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2012 Annual Report for The Oregon Poison Center
The Oregon Poison Center (OPC) is the designated regional poison center for Oregon, Alaska, and Guam. In 2012, the poison center received 53,425 total calls from throughout this region. The vast majority of calls involved exposures to potentially toxic and poisonous substances. The remaining calls involved requests for information. Figure 1 shows a breakdown of call types. Figure 2 details the type of information calls received by OPC. Most calls originate from the public, seeking initial advice prior to any other contact with health care providers. A breakdown of caller sites for human exposure cases is shown in Figure 3.
Pediatric accidental poisoning continues to represent a significant proportion of calls to the OPC, with 23,200 cases reported to the Oregon Poison Center last year. Adults over 19 years of age represented 35% of cases (Figure 4). Pharmaceuticals represent the most common category of exposure, resulting in 76% of calls, and represent the most serious poisoning incidents. The most common substances of exposure for all age groups are shown in Figure 5. Pediatric exposures usually involve substances that are readily accessible and prevalent in the home environment. Personal care products, such as cosmetics, dental products, shampoo and perfume; represent the most frequent source of exposure for children. Analgesics continue to represent a significant risk for pediatric poisoning (Figure 6).
The majority of cases handled by the poison center can be effectively managed at home, with careful ongoing follow-up calls by the poison center nursing staff. In these cases, the nurses provide home treatment advice and instruction regarding symptoms of concern. Safe and effective management of these cases at home saves significant health care costs, and is one of the reasons that poison centers are such an important health care resource. If a poisoning has potential serious complications and cannot be safely treated at home, referral arrangements are made with the nearest emergency department for evaluation and treatment. The poison center staff continues to monitor the patient condition and provide ongoing treatment advice in collaboration with the hospital staff throughout the patient's hospital stay. Figure 7 shows the treatment site of poisoning cases managed by the OPC. Many pediatric exposures require decontamination and observation in an emergency department. More serious poisoning incidents require hospital admission for longer observation, stabilization and treatment. The most serious poisonings and most fatalities occur in adults. Suicidal exposures and drug abuse remain the leading causes of life-threatening poisoning in Oregon as well as throughout the country. Prescription drug abuse is a rapidly growing national concern, effecting not only adults, but also teenagers. Between 2000 and 2009, death rates from unintentional poisoning increased, with a 91 percent increase among teens aged 15-19, largely due to prescription drug overdose according to a recent CDC report. Poisoning deaths exceed the number of motor vehicle-related deaths in the United States.
Substances that result in the greatest number of calls to the poison center do not always represent the most serious poisoning incidents. Figure 8 shows substances resulting in hospital visits for all ages. Figure 9 indicates substances involved in pediatric hospital visits.