1 00:00:01,280 --> 00:00:04,320 Speaker 1: Welcome to Stuff you missed in History Class, a production 2 00:00:04,360 --> 00:00:13,760 Speaker 1: of I Heart Radio, Go Low, and welcome to the podcast. 3 00:00:13,840 --> 00:00:18,360 Speaker 1: I'm Tracy V. Wilson and I'm Holly fry Uh. In 4 00:00:18,560 --> 00:00:21,360 Speaker 1: case you've never heard our show before, this is episode 5 00:00:21,440 --> 00:00:25,400 Speaker 1: two of us recording the show with everyone involved in 6 00:00:25,440 --> 00:00:31,000 Speaker 1: the process in their own homes. Because the current pandemic 7 00:00:31,160 --> 00:00:36,479 Speaker 1: and resulting UM quarantine slash shelter in place slash self 8 00:00:36,520 --> 00:00:42,280 Speaker 1: isolation slash social distancing instructions, we have all been under UM. 9 00:00:42,360 --> 00:00:44,960 Speaker 1: So if you're a longtime listener and you're like, why 10 00:00:44,960 --> 00:00:47,440 Speaker 1: doesn't that sound quite the same, that's why. If you're 11 00:00:47,479 --> 00:00:49,880 Speaker 1: brand new, that's just a heads up. That's where we 12 00:00:49,920 --> 00:00:53,240 Speaker 1: are right now. And we coincidentally have a medical history 13 00:00:53,240 --> 00:00:55,440 Speaker 1: week that we did not plan that just happens to 14 00:00:55,480 --> 00:00:58,080 Speaker 1: be falling in line with all of this. So the 15 00:00:58,120 --> 00:01:00,160 Speaker 1: other day it was time to give our kittens or 16 00:01:00,160 --> 00:01:03,960 Speaker 1: flee and tick prevention. And then afterward, I was idly 17 00:01:04,040 --> 00:01:05,720 Speaker 1: reading the back of the box while I was washing 18 00:01:05,800 --> 00:01:08,000 Speaker 1: my hands, and I noticed that it said to contact 19 00:01:08,080 --> 00:01:12,600 Speaker 1: poison control if swallowed, And at first I thought, why 20 00:01:12,600 --> 00:01:15,679 Speaker 1: not just print want to do on the box instead 21 00:01:15,720 --> 00:01:18,000 Speaker 1: of directing people to call poison control. But then I 22 00:01:18,080 --> 00:01:21,920 Speaker 1: was like, where did poison control even come from? How 23 00:01:21,959 --> 00:01:24,479 Speaker 1: did we get to the point of having this one 24 00:01:24,560 --> 00:01:30,119 Speaker 1: resource specifically for poisoning that's so reliable and available that 25 00:01:30,319 --> 00:01:33,839 Speaker 1: companies can print it on the labels of consumer products 26 00:01:34,400 --> 00:01:36,720 Speaker 1: um and especially here in the US where Holly and 27 00:01:36,720 --> 00:01:38,920 Speaker 1: I are, this is a health care service that is 28 00:01:38,920 --> 00:01:43,399 Speaker 1: staff seven and of inaccessible to everyone for free, which 29 00:01:43,480 --> 00:01:46,000 Speaker 1: is not a thing that exists in many other contexts. 30 00:01:46,000 --> 00:01:49,240 Speaker 1: I mean, there are some other hotlines, but like, it's 31 00:01:49,240 --> 00:01:53,200 Speaker 1: not often that anybody, literally anyone can call a medical 32 00:01:53,280 --> 00:01:55,640 Speaker 1: professional twenty four hours a day and get an answer 33 00:01:55,720 --> 00:02:00,160 Speaker 1: for free. The first service like this was established in 34 00:02:00,200 --> 00:02:03,560 Speaker 1: the Netherlands and nine and today they exist in a 35 00:02:03,600 --> 00:02:06,480 Speaker 1: lot of countries around the world, particularly in the America's 36 00:02:06,520 --> 00:02:09,240 Speaker 1: Western Europe and parts of the Middle East. According to 37 00:02:09,280 --> 00:02:13,800 Speaker 1: the World Health Organization, of member states have a poison 38 00:02:13,840 --> 00:02:17,280 Speaker 1: center of some sort. But because the development of poison 39 00:02:17,320 --> 00:02:21,200 Speaker 1: control centers in the US closely parallels some other shifts 40 00:02:21,240 --> 00:02:24,280 Speaker 1: in American history, that's really where we're focusing on with 41 00:02:24,320 --> 00:02:28,160 Speaker 1: this story today. So you can really define the word 42 00:02:28,240 --> 00:02:30,800 Speaker 1: poisoning in a lot of different ways, but in general, 43 00:02:30,960 --> 00:02:35,240 Speaker 1: it is any toxin related injury. The toxin can come 44 00:02:35,280 --> 00:02:40,119 Speaker 1: from all kinds of sources, cleaning products, medications, mushrooms out 45 00:02:40,120 --> 00:02:43,119 Speaker 1: in the yard, and things that we actually think of poisons, 46 00:02:43,160 --> 00:02:48,360 Speaker 1: like insecticides and rat poisons. Sometimes people describe being envenomed 47 00:02:48,400 --> 00:02:51,200 Speaker 1: from something like a snake bite or insects staying also 48 00:02:51,320 --> 00:02:54,520 Speaker 1: is being poisoned. That a lot of cases, exposure to 49 00:02:54,639 --> 00:02:58,000 Speaker 1: a small amount of one of these substances isn't really dangerous, 50 00:02:58,000 --> 00:03:00,640 Speaker 1: and when it's something like medicine, that can be helpful 51 00:03:00,800 --> 00:03:04,840 Speaker 1: rather than harmful, but in large enough amounts, otherwise harmless 52 00:03:04,919 --> 00:03:08,880 Speaker 1: or even beneficial substances can become lethal. To be clear, 53 00:03:09,120 --> 00:03:12,880 Speaker 1: we also use terms like sun poisoning and food poisoning, 54 00:03:13,080 --> 00:03:16,240 Speaker 1: but that's not really what we're talking about here. Sun 55 00:03:16,280 --> 00:03:19,000 Speaker 1: poisoning is actually a severe type of sunburn, and in 56 00:03:19,000 --> 00:03:22,000 Speaker 1: most cases, food poisoning is an illness that's caused by 57 00:03:22,040 --> 00:03:27,160 Speaker 1: a pathogen like salmonella or Chigella bacteria. There are food 58 00:03:27,160 --> 00:03:31,000 Speaker 1: born illnesses that involve pathogens that can produce toxins, and 59 00:03:31,080 --> 00:03:35,080 Speaker 1: foods can be contaminated with toxic substances, but most of 60 00:03:35,120 --> 00:03:37,840 Speaker 1: the time when we say food poisoning, we're actually talking 61 00:03:37,840 --> 00:03:41,080 Speaker 1: about an illness, not a poison that someone put in 62 00:03:41,120 --> 00:03:44,600 Speaker 1: your food. People have been exposed to poisons, of course 63 00:03:44,680 --> 00:03:48,720 Speaker 1: throughout human history. There are toxic plants and fungi and 64 00:03:48,800 --> 00:03:52,320 Speaker 1: metals all over the world. Most places have at least 65 00:03:52,440 --> 00:03:56,360 Speaker 1: some species of venomous animals. People have also done things 66 00:03:56,400 --> 00:03:59,920 Speaker 1: like making their drinking vessels or makeup out of toxic 67 00:04:00,040 --> 00:04:04,960 Speaker 1: metals like lead, But household toxins really started to proliferate 68 00:04:04,960 --> 00:04:10,040 Speaker 1: with industrialization. Over time, people's most likely sources of poisoning 69 00:04:10,120 --> 00:04:12,960 Speaker 1: shifted from things like berries that they had gathered to 70 00:04:13,040 --> 00:04:17,440 Speaker 1: eat two things like cleaning products and pharmaceuticals. In some 71 00:04:17,480 --> 00:04:20,359 Speaker 1: parts of the world, governments passed laws to try to 72 00:04:20,400 --> 00:04:23,800 Speaker 1: protect people from the most potentially dangerous products, starting in 73 00:04:23,839 --> 00:04:28,400 Speaker 1: the nineteenth century. For example, in the UK, the eighteen 74 00:04:28,440 --> 00:04:31,800 Speaker 1: sixty eight Pharmacy Act restricted the sale of a