Poison Control Centers and Agricultural Health: Missed Opportunities for Surveillance and Prevention?

  • McKnight, Robert;
  • Levine, E. J.;
  • Mays, J. R.;
  • Rodgers, G. C.

Poison control centers are an untapped resource in the effort to detect and prevent agricultural poisonings. The nation's 68 regional poison centers provide services in 39 states through 24-hour telephone assistance to physicians and the general public. At each center, reports of suspected poisonings are recorded in a toxic-exposure surveillance system and indexed by implicated agent. This index lists many toxic agents found in agriculture, including plants, agricultural chemicals and veterinary drugs. In addition to surveillance, poison centers provide prevention services. The alliance of poison centers and agricultural health initiatives appears weak. Only a few agricultural studies have used data from poison centers; we found even fewer examples in which poison center resources were used to prevent agricultural poisonings. We give three examples from the University of Kentucky/Southeast Center and the Kentucky Regional Poison Center to illustrate how a partnership with a poison center can be mutually beneficial to each institution's mission.

Our first study, in 1992, estimated the ratio of agricultural work poisonings to all occupational poisonings reported in Kentucky. A random sample (n=216) was selected from the 1439 occupational poisonings reported during a 12-month period. Of these, 160 cases received follow-up calls; 11.2% were determined to be agricultural. Implicated toxins included tobacco plants, agricultural chemicals and pesticides.

A second study, in 1993, reviewed agricultural poisonings from the tobacco plant Nicotiana tabacum, for 1990-1993. Analysis showed these reports of acute nicotine poisoning (Green Tobacco Sickness) to cluster in both time and space. Most calls to the poison center were received between 8 PM and 2 AM, and a disproportionate number originated from six contiguous tobacco-producing counties in Central Kentucky.

In a third project, in the summer of 1993, the Southeast Center coordinated prevention activities for Green Tobacco Sickness (GTS) through the Kentucky Regional Poison Center. Poison Center staff conducted follow-up interviews with 120 suspected GTS patients and the physicians and hospitals who reported the cases, and also distributed notices to hospitals regarding the treatment of GTS.

We urge other agricultural centers, health departments and extension services to develop links with their poison centers, as such actions will assist in the surveillance and prevention of agricultural poisonings.

This research abstract was extracted from a portion of the proceedings of "Agricultural Safety and Health: Detection, Prevention and Intervention," a conference presented by the Ohio State University and the Ohio Department of Health, sponsored by the Centers for Disease Control/National Institute for Occupational Safety and Health.

The authors noted above are from: R.H. McKnight, J.R. Mays & G.C. Rodgers, University of Kentucky, Lexington, KY; E.J. Levine, Kentucky Regional Poison Center, Louisville, KY.

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