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Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
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Index

A

Access to services, 131, 137, 139, 194, 202, 205, 271, 282, 292

see also Internet;

Public education/ outreach;

Telephone services;

Utilization of health care services

cost factors, 140, 141

emergency service personnel, 114, 126, 282

ethnic minorities, 43

historical perspectives, 84

mass poisonings, 114

nonpoisoning information needs, 117

pharmacists, 230

public education and, 202, 205, 208, 214

research on, 10, 18, 19, 118, 270, 274, 275, 316, 317

toxicologists, 87

Accountability

see also Quality control

government organizational assurance structure, 10, 12, 282, 284-286

poison control centers, 12, 13, 100, 107, 310, 311

Poison Prevention and Control System (proposed), 273, 282, 284-286, 308-309

Accreditation Council for Graduate Medical Education, 122

Adolescents, 3, 29, 223, 224

Advocacy, 10, 11, 25, 31, 39, 203, 204, 205, 218, 271, 274, 289

Age factors, 29

see also Children

adolescents, 3, 29, 223, 224

elderly persons, 3, 29, 43, 51-53, 55, 58, 59, 60, 64, 99

public education materials, 223

incidence data, 48, 51-60 (passim), 63, 64, 68, 69

public education, 209

Agency for Healthcare Research and Quality, 19, 180, 283, 294-295, 317

Agency for Toxic Substances and Disease Registry (ATSDR), 39, 90, 115, 126, 189, 195, 283, 292

Hazardous Substances Emergency Events Surveillance System, 181, 198

Alcohol use and abuse, 30, 99

costs of, 29

deaths due to poisoning, 3, 28, 68

definition of poisoning, 4, 45-46, 79

incidence data, 68, 74

Allergic responses, 4, 45, 46, 223, 294

American Academy of Clinical Toxicology, 83

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

American Association of Poison Control Centers (AAPCC), 6, 17, 25, 32, 49, 115, 118-119, 123, 134, 309

see also Toxic Exposure Surveillance System

certification of centers, 2, 15-16, 26, 84, 127-129, 130, 160

cost-effectiveness/cost-benefit analysis, 137, 142-170

definition of poisoning, 34-35

ethnic diversity issues, 208

funding for centers, 312

historical perspectives, 83, 90, 91, 92, 97-98, 100

incidence data, 48, 90, 91-92, 98, 184-190

public education efforts, 209, 210-212, 219, 234

quality assurance, 127-128, 130

telephone services, 113

American Board of Applied Toxicology, 127

American Board of Medical Specialists, 84, 128, 130

American Board of Medical Toxicology, 83, 128

American College of Emergency Physicians, 83

American Medical Association, 80-81, 86, 230

American Nurses Association, 230

American Pharmacists Association, 80-81, 230

Animals, poisoning of, 110, 119, 144, 165, 186

Animals, venomous, see Insect/snake bites

Anthrax, 25, 46, 99, 114, 132, 133

Antidotes, 120

poison control centers, 112, 114, 116, 134, 205, 213, 281

stockpiles, 132, 134

Arizona, 214

Arsenic, 117, 134-135, 177

Aspirin, 99, 204

Association of Maternal and Child Health Programs, 33, 276

A Su Salud, 208, 215

B

Behavioral Risk Factor Examination Survey, 182, 199

Biological and chemical terrorism, 3, 5, 7-8

see also Mass poisonings

anthrax, 25, 46, 99, 114, 132, 133

Centers for Disease Control and Prevention (CDC), 85, 114-115

committee methodology, 2, 26, 33

committee recommendations, 9, 305, 309

Department of Homeland Security, 134, 282, 285, 288, 298

funding for response services, 14, 85

Haddon Matrix, 203

historical perspectives, 85, 99

poison control centers, 9-10, 25, 35, 37, 85, 99, 100, 107, 114-115, 116, 127, 132-133, 278-282

Poison Prevention and Control System (proposed), 12, 26, 35, 37, 38, 309

Block grants, 14, 15, 92-93, 147, 148, 311

Maternal and Child Health Block Grants, 11-12, 98, 276, 283, 285-286, 308

Bureau of Labor Statistics, 299-300

Census of Fatal Occupational Injuries, 181, 198

C

California, 7, 31, 36, 113, 143, 214, 215

Canada, 212

Case series studies, 119, 191

see also Medical examiners/coroners

Census of Fatal Occupational Injuries, 181, 198

Center for Biologics Evaluation and Research, 294

Centers for Disease Control and Prevention (CDC), 12

see also National Center for Health Statistics

Behavioral Risk Factor Examination Survey, 182, 199

biological and chemical terrorism, 85, 114-115

epidemiology, 18, 48, 176, 316-317

human costs of poisoning, 19

National Center for Environmental Health, 189, 289-290

National Center for Injury Prevention and Control, 18, 196, 291, 316-317

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

National Health and Nutrition Examination Survey, 182, 199

National Institute for Occupational Safety and Health, 33-34, 198, 228, 285, 291-292

National Vital Statistics System, 50, 66-68, 179, 192-193

poison control centers and, 25, 35, 85, 97, 114-115, 122, 134

Poison Prevention and Control System (proposed), 12, 15, 39, 282, 287, 315-317 (passim)

public education, 207, 237-238

role in poison prevention, overview, 288-292

surveillance methodology, 176

Toxic Exposure Surveillance System (TESS), 6, 17, 18, 189, 315-316, 317

Centers for Medicare and Medicaid Services, 294

Certification of professionals, 15, 123, 127-128, 130

emergency medical personnel, 84

toxicologists, 15, 24(n.1), 38, 118-119, 122, 125

Chemical terrorism, see Biological and chemical terrorism

Children, 3, 4, 5, 27, 29

Association of Maternal and Child Health Programs, 33, 276

Head Start program, 211

historical perspectives, 53, 81, 84, 87, 96, 99

incidence data, 51-53, 55, 58, 59, 60, 64

death rates, 3, 50, 66-68, 74, 85, 86

lead poisoning, 120, 227, 228, 230, 276, 289, 290, 296

legislation to protect, 23, 96

packaging, child-resistant caps, 84-85, 99, 106, 204, 205, 210, 218, 287

poison control centers, 4, 5, 84, 87, 96, 99, 106

public education, 209, 210-212, 216, 219, 234-268 (passim), 276, 277, 317

The Clinical Toxicology of Commercial Products, 83, 87, 92, 95

Coding of data, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 187-188

see also E-codes;

