Regional Center for Poison Control and Preventions e rv i n g M a s s a c h u s e t t s a n d r h o d e i s l a n d • A N N U A L R E P O R T

2005

�

Table of Contents e x e c u t i v e r e p o rt a n d M i s s i o n 2

s e rv i c e s 3

b u d g e t 4

p u b l i c e d u c at i o n 6

p r o f e s s i o n a l e d u c at i o n 7

p h o t o c o l l a g e 8

S TAT I S T I C S

W h o M d o W e s e rv e a n d W h y d o t h e y c a l l ? 9

p e n e t r a n c e 1 0

W h e r e d o p o i s o n i n g s h a p p e n ? 1 1

W h e r e d o t h e c a l l s c o M e f r o M ? 1 1

W h e r e a r e p o i s o n i n g s M a n a g e d ? 1 1

W h o a r e t h e p o i s o n e d ? 1 2

W h at a r e t h e M o s t c o M M o n a g e n t s ? 1 3

W h at Wa s t h e i n t e n t r e l at e d t o t h e p o i s o n i n g ? 1 4

W h at Wa s t h e r e s u lt o f t h e p o i s o n i n g ? 1 5

s u M M a ry o f d e at h c a s e s 1 6

a l o o k t o t h e f u t u r e 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 M M i t t e e 2 0

c . M o s t c o M M o n s u b s ta n c e s b y c at e g o r i e s 2 1

d . h o s p i ta l c a l l e r s a n d f u n d i n g pa rt n e r s 2 2

e . p u b l i c at i o n s 2 4

�

Executive Report2005 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

MissionThe 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.

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

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

•

•

•

�

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.

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 I S C A l Y E A r � 0 0 5 ( J u lY � 0 0 � T o J u N E � 0 0 5 )

o p e r at i n g r e v e n u e

d e pa rt M e n t o f p u b l i c h e a lt h , M a s s a c h u s e t t s $ 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 e pa rt M e n t o f h e a lt h , r h o d e i s l a n d $ 3 0 0 , 0 0 0

H R S A H o S p i tA l E m E R g E n c y p R E pA R E d n E S S $ 1 5 0 , 0 0 0

c d c $ 1 0 0 , 0 0 0

S tAt E o f R H o d E i S l A n d $ 5 0 , 0 0 0

f e d e r a l s ta b i l i z at i o n g r a n t $ 4 6 6 , 3 8 5

f e d e r a l n e W e n g l a n d c o n s o rt i u M g r a n t $ 5 9 , 5 8 0

f u n d i n g pa rt n e r s $ 1 0 4 , 1 6 9

p h a r M a c y t r a i n i n g p r o g r a M s $ 1 , 5 0 0

S u b T o TA l $ � , � 5 � , 0 7 �

C h I l D r E N ’ S h o S P I TA l I N - K I N D $ 7 5 5 , 0 7 8

T o TA l $ � , � 0 7 , � 5 �

d i r e c t e x p e n s e s

s a l a r i e s a n d b e n e f i t s $ 1 , 2 1 7 , 1 5 8

t e l e p h o n e $ 3 3 , 6 6 4

p r i n t i n g a n d p o s ta g e $ 4 6 , 3 2 8

t o x i c a l l s o f t Wa r e l i c e n s i n g f e e $ 2 5 , 5 3 9

t r av e l $ 2 1 , 3 2 0

e d u c at i o n a l M at e r i a l s $ 2 6 , 9 4 7

s u p p l i e s $ 9 , 8 4 0

d u e s / M e M b e r s h i p s $ 8 , 6 0 8

o t h e r $ 3 8 , 5 2 8

S u b T o TA l $ � , � � 7 , 9 � �

C h I l D r E N ’ S h o S P I TA l I N - K I N D $ 7 7 5 , 0 7 8

T o TA l $ � , � 0 � , 0 � �

BALANCE: $4 ,141

5

Tide's Toxins Trouble Lungs AshoreThe Boston Globe, March 2005

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. We promote poison prevention through a variety of channels including: participating in area health

fairs and conferences, conducting media outreach during National Poison Prevention Week, and expanding

partnerships with other organizations participating in injury

prevention. The Center also is active in disseminating a variety

of educational resources to the local community on topics such

as poison-proofing in the home, medication safety, and seasonal

poison prevention tips. In 2005, the health education coordinators

continued to collaborate with colleagues from the Connecticut

and Northern New England Poison Centers under a cooperative

education grant to produce two poison education newsletters

featuring articles on carbon monoxide poisoning, outdoor safety

focusing on hazardous plants, and cold medicine abuse. In addition,

the collaborative also created two poison prevention posters,

one addressing inhalation abuse and the second, the high level of

confidential services provided by local poison centers. All resources

were distributed throughout Massachusetts and Rhode Island to

schools, partnering health care organizations and the general public.

Prevention Any substance may become a poison if it is used incorrectly, in the

wrong amount, or by a person with a particular sensitivity to the

product. However, the public can prevent many poison exposures

by adopting techniques and methods to avoid poisonings and by

gaining a general awareness of how poisonings occur. The Regional

Poison Center develops public education resources and implements

information campaigns that highlight the dangers of poisonings

in order to ensure the safety of the local community. In order to

maximize awareness and outreach the Center remains proactive

in encouraging the public to utilize our medical expertise and

educational resources to prevent injuries due to unintentional and

intentional poisonings.

