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In 1950, the American Academy of Pediatrics (AAP) created a Committee on Accident Prevention to explore methods to reduce injuries in young children. A subsequent survey by that committee demonstrated that injuries resulting from unintentional poisoning were a significant cause of childhood morbidity. At the same time, there was a realization that a source of reliable information on the active ingredients of common household xenobiotics was lacking and that there were few accepted methods for treating poisoned patients. In response to this void, the first poison control center (PCC) was created in Chicago in 1953.114 Although initially designed to provide information to health care providers, both the popularity and the success of this center stimulated a PCC movement, which rapidly spread across the country. The myriad of new PCCs not only offered product content information to health care providers but also began to offer first aid and prevention information to members of the community.
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In the past 60 years, countless achievements have been realized by a relatively small group of remarkably altruistic individuals. Throughout this time, poison services have remained free to the public, highlighting their essential role in the American public health system. Many of the legislative and educational accomplishments that are chronicled in Chap. 1 have directly reduced the incidence and severity of poisoning in children.34,109,128 Concurrently, the number, configuration, and specific role of PCCs has shifted in response to public and professional needs.54,86
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Modern regional PCCs are staffed by highly trained and certified health professionals who are assisted by extensive information systems. Support is provided by 24-hour access to board-certified medical toxicologists and consultants from diverse medical disciplines, the natural sciences, and industry. The American PCC is charged with seven major objectives:
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Maintaining and interpreting a database of xenobiotics
Providing information and advice to the public and to health professionals
Collecting epidemiologic data on the incidence and severity of poisoning
Integrating epidemiologic data as part of the public health surveillance system
Preventing unnecessary hospitalizations after exposure and thereby cutting health care costs
Educating health care professionals on the diagnosis and treatment of poisoning
Contributing to the science of toxicology
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In the past, PCCs were evaluated based on the number of incoming calls and measures of community awareness. Current emphasis should be placed on evaluating health outcomes such as intensive care unit (ICU) admissions, length of stay in hospitals, and total health care expenditures. One crucial test of the utility of modern PCCs will be their ability to help reverse the US current trend of increased adult deaths from pharmaceutical poisoning largely driven by prescription opioids.50,72 This chapter explores some of the critical roles of US poison control centers and attempts to offer a vision of the future. An overview of the composition of PCCs worldwide can be found elsewhere.107 Unique issues facing PCCs ...