International Classification of Diseases

morbidity and mortality statistics, 50, 66-68

Confidentiality, see Privacy and confidentiality

Consumer Product Safety Commission, 23, 35, 39, 48, 219, 229, 301

Core activities

see also Telephone services

poison control centers, 8-15 (passim), 31, 37-38, 106-131, 169, 173, 306-307, 308, 310

funding, 11-12, 14-15, 39, 307, 310

Poison Prevention and Control System (proposed), 270-275, 284, 306-307, 308

population-based, 10, 11

quality assessment/assurance, 270-272

telephone services discussed as, 14, 107-113, 116, 123, 125-127, 130, 307

toxiciology training, 15, 24(n.1), 38, 118-119, 122, 125

Coroners, see Medical examiners/coroners

Cost and cost-benefit factors

access to services, 140, 141

American Association of Poison Control Centers, determination of, 137, 142-170

interagency coordination, 157, 159

poison control centers, 9, 13-14, 92, 96, 136-171 (passim), 191, 310, 311

public education, 158, 163, 164, 166, 206

quality assurance, 158

staff, 136, 143-158 (passim), 161-163, 170-171, 310, 311

telephone services, 143, 144, 152-155, 160

Poison Prevention and Control System (proposed), 13, 18, 19, 311-313

poisoning, economic burden, 3, 19, 27, 29, 96, 137-142, 310, 317

methodology for determining morbidity, 27, 28, 34

safety products, low-cost distribution, 204-205

survey data, general, 180

Cultural factors

see also Race/ethnicity

languages, 43-44, 113, 164, 208, 210, 214-215

poison control centers, 11, 43-44, 113, 208-209

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

D

Data needs, 18-19, 78-79, 176-200

see also Definitional issues;

Epidemiology;

National Center for Health Statistics;

Research methodology;

Surveillance

Agency for Toxic Substances and Disease Registry, 39

coding of data, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 187-188

committee charge/methodology, 2, 5, 26

committee recommendations, 18-19, 305, 314-317

cost-effectiveness studies, 142, 153-155, 170, 310

Drugdex, 92

historical perspectives, 90-92, 95, 98

Micromedex, 91, 92, 113

organizational factors, general, 44, 309-310

poison control centers, 10, 11, 12-13, 25, 37, 90-92, 95, 98-99, 106-108, 117-118

quality control, 129, 309-310

Poisindex, 91, 92, 113

Poison Prevention and Control System (proposed), 13, 16-17, 37, 39, 305

privacy issues, 17, 18, 112, 169, 192, 214-215, 315

Toxic Exposure Surveillance System, 6, 17-19 (passim), 178, 184-190, 199-200

Death rates, 18

see also Suicide and attempts

alcohol poisoning, 3, 28, 68

annual, from poisoning, 3, 28, 48

children, 3, 50, 66-68, 74, 85, 86

data coding, 50-51

incidence data, general, 64, 66, 69-72, 74, 88, 94, 181

medical examiners/coroners, 179, 193-194, 197, 199, 200, 273

mortality vital statistics, 50, 66-68, 74, 179, 181, 192-193

Definitional issues

see also Core activities

data coding, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 187-188

epidemiology, 2, 43

Haddon Matrix, 115, 201-204

poisoning, 2, 3, 4, 16-17, 27, 28, 34-35, 43, 45-48, 50-51, 73, 79, 306, 314-315

prevention, primary and secondary, 205

surveillance, 3, 4, 176-177

toxicology, 2, 3, 4, 24(n.1), 27, 45-46

Demographic factors, general, 43, 48

see also Age factors;

Cultural factors;

Geographic factors;

Race/ ethnicity

committee charge, 2, 26

gender factors, 48, 51, 52, 55-60 (passim), 63, 64, 68

incidence data, 48-68 (passim), 76

poison control centers, 7, 209

Department of Agriculture, 297-298

Department of Health and Human Services (DHHS), 19

see also Centers for Disease Control and Prevention;

Food and Drug Administration;

Health Resources and Services Administration;

National Center for Health Statistics

Agency for Healthcare Research and Quality, 19, 180, 283, 294-295, 317

Centers for Medicare and Medicaid Services, 294

definition and classification issues, 16-17, 314-315

legislation, national repository, 12, 309

Maternal and Child Health Bureau, 1, 2, 25, 26, 285

National Institute of Child Health and Human Development, 296

National Institute of Environmental Health Sciences, 296

National Institute on Drug Abuse, 295

National Institutes of Health, 120, 283, 295-296

Poison Prevention and Control System (proposed), 12, 282-283, 285-286, 308-309, 313

privacy issues, 17, 315

role in poison prevention, overview, 12, 282-283, 285-286, 288-292

Substance Abuse and Mental Health Services Administration (SAMHSA), 181, 182, 196, 229, 282, 287, 293

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

Department of Homeland Security, 134, 282, 285, 288, 298

Department of Housing and Urban Development, 282, 288, 289, 296

Department of Justice, 282, 288, 300

Department of Labor, 198, 282, 288, 298

Bureau of Labor Statistics, 299-300

Census of Fatal Occupational Injuries, 181, 198

Mine Safety and Health Administration, 285, 299

Occupational Safety and Health Administration, 198, 285, 298-299

Diagnosis

see also Incidence and prevalence;

Symptoms

definitional issues, 3, 27, 46, 50-61 (passim)

definitional issues, classification codes, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 187-188

poison control centers, core activities, 10, 109

Dosage factors, 3

see also Drugs

data sources, 184-185

definitional issues, 4, 23, 43

Haddon Matrix, 202

legislation, 23

Drug Abuse Warning Network, 19, 181, 196-197, 200

Drug Enforcement Administration, 300

Drugdex, 92

Drugs

see also Alcohol use and abuse;