C u r r E N T E D u C AT I o N A l M AT E r I A l S

p o i s o n c e n t e r b r o c h u r e s ( e n g l i s h & s pa n i s h )

t e l e p h o n e s t i c k e r s ( e n g l i s h & s pa n i s h )

r e f r i g e r at o r M a g n e t s

va r i o u s p o s t e r s ( i n h a l a n t a b u s e , p o i s o n

p r e v e n t i o n W e e k , c a n d y v s . M e d i c i n e

a n n i v e r s a ry t- s h i rt s

M e d i c i n e pa s s p o rt f o r s e n i o r s

c l i n i c a l t o x i c o l o g y r e v i e W

a d u lt e d u c at i o n p r o g r a M v i d e o

va r i o u s e d u c at i o n p r e s e n tat i o n s

( l o o k a - l i k e s , c a n d y v s . M e d i c i n e )

FA C T S h E E T S

c a n d y o r M e d i c i n e ( e n g l i s h & s pa n i s h )

c a r b o n M o n o x i d e

c h i l d r e n a c t fa s t ( e n g l i s h & s pa n i s h )

fa l l p o i s o n s a f e t y t i p s

h a l l o W e e n s a f e t y

i p e c a c s y r u p a l e rt ( e n g l i s h & s pa n i s h )

p o i s o n p r e v e n t i o n t i p s

p o i s o n o u s p l a n t s ( e n g l i s h & s pa n i s h )

p r e v e n t i n g p o i s o n i n g i n y o u r h o M e

( e n g l i s h & s pa n i s h )

s a f e p l a n t s ( e n g l i s h & s pa n i s h )

s a f e r a lt e r n at i v e s

t o p t e n p o i s o n e x p o s u r e s i n c h i l d r e n

W i n t e r h o l i d ay s a f e t y

M AT E r I A l S F o r C h I l D r E N

s p i k e t e M p o r a ry tat t o o s f o r c h i l d r e n

p o i s o n p r e v e n t i o n c o l o r i n g b o o k

p o i s o n W o r d s e a r c h

p i l l s a n d p o i s o n s Q u i z ( e n g l i s h & s pa n i s h )

Additionalarticlescoveringawidearrayofpoisoningconcernsare

availableinbothEnglishandSpanishatwww.maripoisoncenter.org

�

Professional EducationThe professional education program at the Regional Center for Poison Control and Prevention is comprised of

three components: continuing education for center staff, education at Children’s Hospital Boston for healthcare

professionals, and education presented off-site for healthcare professionals. The Center has continued to

provide the highest quality professional development to its staff, as well as to the professional community

outside the Center.

Continuing Education for Center Staff

» Presented in-service programs to the staff on such topics as Alcohols/Glycols, Biologicals, GHB, Pesticides,

Acetaminophen Overdose Management and Weapons of Mass Destruction.

» Instituted a monthly staff required reading list of current medical toxicology literature.

» Participated in New England Regional Toxicology Conferences and Consortium seminars.

» Administered weekly trivia quizzes.

Education for Healthcare Professionals

» Fellowship Program in Medical Toxicology: The Center maintains an active two-year postgraduate

fellowship in medical toxicology. In recognition of its unique service within the Harvard-affiliated hospital

system, the program is designated as the Harvard Medical Toxicology Fellowship.

» Emergency Medicine Resident Rotation: Residents from Boston Medical Center, Brigham and Women’s

Hospital, Massachusetts General Hospital, and Beth Israel Deaconess Medical Center, as well as the

pediatric emergency medicine fellows from Children's Hospital Boston, participated in a one-month rotation

through the Center. The Center also intermittently has rotators from Hasbro Children’s/Rhode Island

Hospital, as well as Harvard Medical students.

» Doctor of Pharmacy Clerkship: Students from the Massachusetts College of Pharmacy and Health Science

and the University Of Rhode Island College Of Pharmacy participated in a six week rotation through the

Regional Poison Center.

Education for Healthcare Professionals—Off Site

» The Center conducted lectures on clinical toxicology at various teaching and community hospitals, as well

as continuing education courses for healthcare professionals, including the 50th Anniversary Symposium at

Children’s Hospital Boston.

» Center staff authored books/chapters and contributed articles to various professional journals.

» Center staff conducted lectures on clinical toxicology at the Massachusetts College of Pharmacy and

Health Science.

» Clinical Toxicology Review (CTR): A quarterly educational update for health professionals in Massachusetts

and Rhode Island was posted on the Center’s web site.

7

8

9

Whom do we serve and why do they call?In 2005, the Center managed a total of 65,210 incoming calls,

including 53,031 exposure calls and 12,179 information calls.

The Center continued to experience a decrease in information

calls in 2005 as a result of a previous policy change in

January of 2004 limiting the service of drug information

and identification calls to only health care facilities and

law enforcement professionals. The policy change

was implemented in the wake of confidentiality and

inappropriate call concerns.

The total population for the region served by the Center is 7,397,416 residents, according to the 2000

Census data. The population of Massachusetts is 6,349,097 (86%) and Rhode Island is 1,048,319 (14%). The

number of calls annually from each state continues to remain proportional to the state population.

T Y P E o F C A l l � 0 0 � � 0 0 � � 0 0 � � 0 0 � � 0 0 5

i n f o r M at i o n 1 5 , 7 8 5 2 5 , 2 0 9 1 5 , 8 5 9 1 2 , 7 0 5 1 2 , 1 7 9

e x p o s u r e t o p o i s o n 4 5 , 1 9 3 5 2 , 1 8 1 5 2 , 7 3 9 5 3 , 8 8 0 5 3 , 0 3 1

t o ta l 6 0 , 9 7 8 7 7 , 3 9 0 6 8 , 5 9 8 6 6 , 5 8 5 6 5 , 2 1 0

T Y P E o F C A l l - r h o D E I S l A N D � 0 0 � � 0 0 � � 0 0 � � 0 0 � � 0 0 5

i n f o r M at i o n 1 , 7 1 3 2 , 7 6 8 2 , 9 5 4 2 , 1 5 9 1 , 7 7 4

e x p o s u r e t o p o i s o n 6 , 0 9 3 8 , 3 3 5 7 , 4 1 5 7 , 7 0 3 7 , 7 9 0

