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BACKGROUND: Poisoning is the second leading mechanism of unintentional injury mortality in the US. In 2012, the US Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses (SOII) reported 8,840 lost workday occupational poisonings nationwide. Poison Control Centers (PCCs) have emerged as a rich data source for work-related poisoning surveillance. PCCs collect timely case-level data not available through the SOII nor most data sources. Though PCCs do not routinely collect industry and occupation (I/O). The Massachusetts Department of Public Health (MDPH) collaborated with its PCC, the Regional Center for Poison Control and Prevention, to characterize occupational poisonings in existing data and pilot the PCC’s collection of additional employment information for work-related calls.
METHODS: The MA PCC submitted to MDPH all work-related MA exposure cases from July to mid-December of 2013, biweekly. For these calls, MDPH trained PCC staff to ask patient’s I/O, tasks performed when exposure occurred, employer name, and employer city/town. MDPH reviewed cases to confirm work-relatedness, conducted descriptive analyses, and used NIOSH’s Industry and Occupation Computerized Coding System (NIOCCS) to code I/O.
RESULTS: The PCC reported 81 work-related cases. Cases were predominantly male (62%), from ages 25-44 (43%), called in from healthcare facilities (51%) and worksites (36%), and occurred within one hour of exposure (53%). Most commonly reported exposures were chemicals (30%) and cleaning agents (23%), via inhalation (35%) and dermal (30%) routes. Most commonly reported clinical effects were none (23%), burns (7%), and headaches (6%). Medical outcomes designated by PCC staff were none-to-minimum (40%), minor (26%), and moderate (11.1%) effects, with 23% of cases lost-to-follow-up. Fourteen cases involved exposures to multiple workers; three were intentional poisonings at work. Completeness of employment data varied by question. Responses were available as follows: industry: 58%; occupation: 49%; tasks performed when exposure occurred: 59%; employer name: 40%; and employer city/town: 42%. 94% and 95% of I/O responses, respectively, were code-able in NIOCCs. Frequency of the PCC asking employment questions was not well-documented. Reasons for non-response included ‘MD reluctant to provide info’, ‘MD unable to obtain’, and ‘Patient does not want to reveal.’
CONCLUSIONS: PCCs are a valuable public health partner and timely data source for occupational poisoning surveillance. Our pilot demonstrates the feasibility of routine employment data collection at the PCC for a substantial proportion of work-related cases and suggests opportunities for expanded collaboration between MDPH and its PCC for prevention activities.