Forging a Poison Prevention and Control System (2004) / Chapter Skim
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Part I: Overview1 Introduction
Part I: Overview1 Introduction
Pages 21-33
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Part I Overview
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Reviews of the history of effective injury prevention strategies frequently highlight the introduction of the "baby aspirin" poisoning legislation in 1966 and the Poison Prevention Packaging Act in 1970. These legislative and regulatory successes were among the first achievements of the modern consumer movement and were consolidated under the jurisdiction of the new Consumer Product Safety Commission in 1973.
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No federal public health agency took responsibility for the oversight of this patchwork poison control network, and no systematic sources of governmental funding emerged to support these heavily utilized health care services. Poison control centers remained generally peripheral to the expansion of the injury control system during the 1980s and 1990s.
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A national "800" telephone number created a single point of contact for consumers. In addition, a real-time, electronic submission of poison exposure data enabled the rapid assessment of toxic exposures handled by poison control centers across the United States.
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As part of this approach, the Committee further examined how poison control centers function (e.g., respond to the public and health care professions regarding poisoning exposures, provide toxicosurveillance, potentially detect bioterrorism, train medical and clinical toxicologists) in light of the functions performed by other health care agencies and governmental organizations at federal, state, and local levels.
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The poison control centers have their own operational definition of what constitutes an "exposure" to a poisonous substance. Various authorities and authors may decide to include or exclude from the operational definition such important components as intentionally self-inflicted poisoning (as in the act of suicide)
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Alcohol and drugs (6,627) Number of poison-related discharges from short-stay hospitals 282,012 Human exposure calls to poison control centers 2,267,979
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Poison control centers were developed to respond primarily to parental concerns about the exposure of their young children to potential poisons and rely on telephone communication. Increasingly, these centers have become involved with the additional situations described above -- suicide
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THE COMMITTEE'S APPROACH TO THE PROBLEM Early in its deliberations, the Committee realized that in order to address its charge, it must step back from a focus on the poison control centers alone and reexamine the overall context for preventing and treating poisoning. Reviewing the history of poison prevention in the United States reminded us that, in the past, a broad array of societal strategies, including safe product packaging and consumer legislation, had been used to reduce the risks posed by potentially hazardous substances.
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Rather, our proposal is based on, first, an analysis of the broad public health functions that underlie all aspects of poison control (e.g., primary prevention through consumer product regulation and public education and secondary prevention through telephonebased poison consultation) ; second, an analysis of the core functions of a poison prevention and control system and, within these, the core functions of poison control centers; and third, a proposal for a national approach to the organization, funding, and accountability for such a system.
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Based on the analysis of these data, the Committee carried out a qualitative survey of 10 poison control centers to better understand the relationship among various organizational arrangements and effective and efficient service provision. Survey interviews were conducted by telephone with poison control center directors and their staff.
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Chapters 5 through 9 examine the current status of poison control centers in terms of functions (including core services) , personnel, quality assurance, organization, cost, funding, data and surveillance, prevention and public education, and linkages to federal, state, and local agencies.
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