Poison control center
A poison control center is a medical facility that is able to provide immediate, free, and expert treatment advice and assistance over the telephone in case of exposure to poisonous or hazardous substances. Poison control centers answer questions about potential poisons in addition to providing treatment management advice about household products, medicines, pesticides, plants, bites and stings, food poisoning, and fumes. More than 72% of poison exposure cases are managed simply by phone, greatly reducing the need for costly emergency room and doctor visits.
After World War II there was a proliferation of new drugs and chemicals in the marketplace, and consequently suicide and childhood poisonings from these agents drastically increased. Around this time up to half of all accidents in children were poisonings with a substantial number of fatalities. These factors led to the medical community developing a response to both unintentional and intentional poisonings. In Europe in the late 1940s special toxicology wards were set up, initial wards were started in Copenhagen and Budapest, and the Netherlands began a poison information service. In the USA the first poison information center was started in Chicago in 1953. By 1957 there were 17 poison control centers in the US, with the Chicago center serving as a model; these centers dealt mainly with physician enquiries by giving ingredient and toxicity information about products, along with treatment recommendations. Over time the poison control centers started taking calls from the general public. The majority of poison centers were not part of a patient treatment facility; they strictly provided information.
In 1958 the American Association of Poison Control Centers (AAPCC) was founded to promote cooperation between poison centers in different cities and to standardize the operation of these centers. An additional part of the AAPCC's activities was poison prevention and education programs for both physicians and the general public. In 1968 the American Academy of Clinical Toxicologists (AACT) was established by a group of medical doctors. The AACT’s main objective was to apply principles of toxicology to patient treatment and improve the standard of care on a national basis. In the 1960s and 1970s a rapid proliferation of poison centers emerged and by 1978 there were 661 centers in the USA. This trend reversed during the 1980s and 1990s with a number of centers closing or merging. In 2000 there were 51 certified centers in the USA. Today there are 55 centers operating in the US.
A similar movement evolved in Europe but unlike the American movement the majority were centralized toxicology treatment centers with integrated poison information centers. The French developed an inpatient unit for the treatment of poisoned patients in the late 1950s. In England the National Poison Information Service was developed at Guy's Hospital under Dr Roy Goulding. At around the same time Dr Henry Mathew started a poison treatment center in Edinburgh. In 1964 the European Association for Poison Control Centers was formed at Tours, France. Australasian centers were also established in the 1960s. The New Zealand center started in Dunedin in December 1964, while in Australia, the New South Wales Poisons Information Center was established in 1966.
Poison control centers provide excellent service and savings. Recent research shows that every dollar invested in the poison center system saves $13.39 in health care costs and productivity.
While poison control centers have traditionally provided expert consultations by telephone, on December 30, 2014 an online option was launched by a group of U.S. poison centers to meet the growing demand for accurate web-based health information. webPOISONCONTROL® is a free, confidential, online triage tool also available as a downloadable app. Based on age, weight and substance implicated, it provides case-specific guidance for poison exposures – limited to unintentional, single ingestions of medicines, household products or berries in asymptomatic individuals. The application uses ingredient-based algorithms to generate a recommendation including whether an emergency room visit or call to poison control is required. If it’s safe to stay home, then home treatment recommendations, specific symptoms to expect, and symptoms of greater concern that would require a call to poison control or a visit to an emergency room are outlined.
The American Association of Poison Control Centers manages a 24-hour hotline (1-800-222-1222), which is continuously staffed by pharmacists, physicians, nurses, and poison information specialists who have received dedicated training in the field of toxicology. Calls to the number are automatically routed to the poison control center that covers the territory from which the call is placed. It has a TTY/TDD number for the hearing impaired. Poison educators across the country also offer poison prevention training and education sessions to community institutions, along with educational materials.
Rest of the world
Article 45 of the CLP_Regulation places the duty upon Member States to appoint "bodies responsible for receiving information relating to emergency health response". These appointed bodies are often known as Poison Centres.
Federal Institute for Risk Assessment (BfR) (Bundesinstitut für Risikobewertung)
National Institute of Health (ISS) (Istituto Superiore di Sanità)
- "American Association of Poison Control Centers (AAPCC) National Poison Data System (NPDS) Annual Report". 2009.
- Miller T, Lestina D (1997). "Costs of poisoning in the United States and savings from poison control centers: a benefit-cost analysis". Annals of Emergency Medicine 29 (2): 239–245. doi:10.1016/S0196-0644(97)70275-0. PMID 9018189.
- Grayson R (1962). "The poison control movement in the United States". Ind Med Surg 31: 296–7. PMID 13901334.
- Govaerts M (1970). "Poison control in Europe". Pediatr Clin North Am 17 (3): 729–39. PMID 5491436.
- Press E, Mellins R (1954). "A poisoning control program". Am J Public Health 44 (12): 1515–1525. doi:10.2105/AJPH.44.12.1515. PMC 1621008. PMID 13207477.
- Ford MD, Delaney KA, Ling LJ, Erickson T., ed. (2001). Clinical toxicology. WB Saunders Company. ISBN 0-7216-5485-1.
- Bronstein AC, Spyker DA, Cantilena LR, Green J, Rumack BH, Heard SE (December 2007). "2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS)". Clin Toxicol (Phila) 45 (8): 815–917. doi:10.1080/15563650701754763. PMID 18163234.
- Proudfoot A (1988). "Clinical toxicology—past, present and future". Hum Toxicol 7 (5): 481–487. doi:10.1177/096032718800700516. PMID 3056845.
- Persson H (1992). "European Association of Poison Centres and Clinical Toxicologists". J. Toxicol. Clin. Toxicol. 30 (2): v–vii. doi:10.3109/15563659209038627. PMID 1588665.
- "History of the New Zealand Poison Centre". New Zealand National Poison Centre. Retrieved 2008-01-20.
- "About the NSW Poisons Information Centre". NSW Poisons Information Centre. 14 January 2008. Retrieved 2008-01-20.
- "webPOISONCONTROL®". NCPC. Retrieved 2015-06-02.
- "American Association of Poison Control Centers". AAPCC. Retrieved 2008-12-01.
- The International Programme on Chemical Safety. "World directory of poison centres". World Health Organization. Retrieved 2013-12-29.
- Poison Control and the Drug Information Center: the Palestinian experience.
- The European Association of Poisons Centres and Clinical Toxicologists
- American Association of Poison Control Centers
- National Poisons Information Centre of Ireland
- New South Wales (Australia) Poisons Information Centre
- New Zealand National Poisons Centre
- Web site for 1-800-222-1222 US Poison Control Center emergency contact number
- webPOISONCONTROL® site for online triage of poison exposures
- World directory of poisons centers