specific 75 00:04:31,839 --> 00:04:36,200 Speaker 1: set of poisons. Only licensed pharmacists could sell them, and 76 00:04:36,240 --> 00:04:38,799 Speaker 1: they had to keep a careful record of every sale. 77 00:04:39,360 --> 00:04:42,320 Speaker 1: There was not a similar federal law in the US, 78 00:04:42,400 --> 00:04:46,000 Speaker 1: but between eighteen seventy and eighteen ninety thirty three states 79 00:04:46,040 --> 00:04:49,479 Speaker 1: adopted some kind of regulation on the sale of poisons 80 00:04:50,040 --> 00:04:53,040 Speaker 1: at the federal level. The first bills were introduced into 81 00:04:53,080 --> 00:04:56,760 Speaker 1: Congress in eighteen seventy nine, but broad legislation didn't come 82 00:04:56,760 --> 00:05:01,719 Speaker 1: along until much later. Manufacturers also recognized the potential dangers 83 00:05:01,800 --> 00:05:04,800 Speaker 1: involved with the products that they were making. Starting in 84 00:05:04,800 --> 00:05:08,600 Speaker 1: the late eighteenth and early nineteenth centuries, manufacturers of things 85 00:05:08,640 --> 00:05:13,000 Speaker 1: like rat poisons packaged their products in distinctively shaped bottles 86 00:05:13,080 --> 00:05:16,080 Speaker 1: marked with things like skulls and crossbones and the word 87 00:05:16,120 --> 00:05:21,320 Speaker 1: poison to try to prevent accidents. Manufacturers also used textured 88 00:05:21,360 --> 00:05:23,480 Speaker 1: glass bottles so that people could tell what they were 89 00:05:23,520 --> 00:05:27,120 Speaker 1: holding just by touch, and they also developed safety caps. 90 00:05:27,680 --> 00:05:30,760 Speaker 1: Most of these innovations weren't being used on products that 91 00:05:30,800 --> 00:05:34,320 Speaker 1: were being sold directly to consumers, though, they were being 92 00:05:34,440 --> 00:05:37,480 Speaker 1: used on products that would be repackaged at a pharmacy 93 00:05:37,640 --> 00:05:40,440 Speaker 1: or another store. So the idea was to keep the 94 00:05:40,520 --> 00:05:45,240 Speaker 1: druggist from selling somebody something dangerous by accident, not to 95 00:05:45,320 --> 00:05:48,960 Speaker 1: prevent the consumer at home from accidentally hurting themselves or 96 00:05:48,960 --> 00:05:52,039 Speaker 1: someone else. By the middle of the nineteenth century, the 97 00:05:52,080 --> 00:05:57,599 Speaker 1: American Pharmaceutical Association and American Medical Association had each passed 98 00:05:57,680 --> 00:06:03,080 Speaker 1: resolutions recommending clearer labeling on dangerous household products, including medicines 99 00:06:03,080 --> 00:06:06,279 Speaker 1: that could be harmful at high doses, but in general, 100 00:06:06,480 --> 00:06:10,120 Speaker 1: manufacturers resisted laws that required this kind of packaging and 101 00:06:10,200 --> 00:06:14,279 Speaker 1: labeling on consumer products. They argued that people might not 102 00:06:14,480 --> 00:06:16,800 Speaker 1: buy a product that was in a scary looking bottle 103 00:06:16,839 --> 00:06:20,120 Speaker 1: with a skull and crossbones on it. Another argument was 104 00:06:20,160 --> 00:06:23,240 Speaker 1: that consumers might put their products in a different container 105 00:06:23,440 --> 00:06:26,440 Speaker 1: or reuse that skull and crossbone bottle to hold some 106 00:06:26,520 --> 00:06:29,280 Speaker 1: other harmless substance, and that could just create all kinds 107 00:06:29,279 --> 00:06:32,360 Speaker 1: of confusion. By the part of the twentie century, a 108 00:06:32,400 --> 00:06:37,000 Speaker 1: couple of simultaneous developments dramatically increase the number of poisons 109 00:06:37,000 --> 00:06:39,839 Speaker 1: that most people had in their homes. The germ theory 110 00:06:39,880 --> 00:06:43,440 Speaker 1: of disease had become more widely accepted and generally known, 111 00:06:43,520 --> 00:06:46,839 Speaker 1: so people became kind of hyper aware of the idea 112 00:06:46,920 --> 00:06:51,680 Speaker 1: of germs infesting their homes and infecting their families. Progressive 113 00:06:51,720 --> 00:06:56,200 Speaker 1: reformers were also advocating ideas like good hygiene and cleanliness. 