devices without increasing their costs (e.g., distribution of cabinet latches to prevent access to medications and household cleaners). Empowerment includes activism at the grassroots level as well as the formation of federal and private-sector advisory panels and injury prevention coalitions or partnerships at the national, state, and local levels (e.g., Health Resources and Services Administration Stakeholders Group; Poison Prevention Week Council). Evaluation includes research, data collection, and surveillance, as well as evaluation of program and product effectiveness (e.g., the Toxic Exposure Surveillance System, or TESS).

This chapter focuses on public education efforts in poison prevention. These efforts have the potential to influence the health behavior of individuals in positive ways, yet as described above, they constitute only one of many factors to be considered. Public education efforts should be considered a necessary but not sufficient component in preventing and mitigating poisonings.

Poison control centers have two relatively distinct education activities—primary and secondary prevention. The goal of primary prevention is to avoid the occurrence of a poisoning exposure. Examples include advising parents to lock up medication and household cleaners to keep them out of reach of young children; requiring employees who could be exposed to hazardous chemicals to wear safety equipment such as gloves, goggles, and protective clothing; and recommending storage techniques to older adults to avoid medication mishaps. Secondary prevention strives to reduce the effect of a poisoning exposure through improved access to poison control services (e.g., raising awareness of the poison control center telephone number as well as urging adults to keep activated charcoal available for use as an antidote on the explicit advice of a physician or the poison control center staff). Educators in centers offer both types of prevention by distributing brochures, refrigerator magnets, and checklists; airing videos and public service announcements; and making presentations in classrooms, at senior centers, and at health and safety fairs. Much of the educational material distributed to the public contains both primary and secondary prevention messages. An example is the widely used Mr. Yuk campaign material, which contains warning labels for poisonous substances and stickers with the poison control center telephone number for rapid access to advice and needed treatment.

Although the size, content, and reach of the public education programs vary among the poison control centers, implementation generally includes a variety of cooperative arrangements involving health departments, health care facilities, pediatricians and family care practitioners, pharmacies, local retail outlets, and various private and public organizations (e.g., National SAFE KIDS Campaign, Red Cross, National Fire Prevention Association’s Risk Watch Program). In 2001, 71.3 full-time



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