sultation function, may be the first part of the health care system to become aware of new types of poisonings in the community, such as previously unknown adverse reactions to a medication, the use of a new type of drug of abuse (e.g., scopolamine poisoning among heroin users [Morbidity and Mortality Weekly Report, 1996]), or an unusual illness suggestive of bioterrorism. Centers may also recognize clusters of cases that would otherwise go unnoticed as isolated events. Prompt reporting of these events to the appropriate public health agencies and in the medical literature can help provide an early warning and offer the option of generating a timely response. Poison control centers also notify public health agencies of reportable diseases or cases or incidents that may be of interest, such as suspected food poisoning.

Research

AAPCC (http://www.aapcc.org) considers research to be a part of the overall mission of poison control centers. Center research may be broadly divided into toxicology research, which focuses on the mechanisms, treatment, or prevention of poisonings; and poison control center clinical services research, which focuses on the role and contribution of centers to studying and managing these problems (North American Congress of Clinical Toxicology, 2003). Examples of poison control center clinical services research include the evaluation of different poison control center service models with regard to costs and outcomes; comparison of different data collection tools or models; efficacy of using center data for real-time surveillance of previously unrecognized toxic effects of medications or mass poisonings; effectiveness of education strategies; comparisons of treatments; or strategies for monitoring herbal medicine toxicities. Although any investigator, regardless of location or affiliation, could perform such research, poison control center staff are particularly well positioned to conduct research in these areas. Their involvement in the management of exposure and information calls provides a unique opportunity to identify important or emerging issues. Access to center data and familiarity with the health care delivery issues facing poison control centers provide staff with a unique perspective on issues surrounding the delivery of center services, and the means to study strategies for improving these services.

Despite these opportunities, the research output of poison control centers is generally modest. One survey of center research efforts, which included all types of research except for “bench science,” found that 5 percent of poison control center staff time (primarily non-SPI staff) was devoted to research and that centers published a mean of three journal articles yearly (Zuvekas et al., 1997). Some centers, such as those affiliated



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