Forging a Poison Prevention and Control System (2004) / Chapter Skim
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Part III: Conclusions and Recommendations 10 Conclusions and Recommendations
Part III: Conclusions and Recommendations 10 Conclusions and Recommendations
Pages 303-317
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Part III Conclusions and Recommendations
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The strengths and weaknesses of various organizational structures for poison control centers and services, including a consideration of personnel needs; 4. Approaches to providing the financial resources for poison prevention and control services; 5.
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The Committee also concluded that in order to fulfill their pivotal role in the overall system, poison control centers must be more stable financially and better integrated and coordinated for performance of their public health roles. SCOPE OF CORE POISON PREVENTION AND CONTROL ACTIVITIES Poison control centers are the fundamental building blocks of the proposed Poison Prevention and Control System.
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Poison control centers alone cannot fulfill the need for public and professional education related to poisoning prevention and treatment and all-hazards response. Public health agencies already have the authorities, networks, and administrative mechanisms to carry out broad educational efforts, as they do for the prevention of other injuries and for other public health campaigns.
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Although there are several programs or components within public health agencies that are relevant to poison prevention and control, some of which currently interact with the poison control centers, there is no clarity concerning the roles of each entity in the integrated system. This has resulted in inefficient interactions among federal, state, and local public health agencies and poison control centers that have limited their potential contributions to prevention of poisoning and promotion of health.
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A specific activity of this effort is to evaluate, through an objective structured review, the use of the Toxic Exposure Surveillance System as a source of case detection to all-hazards surveillance. STRENGTHS AND WEAKNESSES OF POISON CONTROL CENTER ORGANIZATIONAL STRUCTURES Early in its information gathering, the Committee weighed the options of conducting an in-depth analysis of all poison control centers or relying on existing survey data available from the American Association of Poison Control Centers (AAPCC)
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Although an earlier study conducted on six poison control centers suggested possible economies of scale for service areas of 2 million people or more, the Committee found little conclusive evidence from its own analysis that economies of scale operate with respect to size of population served and poison control center costs. Costs were best predicted by variables related to staffing patterns and wage rates rather than hardware expenses, population served, or funding source.
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FINANCIAL SUPPORT FOR THE POISON PREVENTION AND CONTROL SYSTEM Poison Control Centers As noted in Chapter 6, poison control centers are currently funded by a patchwork of sources (including federal, state, institutional, and private) that are subject to budget cuts and changing priorities every year.
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Congress should amend the current Poison Control Center Enhancement and Awareness Act to provide sufficient funding to support the proposed Poison Prevention and Control System with its national network of regional poison control centers. Support for the core activities at the current level of service is estimated to require more than $100 million annually.
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development and maintenance of quality assurance and improvement mechanisms for every component of the Poison Prevention and Control System; (2) training activities for health providers outside the poison control centers who require training in toxicology, such as emergency department workers and emergency medical technicians; (3)
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A fully external, independent body should be responsible for certification of poison control centers and specialists in poison information. This body should be separate from the professional organizations representing them.
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Availability of TESS Data The Toxic Exposure Surveillance System is a proprietary data and surveillance system owned by AAPCC. Using funding from the CDC, AAPCC recently developed the capability to provide real-time surveillance through TESS based on input from the poison control centers.
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The Director of the Centers for Disease Control and Prevention should ensure that exposure surveillance data generated by the poison control centers and currently reported in the Toxic Exposure Surveillance System are available to all appropriate local, state, and federal public health units and to the poison control centers on a "real-time" basis at no additional cost to these users. These data should also be publicly accessible with oversight mechanisms and privacy guarantees and at a cost consistent with other major public use systems such as those currently managed by the National Center for Health Statistics.
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c. The Secretary of Health and Human Services should encourage funding by appropriate agencies, such as CDC and the Consumer Product Safety Commission, to ensure the needed flow of information from toxicology researchers in poison control centers on prevention problems and strategies to regulators and to encourage the study and development of new regulatory strategies and initiatives to reduce poisonings.
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