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.
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