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PubMed2001

The utility of Poison Control Center data for assessing toxic occupational exposures among young workers.

This study assessed the utility of Poison Control Center data for identifying and describing occupational toxic exposures to youth and the associated health outcomes of such exposures. The authors reviewed 1997 data from the American Association of Poison Control Centers' Toxic Exposure Surveillance System for occupational exposures to persons 6 to 19 years old. In 1997, there were 3442 reported occupational exposure cases among 6- to 19-year-olds. Exposure cases included underage workers, exposure to multiple substances, continuous or repeated exposure to the offending substance, and exposures occurring in the home. Poison Control Centers provide unique and valuable information on toxic workplace exposures to youth. Child labor laws may be violated in many cases, and risks exist with respect to industrial work done in the home. Prospective studies with immediate follow-back are needed.

Adolescent↗
PubMed2006

Drug identification calls from law enforcement received by Texas poison control centers, 2002-2004.

Aside from calls involving human exposures to potentially toxic substances, poison control centers handle other types of calls such as drug identifications (drug IDs). A portion of drug ID requests originates from law enforcement. The objective of this study was to describe such drug ID requests from law enforcement received by Texas poison control centers during 2002-2004. These calls were examined with respect to year of call, location of caller, and type of drug. There were in total 26,752 drug ID calls (involving 27,800 individual drug ID requests) from law enforcement, representing 3% of total calls and 16% of all drug ID calls received. The number of drug ID calls received from law enforcement and the proportion of total calls and all drug ID calls these represented increased from 2002 to 2004. A disproportionate number of the drug ID requests originated from eastern-central Texas. The most frequently involved drugs were analgesics (particularly acetaminophen and hydrocodone), sedatives and related drugs (particularly alprazolam), and muscle relaxants (particularly carisoprodol).

Humans↗
PubMed1994

The arrival of the ED-based POISINDEX: perceived impact on poison control center use.

The purpose of this study was to determine the prevalence of emergency department-based POISINDEX (Micromedex Inc, Denver, CO) and assess its perceived impact on use of poison control centers. Survey methodology was used. A written questionnaire was distributed to all emergency departments (EDs) in the state of New York. ED directors or their designee (n = 239) were surveyed regarding the presence of POISINDEX in their ED and their perceptions of its impact on ED use of poison control centers. Completed questionnaires were returned from 180 of 239 (75%) EDs. Of the returned questionnaires, 42 of 180 (23%) have their own POISINDEX. In 32 of 42 (76%) of these EDs that have their own POISINDEX, it was perceived that ED-based POISINDEX decreased poison control center use. Use of ED-based POISINDEX may decrease ED use of poison control centers.

Databases, Factual↗
PubMed2000

Characterization of methylphenidate exposures reported to a regional poison control center.

OBJECTIVE: To investigate the frequency, risk population, symptoms, reason, and outcome surrounding human methylphenidate exposures reported to a regional poison control center. DESIGN: Retrospective case series. SETTING/PATIENTS: All human methylphenidate exposures reported to a regional poison control center during a 2-year period were included. MAIN OUTCOME MEASURES: Data collected included age, dose, reason for exposure, symptoms (type and severity), treatment, and outcome. Age data for all other exposures reported during the same time period were also compiled. RESULTS: The study included 289 patients. Overall, 31% developed symptoms, most commonly tachycardia, agitation, and lethargy. No patient developed severe symptoms, although a less favorable outcome was seen with intentional vs unintentional exposures. When compared with the age data for all other exposures reported during the same time period, a trimodal vs bimodal pattern was seen, with the novel peak occurring in 6- to 9-year-old children. Within this age group, therapeutic error was the most common reason for exposure. CONCLUSIONS: Methylphenidate exposure was associated with symptom development in 31% of cases. An unusually high incidence of therapeutic error was noted surrounding its use, most commonly in the 6- to 11-year-old age group, defining a unique population at risk for toxic exposure. This initial data may allow targeted poisoning prevention efforts for this age group. Arch Pediatr Adolesc Med. 2000;154:1199-1203.

Adolescent↗
PubMed2002

Pharmacy prescription dispensing errors reported to a regional poison control center.