t o ta l 7 , 8 0 6 1 1 , 1 0 3 1 0 , 3 6 9 9 , 8 6 2 9 , 5 6 4

T Y P E o F C A l l - M A S S A C h u S E T T S � 0 0 � � 0 0 � � 0 0 � � 0 0 � � 0 0 5

i n f o r M at i o n 1 3 , 7 2 4 2 2 , 0 2 0 1 2 , 6 5 3 1 0 , 3 0 1 1 0 , 2 3 8

e x p o s u r e t o p o i s o n 3 8 , 3 8 7 4 2 , 3 4 0 4 3 , 8 7 4 4 5 , 1 0 6 4 4 , 6 8 7

t o ta l 5 2 , 1 1 1 6 4 , 3 6 0 5 6 , 5 2 6 5 5 , 4 0 7 5 4 , 9 2 5

Penetrance Penetrance data allows us to examine geographically where calls to the Center come from.

This data reflects the total number of poison exposure calls handled per 1,000 of the population.

�0

C A l l P E N E T r A N C E b Y C o u N T Y: M A S S A C h u S E T T S � 0 0 � � 0 0 � � 0 0 5

CouNTY PoPulATIoN EXPoSurES PENETrENCE EXPoSurES PENETrENCE EXPoSurES PENETrENCE

b a r n s ta b l e 2 2 2 , 2 3 0 1 , 4 2 8 6 . 4 1 , 4 7 2 6 . 4 1 , 4 6 1 6 . 6

b e r k s h i r e 1 3 4 , 9 5 3 7 5 7 5 . 6 7 9 4 6 8 7 8 6 . 5

b r i s t o l 5 3 4 , 6 7 8 2 , 7 9 7 5 . 2 3 , 1 4 4 5 . 7 3 , 7 1 4 6 . 9

d u k e s 1 4 , 9 8 7 1 2 6 8 . 4 1 4 8 9 . 4 1 7 5 1 1 . 7

e s s e x 7 2 3 , 4 1 9 4 , 0 2 4 5 . 6 4 , 6 7 1 6 . 3 5 , 2 6 6 7 . 3

f r a n k l i n 7 1 , 5 3 5 5 5 3 7 . 7 5 5 1 7 . 6 4 9 6 6 . 9

h a M p d e n 4 5 6 , 2 2 8 2 , 2 3 0 4 . 9 2 , 5 8 3 5 . 6 3 , 0 2 1 6 . 6

h a M p s h i r e 1 5 2 , 2 5 1 7 7 9 5 . 1 9 0 5 5 . 9 9 4 0 6 . 2

M i d d l e s e x 1 , 4 6 5 , 3 9 6 8 , 3 6 1 5 . 7 8 , 6 8 8 5 . 9 9 , 7 0 2 6 . 6

n a n t u c k e t 9 , 5 2 0 6 9 7 . 2 1 0 2 1 0 . 1 1 0 5 1 1 . 0

n o r f o l k 6 5 0 , 3 0 8 4 , 0 7 3 6 . 3 4 , 3 5 4 6 . 7 4 , 5 8 5 7 . 1

p ly M o u t h 4 7 2 , 8 2 2 3 , 2 7 0 6 . 9 3 , 6 3 9 7 . 4 3 , 8 8 0 8 . 2

s u f f o l k 6 8 9 , 8 0 7 2 , 9 2 9 4 . 2 3 , 4 5 2 5 . 2 4 , 0 3 1 5 . 8

W o r c e s t e r 7 5 0 , 9 6 3 4 , 6 1 0 6 . 1 5 , 0 1 3 6 . 4 5 , 5 3 5 7 . 4

n o t s p e c i f i e d 7 , 8 2 6 8 9 8

M A S TAT E � , � � 9 , 0 9 7 � � , 8 � � � . 9 � � , 9 9 � 7 . 0 � � , � 8 7

C A l l P E N E T r A N C E b Y C o r E C I T Y: r h o D E I S l A N D � 0 0 � � 0 0 � � 0 0 5

CorECITY PoPulATIoN EXPoSurES PENETrENCE EXPoSurES PENETrENCE EXPoSurES PENETrENCE

c e n t r a l fa l l s 1 7 , 1 9 7 7 4 4 . 3 6 7 3 . 5 5 6 3 . 3

n e W p o rt 2 8 , 1 8 4 2 3 5 8 . 3 2 4 1 9 . 3 4 1 9 1 4 . 9

paW t u c k e t 7 1 , 7 8 4 6 1 6 8 . 6 4 1 2 5 . 5 4 7 6 6 . 6

p r o v i d e n c e 1 5 6 , 7 2 7 1 , 9 2 2 1 2 . 3 1 , 4 6 9 8 . 2 3 , 7 6 9 2 4 . 0

W o o n s o c k e t 4 3 , 3 7 7 3 9 8 9 . 2 3 9 1 8 . 8 3 6 1 8 . 3

a l l o t h e r s 6 9 4 , 6 9 1 4 , 1 6 3 6 . 0 5 , 0 4 0 6 . 8 2 , 7 0 9 3 . 9

r I S TAT E � , 0 � � , 9 � 0 7 , � 0 8 7 . � 7 , � � 0 7 . � 7 , 7 9 0

P o P u l At i o n d AtA S o u r c E : u S c E n S u S B u r E A u , 2 0 0 0

Where do poisonings happen? Of the 53,031 exposure calls managed in 2005 by the Poison Center, 49,608 (94%) calls were exposures that took

place in a home residence; the remaining 3,423 (6%) calls occurred in other locations including schools, workplaces and

other public areas.

Where do calls come from? In 2005 more than 42,122 (78%) of the total exposure calls came from

a home residence, 8,241 (16%) came from health care facilities or medical

professionals, and the remaining 3,267 (6%) come from various other sources

such as public area schools or workplaces.