Packaging and labeling;

Substance abuse

definition of overdose, 27, 43, 45, 46, 51, 78-79

household, 2, 81, 84, 87

incidence of overdose, 50, 51, 61, 62, 64, 67

overdoses during hospitalization, 184

research on overdose, 18, 19, 184, 197-198, 317

suicides and attempts, 3, 5, 27, 29-30, 51, 61, 68, 71

telephone services, 110, 164

unintentional overdose, 3, 30

E

E-codes, 50-63 (passim), 70, 76, 78

Economic factors

see also Cost and cost-benefit factors;

Funding

poison control centers, 3, 6, 7, 136-171

geographic factors, 142, 143, 152-153, 162

prevention incentives, 204-205

Education, see Professional education;

Public education/outreach

Elderly persons, 3, 29, 43, 51-53, 55, 58, 59, 60, 64, 99

public education materials, 223

Emergency and Environmental Health Services, 289-290

Emergency medical services (EMS)

see also Biological and chemical terrorism

certification of specialists, 84

HAZMAT response, 112, 114, 126, 130, 133

historical perspectives, 83-84, 92, 96

incidence data, 53, 54, 59-61, 65-66, 72, 73, 74, 75, 78, 179, 180

National Electronic Injury Surveillance Survey (NEISS), 4, 17-18, 48, 49, 65-66

organizational factors, 6, 39, 309

poison control centers and, 2, 6, 24, 30, 38, 60, 107, 108, 112, 114, 116, 278-282

access by EMS personnel, 114, 126, 282

Poison Prevention and Control System (proposed), 38, 39

state emergency department data, 179

Emergency Medical Services Systems Act, 24, 84

Environment and Natural Resources Division (Department of Justice), 300

Environmental Protection Agency, 98, 219, 226, 227, 273, 282, 284, 285, 288, 289, 301

Epidemiology, 1, 24, 25, 27-30, 48-68, 176, 177

see also Death rates;

Incidence and prevalence;

Surveillance

annual poisoning cases, 3, 28

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

Centers for Disease Control and Prevention (CDC), 18, 48, 176, 316-317

committee study methodology, 32

definitional issues, 2, 43

historical perspectives, 81

public education materials, 221

research recommendations, 18-19

Essential Services of Public Health, 10, 272

Ethnic groups, see Race/ethnicity

External cause of injury codes, see E-codes

F

Federal government, 6

see also Funding;

Legislation;

specific departments and agencies

agencies involved in poison prevention, overview, 282-284, 288-301

committee study methodology, 32-33

definitions and classification systems, 3, 4

poison control centers and, 1-2, 11-12, 35-36, 39, 92-93, 95-96

Poison Prevention and Control System (proposed), 12, 15, 35-36, 39

public education efforts, 219-231

Food and Drug Administration (FDA), 35, 39, 81, 82, 283, 293-294

MedWatch, 181, 197

National Clearinghouse for Poison Control Centers (NCHPCC), 83, 87, 91, 92, 95-96, 97, 184

poison control centers, 84, 87-90, 93, 94-97, 122

historical perspectives, 81, 82, 84, 86

Food and Safety Inspection Service, 297

Food poisoning, 297-298

definitional issues, 46, 51, 53

historical perspectives, 80-81

incidence data, 66, 191

sentinel events, 118

Funding

see also Research recommendations

American Association of Poison Control Centers (AAPCC), 312

biological and chemical terrorism response, 14, 85

block grants, 14, 15, 92-93, 147, 148, 311

core activities, 11-12, 14-15, 39, 307, 310

committee study charge/methodology, 2, 26, 32

federal agencies responsible, overview, 282

Maternal and Child Health Block Grants, 11-12, 98, 276, 283, 285-286, 308

Medicaid, 14, 147, 148, 214, 285, 288, 294, 311

Medicare, 93, 285, 288, 294

poison control centers, 3, 6, 24-25, 26, 32, 36, 83, 130, 147-152, 159-160, 165, 283-286

committee conclusions/ recommendations, 7, 9, 11-12, 13, 14-15, 307, 310, 311-313

core activities, 11-12, 14-15, 39, 307, 310

historical perspectives, 85, 90, 92-93, 95, 97-98, 100, 103-105

hospital funding of, 36, 93

private sector, 148-149

public education, 11, 93

quality assurance, 129, 130, 159

regionalization, 37

state government, 24, 36, 92-93, 98, 136-137, 147, 148, 284, 311, 313

Poison Prevention and Control System (proposed), 8, 12, 14-15, 36, 39, 283-287 (passim), 305, 307

regionalization, 37

technical assistance, 12

public education, general, 11, 93, 211, 286, 313

research, general, 18-19, 90, 316-317

Toxic Exposure Surveillance System, 17-18, 90

G

Gender factors, incidence data, 48, 51, 52, 55-60 (passim), 63, 64, 68

Geographic factors

see also Population-based factors

incidence data, regional, 52, 53, 55, 56, 58, 59, 64, 68, 71

national telephone service, 25, 52, 55, 92, 97, 103, 113, 210, 211

poison control centers case studies, 132-135

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

economic factors, 142, 143, 152-153, 162

general, 93, 95

regionalization, 7-8, 10, 36-37, 88-89, 93, 94, 142, 143, 306, 312

telephone services, 127

H

Haddon Matrix, 115, 201-204

Hazardous Substances Emergency Events Surveillance System, 181, 198

Hazardous Substances Labeling Act, 96

HAZMAT response, 112, 114, 126, 130, 133

Health care professionals

see also Nurses;

Pharmacists;

Physicians;

Poison control center staffing;

