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Poison Control Center Plays
Expanded Role in Changing World
By Kristina Goodnough
hen anthrax mysteriously began to sicken and even kill people last fall, panicky calls started coming into the Connecticut Poison Control Center.
"People wanted information about anthrax and their chances of getting sick from it - immediately," says Mary McCormick, director of the Connecticut Poison Control Center. "We had to gear up quickly so we could answer their questions."
Same thing when a chemical explosion at a pool supply company rocked a Manchester neighborhood the summer before last. "I was on the telephone with a fire official in the helicopter flying over the flume," says McCormick. "We had to find out what was going on, so we could answer calls about exposure to chlorine gas."
The calls - about 100 a day - come in from around the state, around the country, even around the world, asking staffers at the Connecticut Poison Control Center about the health consequences of an exposure to poisonous or hazardous substances.
Most calls come from laymen. Nearly two thirds are related to accidental poisonings in children. Other calls about the toxicity of a substance come from doctors, emergency rooms, police departments or companies around the state.
"Because we are a member of the American Association of Poison Control Centers, our staff has access to a vast amount of expertise and information that helps us respond immediately to calls," says Dr. Marc Bayer, a board-certified toxicologist and
medical director for the Connecticut Poison Control Center. "We're linked to a huge database, the Toxic Exposure Surveillance System, that contains detailed toxicological information on more than 24 million poison exposures reported to U.S. poison centers. And when we get a call about an exposure, we enter the case into the database in real time, so it's immediately available to experts in the national office who can screen for exposure patterns across the entire country."
It's not just terrorism and fears about anthrax or smallpox that changed the nature of work inside the Poison Control Center.
"The practice of toxicology has changed dramatically in recent years," says Laura Caperino Crean, lead poison control specialist. "When I started in the '80s, we used to refer people to emergency rooms for observation fairly routinely, because most of our information about the toxicity of substances was based on animal research. We simply didn't know how to equate it to amounts taken by small children or even by adults."
The national system of poison control centers helped eliminate much of that uncertainty. "Now, because we have a great deal of information about poisonous substances and how to treat people for exposures to them, we can help over the telephone instead of sending people to hospitals or emergency rooms," Crean says.
The national association also established substantial training requirements for all its affiliates. Poison control specialists like Crean have to have 2,000 hours of experience on the telephone answering calls on exposures before they can sit for the national exam. Then they have to be re-certified every seven years. The national association also requires affiliated centers to be staffed 24 hours a day and have a board-certified toxicologist as medical director.
The risks of poisoning often come from everyday substances.
"People now bring extremely dangerous substances into their homes," says Crean. "We used to have a few all-purpose cleaners. Now, we have access to powerful chemicals that we often store under the sink. We all want our house clean, but we might not read the directions thoroughly, or we combine one product with another because we think it will work better or faster."
It's not just cleaning chemicals that create a danger of poisoning. "People today have a vast array of medications in their homes," says Crean. "It's not only that more medicines are available today, but also there are whole new classes of medicines. The population is aging, and we are treating more disorders, and that often translates into using more drugs.
"Accidents happen," she adds. "Perfectly capable adults take the dog's medicine by mistake. Or they forget and take their medicine twice. Or their child puts a pretty berry or strange pill in its mouth. It may be a function of how hurried or busy we all are."
The recent anthrax scare still worries people and the Poison Control Center gets occasional calls about it.
The terrorism has also had another unfortunate effect: "It's reinforced the misconception that poisoning is something done to us by someone else," Crean says, "when more often it is something we do to ourselves."
She adds that it has also made the staff of the Poison Control Center become more sophisticated: "We have to be prepared, and know where to find information - whether it's a snake bite or an anthrax scare," Crean says. "People depend on us to have the information they need at our fingertips."