Regional Center for Poison Control and Prevention SERVING MASSACHUSETTS AND R H O D E I S L A N D • ANNUAL REPORT 2005 Table of Contents E X E C U T I V E R E P O R T A N D M ISSION 2 SERVICES 3 BUDGET 4 P U B L I C E D U C AT I O N 6 P ROFESSIONAL E D U C AT I O N 7 PHOTO COLLAGE 8 STATISTICS WHO M D O W E SERVE AND W HY DO THEY CALL? 9 PENETRANCE 1 0 WHERE DO POISONINGS HAPPEN? 1 1 WHERE DO THE CALLS CO M E F R O M ? 1 1 WHERE ARE POISONINGS M ANAGED? 1 1 WHO ARE THE POISONED? 1 2 w HAT ARE THE MOST CO mm O N A G E N T S ? 1 3 W H AT WAS THE INTENT RELATED TO THE POISONING? 1 4 W H AT WAS THE RESULT OF THE POISONING? 1 5 S U mm ARY OF DEATH CASES 1 6 A LOOK TO THE FUTURE 1 7 A P P E N D I X A . C E N T E R S TA F F 1 9 B . A D V I S O RY C O mm ITTEE 2 0 C . M O S T C O mm ON SUBSTANCES BY CATEGORIES 2 1 D . H O S P I TA L C ALLERS AND F U N D I N G PARTNERS 2 2 E . P UBLICATIONS 2 4 1 Executive Report 2005 marked the 50th anniversary of the founding of the Massachusetts Poison Control Center and five years since the Regional Center was created to jointly serve the people of Massachusetts and Rhode Island. To celebrate this milestone the Center held a symposium during Poison Prevention Week to highlight clinical contributions to the last fifty years of service. Representatives from area hospitals, state agencies and community organizations attended the event, which included presentations such as—The Boston Poison Information Center: a History of Contributions to the Field of Toxicology. The Poison Center remains an important element in both the public safety and health systems of Massachussetts and Rhode Island by reducing the number, severity and frequency of both intentional and unintentional poisoning exposures. The Center works closely with the Departments of Health in both states to educate and inform the public with targeted direct education and outreach, various media campaigns, and other advertising opportunities. Every month, the Center produces and disperses between 15,000 and 25,000 units of educational materials to the public including such items as phone stickers, magnets, and informational brochures advertising the toll-free emergency hotline phone number, 1-800-222-1222. The Center continues to be a resource to federal, state and local officials in the identification and management of biological and chemical exposures. In addition, the Center participates in local and nationwide toxicology surveillance systems targeting the early identification of a potential toxic exposure. In tandem with the Massachusetts Department of Public Health and the Rhode Island Department of Health, we are continuously working to define and increase our capabilities and technologies. As such, the MA & RI Regional Center for Poison Control and Prevention is prepared to play a vital role in any potential large or small scale emergency. As national security continues to be of foremost concern, the Center’s resources remain a vital part of the public health response to chemical and biological terrorism threats as well as infectious disease outbreak management. Accordingly, all segments of the population, including the general public, law enforcement, legislative bodies, first responders, health care providers, and public health specialists have utilized the poison control center as an Mission The mission of Regional Center for Poison Control and Prevention is to provide assistance and expertise in the medical diagnosis, management and prevention of poisonings involving the people of Massachusetts and Rhode Island. The Center seeks to improve the quality of medical care given to patients by maintaining a standard of excellence in both clinical research and professional development. In addition, the Center develops and implements public education and information campaigns to prevent injuries due to intentional and unintentional poisonings. 