Professional education

certification, 15, 123, 127-128, 130

emergency medical personnel, 84

toxicologists, 15, 24, 83, 122

medical examiners/coroners, 179, 193-194, 197, 199, 200, 273

poison control centers, relationships with outside, 107

poison information providers/ specialists, 123, 124-125, 127, 130

telephone services, 110-112

public education materials, 221-231 (passim)

toxicologists, 15, 24(n.1), 83, 87, 122

Health departments

local, 35, 114, 274-282, 289, 307

state, 35, 93, 133, 274-282, 289, 307

Health Insurance Portability and Accountability Act, 17, 112, 169, 191, 192, 315

Health Resources and Services Administration (HRSA)

biological and chemical terrorism, 85, 114-115

committee study charge, 1, 2, 26, 305

Maternal and Child Health Block Grants, 11-12, 98, 276, 283, 285-286, 308

poison control centers, 11-12, 15, 25, 35, 39, 97

Poison Prevention and Control System (proposed), 12, 13, 15, 39, 282, 285, 287, 309

role in poison control, overview, 292-293

Healthcare Cost and Utilization Program National Inpatient Sample, 180

Healthy People 2000, 5, 25, 276

Healthy People 2010, 9-10, 25, 30, 269, 273

Historical perspectives, 23-26, 30, 80-105

access to services, 84

American Association of Poison Control Centers (AAPCC), 83, 90, 91, 92, 97-98, 100

children, 53, 81, 84, 87, 96, 99

committee study charge/methodology, 1, 2

epidemiology, 81

data needs, 90-92, 95, 98

definition of poisoning, 3

emergency medical services, 83-84, 92, 96

food adulteration, 80-81

Food and Drug Administration (FDA), 81, 82, 84, 86

incidence of poisonings, 3, 30, 43-44, 48-75 (passim), 79, 270

legislation, 23, 24, 30, 31, 82

pharmacists, 80-81

poison control centers, 2, 5-6, 24-25, 30, 81-84, 86-96, 159

Food and Drug Administration (FDA), 81, 82, 84, 86

funding, 85, 90, 92-93, 95, 97-98, 100, 103-105

organizational factors, 84, 87-90, 93-100

state government role, 86, 87, 88-89, 91-93, 98

telephone services, 81, 83, 88, 92, 94, 97, 103

regulatory issues, 80-81, 84-85, 87, 94, 95, 96, 98

surveillance, 90

terrorism, 85, 99

toxic exposure surveillance system, 90, 91, 92

Home Safety Council, 206

Hospitals and hospitalization, 8, 14, 306

see also Emergency medical services

bioterrorism preparedness, 33

committee study charge/methodology, 26, 28, 33

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

incidence data, 3, 28, 49, 53, 54, 58, 66, 72

National Hospital Ambulatory Care Survey, 4, 49, 51, 54, 57-63, 71, 72, 73-74, 75, 78, 180, 195

National Hospital Discharge Survey, 4, 49, 63-65, 72, 74, 78, 179, 195

state/local hospital discharge data systems, 194

overdoses during hospitalization, 184

poison control center funding, 36, 93

Household products, 2, 3, 81, 84, 87, 88, 206

see also Packaging and labeling

I

Illinois, 86, 87, 91

Incidence and prevalence, 3, 5, 6, 18, 27-30, 44, 48-79, 94, 95

see also Death rates

alcohol poisoning, 3, 28, 68, 74

American Association of Poison Control Centers (AAPCC), 48, 90, 91-92, 98, 184-190

children, 51-53, 55, 58, 59, 60, 64

death rates, 3, 50, 66-68, 74, 85, 86

data coding, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 187-188

data needs, 176-199 (passim)

definitional issues, 47-48

drug overdoses, 50, 51, 61, 62, 64, 67

emergency medical services, 53, 54, 59-61, 65-66, 72, 73, 74, 75, 78, 179, 180

National Electronic Injury Surveillance Survey (NEISS), 4, 17-18, 48, 49, 65-66

public education, evaluation of impacts, 218

food poisoning, 66, 191

historical perspectives, 3, 30, 43-44, 48-75 (passim), 79, 270

hospital data, 3, 28, 49, 53, 54, 58, 66, 72

National Hospital Ambulatory Care Survey, 4, 49, 51, 54, 57-63, 71, 72, 73-74, 75, 78, 180, 195

National Hospital Discharge Survey, 4, 49, 63-65, 72, 74, 78, 179, 195

state/local hospital discharge data systems, 194

International Classification of Diseases (ICD), use in incidence surveys, 50-51, 55, 57, 58, 59, 60, 62, 63, 76, 77, 192-193

physicians, data from, 53, 54, 55, 65, 72, 77, 78

poison control center call volume, 110, 143, 144, 164, 187, 309

racial/ethnic breakdowns, 48, 52-60 (passim), 63, 68, 70

referral data, 59, 60, 63-66 (passim), 72, 74

regional breakdowns, 52, 53, 55, 56, 58, 59, 64, 68, 71

research methodology, 53-79 (passim)

substance abuse, 62, 67

suicide attempts, 51, 61, 68, 71

symptoms, 46, 55, 56, 58, 59, 61

telephone services, data on, 52, 53, 55, 69, 70-71, 72, 73-74, 94, 178, 184-190

race/ethnicity data, 208-209

Toxic Exposure Surveillance System (TESS), 66, 68-74, 76

Injury prevention and control field

committee study methodology, 1, 26

definition of poisoning, 3, 45, 50

Haddon Matrix, 115, 201-204

medical directors, 12, 33

poison control center organization, 23, 122

Poison Prevention and Control System (proposed), 40

public education materials, 224

state public health departments, linkage, 277

Insect/snake bites, 61, 62, 65, 66, 74, 131, 191

Interagency coordination, 3, 26, 30-31, 35-36, 39, 100, 114-115, 132-135, 165-166, 172-173, 273, 276-278, 284, 289

committee recommendations, 6, 10-11, 12, 17, 18-19, 305, 307, 308-309

cost effectiveness, 157, 159

public education, 205-206, 211, 219-232

International Classification of Diseases (ICD), 3, 16-17, 27, 34, 47, 78-79, 314-315

incidence surveys, 50-51, 55, 57, 58, 59, 60, 62, 63, 76, 77, 192-193

surveys, various, 179-181, 195

vital statistics mortality data, 66-67

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

Internet

American Association of Poison Control Centers (AAPC), public education site, 211-212, 216

educational materials published by non-poison center sources, 221-231

federal agency websites, 288-301 (passim)