114 00:06:56,279 --> 00:06:58,200 Speaker 1: There was just messaging about this kind of thing all 115 00:06:58,240 --> 00:07:01,200 Speaker 1: over the place, and news articles, women's magazines, and that 116 00:07:01,240 --> 00:07:05,239 Speaker 1: type of thing. As a result, manufacturers introduced a ton 117 00:07:05,760 --> 00:07:09,480 Speaker 1: of cleaning and disinfecting products, many of which were toxic. 118 00:07:10,080 --> 00:07:13,640 Speaker 1: They marketed these products primarily to women as household time 119 00:07:13,680 --> 00:07:17,120 Speaker 1: savers and as a vital part of keeping a clean home. 120 00:07:17,960 --> 00:07:21,120 Speaker 1: Women's magazines also caught up to the trend and published 121 00:07:21,160 --> 00:07:26,040 Speaker 1: household cleaning and sanitation tips, along with consumer education about safety, 122 00:07:26,240 --> 00:07:29,120 Speaker 1: like keeping these products out of the reach of children, 123 00:07:29,640 --> 00:07:33,040 Speaker 1: clearly labeling their packaging, and sticking a pin through the 124 00:07:33,040 --> 00:07:36,040 Speaker 1: stopper of toxic products so it would be obvious which 125 00:07:36,040 --> 00:07:39,040 Speaker 1: bottle you were about to open. At about the same time, 126 00:07:39,280 --> 00:07:43,480 Speaker 1: drug makers were also introducing all kinds of new medications. 127 00:07:43,840 --> 00:07:46,400 Speaker 1: This is something that we've talked about in previous episodes, 128 00:07:46,440 --> 00:07:49,480 Speaker 1: including our two part are on the litamide. These new 129 00:07:49,520 --> 00:07:53,800 Speaker 1: medications also became a potential source of poisoning. With so 130 00:07:53,880 --> 00:07:57,760 Speaker 1: many new sources of potential poisoning in people's homes, the 131 00:07:57,880 --> 00:08:02,160 Speaker 1: number of accidental exposures sky rocket in Doctors and other 132 00:08:02,240 --> 00:08:05,520 Speaker 1: members of the medical community reported huge increases in the 133 00:08:05,600 --> 00:08:08,240 Speaker 1: number of patients they saw who had been harmed by 134 00:08:08,240 --> 00:08:12,160 Speaker 1: a poisonous product, and because these products were brand new, 135 00:08:12,360 --> 00:08:15,600 Speaker 1: doctors often didn't know what to do to treat these exposures. 136 00:08:16,240 --> 00:08:19,840 Speaker 1: During the progressive era, muck raking journalists also tried to 137 00:08:19,880 --> 00:08:23,440 Speaker 1: expose the dangers of these products, especially if they were 138 00:08:23,480 --> 00:08:27,800 Speaker 1: poorly labeled or incorrectly handled. Running in parallel with this 139 00:08:27,920 --> 00:08:32,080 Speaker 1: focus on household poisons was a similar focus on food safety. 140 00:08:32,520 --> 00:08:35,760 Speaker 1: This included the safety and quality of the foods themselves, 141 00:08:36,240 --> 00:08:39,760 Speaker 1: the cleanliness and safety of facilities like slaughter houses and 142 00:08:39,880 --> 00:08:43,680 Speaker 1: packing houses, and the safety of food additives. As part 143 00:08:43,679 --> 00:08:47,360 Speaker 1: of all this, doctor Harvey Washington wildly studied the effects 144 00:08:47,360 --> 00:08:50,679 Speaker 1: of food additives by feeding things to a team of 145 00:08:50,800 --> 00:08:53,520 Speaker 1: volunteers who came to be known as the Poison Squad. 