2 emergency preparedness resource. The Center participates in Epi-X, and the national Toxic Exposure Surveillance System, both of which are monitored by the CDC for potential early detection of a mass toxic exposure or bioterrorism response. Locally, the Center provides its resources for regional exercises that test emergency protocols and identify gaps in preparedness. We remain committed to maintaining a level of excellence in emergency preparedness and continually train our health care professionals in such areas of pandemic medication management and biological warfare issues so that the center can function as a knowledge base resource in a time of need. • In 2005, the Poison Center managed over 65,000 poison exposure and general information calls, which translates to more than 175 calls every day. 17.5% of the exposure calls required follow up to ensure the appropriate care and management of the patient. • It has been estimated that for each dollar invested in a poison control center, more than seven dollars in unnecessary health care expenditures are saved1. • The Center is continually training the next cadre of physicians, nurses, and pharmacists specializing in Toxicology, that will be responsible for taking care of the future generations of poisoned patients. This report provides information on the demographics and substances involved in poisonings as reported to the Center during 2005, as well as the treatments and outcomes of these cases. Services • Emergency Hotline for Public • Public Education and Outreach • Telephone Consult Service for Health Care Facilities • Professional Education • Children's Hospital Boston In-Patient Toxicology Service • Data Analysis • Harvard Medical Toxicology Fellowship • Clinical Research • Beth Israel Deaconess Medical Center Consult Toxicology Service What is a poisoning? A poisoning is caused by any substance that has a toxic, or damaging, effect to the tissues and/or systems of the body upon exposure. Exposures can occur through ingestion, inhalation or through dermal and ocular contact. Any substance may become a poison if it used incorrectly, in the wrong amount, or by a person with a particular sensitivity to the product. Common poisons include household products, industrial and environmental chemicals, medications (prescription, over the counter, veterinary and herbal), illicit drugs, and venom. 1Miller, T.R., and Lestina, D.C. (1997). Costs of poisoning in the united states and savings from poison control centers; A benefit-cost analysis. Annals of Emergency Medicine, 29 (2), 239-245 3 Budget In fiscal year 2005, the annual operating budget for the Regional Center for Poison Control and Prevention was over $2 million. Most of the funding for Center operations is provided by the Massachusetts Department of Public Health and Rhode Island Department of Health, with additional funding from federal grants, hospital partners and pharmacy training programs. The Center continues to receive federal funds appropriated from the Health Resources and Services Administration Poison Control Center Enhancement and Awareness Act of 2000. The following table highlights revenue and expenditures for fiscal year 2005. F isca L Y ea R 2 0 0 5 (JULY 2 0 0 4 T O JU N E 2 0 0 5 ) O P E R AT I N G R EVENUE D EPART M E N T O F P U B L I C H EALTH, MASSACHUSETTS $ 5 2 0 , 4 4 0 4 5 0 0 - 2 0 0 0 $ 3 2 8 , 2 5 6 4 5 1 0 - 0 4 0 4 $ 1 7 7 , 1 8 4 4 0 0 0 - 9 4 0 2 $ 1 5 , 0 0 0 D EPART M E N T O F H E A LT H , R H O D E I SLAND $ 3 0 0 , 0 0 0 H R S A HO S PITA L EM er G E NCY P R E Pare DN ess $ 1 5 0 , 0 0 0 CDC $ 1 0 0 , 0 0 0 STAT E OF R H OD E I S L A N D $ 5 0 , 0 0 0 F E D E R A L S TABILIZATION G RANT $ 4 6 6 , 3 8 5 F E D E R A L N E W E N G L A N D C ONSORTIU M G RANT $ 5 9 , 5 8 0 F U N D I N G PARTNERS $ 1 0 4 , 1 6 9 P HAR M A C Y T R A I N I N G P ROGRA M S $ 1 , 5 0 0 SUB T O ta L $ 1 , 4 5 2 , 0 7 4 C H I L D R en ’ S H O spita L I N -K ind $ 7 5 5 , 0 7 8 T O TA L $ 2 , 2 0 7 , 1 5 2 D I R E C T E XPENSES S ALARIES AND B ENEFITS $ 1 , 2 1 7 , 1 5 8 T ELEPHONE $ 3 3 , 6 6 4 P RINTING AND P O S TA G E $ 4 6 , 3 2 8 T O X I C A L L S OFT WA R E L I C E N S I N G F EE $ 2 5 , 5 3 9 T RAVEL $ 2 1 , 3 2 0 E DUCATIONAL MATERIALS $ 2 6 , 9 4 7 S UPPLIES $ 9 , 8 4 0 D UES/ME M BERSHIPS $ 8 , 6 0 8 O THER $ 3 8 , 5 2 8 SUB T O ta L $ 1 , 4 2 7 , 9 3 3 C H I L D R en ’ S H O spita L I N -K ind $ 7 7 5 , 0 7 8 T O TA L $ 2 , 2 0 3 , 0 1 1 B A L A N C E : $ 4 , 1 4 1 4 Tide's Toxins Trouble Lungs Ashore The Boston Globe, March 2005 5 Public Education The goal of the Poison Control Center’s public education program is to reduce both intentional and unintentional poisonings through poisoning prevention education and an enhanced awareness of the Center’s services.