Toxicology
2004 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System

https://doi.org/10.1016/j.ajem.2005.05.001Get rights and content

Introduction

Toxic Exposure Surveillance System (TESS) data are compiled by the American Association of Poison Control Centers (AAPCC) on behalf of the US poison centers. These data are used to identify hazards early, focus prevention education, guide clinical research, direct training, and detect chemical/bioterrorism incidents. TESS data have prompted product reformulations, repackaging, recalls, and bans; are used to support regulatory actions; and form the basis of postmarketing surveillance of newly released drugs and products.

From its inception in 1983, TESS has grown dramatically, with increases in the number of participating poison centers, population served by those centers, and reported human exposures (Table 1A) [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21].

The cumulative AAPCC database now contains 38.7 million human poison exposure cases. This report includes 2 438 644 human exposure cases reported by 62 participating poison centers during 2004, an increase of 1.8% compared to 2003. The data do not directly identify a trend in the overall incidence of poisonings in the United States because the percentage of poisonings reported to poison centers is unknown (Fig. 1).

Section snippets

Characterization of participating centers

Of the 62 reporting centers, 60 submitted data for the entire year. Fifty-two of the 62 participating centers were certified as regional poison centers by the AAPCC at the end of 2004. The annual human exposure case volume by center ranged from 12 124 to 111 242 (mean 40 521) for centers participating for the entire year. The number of human poison exposure cases reported per 1000 population per year was calculated by state and ranged from 5.5 to 18.1 (mean 8.3) reported exposures per 1000

Review of the data

No changes to the data collection format were implemented in 2004. Prior revisions occurred in 1984, 1985, 1993, 2000, 2001, and 2002. Data reported after January 1, 2000, allow an unlimited number of substances for each case, a factor that should be considered when comparing substance data with prior years.

Of the 2 438 644 human exposures reported in 2004, 92.7% occurred at a residence (Table 2). Exposures occurred in the workplace in 2.0% of cases, in schools (1.4%), health care facilities

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The American Association of Poison Control Centers gratefully acknowledges the generous financial contribution of McNeil Consumer and Specialty Pharmaceuticals in support of the compilation and production of this report. The compilation of these data was also supported, in part, by the US Centers for Disease Control and Prevention, Cooperative Agreement U50/CCU323406-02.

US poison centers make possible the compilation and reporting of this comprehensive description of human exposures to potentially toxic substances through their meticulous documentation of each case using standardized definitions and compatible computer systems. Participating centers include the Regional Poison Control Center, Birmingham, AL; Alabama Poison Center, Tuscaloosa, AL; Arizona Poison and Drug Information Center, Tucson, AZ; Banner Poison Control Center, Phoenix, AZ; Arkansas Poison and Drug Information Center, Little Rock, AK; California Poison Control System–Fresno/Madera Division, CA; California Poison Control System–Sacramento Division, CA; California Poison Control System–San Diego Division, CA; California Poison Control System–San Francisco Division, CA; Rocky Mountain Poison and Drug Center, Denver, CO; Connecticut Poison Control Center, Farmington, CT; National Capital Poison Center, Washington, DC; Florida Poison Information Center, Tampa, FL; Florida Poison Information Center, Jacksonville, FL; Florida Poison Information Center, Miami, FL; Georgia Poison Center, Atlanta, GA; Illinois Poison Center, Chicago, IL; Indiana Poison Center, Indianapolis, IN; Iowa Statewide Poison Control Center, Sioux City, IA; Mid-America Poison Control Center, Kansas City, KA; Kentucky Regional Poison Center, Louisville, KY; Louisiana Drug and Poison Information Center, Monroe, LA; Northern New England Poison Center, Portland, ME; Maryland Poison Center, Baltimore, MD; Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island, Boston, MA; Children's Hospital of Michigan Regional Poison Control Center, Detroit, MI; DeVos Children's Hospital Regional Poison Center, Grand Rapids, MI; Hennepin Regional Poison Center, Minneapolis, MN; Mississippi Regional Poison Control Center, Jackson, MS; Missouri Regional Poison Center, St Louis, MO; Nebraska Regional Poison Center, Omaha, NE; New Hampshire Poison Information Center, Lebanon, NH; New Jersey Poison Information and Education System, Newark, NJ; New Mexico Poison and Drug Information Center, Albuquerque, NM; New York City Poison Control Center, New York, NY; Long Island Regional Poison and Drug Information Center, Mineola, NY; Finger Lakes Regional Poison and Drug Information Center, Rochester, NY; Central New York Poison Center, Syracuse, NY; Western New York Poison Center, Buffalo, NY; Carolinas Poison Center, Charlotte, NC; Cincinnati Drug and Poison Information Center, Cincinnati, OH; Central OH Poison Center, Columbus, OH; Greater Cleveland Poison Control Center, Cleveland, Ohio; Oklahoma Poison Control Center, Oklahoma City, OK; Oregon Poison Center, Portland, OR; Pittsburgh Poison Center, Pittsburgh, PA; The Poison Control Center, Philadelphia, PA; Palmetto Poison Center, Columbia, SC; Tennessee Poison Center, Nashville, TN; Southern Poison Center, Memphis, Tenn; Central Texas Poison Center, Temple, TX; North Texas Poison Center, Dallas, TX; Southeast Texas Poison Center, Galveston, TX; Texas Panhandle Poison Center, Amarillo, TX; West Texas Regional Poison Center, El Paso, TX; South Texas Poison Center, San Antonio, TX; UT Poison Control Center, Salt Lake City, Utah; Virginia Poison Center, Richmond, VA; Blue Ridge Poison Center, Charlottesville, VA; Washington Poison Center, Seattle, WA; West Virginia Poison Center, Charleston, WV; and Children's Hospital of Wisconsin Poison Center, Milwaukee, WI.

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