effects, such as CNS depression with respiratory depression or persistent non-anion gap metabolic acidosis, are infrequent.

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