OBJECTIVES: To identify the incidence, types, associations, and outcomes of pharmacy prescription dispensing errors reported to a regional poison control center. METHODS: Retrospective chart review over a 35-month period. RESULTS: Of 77,992 drug exposures reported, there were 6450 unintentional therapeutic exposures. Forty were the result of pharmacy prescription dispensing errors. Of these, 20 (50%) were medication substitution errors (wrong drug), 17 (42.5%) were labeling errors (correct drug, wrong formulation or instructions), and 3 (7.5%) were compounding errors (incorrect liquid dilution or capsule preparation). Both compounding and labeling errors were significantly more likely than substitution errors to be order-of-magnitude amounts. Compounding errors were also significantly more likely than labeling errors to be order-of-magnitude amounts. Labeling errors were significantly more likely to be liquids prescribed to children than substitution errors. Compounding errors had significantly more serious outcomes compared with substitution or labeling errors. CONCLUSIONS: Substitution and labeling errors are the most common pharmacy prescription dispensing errors reported to a regional poison control center. Compounding errors have the greatest potential for serious outcomes. Children are particularly at risk because of the increased potential for error in the preparation and use of liquids. Inclusion of scenarios of prescription dispensing errors in the Toxic Exposure Surveillance System database would improve error detection and tracking. Poison control centers may be a source of valuable feedback to physicians and pharmacists.

Child↗
PubMed1990

Poison Control Center follow-up of occupational disease.

We followed up 73 of 372 calls to a Regional Poison Control Center (RPCC) that involved workplace disease/exposure(s); most other calls were not made by the workers. An average of 12 additional people per workplace were potentially exposed. Six of the 73 contacted a government agency for investigation of the hazard/illness. Twenty-five percent of callers were still exposed an average of seven months after the original call. The results indicate that poison control centers should develop a public health component to calls about possible workplace poisonings.

Adult↗
PubMed2006

Aripiprazole exposures reported to Texas poison control centers during 2002-2004.

Aripiprazole is an oral atypical antipsychotic drug used in the treatment of schizophrenia and potentially other behavior disorders. The purpose of this study was to describe the epidemiology of aripiprazole exposures reported to Texas poison control centers. Human aripiprazole exposures reported to six Texas poison control centers were identified and comparisons were made between isolated and nonisolated cases with respect to various demographic and clinical factors. Of 280 human exposures involving aripiprazole, 35% were isolated and 65% were nonisolated. The patients were female in 52% of isolated and 60% of nonisolated cases. Isolated cases were significantly more likely to involve children < 6 yr of age. Fifty-eight percent of isolated cases were unintentional while 68% of nonisolated cases were intentional. Nonisolated cases were much more likely to already be at or en route to a health care facility when the poison control center was contacted. Of those cases with a known medical outcome, no adverse clinical effect was reported in 52% of isolated cases and 35% of nonisolated cases. The adverse clinical effects associated with isolated aripiprazole exposures were mainly neurological, cardiovascular, and gastrointestinal, with the most frequently reported adverse clinical effect being drowsiness or lethargy. The most commonly reported treatments for isolated aripiprazole exposures were single dose of activated charcoal, cathartic, intravenous fluids, dilution, lavage, and antihistamines. In conclusion, isolated and nonisolated aripiprazole exposures varied with respect to patient age, exposure reason, management site, and clinical outcome.

Adolescent↗
PubMed2000

Characterization of US poison centers: a 1998 survey conducted by the American Association of Poison Control Centers.

A 1998 survey of all 73 US poison centers, including 52 certified centers and 21 noncertified centers, is presented. Despite a continued decline of the number of poison centers operating in the US, the volume of calls has steadily increased. In 1997 these centers handled 3.65 million telephone consultations, including 2,475,010 human poison exposure cases, 134,646 animal poison exposures, and 1,036,148 information calls. Nearly the entire US population had access to a poison center (99.9%), although only 78.5% of the US population was served by a certified center. Certified poison centers handled 83.6% of human poison exposure cases reported to US poison centers. Calls to certified centers were twice as likely to be handled by staff who were certified as specialists in poison information. On average, poison center utilization was 9.2 human exposure consultations/1,000 population. Total national poison center expenses approached $81 million. The average cost/human exposure case was $33.30 in certified centers, a substantial savings when compared with the alternative of emergency department management. State governments provided the single largest source of funding. Poison center funding remains unstable, with 41% of centers reporting a possible or definite budget reduction anticipated in the next budget year. In the past 5 y, 47.9% of centers faced threat of closure. Center certification and increased public education activity, especially the distribution of poison prevention materials and number of media contacts, were associated with greater utilization of the poison center in the region served.