Where are poisonings managed? In 2005, the majority of the poison exposure calls

40,749 (77%) were managed on-site and did not require

treatment at a healthcare facility.

Of interest are those calls that were managed at a health care facility but

resulted in the patient being treated and released. While it is unclear whether a

pre-hospital call could have prevented the trip to the emergency room, there is

a clear potential cost savings that exists if the Poison Center is involved prior to

the hospital.

��

M A N A g E M E N T S I T E � 0 0 5

o n s i t e : 4 0 , 7 4 9

h c f : 1 1 , 1 5 2

u n k n o W n : 6 1 6

r e f u s e d r e f : 5 1 4

t r e at e d a n d r e l e a s e d : 4 4 %

lost to folloW-up: 25%

a d M i t t e dcritical: 14%

a d M i t t e d p s y c h i at r i c : 6 %

a d M i t t e d n o n - c r i t i c a l : 1 1 %

r e s i d e n c e : 7 8 %

health care facility: 16%

o t h e r : 6 %

Who are the poisoned? In 2005, as in previous years, calls were split equally

between males and females. Of the exposure calls received,

gender was recorded for 52,730 (99.4%) of calls in 2005.

The specific age of the caller was also captured for 52,895

(99.7%) of cases. Over 53% (27,976) of the exposure calls involved children 5 years of age and younger.

Specifically, the greatest number of exposure calls in any single age category involved two-year-olds; 9,466

calls for this age group were received, representing over 18% if the exposure calls. Children ages three and

under represent 47% (24,979) of exposure calls. Overall, the distribution of the age or gender has not changed

in recent years.

��

g E N D E r � 0 0 5 M A r I o T h E r

M a l e s 2 6 , 4 7 5 2 2 , 3 0 5 3 , 8 8 2 2 8 8

f e M a l e s 2 6 , 2 5 5 2 2 , 1 5 1 3 , 8 7 6 2 2 8

u n k n o W n 3 0 1 2 3 1 3 2 3 8

T o TA l 5 � , � 9 � � � , � 8 7 7 , 7 9 0 5 5 �

C A l l V o l u M E b Y A g E : � 0 0 5

1 2 , 0 0 0

1 0 , 0 0 0

8 , 0 0 0

6 , 0 0 0

4 , 0 0 0

2 , 0 0 0

0

< 1 y r 1 y r 2 y r 3 y r 4 y r 5 y r 6 - 1 2 y r 1 3 - 1 9 y r 2 0 - 2 9 y r 3 0 - 5 9 y r 6 0 + y r

exposures 3,586 7,553 9,466 4,374 1 , 9 1 9 1,078 3,635 4,039 3,313 7,417 2 , 5 0 4

a g e t o ta l M a r i o t h e r

<1 3,586 3,093 448 45

1 7,553 6,440 1,025 88

2 9,466 8,128 1,248 90

3 4,374 3,750 574 50

4 1,919 1,660 239 20

5 1,078 935 135 8

6-12 3,635 3,131 467 37

13-19 4,039 3,374 624 41

20-29 3,313 2,608 664 41

30-39 2,807 2,329 446 32

40-49 2,924 2,347 547 30

50-59 1,686 1,376 293 17

60+ 2,504 2,038 450 16

<=19 pediatric other 279 239 26 14

>=20 adult other 3,732 3,121 575 36

What are the most common agents of poison? Products involved in poisonings are regularly divided into drug

and non-drug categories. The percentage of calls and products

in each category has remained consistent over the past several

years. In 2005, calls involving non-drug agents accounted for

31,927 (44%) of all substance calls. The top five non-drug

agents most commonly involved in poisonings are detailed below.

Other common agents include alcohol, arts/crafts/office supplies,

chemicals, food products, and hydrocarbons.

��

T o p F i v e S u b S Ta n c e S M o S T F r e q u e n T ly i n v o lv e d i n n o n - d r u g r e l aT e d e x p o S u r e S , 2 0 0 4

S u b S Ta n c e M o S T c o M M o n p r o d u c T S

C o s m e t i C s / P e r s o n a l C a r e P r o d u C t s C r e a m s / l o t i o n s / f o u n d at i o n , t o o t h Pa s t e w i t h f l o u r i d e ,m o u t h wa s h , n a i l P r o d u C t s , h a i r C a r e P r o d u C t s

C l e a n i n g s u b s ta n C e s ( h o u s e h o l d ) b l e a C h , h o u s e l h o l d C l e a n e r s , d i s h wa s h e r d e t e r g e n t s ,d i s i n f e C ta n t s

f o r e i g n b o d i e s / t o y s / m i s C e l l a n e o u s s i l i C a g e l , t h e r m o m e t e r s , g l o w P r o d u C t s , t o y s

P l a n t s n o n - t o x i C P l a n t s , g a s t r o i n t e s t i n a l i r r i ta n t s

P e s t i C i d e s i n s e t i C i d e s , r e P e l l e n t s , r o d e n t i C i d e s , h e r b i C i d e s

In 2005, drugs were a reported agent in 36,159 (49%)

of calls. Analgesics, such as acetaminophen, continue to be

the most commonly reported drug agent involved in poison

exposures. Appendix C provides a more detailed analysis

of the most common substances reported in both drug and

non-drug categories.

