Consistency Between Opioid-Related Mortality Trends Derived From Poison Center and National Vital Statistics System, United States, 2006-2016.

OBJECTIVES: To determine the association between poison center opioid exposure calls and National Vital Statistics System (NVSS) deaths. METHODS: We categorized Centers for Disease Control and Prevention NVSS mortality and the Researched Abuse, Diversion and Addiction-Related Surveillance System poison center program cases from 2006 to 2016 by International Classification of Diseases, Tenth Revision, codes (heroin [T40.1]; natural or semisynthetic opioids [T40.2]; methadone [T40.3]; synthetic opioids, other than methadone [T40.4]). We scaled rates by 100 000 population and calculated Pearson correlation coefficients. Sensitivity analysis excluded polysubstance cases involving either heroin or synthetic opioids as well as natural and semisynthetic opioids. RESULTS: The NVSS mortality and poison center program exposure rates showed similar trends from 2006 to 2012, and diverged after 2012 for all opioids combined, natural and semisynthetic opioids, and synthetic opioids (r = -0.37, -0.12, and 0.30, respectively). Sensitivity analysis with removal of heroin or synthetic opioid polysubstance deaths markedly improved correlations for all opioids combined and natural and semisynthetic opioids (r = 0.87 and 0.36, respectively). CONCLUSIONS: The NVSS mortality and poison center exposure rates showed similar trends from 2006 to 2012 then diverged, with sensitivity analysis suggesting polysubstance cases also involving heroin or illicit fentanyl as the cause. Public Health Implications. The NVSS and poison center program may provide complementary data when trends diverge. Public health interventions must include both licit and illicit opioids for maximal impact.

[Analysis of data from Poison Control Centers in Rio de Janeiro, Brazil, for use in public health activities]. / Análise dos dados dos Centros de Controle de Intoxicação do Rio de Janeiro, Brasil, como subsídio às ações de saúde pública.

Health information systems should be sources of reliable and valid data that can be used for surveillance to reduce morbidity and mortality. Unintentional poisoning is highly relevant to public health, since it is the most frequent cause of emergency pediatric care. Information on such events is recorded in Poison Control Centers (PCCs). The current study analyzed the records on unintentional poisoning with household cleaning products in two PCCs in the State of Rio de Janeiro, Brazil, in 2000-2002. The variables analyzed were gender, age, cause of the accident, exposure route, toxic agent, and outcome. In the 2,810 records studied, boys four years and younger were the most vulnerable group and oral ingestion was the most common exposure route. However, analysis of the data on the toxic agent, cause, and outcome showed that the data currently recorded in the PCCs are inconsistent. It is necessary to review the definitions used by the PCCs in order for the resulting data to effectively support public health measures and health surveillance policies.

Análise dos dados dos Centros de Controle de Intoxicação do Rio de Janeiro, Brasil, como subsídio às ações de saúde pública / Analysis of data from Poison Control Centers in Rio de Janeiro, Brazil, for use in public health activities

Os sistemas de informação em saúde devem ser fonte de informações confiáveis e válidas, para que possam ser utilizadas pelos sistemas de vigilância para reduzir morbidade e mortalidade na população. Intoxicação não intencional é de interesse para a saúde pública, uma vez que é a principal causa de atendimento de emergência pediátrica. As informações sobre estes eventos estão registradas nos Centros de Controle de Intoxicações (CCIs). Este estudo analisou os registros de intoxicações não intencionais com produtos saneantes domissanitários existentes nos dois CCIs do Estado do Rio de Janeiro, Brasil, no período de 2000-2002. As variáveis analisadas foram sexo, idade, causa do acidente, via de exposição, agente tóxico e evolução do caso. Nos 2.810 registros estudados foi identificada a população vulnerável de meninos até quatro anos e a via de exposição (oral). Entretanto, a análise dos dados relativos ao agente tóxico, causa e evolução demonstrou que os dados registrados atualmente nos CCIs são inconsistentes. Há necessidade de revisar as definições adotadas pelos CCIs para que as informações geradas possam ser efetivas em subsidiar ações e políticas de vigilância sanitária.

Health information systems should be sources of reliable and valid data that can be used for surveillance to reduce morbidity and mortality. Unintentional poisoning is highly relevant to public health, since it is the most frequent cause of emergency pediatric care. Information on such events is recorded in Poison Control Centers (PCCs). The current study analyzed the records on unintentional poisoning with household cleaning products in two PCCs in the State of Rio de Janeiro, Brazil, in 2000-2002. The variables analyzed were gender, age, cause of the accident, exposure route, toxic agent, and outcome. In the 2,810 records studied, boys four years and younger were the most vulnerable group and oral ingestion was the most common exposure route. However, analysis of the data on the toxic agent, cause, and outcome showed that the data currently recorded in the PCCs are inconsistent. It is necessary to review the definitions used by the PCCs in order for the resulting data to effectively support public health measures and health surveillance policies.

Quality assurance: how it can help a poison information center.

Quality assurance (QA) has become a benchmark program for health care in the 1980's. We have developed and implemented an innovative poison information center (PIC) QA program which includes: a peer review system of the PIC's medical records; a detailed routing system of medical records that allows for immediate access to cases involving business and industry accounts, on-going research, hospitalization, etc; and a standardized list of abbreviations for documentation of PIC medical records. The program additionally provides secondary gains of improving internal communications between the PIC staff and provides an excellent source of professional continuing education relative to poison management. QA is an essential program for all PIC's.