Clinical toxicology: past and future

Everyone needs an editor. – Tim Foote

It is traditional for the incoming Editor-in-Chief (EIC) of Clinical Toxicology to reflect, in print, on the past and to look to the future [1,2]. I am fortunate to inherit a journal with a long history of excellence. My tenure as Editor-in-Chief follows that of E. Martin Caravati, whose dynamic leadership has helped to improve the speed and quality of the peer-review process, expand the inclusion and quality of systematic reviews, and to guide the journal steadily through the changes and challenges of the past five years. As one example, Clinical Toxicology saw its Impact Factor (IF) increase from 2.21 in 2011 to 3.673 in 2014 [3]. Impact factor is an imperfect measure of a journal’s scientific quality – particularly in as small a field as toxicology – but a rising IF reflects the increasing value of our published work to those involved in advancing the science of our field. Dr. Caravati improved the readability and relevance of the journal in multiple ways. In addition to structural improvements, during Dr. Caravati’s tenure as EIC, the journal published important articles in basic and translational science [4], randomized, prospective clinical trials of new antidotes [5], systematic reviews [6], toxicological history [7], standardization of care [8], and public health [9]. Dr. Caravati moves on for personal reasons, but his contributions will be felt for a long time to come. I am most appreciative for the opportunity he gave me to become a decision-editor, the guidance and support he has provided in this transition, and to the friendship we have shared over many years.

It may be a cliché to say that we are in a time of rapid and unprecedented change, but that does not change the truth of that reality. Changes in the marketplace for scientific journals – how they are produced, accessed, and used – create challenges to continuing to provide our readership with high quality, scientific information in clinical toxicology. The transition to the publishing house of the Taylor & Francis Group and Charles Whalley as Managing Editor has given the journal the support and resources needed to continue to face these challenges.

The new year also sees the addition of the Asia Pacific Association of Medical Toxicology (APAMT) as one of our sponsoring societies, joining the American Academy of Clinical Toxicology (AACT), the European Association of Poison Centres and Clinical Toxicologists (EAPCCT), and the American Association of Poison Control Centers (AAPCC). Clinical Toxicologists from the Asia Pacific region have long been important contributors to the science of toxicology and to the journal. The addition of members from the APAMT to the editorial boards and other editorial positions adds new personnel, new experiences, and new expertise. Their inclusion as a sponsoring society will further improve the quality, scope, and reach of our journal.

I come to this position with professional and personal experiences which I believe have prepared me to meet this challenge. I performed bench science as an undergraduate, developing an appreciation of the process of scientific discovery. I practiced as an Emergency Physician for more than 20 years. Poisonings and envenomations were a daily occurrence and I saw first-hand the impact of toxicological exposures on individuals and on those around them. I lived and practiced in the southwest desert of the US, an area with a high rate of envenomations, and became an investigator in the clinical trials of new antivenoms. Through this work, and the process of disseminating the knowledge gained, I realized that I wanted an academic career and that toxicology was the field in which I wanted to continue to make my professional contribution. I entered a medical toxicology fellowship and have since worked as an academic medical toxicologist. I am the medical director of a US poison center, involved in clinical practice, public health, health professional and public education, scientific research and publication, and the regional, national, and international advancement of our field. Over time, I have also become involved in medical editing. Peer-reviewed, scientific journals are the trusted conduits of new, scientific knowledge.

Looking to the future, I see ongoing threats to individuals and to public health by envenomations [10], misused and abused pharmaceuticals [11], environmental and occupational exposures [12], and the rapid development of novel psychoactive substances, which are an ongoing challenge to detect, characterize, regulate, and treat [13]. There are content areas in toxicology where we have not published a large body of work and a number of areas of the world where Clinical Toxicology does not have a large readership or many scientific contributors. Expanding the focus and reach of the journal are important tasks of the years ahead.

I look forward to the challenge of editing a journal that is, and to the best of my abilities will remain, the premier, scientific journal of clinical toxicology in the world.

Disclosure statement

The author reports no conflicts of interest. The author alone is responsible for the content and writing of this paper.