Regional centers: Added value to poison center surveillance

To the Editor:

Law et al.'s article “National surveillance for radiological exposures and intentional potassium iodide and iodine product ingestions in the United States associated with the 2011 Japan radiological incident”¹ parallels our own British Columbia Drug and Poison Centre (BC DPIC) experience.² The reasons for calling (concerns around radiation, questions concerning KI, and other radiation antidotes) and call volume patterns (surge of calls within the first week of the incident) reported by Law et al. mirrored those received in BC. The 47 calls related to the Fukushima incident received at the BC DPIC approximated the 48 from neighbouring Washington State residents over roughly the same time period, this despite our province having a population 36% smaller and our center's not having messages on radiation targeted to either health care professionals or the general public to direct them to our center's toll-free number.

We agree with Law et al. in acknowledging the value of regional poison control centers in providing timely information during public health emergencies in addition to that collected through national surveillance activities. Canada does not yet have a national poison call data system, relying on regional centers to identify local, regional and often national patterns reflective of public concern. The surge in calls immediately after the Fukushima incident, led BC DPIC to brief provincial public health authorities on the need to inform medical practitioners of their role in communicating valid advice to a concerned public. The added value of the regional center was in the real-time access to free text notes in client call records and the ability to stratify calls by geographic area. Detailed chart reviews identified that BC residents were misusing iodinated compounds in an effort to block the uptake of I¹³¹, and stratification of calls by BC health region showed that Vancouver Island (the third most populous region in our province with 16% of the BC population) accounted for only 15% of the calls during the 6 weeks following the Fukushima incident. Given that radiation from Japan would first impact Vancouver Island, we were surprised that relative call volumes did not reflect the exaggerated public concern for coastal impacts expressed in media accounts. Such findings represent an opportunity to target what might have been a concerned population to call their poison control center.

While we agree with Law et al. as to the value of a robust national poison surveillance system, regional poison control centers are at the core of local, regional and national success; regional poison control centers should be proactive in analyzing their call records and in partnering with public health authorities in the face of an environmental incident.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.