Poison control centers : is there an antidote for budget cuts? : hearing before the Human Resources and Intergovernmental Relations Subcommittee of the Committee on Government Operations, House of Representatives, One Hundred Third Congress, second sessio

410 Pages·1994·12.8 MB·English

by  United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee

POISON CONTROL CENTERS: IS THERE AN
ANTIDOTE FOR BUDGET CUTS?
Y 4. G 74/7: P 75/5
Poison Control Centers: Is There at. . .
HEARING
BEFORE THE
HUMAN RESOURCES AND INTERGOVERNMENTAL
RELATIONS SUBCOMMITTEE
OF THE
COMMITTEE ON
GOVERNMENT OPERATIONS
HOUSE OP REPRESENTATIVES
ONE HUNDRED THIRD CONGRESS
SECOND SESSION
MARCH 15, 1994
Printed for the use of the Committee on Government Operations
°CT 26
fig*
J
U.S. GOVERNMENT PRINTING OFFICE
82-892CC WASHINGTON : 1994
ForsalebytheU.S.GovernmentPrintingOffice
SuperintendentofDocuments,CongressionalSalesOffice,Washington,DC 20402
ISBN 0-16-045845-5

POISON CONTROL CENTERS: IS THERE AN
^ ANTIDOTE FOR BUDGET CUTS?
Y 4. G 74/7: P 75/5
Poison Control Centers: Is There an...
HEARING
BEFORE THE
HUMAN RESOURCES AND INTERGOVERNMENTAL
RELATIONS SUBCOMMITTEE
OF THE
COMMITTEE ON
GOVERNMENT OPERATIONS
HOUSE OP REPRESENTATIVES
ONE HUNDRED THIRD CONGRESS
SECOND SESSION
MARCH 15, 1994
Printed for the use of the Committee on Government Operations
OCT 26
1994
^kommpw
U.S. GOVERNMENT PRINTING OFFICE
82-892CC WASHINGTON : 1994
ForsalebytheU.S.GovernmentPrintingOffice
SuperintendentofDocuments,CongressionalSalesOffice,Washington,DC 20402
ISBN 0-16-045845-5
COMMITTEE ON GOVERNMENT OPERATIONS
JOHN CONYERS, JR., Michigan, Chairman
CARDISS COLLINS, Illinois WILLIAM F. CLINGER, Jr., Pennsylvania
HENRY A. WAXMAN, California AL McCANDLESS, California
MIKE SYNAR, Oklahoma J. DENNIS HASTERT, Illinois
STEPHEN L. NEAL, North Carolina JON L. KYL, Arizona
TOM LANTOS, California CHRISTOPHER SHAYS, Connecticut
MAJOR R. OWENS, New York STEVEN SCHIFF, New Mexico
EDOLPHUS TOWNS, New York C. CHRISTOPHER COX, California
JOHNM. SPRATT, JR., South Carolina CRAIG THOMAS, Wyoming
GARY A. CONDIT, California ILEANA ROS-LEHTINEN, Florida
COLLIN C. PETERSON, Minnesota DICK ZIMMER, New Jersey
KAREN L. THURMAN, Florida WILLIAM H. ZELIFF, Jr., New Hampshire
BOBBY L. RUSH, Illinois JOHN M. MCHUGH, New York
CAROLYN B. MALONEY, New York STEPHEN HORN, California
THOMAS M. BARRETT, Wisconsin DEBORAH PRYCE, Ohio
DONALD M. PAYNE, New Jersey JOHN L. MICA, Florida
FLOYD H. FLAKE, New York ROB PORTMAN, Ohio
JAMES A. HAYES, Louisiana
CRAIG A. WASHINGTON, Texas
BARBARA-ROSE COLLINS, Michigan BERNARD SANDERS, Vermont
CORRINE BROWN, Florida (Independent)
MARJORIE MARGOLIES-MEZV1NSKY,
Pennsylvania
LYNN C. WOOLSEY, California
GENE GREEN, Texas
BART STUPAK, Michigan
JUUAN EPSTEIN, StaffDirector
Matthew R. Fletcher, Minority StaffDirector
Human Resources and Intergovernmental Relations Subcommittee
EDOLPHUS TOWNS, New York, Chairman
HENRY A. WAXMAN, California STEVEN SCHIFF, New Mexico
THOMAS M. BARRETT, Wisconsin JOHN L. MICA, Florida
DONALD M. PAYNE, New Jersey ROB PORTMAN, Ohio
CRAIG A. WASHINGTON, Texas
BERNARD SANDERS, Vermont (Ind.)