T o P F I V E S u b S TA N C E S M o S T F r E q u E N T lY I N V o lV E D I N D r u g r E l AT E D E X P o S u r E S , � 0 0 �

S u b S TA N C E M o S T C o M M o N P r o D u C T S

a n a l g e s i c s i b u p r o f e n , a c e ta M i n o p h e n , o p i o i d s , a s p i r i n , n a p r o x e n

s e d at i v e s / h y p n o t i c s / a n t i p s y c h o t i c s b e n z o d i a z e p i n e s , at y p i c a l a n t i p s y c h o t i c s

a n t i d e p r e s s a n t s s e r o t i n i n r e - u p ta k e i n h i b i t o r s , t r a z o d o n e , a M i t r i p t y l i n e , l i t h i u M

t o p i c a l p r e pa r at i o n s d i a p e r r a s h p r o d u c t s , t o p i c a l s t e r o i d s

c o l d a n d c o u g h p r e pa r at i o n s d e x t r o M e t h o r p h a n , p r o d u c t s W i t h o u t o p i o i d s

a n a l g e s i c s : 1 7 . 8 1 %

s e d at i v e s / h y p n o t i c s / a n t i p s y c h o t i c s : 9 .05%

o t h e r : 5 4 . 6 1 %

a n t i d e p r e s s a n t s : 6 . 4 7 %

t o p i c a l s : 6 . 2 4 %

c o u g h a n d c o l d r e M e d i e s : 5 . 8 2 %

c o s M e t i c / p e r s o n a l care products: 20.16%

c l e a n i n gsubstances: 14 .85%

o t h e r : 4 2 . 9 9 %

f o r e i g n b o d i e s / t o y s / M i s c e l l a n e o u s : 9 . 6 3 %

p l a n t s : 6 . 3 1 %

p e s t i c i d e s : 6 . 0 7 %

What was the intent related to the poisoning?The majority of poison exposures in 2005 were recorded as unintentional. Of the determined intentional

poisonings, suspected suicides 6,666 (8%) were recorded as the largest source of intentional poisonings

managed by the Center. These data are consistent with the national poisoning statistics reported by the

American Association of Poison Control Centers (AAPCC).

��

intentional: 13%

unintentional 85%

other: 2%

s u s p e c t e d s u i c i d e : 8 %

u n k n o W n : 1 %

a b u s e : 2 %

M i s u s e : 2 %

The Fungus Among UsThe Boston Globe, November 2005

�5

D E F I N I T I o N o F M E D I C A l o u T C o M E S � 0 0 5

M i n o r e f f e c t: 2 , 5 7 3

the patient exhibited some symptoms as a result of the exposure, but they were minimally

bothersome to the patient. the patient has returned to a pre-exposure state of well being

and has no residual disability or disfigurement.

M o d e r at e e f f e c t: 2 , 5 1 5

the patient exhibited symptoms as a result of the exposure that are more pronounced,

more prolonged or more of a systematic nature than minor symptoms.

M a j o r e f f e c t: 8 2 1

the patient has exhibited some symptoms as a result of the exposure.

the symptoms were life-threatening or resulted in significant residual disability or disfigurement.

d e at h : 3 5

the patient died as a result of the exposure or as a direct complication of the exposure which

was unlikely to have occurred had the toxic exposure not preceded the complication.

only included are those deaths that are probably or undoubtedly related to the exposure.

u n r e l at e d e f f e c t: 5 4 6

based upon all information available, the exposure was probably not responsible for the effect(s).

n o e f f e c t: 2 , 7 9 8

the patient developed no symptoms as a result of the exposure.

C A S E S N o T F o l l o W E D N = � � , 7 � �

M i n i M a l e f f e c t 3 6 , 5 1 8

j u d g e d n o n t o x i c 4 , 4 6 7

u n a b l e t o f o l l o W 2 , 7 5 8

What was the result of the poisoning? Of the exposure calls recoded in 2005, 40,985 (77.3%) cases did not require follow-up by the Poison

Center staff because the exposure was judged to cause only minimal effect or to be a non-toxic event. 2,758

(5.2%) cases could not be followed.

In 2005, 9,288 (17.5%) poison exposures were followed to determine the medical outcome of the poisoning.

Below are the results for those cases by category of medical outcome.

Summary of death casesThe deaths listed below are those cases reported to the Poison Center by health care facilities for the

management of a suspected poisoning that resulted in a fatal outcome. In those cases where several substances

were ingested, the cause of death was determined by the substance deemed to have had the most toxic effect.

��

A g E M A l E F E M A l E S u b S TA N C E

0 - 5 0 0

6 - 1 2 1 0 c a r b o n M o n o x i d e

1 3 - 1 9 1 1 s e p s i s ( p o i s o n i n g r u l e d o u t ) , a c e ta M i n o p h e n

2 0 - 2 9 2 2 e t h a n o l , c o c a i n e , t r i c y c l i c a n t i d e p r e s s a n t s , o p i o i d , v e n l a fa x i n e

3 0 - 3 9 6 0 a M i t r i p t y l i n e , a c e ta M i n o p h e n ( 2 ) , a s p i r i n , c o c a i n e , h e r o i n

4 0 - 4 9 4 5 d o x e p i n , a c e ta M i n o p h e n ( 3 ) , M e t h a n o l , M e t h a d o n e , v e r a pa M i l , d i Q u at, t r i p ta n s

5 0 - 5 9 5 4 e t h y l e n e g ly c o l , M e t o p r o l o l ( 2 ) , n i f e d i p i n e e r , a c e ta M i n o p h e n ( 2 ) t r i c y c l i c

a n t i d e p r e s s a n t, M e t h a n o l , c a r i s o p r o d o l , a s p i r i n

6 0 - 6 9 2 1 a c e ta M i n o p h e n , a s p i r i n , g ly b u r i d e

7 0 - 7 9 0 0

8 0 - 8 9 0 1 at e n o l o l , n i f e d i p i n e

t o ta l ( 3 5 ) 2 1 1 4

The relatively small number of deaths reported to the Poison Center does not accurately represent the true

significance of poisonings as a cause of acute injury and death in the region. In fact, poisonings are the

leading cause of injury death among both Massachusetts and Rhode Island residents. In 2003, there were

836 (75 unintentional, 87 intentional, 674 undetermined) poisoning fatalities in Massachusetts and 156 (13

unintentional, 25 intentional, 118 undetermined) in Rhode Island, as reported by death certificate data.

