Forging a Poison Prevention and Control System (2004) / Chapter Skim
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4 Historical Context of Poison Control
4 Historical Context of Poison Control
Pages 80-105
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From page 80... ...
Understanding this history can enhance efforts to advance this vital health care service by identifying potential barriers to the evolution of an optimal poison control and management system. BRIEF OVERVIEW Issues of misbranding, mislabeling, and adulteration of food and drugs concerned those who were involved in public health as well as health care providers and led to the founding of the United States Pharmacopeia (1820)
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From page 81... ...
. Provision of timely information to physicians regarding drugs and the toxicity of other agents was the driving force for poison control center
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93154) , Department of Health and Human Services Develops regional trauma cen ters, burn centers, and others, and establishes poison control centers as one of seven priorities.
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Emergency medicine was recognized as a specialty in the BOX 4-2 Statement of Objectives of the American Association of Poison Control Centers To provide a forum for poison centers and interested individuals to promote the reduction of morbidity and mortality from poisonings through public and profes sional education and scientific research. To set voluntary standards for poison center operations.
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From page 84... ...
access points produced the opportunity for integration of poison control centers within EMS systems. Concurrent steps to enhance home safety (e.g., product labeling, smaller quantities of over-the-counter medications per package, prescription drug safety caps, childproof cabinet locks)
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From page 85... ...
and the Centers for Disease Control and Prevention (CDC) have recognized the importance of poison control centers as a component of an all-hazards emergency planning and response system that is integrated with state health departments and supports regional and hospital-based emergency service efforts.
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. POISON CONTROL CENTERS Origins Although the preceding overview provides a brief context for poison control centers, the detailed history of their development provides further insight into their current status and function.
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However, the prevention education in centers has continued to emphasize pediatric poisoning prevention. Evolution of Structure and Function As noted previously, poison control centers were established to provide drug and chemical toxicity information and patient management guidance to physicians.
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Currently, candidates for this subspecialty certification must complete a residency in one of the sponsoring boards or other boards by petition and a medical toxicology fellowship affiliated with a poison control center. Professional activities by pharmacists and nurses have grown dramatically in both the management and operation of poison control centers.
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From page 89... ...
Although concern has been expressed that states without poison control centers would be less well served than states with centers, there is no evidence to show decreased call rates in states without centers physically present, such as Alaska, Hawaii, Wyoming, Montana, North Dakota, and Idaho.
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From page 90... ...
Annual TESS summary data for reporting poison control centers are published annually in the American Journal of Emergency Medicine (Watson et al., 2003)
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From page 91... ...
A company called Micromedex employs an internal staff to obtain and code products, as well as to prepare the management documents for review by an outside editorial board. Data Acquisition Although NCHPCC summarized data from many poison control centers to provide estimates of poisoning in the United States, the process suffered from limited standardization of data collection and definition and from its voluntary submission nature.
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From page 92... ...
. Poison control centers have not been included as specific requirements in the key public health block grants to state health departments
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From page 93... ...
In both examples, the institutions have been willing to absorb some costs, although in one instance the poison control center provides community goodwill and raises the recognition of the institution, whereas in the other the center primarily enriches a training program. One poison control center director wrote in a pharmacy journal in 1976: "The development of poison control centers over the past 20 years has been haphazard.
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From page 94... ...
were instituted over time by poison control centers, although the FDA, which commissioned the report, ceased to be involved in center activities in 1987. Other key findings contained in the 1973 FDA report characterized the poisoning rates of the time: · The mortality rate from accidental poisoning combined across all ages was increasing 4.4 percent annually, while the mortality rate from accidental poisoning among children under age 5 was decreasing 4 percent annually.
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From page 95... ...
Acquisition of product information from manufacturers could be improved by developing and disseminating to manufacturers a recommended format with which to supply product information and a timetable for such submis sions b. Insufficient advertising of services provided by poison centers could be im proved by modifying Poison Prevention Week activities to include advertis ing of poison center services continued
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The report estimated that in 1972 consumers saved $4 million and avoided 400,000 emergency department visits by receiving free treatment information by telephone from poison control centers.
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Since 2000, more than $60 million have been infused into the AAPCC and poison control centers through the Poison Control Center Enhancement and Awareness Act (Pub.
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From page 98... ...
PUBLIC HEALTH LINKAGES As noted previously, public health agencies, for the most part, had little involvement with poison control centers until 2001, when bioterrorism and related activities created interest in poison control center activities. Few public health leaders were involved during the formative years of poison control centers.
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From page 99... ...
· The current structure of poison control centers is quite variable and developed as a result of historical factors that may be irrelevant to current functional needs. · Poison prevention efforts have historically focused on children, despite more recent recognition of greater risk for morbidity and mortality in adults.
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From page 100... ...
Furthermore, federal grants earmarked for poison control center enhancement have done little to stabilize centers in need of financial support for basic service delivery. · There is considerable opportunity for coordination and cooperation between poison control centers and public health agencies at federal, state, and county levels.
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HISTORICAL CONTEXT OF POISON CONTROL 101 Appendix 4-A Poison Control Center Enhancement and Awareness Act Amendments of 2003
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(3) Stabilizing the funding structure and increasing accessi bility to poison control centers will promote the utilization of poison control centers, and reduce the inappropriate use of emergency medical services and other more costly health care services.
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REGIONAL POISON CONTROL CENTERS -- The Secretary shall award grants to certified regional poison control centers for the purposes of achieving the financial stability of such centers, and for preventing and providing treatment recommendations for poisonings.
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improve and expand the poison control data collection systems, including, at the Secretary's discretion, by assisting the poison control centers to improve data collection activities; ``(4) improve national toxic exposure surveillance by enhancing activities at the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry; ``(5)
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From page 105... ...
The Poison Control Center Enhancement and Awareness Act (42 U.S.C.
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