Ex Officio
JOHN CONYERS, Jk., Michigan WILLIAM F. CLINGER, JR., Pennsylvania
RONALD A. Stroman, StaffDirector
William M. Layden, ProfessionalStaffMember
Martine M. DiCroce, Clerk
MARTHA B. MORGAN, Minority Professional Staff
(II)
CONTENTS
Page
Hearingheldon March 15, 1994 1
Statementof:
Brown, Ann,chairman, U.S. ConsumerProductSafety Commission „ 114
Dosh, Cheryl, motherofpoisonedchild 14
Fise, Mary Ellen R., product safety director, Consumer Federation of
America 196
Grover,Jennifer, motherofpoisonedchild 4
Kauffman, Ralph E., M.D., medical director, regional poison control cen-
ter, Childrens HospitalofMichigan 44
Kearney, Thomas E., Pharm.D., American Association ofPoison Control
Centers 70
Krenzelok, EdwardP., Pharm.D., director, Pittsburgh poison center, Chil-
dren's HospitalofPittsburgh 62
Litovitz, Toby L., M.D., director, National Capital Poison Center, Wash-
ington, DC 52
Marcus, Steven M., M.D., New Jersey Poison Information and Education
System 155
McDonald, Margaret, motherofpoisonedchild 8
McGinnis, J. Michael, M.D., Deputy Assistant Secretary for Health, and
Director, Office of Disease Prevention and Health Promotion, Health
and Human Services, accompanied by Rick Waxweiler, National Center
forInjuryPrevention and Control 119
Miller, Ted, Ph.D., National Public Services Research Institute 183
Rodgers, George C, M.D., Ph.D., AmericanAcademyofPediatrics 144
Simon, Jeffrey L., NewYork State DepartmentofHealth 206
Towns, Hon. Edolphus, a Representative in Congress from the State
ofNew York, and chairman, Human Resources and Intergovernmental
RelationsSubcommittee: Opening statement 1
Trestrail, John H. Ill, R.Ph., codirector, Blodgett Regional Poison Center,
GrandRapids, MI 30
Letters, statements, etc., submitted forthe recordby:
Brown, Ann, chairman, U.S. ConsumerProductSafety Commission:
Informationconcerningpoison control centers 134
Prepared statement 116
Dosh, Cheryl, motherofpoisonedchild: Preparedstatement 16
Fise, Mary Ellen R., product safety director, Consumer Federation of
America: Preparedstatement 198
Grover,Jennifer, motherofpoisonedchild: Prepared statement 6
Kauffman, Ralph E., M.D., medical director, regional poison control cen-
ter, Childrens Hospital ofMichigan: Prepared statement 46
Kearney, Thomas E., Pharm.D., American Association of Poison Control
Centers: Prepared statement 72
Krenzelok, EdwardP., Pharm.D., director, Pittsburgh poison center, Chil-
dren's Hospital ofPittsburgh: Preparedstatement 64
Litovitz, Toby L., M.D., director, National Capital Poison Center, Wash-
ington, DC:
Informationconcerningcertified regional poisoncenters 109
Preparedstatement 54
Marcus, Steven M., M.D., New Jersey Poison Information and Education
System: Prepared statement 157
McDonald, Margaret, motherofpoisonedchild: Prepared statement 11
McGinnis, J. Michael, M.D., Deputy Assistant Secretary for Health, and
Director, Office of Disease Prevention and Health Promotion, Health
andHuman Services:
Informationconcerningthe injurycontrol board 141
(III)
IV
— Page
Letters, statements, etc., submitted forthe recordby Continued
McGinnis, J. Michael, M.D., Deputy Assistant Secretary for Health, and
Director, Office of D—isease Prevention and Health Promotion, Health
andHuman Services Continued
Prepared statement 122
Miller, Ted, Ph.D., National Public Services Research Institute: Prepared
statement 185
RockyMountain Poison Center: Prepared statement 19
Rodgers, George C, M.D., Ph.D., American Academy of Pediatrics: Pre-
paredstatement 147
Simon, Jeffrey L., New York State Department ofHealth: Prepared state-
ment 208
Trestrail, John H. ID, R.Ph., codirector, Blodgett Regional Poison Center,
GrandRapids, MI:
A condensed transcript of a recording of an actual call to a poison
control center 31
Prepared statement 34
APPENDDC
Additional material forthe record 221
POISON CONTROL CENTERS: IS THERE AN
ANTIDOTE FOR BUDGET CUTS?
TUESDAY, MARCH 15, 1994
House of Representatives,
Human Resources and
Intergovernmental Relations Subcommittee
of the Committee on Government Operations,
Washington, DC.
The subcommittee met, pursuant to notice, at 10:10 a.m., in room
2247, Rayburn House Office Building, Hon. Edolphus Towns (chair-
man oftne subcommittee) presiding.
Present: Representatives Edolphus Towns, Donald M. Payne, and
John L. Mica.