Serious injuries due to poisonings are an area of significant of

concern. In 2004, in Massachusetts, there were 6,881 non-fatal

poisonings reported to the Massachusetts Hospital Discharge

and Observation Stay Databases, and almost 12,904 emergency

department discharges (6,600 unintentional, 3,595 intentional,

2,674 undetermined, 29 assault related, 6 other).

Many cases of poison fatalities are never reported to the poison

center. Law enforcement, first responders, medical examiners, or

a c e ta M i n o p h e n :2 6 %

Misc: 14%

antifreeze: 11%

drugs ofabuse: 14%

c a r d i a c : 1 1 %

antidepressant:11%

a s p i r i n : 9 %

carbon Monoxide: 3%

�7

other health care professionals that are the initial contact with poisoned patients, may not call the center to

report the poisoning when treatment advice is not required or when the patient is determined to be dead on

arrival. Overdoses of abused substances may also go unrecognized as a significant poisoning issue. In 2004,

the Massachusetts Department of Public Health and the Rhode Island Department of Health reported 17,704

and 1,790 hospital discharges related to opioid abuse respectively. During that year, the Poison Center was

called regarding only 702 (4%) of these cases.

A look to the future... The majority of poisonings are preventable. The Regional Center for Poison Control and Prevention

works to reduce the number of poisonings that occur through outreach and the dissemination of educational

materials to the public. These programs are a vital component of what must necessarily be a multifaceted and

comprehensive prevention system and public awareness campaign. Continued efforts in primary prevention

are needed in the areas of environmental modification (e.g. locks on cabinets, safety caps, manufacturing

of pills), policy (e.g. monitoring prescription drug dispensing, and drug enforcement by public safety), and

educational initiatives performed by other public health professionals, such as pharmacists and clinicians.

The Poison Center will continue to be unique in the region for its combined participation in the medical

management of actual poisonings and national real-time surveillance of potential poisonings, as well as for its

professional training and public education programs. As such, the Center is a valuable resource that seeks to

address such critical issues as potential bioterrorism events, environmental exposures, and trends in substance

abuse.

Appendices

�8

A

�9

Appendix A� 0 0 5 o r g A N I z AT I o N A l C h A rT

B

�0

Angela Anderson, MD

Rhode Island Hospital

Andrew Erickson

Retired: AMICA Insurance

Anara Guard

Education Development Center

Daniel Halpen-Rueder, MD

Emergency Medicine Physician

Stacy Inman

CVS

Kristi Kangas

Children’s Hospital Boston, Injury Prevention

Maria Kostka-Rokosz, RPh

Massachusetts College of Pharmacy

William Lewander, MD

Rhode Island Hospital

Jeff Newell

Quality Partners of Rhode Island

Kathy Stimson

Springwell

Taranjeeve Walia

Children’s Hospital Boston, Injury Prevention

Kristina Ward, PharmD

Rhode Island College of Pharmacy

Susan Webb

Massachusetts Medical Society

hEAlThDEPArTMENTrEPrESENTATIVES

Massachusetts Department of Public Health

• Sally Fogerty, Assistant Commissioner

• Cynthia Rodgers, Director,

Injury Prevention and Control Program

• Janet Berkenfield, Director,

Emergency Medical Services for Children

Rhode Island Department of Health

• Dhitinut Ratnapradipa, PhD

Environmental Health Program Manager

• Robert Vanderslice, PhD

Chief of Office of Environmental Health Risk

Assessment

• L. Anthony Cirillo, MD

Interim Director, Center for Emergency

Preparedness

• Peter Leary, MD

Chief of Emergency Medical Services

• William Hollinshead, MD

Medical Director, Familiy Health Division

rEgIoNAlPoISoNCENTErrEPrESENTATIVES

• Michele Burns Ewald, MD

• Mary Hochstin, MBA

• Aarthi Iyer, MPH

• Deborah Turner, MS

Appendix BA D V I S o rY C o M M I T T E E

C

��

Appendix CM o S T C o M M o N S u b S TA N C E S b Y C AT E g o rY

P E r C E N TA g E o F E X P o S u r E S T o A l l S u b S TA N C E S T o TA l P E r C E N TA g E

C o S M E T I C S / P E r S o N A l C A r E P r o D u C T S

d e n ta l c a r e p r o d u c t s 8 0 2 1 . 1

h a i r c a r e p r o d u c t s 5 2 5 0 . 7

M o u t h Wa s h 6 4 0 0 . 9

n a i l p r o d u c t s 5 8 2 0 . 8

c l e a n s i n g / l o t i o n s 3 , 4 9 3 4 . 8

o t h e r 3 9 3 0 . 5

C AT E g o rY T o TA l � , � � 5 8 . 8

C l E A N I N g S u b S TA N C E S ( h o u S E h o l D )

d i s h Wa s h e r d e t e r g e n t s 5 6 3 0 . 8 %

b l e a c h e s 1 , 0 1 0 1 . 4 %

h o u s e h o l d c l e a n s e r s 1 , 6 5 4 2 . 3 %

l a u n d ry 4 8 8 0 . 7 %

M i s c e l l a n e o u s c l e a n e r s 1 , 0 2 7 1 . 4 %

C AT E g o rY T o TA l � , 7 � � � . 5 %

F o r E I g N b o D I E S / T o Y S / M I S C E l l A N E o u S

d e s i c c a n t 7 3 0 1 . 0

g l o W p r o d u c t s 3 9 5 0 . 5

t o y s 3 3 1 0 . 5

t h e r M o M e t e r s 3 3 2 0 . 5

o t h e r 1 , 3 0 5 1 . 8

C AT E g o rY T o TA l � , 0 9 � � . �

P l A N T S

g a s t r o i n t e s t i n a l i r r i ta n t s 3 7 4 0 . 5

n o n - t o x i c 3 2 7 0 . 4

o t h e r 1 , 3 1 4 1 . 8

C AT E g o rY T o TA l � , 0 � 5 � . 7

P E S T I C I D E S

h e r b i c i d e s 1 0 6 0 . 1

i n s e c t i c i d e s 1 , 0 4 8 1 . 4

r e p e l l e n t s 4 8 9 0 . 7

r o d e n t i c i d e s 2 7 5 0 . 4

o t h e r 1 9 0 . 0

C AT E g o rY T o TA l � , 9 � 7 � . �

P E r C E N TA g E o F E X P o S u r E S T o A l l S u b S TA N C E S T o TA l P E r C E N TA g E