Computers↗
PubMed2005

Poison control centers in developing countries and Asia's need for toxicology education.

Poison control centers (PCCs) in developing countries have been set up in response to the challenge of decreasing mortality and morbidity from poisoning. The services range from poison information to actual clinical treatment mostly of acute cases. Lately, PCCs have expanded from their traditional role to one that actively engages in community health studies, toxicovigilance along with treatment of chronic poisoning. Recognizing that types of poisoning and specific needs may vary from country to country, toxicology education that addresses these unique regional issues has become more necessary. Toxicology education, both formal and informal, exists in various stages of development in Asia. Clearly, there are gaps that need to be addressed especially in areas where there are no poison centers or where strengthening is necessary. Collaboration between PCCs in developing countries can help augment available resources including human, analytical and technical expertise. The critical mass of trained toxicologists will fill in the demand for clinical and regulatory specialists and educators as well. This paper highlights the experiences and resources available to the Philippine and Malaysian poison centers and the strengths generated by networking and collaboration. The role of Asia Pacific Association of Medical Toxicology (APAMT) as the Science NGO representative to the Intergovernmental Forum on Chemical Safety (IFCS) forum standing committee in promoting chemical safety at the regional level will be discussed. The "Clearinghouse on the Sound Management of Chemicals", a platform for engaging multi-stakeholder and interdisciplinary partnerships, will be described as a possible model for capacity building to advance chemical safety through education and training not only in developing countries in Asia but globally as well.

Asia↗
PubMed2003

Ten years of latrogenic intoxications from the Spanish poison control center.

Iatrogenic incidents involving drugs are the main type of nosocomial intoxications reported to the Spanish Poison Control Center. We examined 231 such incidences from January 1991 to December 2000; 46.1% were route errors, 42.4% overdoses and 7.3% administration to the wrong patient. The most important cause of error in hospitals and dentist consults was route confusions and overdoses in primary health care units. In 56.2% of the dose errors the patient was a child < 2y old in a pediatric inpatient setting, involving the iv route; the common administered drugs were anti-infectives, anticoagulants, analgesics and sedatives. Poison Control Centers have an important role in the prevention of iatrogenic intoxications.

Adolescent↗
PubMedDate not supplied

[Suicide attempts in epileptic patients during the years 1990-92. Analysis of patients in the Regional Poison Control Center in Sosnowiec].

During the years 1990-92 in the Regional Poisons Control Center in Sosnowiec 42 epileptics (20 females and 22 males) were hospitalized because of suicide attempt. It amounted to 9% of all attempters, treated there in this period. The majority of patients were males of age range from 21 to 62 years. In 23 patients the suicide attempts were performed for the first time. the main reason for suicide was the family conflicted situation. Additionally, in 14 patients the poisoning attempts have been done during alcohol abuse. In the suicide attempts the antiepileptic drugs were most frequently used, mainly carbamazepine (23 cases).

Adolescent↗
PubMed2005

Using U.S. Poison Control Center records to identify bystander pesticide exposures: a one-year surveillance of four southeastern states.

The extent to which bystanders are exposed to pesticide applications is unknown. Systematic monitoring around spray areas is not routine. Quantifying exposures is extremely difficult. Persons inadvertently exposed to pesticides often do not know the chemical or quantity, and persons living near areas of frequent field spraying may receive multiple exposures. In the U.S., concerns about health consequences from these exposures may prompt calls to poison control centers. The goal of this study was to determine what surveillance poison control centers can provide on environmental pesticide exposures to bystanders. We searched the American Association of Poison Control Centers' 2001 electronic medical records for exposure reports involving persons from 129 agriculturally intensive counties in Kentucky, Tennessee, Louisiana, and Arkansas that implicated at least one of 54 generic classifications of agricultural chemicals. We abstracted 980 pesticide-related records. Narrative sections were reviewed to determine bystander status of the exposed person. Forty-six bystander exposures were identified from 32 events. Bystander ages ranged from 2 to 81 (median: 45; 16 females, 13 males). All pertinent information for bystander classification came from narrative sections of the record. 28% identified aircraft crop dusters as the pesticide source. The most implicated substance was malathion (30.4%), while 19.6% did not know the exposure substance. 73.9% of cases were symptomatic; 65.2% of the exposed persons were seen in or referred to a healthcare facility. No hospitalizations or deaths were reported. Although they may underestimate the true numbers, U.S. poison control center data can provide valuable information about bystander environmental pesticide exposures.

Adolescent↗