Unintentional poisonings are a global health concern. According to the World Health Organization (WHO), in 2002 approximately 350,000 people died worldwide from unintentional poisoning. WHO has undertaken initiatives in many countries including China, Trinidad and Tobago, Ghana, the Bahamas, Myanmar, Senegal, and Lebanon to establish Poison Centers (PC) and raise awareness about poison prevention.28 This chapter focuses on programs in North America that aim to prevent unintentional poisonings and improve access to PC services.
Healthy People 2010 is a US federal program that outlines the health goals for the nation. The goals reflect the input of public health individuals and organizations and consist of 28 areas to reach 2 main goals: increasing quality and years of healthy life, and eliminating health disparities. Two objectives in the Injury and Violence Prevention section relate to poison prevention. Objective 15–7 is to reduce nonfatal poisonings and Objective 15–8 is to reduce deaths caused by poisoning. Objective 1–12 under Access to Quality Health Services recommends establishing a single toll-free telephone number for access to PCs on a 24-hour basis throughout the United States.26 This objective was achieved in 2002. Community-based public education programs at PCs are designed to help meet these other public health objectives.
Since the first PC was established in 1953, a number of legislative events have improved poison prevention and awareness efforts and reduced the number of unintentional poisonings in children. Public education programs at PCs have been influenced by these federal measures.71
National Poison Prevention Week
In 1961, President John F. Kennedy signed Public Law 87–319, designating the third week of March as National Poison Prevention Week (PPW)6 to raise awareness of the dangers of unintentional poisonings. Each year, during PPW, PCs and other organizations around the country organize events and activities to promote poison prevention.
Child-Resistant Packaging Act
In 1970, the Poison Prevention Packaging Act was passed. This law requires that the Consumer Product Safety Commission (CPSC) mandate the use of child-resistant containers for toxic household substances. In 1974, oral prescription medications were included in this requirement. A review of mortality data in children younger than age 5 shows a significant decrease in deaths after enforcement of the child-resistant packaging legislation.59,71,74
Taste-Aversive Xenobiotics and Poison Prevention
Nontoxic taste-aversive xenobiotics are frequently added to products such as shampoo, cosmetics, cleaning products, automotive products, and rubbing alcohol to discourage ingestion.25 Except in the case of rubbing alcohol, this is done primarily to prevent poisoning in children. The most common taste-aversive xenobiotics are the denatonium salts, particularly denatonium benzoate (Bitrex, benzyldiethyl[(2,6-xylylcarbamoyl)methyl] ammonium benzoate), one of the most bitter-tasting xenobiotics known. The bitter taste of denatonium benzoate can be detected at 50 parts per billion (ppb). This aversive xenobiotic is used in concentrations of 6–50 parts per million (ppm), typically 6 ppm in cosmetic products and ...