A N A l g E S I C S

a c e ta M i n o p h e n 3 , 5 2 1 4 . 8

a s p i r i n 4 3 3 0 . 6

o p i o i d s 9 7 5 1 . 3

i b u p r o f e n 1 , 8 8 6 2 . 6

n a p r o x e n 2 4 7 0 . 3

o t h e r 3 0 7 0 . 4

C AT E g o rY T o TA l 7 , � � 9 � 0 . �

C o l D A N D C o u g h P r E PA r AT I o N S

d e x t r o M e t h o r p h a n 1 , 4 0 6 1 . 9

W i t h o u t o p i o i d 7 8 3 1 . 1

o t h e r 2 1 9 0 . 3

C AT E g o rY T o TA l � , � 0 8 � . �

S E D AT I V E / h Y P N o T I C S / A N T I P S Y C h o T I C S

atypical antipsychotic 1,228 1.7

benzodiazepine 1,934 2.6

other 582 0.8

C AT E g o rY T o TA l � , 7 � � 5 . �

A N T I D E P r E S S A N T S

a M i t r i p t y l i n e 1 9 2 0 . 3

l i t h i u M 1 9 4 0 . 3

seratonin re-uptake inhibitors 1 , 1 7 6 1 . 6

t r a z o d o n e 4 7 4 0 . 6

o t h e r 6 4 0 0 . 9

C AT E g o rY T o TA l � , � 7 � � . 7

T o P I C A l P r E PA r AT I o N S

d i a p e r c a r e / r a s h p r o d u c t 1 , 3 0 6 1 . 8

t o p i c a l s t e r o i d 2 8 1 0 . 4

o t h e r 9 9 7 1 . 4

C AT E g o rY T o TA l � , 5 8 � � . 5

The following tables describe the incidence of the most common exposures reported to the Center, divided by

pharmaceutical (drug) and non-pharmaceutical (non-drug) substances and by frequency of the most common

substances within each category. For each substance listed, both the number of cases in which it was involved

and the percentage of all substance exposures is listed. Some poisoning cases involve multiple exposures. As

a result, in 2005 there were 73,305 exposures to individual substances among the 53,031 exposure calls the

Center received.

D

��

Appendix Dh o S P I TA l C A l l E r S

h o S P I TA l S I N M A S S A C h u S E T T S C A l l S : � 0 0 5

(Funding partners in bold)

Addison Gilbert 57

Anna Jaques 102

Athol Memorial Hospital 48

Bay State Medical Center 252

Berkshire Medical Center 81

Beth Israel Deaconess Medical Center 62

Beverly Hospital 159

Boston Medical Center 336

Brigham & Women's Hospital 75

Brockton Hospital 228

Burbank Hospital 2

Cambridge Hospital 150

Cape Cod Hospital 66

Caritas Holy Family Hospital 105

Charlton Memorial Hospital 62

Carney Hospital 113

Children's Hospital Boston 202

Clinton Hospital 5

Cooley Dickinson Hospital 53

Dana Farber Cancer Insitute 0

Emerson Hospital 12

Fairview Hospital 16

Falmouth Hospital 29

Faulkner Hospital 26

Franklin Medical Center 23

Fransician Hospital 3

Good Samaritan Medical Center 97

Harrington Memorial Hospital 111

Heywood Hospital 125

h o S P I TA l S I N M A S S A C h u S E T T S C A l l S : � 0 0 5

Holyoke Hospital 57

Hubbard Regional Hospital 34

Jordan Hospital 91

Lahey Clinic 88

Lawrence General Hospital 57

Lawrence Memorial Hospital 60

Leominster Hospital 28

Lowell General Hospital 52

Malden Hospital 1

Marlborough Hospital 18

Martha's Vineyard Hospital 35

Mary Lane Hospital 7

Mass Eye and Ear Infirmary 3

Massachusetts General Hospital 175

McLean Hospital 0

Melrose Wakefield 92

Mercy Hospital 37

Merrimac Valley Hospital 77

Metrowest Medical Center 203

Milford Regional Medical Center 34

Milton Hospital 35

Morton Hospital & Medical Center 124

Mount Auburn Hospital 131

Nantucket Cottage Hospital 40

New England Baptist 1

New England Medical Center (NEMC) 56

Newton Wellesley 84

Noble Hospital 186

North Adams Regional 21

North Shore Medical Center 168

��

h o S P I TA l S I N M A S S A C h u S E T T S C A l l S : � 0 0 5

Norwood Hospital (Caritas) 162

Quincy Medical Center 111

Saint Anne's Hospital 108

Saint Elizabeths' Medical Center 51

Saint Luke's Hospital (Southcoast) 169

Saints Memorial Medical Center 39

Somerville Hospital 47

South Shore Hospital 160

Stillman Infirmary-Harvard University 1

Sturdy Memorial Hospital 67

Tobey Hospital 24

Union Hospital 104

Univ of Massachusetts Medical Center 129

VA Bedford 3

VA Brockton 2

VA Jamaica Plain 2

VA Northampton 3

VA West Roxbury 12

Whidden Memorial Hospital 167

Winchedon Hospital 1

Winchester Hospital 149

Wing Memorial 42

Worcester Medical Center 110

h o S P I TA l S I N r h o D E I S l A N D C A l l S : � 0 0 5

Butler Hospital 6

Emma Pendleton Bradley Hospital 1

Kent County Memorial Hospital 271

Landmark Medical Center 102

Memorial Hospital of RI 156

Newport Naval Hospital 1

RI Hospital/HASBRO 480

Roger Williams Hospital 51

South County Hospital 96

St. Joseph (Fatima) 49

The Miriam Hospital 76

The Westerly Hospital 65

VA RI Hospital (Providence VA Medical Center) 8

Woman & Infants Hospital 8

E

��

Appendix EP u b l I C AT I o N S � 0 0 5

Osterhoudt K, Burns Ewald M, et al. Toxicologic Emergencies. Textbook of Pediatric Emergency Medicine 5th ed.

