National Poison Data System
The National Poison Data System (NPDS) is the only comprehensive poisoning exposure surveillance database in the United States. Maintained by the American Association of Poison Control Centers (AAPCC), NPDS contains case information from calls placed to all 55 (January 1, 2012) poison centers across the U.S. Initiated in 1985, NPDS today has over 50 million case records and information on over 360,000 products. Annually, the nation’s 57 poison centers take over four million calls. All calls are entered into NPDS. These calls include data on over 2.5 million confirmed human exposures, animal exposures, information calls, and cases that were later confirmed to be non-exposures. Specialists in Poison Information (specially trained nurses, pharmacists, and physicians) at each poison center collect NPDS data on site immediately. Information is uploaded to NPDS from the poison centers approximately every 11 minutes. This advanced database acts as a protective screen for poison outbreaks across the country—methodically searching and analyzing potential poisoning trends ranging from contaminated peanut butter to biological warfare. Key regulatory agencies rely on NPDS data including the Centers for Disease Control and Prevention, Health Resources Services Administration, Food and Drug Administration, Environmental Protection Agency, Consumer Product Safety Commission and the Drug Enforcement Agency.
The information in the NPDS annual report reflects only those cases that are not duplicates and classified by the PC as CLOSED. A case is closed when the PC has determined that no further follow-up/recommendations are required or no further information is available. Exposure cases are followed to obtain the most precise medical outcome possible. Depending on the case specifics, most calls are “closed ” within a few hours of the initial call. Some calls regarding complex hospitalized patients or cases resulting in death may remain open for weeks or months while data continues to be collected. Follow-up calls provide a proven mechanism for monitoring the appropriateness of management recommendations, augmenting patient guidelines, and providing poison prevention education, enabling continual updates of case information as well as obtaining final/known medical outcome status to make the data collected as accurate and complete as possible.
61 poison control centers serving 304.1 million people (2008).
Comparison of exposure or outcome data from previous AAPCC Annual Reports is problematic. In particular, the identification of fatalities (attribution of a death to the exposure) differed from pre-2006 Annual Reports (see Fatality Case Review – Methods). Poison center death cases are described as all cases resulting in death and those determined to be poison related fatalities. Likewise, Table 22 (Exposure Cases by Generic Category) since year 2006 restricts the breakdown including deaths to single substance cases to improve precision and avoid misinterpretation. (see AAPCC annual reports of NPDS).
Clinical Toxicology (2009) 47, 911–1084 Copyright © American Association of Poison Control Centers ISSN: 1556-3650 print / 1556-9519 online DOI: 10.3109/15563650903438566