National Poison Prevention Week, 219

poison control centers, 112, 113, 118, 120, 215-216, 234-268

surveillance surveys, various, 12, 183

technical assistance for site development, 12, 309

Toxic Exposure Surveillance System (TESS), 49-50, 183

L

Labeling, see Packaging and labeling

Languages, non-English, 43-44, 113, 127, 164, 208, 210, 214-215

Lead poisoning, 120, 227, 228, 230, 276, 289, 290, 296

Legislation

see also Advocacy;

Funding;

Regulatory issues

Emergency Medical Services Systems Act, 24, 84

Food and Drug Act, 81, 82

Hazardous Substances Labeling Act, 96

Health Insurance Portability and Accountability Act (HIPAA), 17, 112, 169, 191, 192, 315

historical perspectives, 23, 24, 30, 31, 82

Maternal and Child Health Block Grants, 11-12

national repository, committee recommendation, 12, 309

Poison Control Center Enhancement and Awareness Act, 6, 14-15, 25, 97-98, 101-105, 312

Poison Prevention and Control System (proposed), 39, 312, 313

Poison Prevention Packaging Act, 23, 94, 96, 204

Local government

health departments, 35, 114, 274-282, 289, 307

hospital discharge data systems, 194

poison control centers and, 1-2, 5, 9, 114, 148, 307, 312-313

Poison Prevention and Control System (proposed), 273-282

M

Managing directors, 31, 32, 33, 84, 123, 127, 133, 159, 224

Mass media, 95, 103, 107, 116, 207, 210, 286, 307

National Poison Prevention Week, 95, 103, 209, 219

Mass poisonings

see also Biological and chemical terrorism

access to poison services, 114

HAZMAT response, 112, 114, 126, 130, 133

legislation on, 103

poison control centers, 107, 112, 114, 127, 191

Poison Prevention and Control System (proposed), 37

Maternal and Child Health Block Grants, 11-12, 98, 276, 283, 285-286, 308

Maternal and Child Health Bureau, 1, 2, 25, 26, 285

Medicaid, 14, 147, 148, 214, 285, 288, 294, 311

Medicare, 93, 285, 288, 294

Medical directors

background of, 84

injury prevention directors, 12, 33

poison control centers, 84, 145

committee methodology, 31, 32, 33

Medical examiners/coroners, 179, 193-194, 197, 199, 200, 273

Medication poisoning, see Drugs

MEDMARX, 197-198

MedWatch, 181, 197

Men, see Gender factors

Methodology, see Epidemiology;

Quality control;

Research methodology;

Surveillance

Micromedex, 91, 92, 113

Mine Safety and Health Administration, 285, 299

Minnesota Poison Control System, 189-190

Minority groups, see Race/ethnicity

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

Morbidity

alcohol poisoning, 36

committee study methodology, 27, 28, 34, 43

cost of poisoning, methodology, 27, 28, 34

definitional issues, 28

national reduction goals, 5

Mortality, see Death rates;

Suicide and attempts

Mortality Vital Statistics, 50

N

National Ambulatory Medical Care Survey (NAMCS), 4, 48-49, 51, 54, 55-57, 71, 73, 77, 78, 180, 195

National Bioterrorism Hospital Preparedness Programs, 33

National Center for Environmental Health, 189, 289-290

National Center for Health Statistics (NCHS), 4, 17, 18, 32, 39, 47-48, 290-291, 315, 317

see also National Ambulatory Medical Care Survey;

National Hospital Ambulatory Medical Care Survey;

National Hospital Discharge Survey;

National Vital Statistics System

National Center for Injury Prevention and Control, 18, 196, 291, 316-317

National Clearinghouse for Poison Control Centers (NCHPCC), 83, 87, 91, 92, 95-96, 97, 184

National Drug Intelligence Center, 300

National Electronic Injury Surveillance Survey (NEISS), 4, 17-18, 48, 49, 65-66, 72, 181, 196, 317

National Health and Nutrition Examination Survey, 182, 199

National Health Interview Survey (NHIS), 4, 17-18, 48, 51-55, 68-74, 76, 182, 192, 317

National Hospital Ambulatory Medical Care Survey (NHAMCS), 4, 49, 51, 54, 57-63, 71, 72, 73-74, 75, 78, 180, 195

National Hospital Discharge Survey (NHDS), 4, 49, 63-65, 72, 74, 78, 179, 195

National Household Survey on Drug Abuse, 182

National Institute for Occupational Safety and Health, 33-34, 198, 228, 285, 291-292

National Institute of Child Health and Human Development, 296

National Institute of Environmental Health Sciences, 296

National Institute on Drug Abuse, 295

National Institutes of Health, 120, 283, 295-296

National Poison Prevention Week, 95, 103, 209, 219

National Vital Statistics System, 50, 66-68, 179, 192-193

Northern New England Poison Center, 134-135

Nurses

American Nurses Association, 230

poison control centers

calls to, 112, 132

training, 6, 84

public education materials, 221, 222

O

Occupational Safety and Health Administration, 198, 285, 298-299

Office of National Drug Control Policy, 282, 285, 288, 301

Ohio, 215

Organizational factors

see also Accountability;

Cost and cost-benefit factors;

Funding;

Quality control

committee charge, 2, 26

committee methodology, 5, 31-33, 34-35

data needs, 44, 309-310

emergency medical services, 6, 39, 309

health departments

local, 35, 114, 274-282, 289, 307

state, 35, 93, 133, 274-282, 289, 307

interagency coordination, 3, 26, 30-31, 35-36, 39, 100, 114-115, 132-135, 165-166, 172-173, 273, 276-278, 284, 289

poison control centers, 1-3, 5-7, 8-10, 12-14, 23, 24-25, 26, 30-31, 32, 114, 155-175, 309-311