Philadelphia: Lippincott Williams & Wilkins, 2005: 951-1007

Burns Ewald M, Baum C. Environmental Emergencies. Textbook of Pediatric Emergency Medicine 5th ed.

Philadelphia: Lippincott Williams & Wilkins, 2005: 1009-1031

Saidinejad M, Burns Ewald M. Ocular Irrigation Alternatives in Pediatric Emergency Medicine. Pediatric

Emergency Care 2005: 21 (1): 23-26

Evans J, Burns Ewald M. Pyomyositis: A Fatal Case in a Healthy Teenager. Pediatric Emergency Care 2005: 21

(6): 1-3

Saidinejad M, Burns Ewald M, Shannon M. Transient psychosis in an immune competent patient after oral

trimethoprim-sulfamethoxazole administration. Pediatrics 2005: 115 (6) e739-741

Lai MW, Boyer, EW, Kleinman ME, Rodig, NM, Burns Ewald M. Acute Arsenic Poisoning in Two Siblings.

Pediatrics 2005:116 (1): 1-9

Boyer EW, Shannon M, HIbberd PL. The Internet and Psychoactive Substance Use Among Adolescents. Pediatr.

2005: 115: 302-305

�5

James C, Bourgeois F, Shannon M. The Influence of Race/Ethnicity on Emergency Department Waiting Times.

Pediatr. 2005: http://pediatrics.aappublications.org/cgi/content/full/115/3/e310

Cohen MH, Hrbek A, Davis RB, Schacter SC, Kemper K, Boyer EW, Eisenberg DM. Emerging credentialing

practices, malpractice liability policies, and guidelines governing complementary and alternative medical practices

and dietary supplement recommendations. A descriptive study of 19 integrative health care centers in the United

States. Archives of Internal Medicine. 2005:165:289-296

Bird SB, Orr PG, Mazzola JL, Brush DE, Boyer EW. Levofloxacin-related seizure activity in a patient with

Alzheimer’s disease: Assessment of potential risk factors. J Clinical Psychopharmacology. 2005: 25:287-89

Boyer EW, Shannon M. The Serotonin Syndrome, New England Journal of Medicine. 2005: 352:1111-1119

1955 boston poison control center established. first of its kind in the state and third center in the nation.

1955 – 1978 additional poison control centers established in Worcester, fall river, new bedford and springfield.

1973 congress passed the national emergency Medical services system act.

1976 Massachusetts department of public health appointed a poison committee to create a statewide poison system.

1978 Massachusetts poison control system replaced the local poison centers.

1981 rhode island poison center began operations as a community service funded by rhode island hospital.

january 1999 lifespan, through its affiliate rhode island hospital, announced closing the rhode island poison center.

March 1999 rhode island general assembly allocated state funding for poison center services.

august 1999 Massachusetts and rhode island departments of health issued joint request for proposals for poison center services.

january 2000 regional center for poison control and prevention serving Massachusetts and rhode island established at children’s hospital.

february 2000 president clinton signed into law the poison control center enhancement and awareness act,

which allocated federal funding to poison centers.

March 2000 Massachusetts and rhode island departments of health convened first meeting of the regional poison center advisory committee.

september 2001 the regional center for poison control and prevention was awarded a three-year stabilization grant and a two-year competitive

grant for the first time through the poison control center enhancement and awareness act

january 2002 the new toll-free phone number (1-800-222-1222) was launched nationwide.

january 2002 the regional center for poison control and prevention began taking calls from the state of new hampshire during the overnight hours.

september 2002 the 1st new england regional toxicology conference was held in sturbridge, Massachusetts

March 2003 the regional center for poison control and prevention held legislative awareness events at the Massachusetts and

rhode island state houses during poison prevention Week to draw attention to our funding needs.

june 2003 us food and drug administration subcommittee voted, 6 to 4, in favor of removing ipecac from over-the-counter status.

september 2003 the regional center for poison control and prevention was awarded a two-year competitive grant for the second time through the

poison control center enhancement and awareness act.

september 2003 the 2nd annual new england regional toxicology conference was held in storrs, ct.

november 2003 american academy of pediatrics announced its new policy on "poison treatment in the home". it recommends that syrup of ipecac

should no longer be used routinely as a residential poison treatment intervention.

december 2003 president bush signed into law p.l. 108-194, the poison control center enhancement and awareness act amendments of 2003,

reauthorizing p.l. 106-174.

april 2004 the institute of Medicine publishes its report ForgingaPoisonPreventionandcontrolSystem that encourages integrating poison

control services into the federal and state public health infrastructure.

March 2005 celebrated 50th anniversary of the poison control center in boston

Historical Timeline

r E g I o N A l C E N T E r F o r P o I S o N C o N T r o l A N D P r E V E N T I o N

S E r V I N g M A S S A C h u S E T T S & r h o D E I S l A N D

children’s hospital boston, 300 longWood avenue, boston, Ma 02115 , 800-222-1222

W W W. M a r i p o i s o n c e n t e r . o r g

1-800-222-1222