New York State Poison Control Network - Annual Report on 2001 Data
Management Of The Societal Impact Of Poisoning
Early Warning System
The Network participates in early warning surveillance by notifying each other of local trends, personal hazards, hazardous material incidents, and product recalls. In addition, the New York State Network shares and reviews this information with centers nationwide through the American Association of Poison Control Centers.
Each center has conducted a survey of hospitals, their services and their antidote availability.
Toxic Exposure Surveillance System (TESS)
Administered by the American Association of Poison Control Centers (AAPCC), all poison centers nationwide contribute to the TESS database. During 2001, the AAPCC initiated an auto upload program that immediately collects and categorizes all cases entered into each poison center's database. The data is immediately analyzed and monitored for trends in poisoning as well as chemical and/or bioterroristic events. In case of a recognized sentinel event, the AAPCC will notify the local poison center who, in turn, will notify the proper governmental agencies. Other information or feedback that is recovered can be used to monitor product safety and can provide an early opportunity to consider product reformulation or repackaging. The information collected by the AAPCC is distributed to poison centers, governmental agencies and industry.
An example of the value of this database was shown during the events of September 11, 2001. At that time, portions of the state (and country) were activated on the auto-upload system. The AAPCC was able to track Anthrax calls throughout the nation and observe for additional small pockets of cases. In addition, the poison centers in New York State monitor both pesticide exposures and West Nile Virus, and the data collected is distributed to the New York State Pesticide Agency.
Centers continue to provide training and education to the 911 dispatchers. Protocol stipulates that all 911 calls involving a poison exposure are called into the poison center prior to dispatching an ambulance. With 911 on the line, the centers triage the calls and then determine if the patient needs to be transported. If the patient is unconscious or experiencing life-threatening problems, 911 dispatches an ambulance and the EMTs on the scene contact the poison center for recommendations during transport. If the patient is asymptomatic and no serious effects are expected from the exposure, 911 are advised that a transport is not necessary and the poison center handles the case, including follow-up.
Each center in the Network reports information on pesticide poisonings to the New York State Department of Health, which maintains a registry that monitors both the acute and chronic effects of pesticide exposure. It investigates occurrences of pesticide poisoning and may perform environmental monitoring to determine the source and circumstances of exposure. Both occupational and environmental incidents are followed. Appropriate acute and long-term interventions (changes in work practice/protective equipment) work to prevent pesticide poisoning.
West Nile Virus (WNV) encephalitis transmission via mosquitoes continued in the greater New York metropolitan area during the summer and fall of 2001. Consistent with year 2000, ground and aerial application of pesticides were used to control the adult mosquito population. As concerns regarding possible public health effects among individuals who may have been exposed to these pesticides continued, the New York State Pesticide Poisoning Registry (NYSPPR) evaluated all calls regarding pesticide exposures received by poison control centers during the period of active spraying.
Centers work with local emergency planning boards and emergency services to assist and advise during toxic spills, fires and hazardous incidents. They also participate in disaster drills conducted by host institutions.
After the events of September 11, 2001, the focus of the Network has been in the training of health care professionals, governmental, and uniformed agencies regarding biological and chemical agents. In addition, the Network has also focused on the development and distribution of public education within the communities served. Network members were also involved in:
- the development of decontamination rooms and hospital medical response systems in their local areas;
- serving as advisors to local and State health Bioterrorism Task Forces;
- assisting in the Metropolitan Medical Response System; and
- participating in the enhanced health Alert Network.
Since poison centers are considered sentinel units, the members of the Network assist local health departments in bioterrorism surveillance, including daily reports. Training, including mock drills in coordination with other governmental and uniformed agencies, has been ongoing.
Centers conduct quality assurance activities on a daily basis. Direct assessment occurs with peer review of active cases and supervisory review of active, random and high-risk cases. Feedback is provided and instruction given at staff meetings to address recurring problems and unusual poisonings, as well as review of protocols and guidelines. In addition, centers conduct periodic satisfaction surveys, hospital services and antidote availability. Fatalities are reviewed and discussed and abstracts written for submission to the national database. Staff receive periodic evaluation and skills assessment for competency.