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

see also Poison control centers staffing

affiliation (private/public), 13, 93, 100, 108, 118-119, 124, 125, 136, 157-158, 160-161, 173, 311

core activities, 8-15 (passim), 31, 37-38, 106-131, 169, 173, 306-307, 308, 310

historical perspectives, 84, 87-90, 93-100

injury prevention and control field, general, 23, 122

partnerships, 10, 11, 13, 277-278, 308

planning, 35-36, 93, 98-99, 115, 123, 133, 147, 171, 175, 177

Poison Prevention and Control System (proposed), 7-8, 35-40, 306

regionalization, 7-8, 10, 14, 36-37

systems approach, 35-36, 38, 305-306

telephone services, 107-109

Poison Prevention and Control System (proposed), 5, 7, 8, 12, 13, 35-36, 38-40, 268-301, 305-306, 308-309

Overdose, see Drugs

P

Packaging and labeling, 23, 30, 35, 80-81, 84-85, 94, 95, 96, 99, 196, 203, 210, 218

child-resistant caps, 84-85, 99, 106, 204, 205, 210, 218, 287

Haddon Matrix, 202-203, 204

imprint codes, 84, 89

Poison Prevention Packaging Act, 23, 94, 96, 204

Pharmacists

accessibility, 230

American Pharmacists Association, 80-81, 222

elderly persons, 99

historical perspectives, 80-81

poison control centers, 115, 212

training, 6, 9, 99

public education materials, 221

Physicians

American College of Emergency Physicians, 83

American Medical Association, 80-81, 86, 230

biochemical terrorism, poison control center consultations, 7-8, 37

incidence data, 53, 54, 55, 65, 72, 77, 78

poison control centers, 53, 112, 116, 212, 306

public education materials, 221

telephone consultations, 53, 112

toxicology training and certification of, 15, 24, 83, 122

Poisindex, 91, 92, 113

Poison Control Center Advisory Working Group study (1996), 136

Poison Control Center Enhancement and Awareness Act, 6, 14-15, 25, 97-98, 101-105, 312

Poison control centers staffing, 6, 7, 8, 9, 13, 14, 24, 37, 168, 172, 311

costs, 136, 143-158 (passim), 161-163, 170-171, 310, 311

managing directors, 31, 32, 33, 84, 123, 127, 133, 159, 224

medical directors, 31, 32, 33, 84, 145

pharmacists, 115, 212

training, 6, 9, 99

physicians, 53, 112, 116, 212, 306

professional education, 37, 123-126, 167, 307

public education, 205-206, 209, 212-213

recruitment and retention, 14, 159, 168, 169, 170, 171, 172, 310, 311

specialists in poison information/ poison information providers, 123, 124-125, 127, 130, 143-145, 153-155

training of staff, 37, 123-126, 167, 307

volunteers, 124, 161, 172, 208

Poison Prevention and Control System (proposed), 5, 7-8, 12, 269-301, 305-317

accountability issues, 273, 282, 284-286, 308-309

biological and chemical terrorism, 12, 26, 35, 37, 38, 309

Centers for Disease Control and Prevention (CDC), 12, 15, 39, 282, 287, 315-317 (passim)

concept of, 34-40, 305-306

core activities, 270-275, 284, 306-307, 308;

see also Telephone services

cost factors, 13, 18, 19, 311-313

data needs, 13, 16-17, 37, 39, 305

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

Department of Health and Human Services (DHHS), 12, 282-283, 285-286, 308-309, 313

emergency medical services, 38, 39

federal government, general,, 12, 15, 35-36, 39;

see also specific departments and agencies

funding, 8, 12, 14-15, 36, 39, 283-287 (passim), 305, 307

regionalization, 37

technical assistance, 12

local government role, 273-282

mass poisonings, 37

organizational factors, 5, 7, 8, 12, 13, 35-36, 38-40, 268-301, 305-306, 308-309

population-base factors, 18, 287

professional education, 15, 37

public education, 12, 15, 37, 39, 274

quality control, 8, 13, 37, 270-272, 274-275, 284-285, 305, 308-309, 313-314

regionalization of centers, 7-8, 10, 36-37, 306, 312

state government role, 12, 273-282, 285-286, 309

surveillance, 14-15, 37, 305

Toxic Exposure Surveillance System (TESS), 35, 309

Poison Prevention Council, 219

Poison Prevention Packaging Act, 23, 94, 96, 204

Poison Prevention Week, see National Poison Prevention Week

Poisoning, 2, 3, 4, 16-17, 27, 28, 34-35, 43, 45-48, 50-51, 73, 79, 306, 314-315

Department of Health and Human Services, committee recommendations, 16-17, 314-315

diagnosis, 3, 27, 46, 50-61 (passim)

dosage, 4, 23, 43

overdose, 27, 43, 45, 46, 51, 78-79

Toxic Exposure Surveillance System (TESS), 34-35, 45-46, 79

Policy, see Advocacy;

Legislation;

Regulatory issues

Population-based factors

see also Demographic factors;

Geographic factors

committee study charge, 2, 26

poison control centers, 35, 164, 169-170, 171

core activities, 10, 11

population at risk, 29-30

regionalization, 7-8, 10, 36-37

Poison Prevention and Control System (proposed), 18, 287

PRECEDE/PROCEED model, 206-207

Prevalence, see Incidence and prevalence

Privacy and confidentiality, 17, 18, 112, 169, 192, 214-215, 315

Private sector

see also Toxic Exposure Surveillance System

Drugdex, 92

epidemiological data, 38, 90

Poisindex, 91, 92, 113

poison control centers and, 1-7, 13, 14, 17, 35, 117, 122, 160, 164

affiliation (private/public), 13, 93, 100, 108, 118-119, 124, 125, 136, 157-158, 160-161, 171, 173-174, 311

funding, 148-149

Professional education, 26

certification of professionals, 15, 123, 127-128, 130

cultural competence, 11, 43-44, 113, 208-209

educational materials, 221-231

poison control centers, 6, 9, 10, 11, 15, 24, 25, 81, 83, 87, 107, 115-116, 117, 118-119, 121-131 (passim), 133, 158, 162-163

staff of, 37, 123-126, 167, 307

telephone services, 110-112

Poison Prevention and Control System (proposed), 15, 37

privacy regulations, 17, 315

toxicologists, 15, 24(n.1), 38, 118-119, 122, 125

Program Evaluation Logic Model, 207-208, 214

Public education/outreach, 201-268

see also Advocacy;

