Poisoning Interventions

Poison Control Centers

Background

Poison control centers in the United States provide a 24-hour per day, emergency hotline service staffed by toxicology professionals who can dispense immediate information and treatment advice regarding suspected exposure to toxic substances. In 1994, there were 87 certified poison control centers serving the United States at least part-time. The cost-benefit study by Miller and Lestina24 provides evidence that poison control centers are an excellent societal investment, resulting in significant savings of medical spending.

No studies have been found that specifically examine poison control centers’ effect on the morbidity and mortality of poisonings. However, the one study reviewed below does examine one center’s educational intervention among families who utilized the poison control center’s hotline.


Review of poison control center studies:

Author

Woolf et al., 1992

Study design and target population

Randomized controlled trial

All children under 5 for whom a call was made to Massachusetts Poison Control System for acute poisoning during a 17-day period. (n=336)

Intervention

Poison center-initiated educational intervention, including syrup of ipecac coupon, telephone stickers, cabinet lock, a checklist for "poison-proofing" home, and educational pamphlet.

Only those families without syrup of ipecac were randomized to intervention (n=169) or control groups (n=167).

Outcomes

Blinded, telephone interview three months post-intervention evaluating use of safety devices from mailing.

Results

Intervention families more likely to have telephone sticker than control families (78% v. 39%, p<0.0001) and use at least one cabinet lock (59% v. 40%, p<0.001).

Intervention not effective in increasing ownership of syrup of ipecac (57% v. 52%).

Poisoning recurrence rate of 3.7% seen in total sample during three-month study period.

Study quality and conclusions

Good study design, although only families aware of (and that used) poison center could be analyzed; extrapolation to other populations difficult.

No differences in interval rates of repeated poisonings between intervention and control families.

Syrup of ipecac coupon had no effect on increasing its prevalence in homes.

Compliance might be better assessed with home visit.

Summary of poison control center studies

The intervention initiated by the poison control center (increasing prevalence of syrup of Ipecac in the home) was not successful. However, intervention families were more likely to use at least one cabinet lock and to have a sticker that displayed the local poison control center telephone number.

Recommendations on poison control centers

Studies using cost-benefit analysis have shown that poison control centers can result in significant medical savings. The main issue, however, remains how well informed the public is regarding the use of their local or state poison control center.

Recommendations for future research

In order to examine specifically the effect poison control centers have on the morbidity and mortality of childhood poisonings, one might conduct a before-and-after study, controlling for such confounders as changes in population distribution and median family income.