The full content of Annals is available to subscribers

Subscribe/Learn More  >
Academia and the Profession |

Occupational Illness: Case Detection by Poison Control Surveillance

Paul D. Blanc, MD, MSPH; David Rempel, MD, MPH; Neil Maizlish, PhD, MPH; Patricia Hiatt, BS; and Kent R. Olson, MD
[+] Article, Author, and Disclosure Information

Grant Support: Supported in part by the Occupational Health Surveillance and Evaluation Program, California State Department of Health Services and by a grant from the Robert Wood Johnson Foundation.

Requests for Reprints: Paul D. Blanc, MD, Division of Occupational and Environmental Medicine, University of California, San Francisco, 350 Parnassus, Suite 609, San Francisco, CA 94117-9024.

Current Author Addresses: Dr. Blanc: Division of Occupational and Environmental Medicine, University of California, San Francisco, 350 Parnassus, Suite 609, San Francisco, CA 94117-9024.

Drs. Rempel and Maizlish: State of California Department of Health Services, 2151 Berkeley Way, Room 504, Berkeley, CA 94704.

Ms. Hiatt and Dr. Olson: San Francisco Regional Poison Control Center, 1001 Potrero Avenue, Building 30, Room 3216, San Francisco, CA 94110.

Ann Intern Med. 1989;111(3):238-244. doi:10.7326/0003-4819-111-3-238
Text Size: A A A

Study Objective: To evaluate the usefulness of poison control center detection in occupational illness surveillance.

Design: Case series of all occupationally related exposures referred for poison control center consultation over 6 months. Follow-up structured interviews were done of exposed persons and health care providers. Cases were traced under established occupational illness reporting programs.

Setting: A regional poison control center.

Patients: Consecutive sample of 461 symptomatic occupational exposure cases. After exclusions and losses to follow-up, interview of 301 patients and the treating physician, physician's assistant, or nurse practitioner for the 223 of the patients under direct medical care.

Measurements and Main Results: One hundred and fifty-five persons (61%; CI, 55% to 67%) had systemic or respiratory illness; 109 (36%; CI, 31% to 41%) had eye or skin conditions. Work practices were associated with exposures more often than technical failure; 118 persons (39%; CI, 33% to 45%) reported lack of respirators or other appropriate personal protective equipment. For 223 persons who received direct medical care, only five treating health care providers (2%; CI, 0.2% to 4%) reported occupational specialization, although occupational care was a regular practice activity for 128 of the health care providers (57%; CI, 51% to 63%). Sixty-seven cases (22%; CI, 17% to 27%) were detected by the Doctor's First Report surveillance program; 97 cases (32%; CI, 27% to 37%) comprised the maximal detection estimated for Occupational Safety and Health Administration surveillance.

Conclusions: Poison control center detection provides a useful surveillance measure for occupational illness. The proportion of case detection failures by established surveillance programs suggests that the incidence of occupational illness in the United States, which is calculated from these incomplete programs, may be three to five times greater than previously estimated.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Journal Club
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.