The Institute of Medicine was asked by the Maternal and Child Health Bureau of the Health Resources and Services Administration to assist in developing a more systematic approach to understanding, stabilizing, and providing long-term support for poison prevention and control services. Within this context the Committee was asked to examine the future of poison prevention and control services in the United States. The specific tasks included in the charge are to review:
The Committee was asked to consider these questions in light of future demographic and population trends, and in the context of the threats of biological and chemical terrorism.
care agencies and government organizations at the federal, state, and local levels.
Poisoning is a much larger public health problem than has generally been recognized, and no comprehensive system is in place for its prevention and control. To address its charge of creating such a system, the IOM Committee faced two major, overarching issues. The first of these was a definitional problem—there is simply no universally agreed upon definition of poisoning from either a clinical or epidemiological perspective. Thus, in order to assess the magnitude, scope, and boundaries of the area under study, the Committee adopted an operational definition of poisoning without attempting to resolve all the classification disputes about specific elements of the definition. The second major issue concerned the historical development of the poison control centers and their position in the broader fields of public health and emergency medical services. In order to make recommendations about stabilizing and providing long-term support to the network of centers, the Committee developed a vision