Faces of Public Health: Henry Spiller, Director, Kentucky Regional Poison Control Center
March 18-24 is the 50th anniversary of National Poison Prevention Week. More than 2 million poisonings are reported each year to the 57 poison control centers across the country.
In 1972, more than 200 children in the U.S. died as a result of poisoning. By 2007, that number dropped to 39. However, deaths in other age groups have risen dramatically and poisoning is the leading cause of death from unintentional injuries in the United States—ahead of motor vehicle crashes and guns.
Tips to prevent poisonings include:
- Store your medicines in a place that is too high for a child to reach or see.
- Use only rat and mouse control household products that are contained in a tamper-resistant bait station (not loose bait and pellets), to protect children from exposure to the bait.
- Ask houseguests and visitors to keep purses, bags or coats that have medicines in them up and away and out of sight when they are in your home.
- Keep cleaning supplies and medicines locked up and away from children.
- Call your local poison center right away if a battery is missing from a toy or other household item. A swallowed button battery can be deadly for a child.
- Keep the national Poison Help Line phone number posted in a prominent place in your house and stored in your cell phone. The number is 800-222-1222 and connects you to your local poison center 24 hours a day, 7 days a week, and 365 days a year.
- Download the iPhone app from the American Association of Poison Control Centers.
In observance of National Poison Prevention Week, NewPublicHealth spoke with Henry Spiller, MS, director of the Kentucky Regional Poison Control Center.
NewPublicHealth: The critical task that is best known about poison control centers it that they are manned 24/7 by experts who can answer questions about possible poisonings, and manage emergencies. Do you also have a community education role?
Henry Spiller: Yes, there are a number of things we do in the community. We let people know about the service of the center because a great deal of the value is the public accessing us. We reduce health care utilization. In many cases we can manage them outside of the health care facility, but to do that they have to call us. An example is we recognized over a 10-year period we had a 500% increase in insulin errors in adults, and that’s partially because between 2000 and 2010, there was an increase in type 2 diabetes, but also a change in how to treat type 2 diabetes. It used to be called non-insulin dependent diabetes. Now actually they use insulin in many of these cases.
With insulin you take different doses in the morning when you’re going to be active and have meals than you take at night when you’re going to stop eating and essentially your level of physical activity decreases. So you tailor the doses and you tailor the type of insulin you use, and we found that so many people would make errors such as using their morning dose at night, which can result in severely low blood sugar levels. They get confused about which ones to use, or don’t have their glasses on and choose the wrong one.
Because the calls became so common, we found we could monitor many people at home, without sending them to the emergency room, so long as there was someone at home to check their glucose, and answer when we called to check up. And to help reduce the errors, we gave out information to the pharmacists association so that people could be reminded how to use insulin when they purchased it.
NPH: How does your workload break down? What percentage of what you do is individual calls to the center and what percentage is public and professional education?
Henry Spiller: I do the professional education; we have one person taking care of public education and 14 doctors, nurses and pharmacists who rotate on calls.
NPH: What are the most common issues you’d like to public to be aware of and prevent?
Henry Spiller: Especially in households with children, we want people to keep medicine and cleaning supplies locked up and high. There has been a dramatic decline in childhood poisonings since the 1960s, when the Consumer Product Safety Commission required child resistant closures, but it is slowly beginning to rise.
NPH: Do you know why?
Henry Spiller: It’s not going to get back to the level it was in the ‘60s, but I think we’ve got everything we’re going to get out of child resistant closures, and they’re very, very important, but now we have to go after the human element. Those products that can be dangerous and lethal are easily available. When we’re talking about young children, it’s their job to be curious, so parents have to keep away products that can be harmful.
And what’s important is that we have to keep reinforcing that message because new people become parents every year, and the issue of poison control wasn’t important to them before, so we have to be able to continually reach new people. Among our efforts, in Kentucky and at other centers, are packets on poison prevention for parents when the mom is discharged.
NPH: In addition to insulin, what are the poison concerns among adults?
Henry Spiller: Among adults from middle age on, we find that they are often taking multiple drugs and call us about missing doses, extra doses and combining drugs and non-prescription medicines, among other concerns.
And the greatest concern we have right now is the almost epidemic issue of prescription drug abuse, what we call prescription drug diversion. With prescription drug abuse, it’s a whole subculture. It’s sold, it’s sought after. In some cases it’s stolen from legitimate patients by drug-seeking patients.
NPH: What’s your public education effort?
Henry Spiller: We’re working with groups in the community to educate the public. We promote drug take-backs, where people can bring in prescription medicines that are no longer needed by the person for whom they were prescribed. And if there’s no public take-back scheduled in your area, the poison control center can tell you where to take the drugs, or how to safely dispose of them.
NPH: Are there new ways you’re communicating with the public?
Henry Spiller: We, and many other centers do too, have Facebook pages where we post information that is relevant to the time period. We’re going to start writing about insect bites and stings shortly.
NPH: So you would agree that one of the best friends you can have on Facebook is your local poison control center?
Henry Spiller: Yes, if you could put that in there we’d appreciate it.