Mass media;

Packaging and labeling;

Telephone services

access to services, enhancement, 202, 205, 208, 214

American Association of Poison Control Centers (AAPCC), 209, 210-212, 219, 234

Centers for Disease Control and Prevention (CDC), 207, 237-238

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

children, 209, 210-212, 216, 219, 234-268 (passim), 276, 277, 317

federal government, general, 219-231

funding for, general, 11, 93, 211, 286, 313

Haddon Matrix, 115, 201-204

language factors, 43-44, 113, 164, 208, 210, 214-215

materials by organizations other than poison centers, 219-231

pharmacists, 221

poison control centers, 9, 10, 11, 37, 89, 93, 95, 107, 116-117, 120-121, 123-124, 204, 205-268, 307

best practices, 213-215

biological/chemical terrorism, 115

children, 209, 216, 217, 234-268 (passim)

cost and cost-effectiveness, 158, 163, 164, 166, 206

educational materials available from, 233-268

ethnic diversity and, 43-44, 113, 208, 210, 214-215

quality control, 206-209, 217-219

staff types and roles, 205-206, 209, 212-213

state government role, 213-215, 234-268

Poison Prevention and Control System (proposed), 12, 15, 37, 39, 274

quality control, 206-209, 217-219, 231-232

racial/ethnic factors, 43-44, 113, 208-209, 214, 215

theoretical models, 206-208

Q

Quality control

see also Accountability;

Core activities;

Cost and cost-benefit factors

American Association of Poison Control Centers (AAPCC), 127-128, 130

assessment as core public health function, 270-271

assurance as core public health function, 271-272

best practices, 11, 15, 37, 213-215, 232, 275, 287, 313

certification of professionals, 15, 123, 127-128, 130

emergency medical personnel, 84

toxicologists, 15, 24, 83, 122

committee study charge, 2, 26

data coding, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 188

data on, 12-13, 129, 309-310

data quality, 176, 187-188

national tool free telephone service, 211

poison control centers, 37, 95, 107, 127-130, 167, 171, 174, 206-208, 313-314

best practices, 11, 15, 37, 213-215

certification of, 2, 15-16, 26, 84, 127-129, 130, 160

committee recommendations, 8, 10, 11, 13, 15-16, 309, 310

cost factors, 158

public education, 206-209, 217-219

telephone services, 211, 217

Poison Prevention and Control System (proposed), 8, 13, 37, 270-272, 274-275, 284-285, 305, 308-309, 313-314

public education, 206-209, 217-219, 231-232

theoretical models

Haddon Matrix, 115, 201-204

program development and evaluation, 206-208, 214

R

Race/ethnicity, 43

see also Cultural factors

access to services, 43

incidence data, 48, 52-60 (passim), 63, 68, 70

language factors, 43-44, 113, 164, 210, 214-215

A Su Salud, 208, 215

public education and, 43-44, 113, 208-209, 214, 215

Reducing the Burden of Injury: Advancing Prevention and Treatment, 25

Referrals

incidence data, 59, 60, 63-66 (passim), 72, 74

poison control centers, 166-167

telephone services, 110, 112, 116, 131, 137, 157

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

self-referrals to emergency departments, 138-139

Regional factors, see Geographic factors

Regulatory issues, 18

see also Legislation;

Packaging and labeling

advocacy, 10, 11, 25, 31, 39, 203, 204, 205, 218, 271, 274, 289

data coding, 315

data sources on regulation fulfillment, 186

historical perspectives, 80-81, 84-85, 87, 94, 95, 96, 98

privacy, 17, 18, 112, 169, 192, 214-215, 315

telephone services, 112

Reporting, 6

definition of poisoning, 46

National Clearinghouse for Poison Control Centers (NCHPCC), 97

poison control centers, 117-118, 310

sentinel events, 117-118, 188-190

Research methodology

see also Data needs;

Definitional issues;

Epidemiology;

Quality control;

Surveillance;

Theoretical models

committee charge/methodology, 1, 2, 5-6, 26, 30-33, 34, 172-175, 305-306, 309

committee reviewers, ix-x

incidence data, 53-79 (passim)

Poison Control Center Advisory Working Group study (1996), 136-137

poison control centers

cost-benefit/cost-effectiveness, 142, 153-157, 170

used by, 118-120

Research recommendations, 18-19, 39, 287, 309-311, 314-317

access to services, 10, 18, 19, 118, 270, 274, 275, 316, 317

Rocky Mountain Poison and Drug Center, 31, 89, 116, 132-133

S

Safety equipment, 84, 203, 204-205, 218

child-resistant caps, 84-85, 99, 106, 204, 205, 210, 218, 287

Sentinel events, 106, 115, 117-118, 188-190

Sex differences, see Gender factors

Snake bites, see Insect/snake bites

Special Supplemental Nutrition Program for Women, Infants, and Children, 209

State and Territorial Injury Prevention Directors Association, 33

State government

biological and chemical terrorism, 85

block grants, 14, 15, 92-93, 147, 148, 311

classification systems, 3

committee study methodology, 33

emergency department data, 179

emergency preparedness/response, 12

health departments, 35, 93, 133, 274-282, 289, 307

hospital discharge data systems, 179, 194

Maternal and Child Health Block Grants, 11-12, 98, 276, 283, 285-286, 308

poison control centers and, 1-2, 35-36, 93, 100, 114, 116, 132-135, 161, 276-278

committee conclusions/ recommendations, 7, 9, 307, 312-313

funding, general, 24, 36, 92-93, 98, 136-137, 147, 148, 284, 311, 313

historical perspectives, 86, 87, 88-89, 91-93, 98

Maternal and Child Health Block Grants, 11-12, 98, 276

public education, 213-215, 234-268

regionalization, 7-8, 10, 36-37, 88-89, 93, 94, 142, 143, 306, 312

websites, 234-268

Poison Prevention and Control System (proposed), 12, 273-282, 285-286, 309

surveillance efforts, 17, 179, 189-190

Toxic Exposure Surveillance System and, 6, 309, 316

Substance abuse, 5, 28, 29, 99

see also Alcohol use and abuse

data coding, 51, 62, 181

Drug Abuse Warning Network, 19, 181, 196-197

Haddon Matrix, 202

incidence data, 62, 67

MEDMARX, 197-198

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

National Household Survey on Drug Abuse, 182

Substance Abuse and Mental Health Services Administration (SAMHSA), 181, 182, 196, 229, 282, 287, 293

