Pharmacists Association (1852), and other organizations. Concerns about food and drug safety, beginning in the 19th century, provided the impetus for the first human clinical food additive trials to demonstrate safety and efficacy in December 1902 (Hurt, 1985). These efforts led to the Pure Food and Drug Act of 1906 (Lewis, 2002). This legislation (“Wiley Act”) created the Food, Drug, and Insecticide Administration, which in 1930 became the Food and Drug Administration (FDA). The Act required approval for foods and drugs meant for human consumption. Subsequently, the federal government passed a number of laws, created regulations, and proposed other controls and management of poisoning. These efforts are summarized in Box 4-1.

In the 1930s, childhood poisoning was recognized as a significant component of pediatric practice and patient morbidity. Unfortunately, little information existed regarding the toxicity of household products and management recommendations. Jay Arena, M.D., a pediatrician at Duke University, began to systematically collect information regarding toxic hazards in the early 1930s and provided advice to physicians on poisoning cases in the surrounding area. He provided one of the first reports on the hazards of household products to children (Martin and Arena, 1939). Louis Gdalman, R.Ph., a pharmacist in Chicago, collected information during World War II. He developed a toxicological information system using index cards and eventually converted to microfiche. This system eventually covered more than 9,000 commercial and consumer products. Moreover, Gdalman established the precursor to the modern poison control center by personally taking telephone calls 24 hours per day (Botticelli and Pierpaoli, 1992; Burda and Burda, 1997).

Although recognized as a growing problem during this period, the magnitude of childhood poisoning was not appreciated until a 1949–1950 epidemiological study focusing on children under 5 years of age reported a significant number of poisoning deaths (Bain, 1954). In 1950, the American Academy of Pediatrics (AAP), which was founded in 1930, established its Accident Prevention Committee, chaired by George M. Wheatley, M.D. That committee surveyed the 3,000 members of AAP and found that 49 percent of reported “accidents” treated by AAP members involved poisoning (Wheatley, 1953).

In 1953, Edward Press, M.D., and Gdalman developed the first formal poison control center in Chicago. Their center provided professional telephone advice and included a standard data collection form (Botticelli and Pierpaoli, 1992; Burda and Burda, 1997). These centers rapidly developed, with as many as 265 by 1958 and 661 by 1978 (Scherz and Robertson, 1978).

Provision of timely information to physicians regarding drugs and the toxicity of other agents was the driving force for poison control center



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