Also present: Representative Barbara-Rose Collins.
Staff present: Ronald A. Stroman, staff director; William M.
Layden, professional staffmember; Martine M. DiCroce, clerk; and
Martha B. Morgan, minority professional staff, Committee on Gov-
ernment Operations.
OPENING STATEMENT OF CHAIRMANTOWNS
Mr. Towns. The Human Resources and Intergovernmental Rela-
tions Subcommittee of the Government Operations Committee will
now come to order.
When your child is poisoned, you have a life threatening emer-
gency. You need immediate help. Who do you call? You call your
poison center. That phone call may be the difference between life
or death. But who do you call when your poison center closes?
The subcommittee's 6-month investigation into the funding plight
ofpoison control centers has found that the Nation's poison centers
are in critical condition. Only about half of all Americans have ac-
cess to poison centers that meet national quality standards, and
the number is declining rapidly. As hospitals cut nonrevenue gen-
erating community services, poison centers across the country are
closing down.
The subcommittee has found that poison centers have been
forced to put emergency calls on hold or tell frightened parents
that they cannot help a poisoned child because ofbudget cuts. Poi-
son experts have stopped visiting schools to teach children about
the dangers of poison. Poison experts have stopped spreading the
word about "Mr. Yuk."
Poison centers save lives, and they save money. In 1992 poison
centers provided free first aid advice over the phone to 2.4 million
poisoning cases, about 60 percent ofwhich involved children young-
er than 6 years of age. Because over 70 percent of cases reported
(1)
to poison centers are handled over the phone in the patient's own
home, poison centers avoid unnecessary emergency room visits, am-
bulance runs, and hospital admissions. Several studies have shown
that every $1 spent on poison control centers saves between $4 and
$9 in unnecessary health care expenses.
Today the subcommittee will explore whether there is an anti-
dote for the budget cuts that are forcing the Nation's poison centers
to close. Closing poison centers is health care retreat, not health
care reform, and we need to understand that.
Next week is National Poison Prevention Week. It is a chance for
the Nation to recommit itselfto prevent poisonings and deaths due
to poisonings. Let's work together to ensure that we guarantee ac-
cess to quality poison control services to all Americans.
At this time, I would like to yield to Congressman Payne, a mem-
ber ofthe subcommittee from New Jersey.
Mr. Payne. Thank you very much, Mr. Chairman. I would like
to commend you, Mr. Chairman, for your leadership in calling this
hearing today. I also would like to thank the witnesses who have
agreed to testify today. Also, let me congratulate you for the press
conference held on Poison Prevention Week, because we feel that
it is very important to focus on this issue, educating children and
parents about taking safety precautions that can literally be a mat-
ter oflife and death.
Furthermore, I would like to welcome Dr. Steven Marcus, execu-
tive director of the New Jersey Poison Information and Education
System, who will testify later in the hearing. He has worked tire-
lessly in eliminating dangers to our children's health.
Unintentional childhood poisonings are a very, very serious prob-
lem in this country. Almost half of emergency telephone cases in-
volve children under 2. Almost 60 percent of these cases involve
children younger than 6. In New Jersey, childhood lead poisoning
remains a very, very serious problem in our public health system.
According to the 1988 statistics of the Agency for Toxic Sub-
stance and Disease Registry, 80,300 children living in Newark were
at risk of lead poisoning because they resided in dwellings with
lead interior paint.
Newark ranked 6th and Jersey City, 21st among cities with the
most children living in danger of poisoning because of their hous-
ing. The increased number ofhazardous chemical compounds avail-
able on the market are also fueling the increase in the number of
children exposed to these dangers. Unfortunately, it is statistics
like these that dictate the need for places like New Jersey Poison
Information and Education System, headed by Dr. Marcus in New-
ark, to have more attention.
Most cases of unintentional poisonings are handled over the
phone in the patient's home. In recent years, funding for these life-
saving centers has dwindled, and every time government has
sought to reduce expenditures, these centers have been the first
lined up for the budgetary axe. Because unnecessary runs to emer-
gency rooms have been eliminated, as has been indicated by the
chairman, poison control centers have shown that we can save be-
tween $4 and $9 in unnecessary health care expenses by having
these activities.
Having been active in lead abatement efforts in New Jersey, I
have a personal stake in ensuring that everyone has access to these
types oflife-saving services. I believe that tne issue shaping the de-
bate should be the health and welfare ofour children.
I would like once again to thank you, Mr. Chairman, for calling
this hearing on this very important subject. I look forward to hear-
ing the testimony ofour witnesses.
Mr. Towns. I would like to thank the gentleman from New Jer-
sey, first of all, for his kind remarks and also to thank him for all
the work that he has done in this area. He believes in doing any-
thing that you can do to protect the lives of people, and he has
been in the forefront ofnot only this issue, but other issues as well.