Suicide and attempts, 3, 5, 27, 29-30

incidence data, 51, 61, 68, 71

Surveillance, 176-200

see also Centers for Disease Control and Prevention;

Data needs;

Incidence and prevalence;

Reporting;

Toxic Exposure Surveillance System

Agency for Toxic Substances and Disease Registry, 39, 90, 115, 126, 189, 195, 283, 292

Hazardous Substances Emergency Events Surveillance System, 181, 198

committee recommendations, 9, 16-17, 314-317

committee study charge, 2, 26

data coding, 50-51, 61, 63, 73, 74-75, 78-79, 99, 178-184, 186, 187-188

definitions and classification systems, 3, 4, 176-177

historical perspectives, 90

overview and distribution of poisonings in United States, 43-79

poison control centers, 9, 10, 11, 37, 90, 115, 190-192

Toxic Exposure Surveillance System (TESS), 111, 113, 115, 117, 134, 137, 178, 184-191, 211

Poison Prevention and Control System (proposed), 14-15, 37, 305

sentinel events, 106, 115, 117-118, 188-190

state government, 17, 179, 189-190

Symptoms

see also Diagnosis

incidence data, 46, 55, 56, 58, 59, 61

T

Technical assistance, 12, 225

federal assistance to health departments, 289

Internet, 12, 309

patient care, 26, 305

Telephone services, 5, 6, 29, 37, 106, 107-113, 116, 130, 210-211, 212

American Association of Poison Control Centers (AAPCC), 113

call volume, 110, 143, 144, 164, 187, 309

committee recommendations, 9

committee study charge, 2, 26

core activity of poison centers, 14, 107-113, 116, 123, 125-127, 130, 307

cost factors, 143, 144, 152-155, 160

definition of poisoning, 4, 34-35

drug overdoses, 51, 61, 68, 71

evaluation of, 211, 218

historical perspectives, 81, 83, 88, 92, 94, 97, 103

incidence data, 52, 53, 55, 69, 70-71, 72, 73-74, 94, 178, 184-190

race/ethnicity data, 208-209

national number, 25, 52, 55, 92, 97, 103, 113, 210, 211

physician consultations, 53, 112

quality assurance, 127-129, 167,

sentinel event reporting, 117-118, 188-190

specialists in poison information/ poison information providers, 123, 124-125, 127, 130, 143-145, 153-155

Toxic Exposure Surveillance System (TESS), 111, 113, 115, 117, 134, 137, 178, 184-190, 211

Terrorism, see Biological and chemical terrorism

Texas, 116, 133, 214

Theoretical models

Haddon Matrix, 115, 201-204

program development and evaluation, 206-208

Toxic Exposure Surveillance System (TESS), 4, 6, 28, 29, 48, 49-50, 113, 115, 117, 127, 177

biological/chemical terrorism, 114

Centers for Disease Control and Prevention (CDC), 6, 17, 18, 189, 315-316, 317

committee/conclusions recommendations, 12, 17-18, 25, 315-316

data needs/methodology described, 6, 17-19 (passim), 178, 184-190, 199-200

definition of poisoning, 34-35, 45-46, 79

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
×

emergency preparedness, 115

funding, 17-18, 90

historical perspectives, 90, 91, 92

incidence data, 66, 68-74, 76

Internet, 66, 68-74, 76

Poison Prevention and Control System (proposed), 35, 309

telephone services, 111, 113, 115, 117, 134, 137, 178, 184-190, 211

Toxicology

see also Dosage factors

certification of professionals, 15, 24, 83, 122

committee study methodology, 1, 26

definitional issues, 2, 3, 4, 24(n.1), 27, 45-46

poison control centers, 15, 38, 87, 107-108, 118-119, 122

telephone services, 107-108

training of professionals, 15, 24(n.1), 38, 118-119, 122, 125

Training, see Professional education

U

United States Pharmacopoeia, 197-198

Utilization of health care services, 53, 121, 129, 169, 180, 195, 196, 198, 209

see also Access to services;

Incidence and prevalence;

Public education/outreach;

Telephone services

V

Venom, see Insect/snake bites

W

Women, see Gender factors

World Health Organization, 16-17

see also International Classification of Diseases

World Wide Web, see Internet

Suggested Citation:"Index." Institute of Medicine. 2004. Forging a Poison Prevention and Control System. Washington, DC: The National Academies Press. doi: 10.17226/10971.
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Forging a Poison Prevention and Control System Get This Book
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Poisoning is a far more serious health problem in the U.S. than has generally been recognized. It is estimated that more than 4 million poisoning episodes occur annually, with approximately 300,000 cases leading to hospitalization. The field of poison prevention provides some of the most celebrated examples of successful public health interventions, yet surprisingly the current poison control “system” is little more than a loose network of poison control centers, poorly integrated into the larger spheres of public health. To increase their effectiveness, efforts to reduce poisoning need to be linked to a national agenda for public health promotion and injury prevention.

Forging a Poison Prevention and Control System recommends a future poison control system with a strong public health infrastructure, a national system of regional poison control centers, federal funding to support core poison control activities, and a national poison information system to track major poisoning epidemics and possible acts of bioterrorism. This framework provides a complete “system” that could offer the best poison prevention and patient care services to meet the needs of the nation in the 21st century.

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