title: Incidents of potential public health significance identified using national surveillance of US poison center data (2008-2012).
abstract: BACKGROUND
  The Centers for Disease Control and Prevention (CDC) and the American Association of Poison Control Centers conduct national surveillance on data collected by US poison centers to identify incidents of potential public health significance (IPHS). The overarching goals of this collaboration are to improve CDC's national surveillance capacity for public health threats, identify early markers of public health incidents and enhance situational awareness. The National Poison Data System (NPDS) is used as a surveillance system to automatically identify data anomalies.
  
  
  OBJECTIVE
  To characterize data anomalies and IPHS captured by national surveillance of poison center data over 5 years.
  
  
  METHODS
  Data anomalies are identified through three surveillance methodologies: call-volume, clinical effect, and case-based. Anomalies are reviewed by a team of epidemiologists and clinical toxicologists to determine IPHS using standardized criteria. The authors reviewed IPHS identified by these surveillance activities from 2008 through 2012.
  
  
  RESULTS
  Call-volume surveillance identified 384 IPHS; most were related to gas and fume exposures (n = 229; 59.6%) with the most commonly implicated substance being carbon monoxide (CO) (n = 92; 22.8%). Clinical-effect surveillance identified 138 IPHS; the majority were related to gas and fume exposures (n = 58; 42.0%) and gastrointestinal complaints (n = 84; 16.2%), and the most commonly implicated substance was CO (n = 20; 14.4%). Among the 11 case-based surveillance definitions, the botulism case definition yielded the highest percentage of identified agent-specific illness.
  
  
  CONCLUSIONS
  A small proportion of data anomalies were designated as IPHS. Of these, CO releases were the most frequently reported IPHS and gastrointestinal syndromes were the most commonly reported illness manifestations. poison center data surveillance may be used as an approach to identify exposures, illnesses, and incidents of importance at the national and state level.
authors.affiliation: Health Studies Branch, National Center for Environmental Health, Centers for Disease Control and Prevention , Atlanta, GA , USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Law
authors.forename: S
authors.initials: S
authors.lastname: Sheikh
authors.forename: A
authors.initials: A
authors.lastname: Bronstein
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: H A
authors.initials: HA
authors.lastname: Spiller
authors.forename: J G
authors.initials: JG
authors.lastname: Schier
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S. / Q000706:statistics & numerical data; D016208:Databases, Factual; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005740:Gases / Q000633:toxicity; D006801:Humans; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011634:Public Health; D014481:United States
chemical_list: D005740:Gases
keywords: Poisonings; Public Health; Surveillance