At this time, I would like to yield to Congresswoman Barbara-
Rose Collins, who is another person who has been in the forefront
ofsaving lives, as well.
Congresswoman Barbara-Rose Collins.
Ms. Collins. Thank you very much, Mr. Chairman.
I applaud Congressman Towns for recognizing the importance of
children's poison centers' saving children, and I want to thank him
and the subcommittee for inviting me to participate in today's
hearings on the need to support poison control centers across tne
Nation.
What parent has not been jolted out ofhis or her wits by a young
child eating or drinking something potentially dangerous? What
parent has not had that gripping fear when a child has accidentally
imbibed a substance that may be poisonous? Most of us have. I
have as a grandmother. Today's homes are full of dangerous sub-
stances, from bleach to floor polish, from hair mousse to bug spray.
Parents are tremendously comforted by the security of having
knowledgeable, authoritative people we can call for instant answers
on how to handle emergency situations like this. We depend on our
established institutions to be there for us in an emergency.
In my home area of Detroit, we have an outstanding program,
the poison control center at the Children's Hospital of Michigan,
part ofWayne State University, which serves 18 counties in south-
eastern Michigan with a population of 5.9 million. Our center pro-
vides 24-hour telephone assistance, thank God. And we get about
60,000 calls every year. We have a physician toxicologist available
24 hours a day. Our center also provides educational services for
professionals and the general public on poison prevention and
treatment.
Until 1991, our center received $250,000 or one-fourth of its
budget from the State. The legislature approved funding in 1992
and 1993, but it was vetoed by our Governor. Today our center re-
ceives no Federal, State, county, or city funding. Children's Hos-
pital and some generous donors have essentially been financing the
center's operations. But the hospital board has said that new fund-
ing must be found or the center may be closed on October 1, a mere
7 months away.
Our center has already cut some education services, services that
prevent poisoning and prevent hospitalizations and prevent death.
We have already eliminated the toll-free 800 public access number.
Our center is struggling to survive.
I hope today's testimony will help us formulate a survival plan.
I want to welcome to the subcommittee this morning, Mr. Chair-
man, Dr. Ralph E. Kauffman, medical director ofthe poison control
A
center at Children's Hospital of Michigan. professor of pediatrics
and pharmacology, Dr. Kauffman will make a strong case for find-
ing the funds to Keep our poison centers going nationwide.
Again, thank you for the opportunity to participate in this impor-
tant hearing. I look forward to working with you to find a way to
prevent poison incidents and to maintain public services for people
who have public accidents. In our civilized society, we expect poison
control centers to be there when we need them.
Thank you, Mr. Chairman.
Mr. Towns. Thank you very much, Congresswoman Collins, for
your statement and also, as indicated early on, your involvement
not only in this issue but in so many issues that lead to saving
lives. Thank you for your participation. I know that you have an-
other hearing and we understand the time demands that you have.
We are just delighted that you were able to come by, make a state-
ment, and show your support.
Ms. Collins. Thank you.
Mr. Towns. At this time, I would like to call on Jennifer Grover.
mother ofa poisoned child, ifshe would come forward. And I would
like to ask Margaret McDonald, mother of a poisoned child, to
please come forward, and Cheryl Dosh, mother of a poisoned child,
to also come forward.
I would like to request special permission from the members, be-
cause, as you can see, Ms. Grover has a little one with her, and
I would like to allow her to go first. Then after that, any questions
that you might have for Ms. Grover, you can raise them with her,
and then we would allow her to be excused. We can see that she
is extremely busy. Without objection, we would take her out of
order, and of course we would have questions with her and then
move forward.
Also, let me just say that there is a light in front of you. When
you start out, the light will be on green; 5 minutes later, the light
will turn red. Now, I know that some ofyou have an opening state-
ment, but I will assure you that your entire statement will be put
in the record, every period, every I, every T, every everything will
be in the record. So at that point, when trie light goes to red, ifyou
wouldjust quickly summarize we would certainly appreciate it, and
then we will allow the members of the panel to raise specific ques-
tions with
you.
At this time, Ms. Grover, ifyou would go forward.
STATEMENT OFJENNIFER GROVER, MOTHER OF POISONED
CHILD
Ms. Grover. Mr. Chairman and members of the subcommittee,
my name is Jennifer Grover, and this is my son Henry. He is IOV2
months old. Thank you for inviting us here to share our story with
you about the poison control center.
About 3 weeks ago, Henry was bitten by a lizard. We had been
visiting my next-door neighbor in the evening, and she has a pet
lizard. It's really very small, only about 3 inches long and only
about as wide as two ofmy fingers. Henry reached out to touch the