146 00:08:54,160 --> 00:08:57,040 Speaker 1: There's an episode in our archive about this. It's called 147 00:08:57,360 --> 00:09:00,160 Speaker 1: Pure Food Father and His Poison Squad, and it came 148 00:09:00,160 --> 00:09:04,520 Speaker 1: out in May. It's shorter than our episodes typically are today, 149 00:09:04,520 --> 00:09:06,480 Speaker 1: and I haven't found a good companion to kind of 150 00:09:06,520 --> 00:09:08,760 Speaker 1: pair it with, so we haven't lined up as a 151 00:09:08,840 --> 00:09:12,680 Speaker 1: Saturday classic as of yet. All of this together read 152 00:09:12,800 --> 00:09:15,400 Speaker 1: the passage of the Pure Food and Drugs Act of 153 00:09:15,480 --> 00:09:18,240 Speaker 1: nineteen o six, which is also known as the Wiley Act. 154 00:09:19,080 --> 00:09:22,520 Speaker 1: Most of its provisions were focused on food and food additives, 155 00:09:22,600 --> 00:09:26,200 Speaker 1: but it also included labeling requirements for drugs, and it 156 00:09:26,280 --> 00:09:30,880 Speaker 1: forbade patent medicines in interstate commerce. The Widely Act was 157 00:09:30,920 --> 00:09:33,800 Speaker 1: one of the first consumer protection laws of its kind, 158 00:09:34,240 --> 00:09:37,199 Speaker 1: and while it did introduce some requirements for drugs and 159 00:09:37,280 --> 00:09:41,400 Speaker 1: drug labeling, it didn't really address the many toxic household 160 00:09:41,400 --> 00:09:44,600 Speaker 1: products that were being introduced into the market. Then, in 161 00:09:44,720 --> 00:09:48,000 Speaker 1: nineteen twenty six, bills were introduced in the House and 162 00:09:48,040 --> 00:09:52,040 Speaker 1: the Senate that required labeling for a list of caustic substances. 163 00:09:52,600 --> 00:09:57,840 Speaker 1: This included several acids ammonia, silver nitrate, and sodium hydroxide 164 00:09:57,880 --> 00:10:02,160 Speaker 1: also known as lie. As part of this, Chevalier Jackson 165 00:10:02,360 --> 00:10:06,680 Speaker 1: of Jefferson Medical College and Philadelphia testified before the Senate 166 00:10:06,720 --> 00:10:09,720 Speaker 1: about injuries that he had witnessed from these types of 167 00:10:09,720 --> 00:10:13,439 Speaker 1: substances in his practice. One case was a child who 168 00:10:13,559 --> 00:10:16,840 Speaker 1: swallowed a product called clean all and that had caused 169 00:10:17,160 --> 00:10:21,040 Speaker 1: terrible damage to his esophagus. When the mother was asked 170 00:10:21,040 --> 00:10:23,360 Speaker 1: why she had given this product to her child, she 171 00:10:23,400 --> 00:10:27,160 Speaker 1: said she had not known it was poison. In his testimony, 172 00:10:27,320 --> 00:10:30,520 Speaker 1: Jackson said, quote, I got her to bring me a can, 173 00:10:30,720 --> 00:10:32,840 Speaker 1: and here you can see on this can that I 174 00:10:32,920 --> 00:10:35,760 Speaker 1: have here, which was bought in the stores, that there 175 00:10:35,840 --> 00:10:39,000 Speaker 1: is not only no poison label whatever on it, but 176 00:10:39,040 --> 00:10:42,280 Speaker 1: it says does not injure the finest fabric or the 177 00:10:42,320 --> 00:10:46,280 Speaker 1: most delicate skin. Now, how could you expect any mother 178 00:10:46,360 --> 00:10:49,880 Speaker 1: to think that this thing was dangerous? After this and 179 00:10:50,040 --> 00:10:55,280 Speaker 1: other testimony, in President Calvin Coolidge signed the Caustic Poison 180 00:10:55,320 --> 00:10:58,560 Speaker 1: Act into law. This act required a list of caustic 181 00:10:58,600 --> 00:11:02,359 Speaker 1: poisons to be clearly labeled, with the warnings and contrasting 182 00:11:02,400 --> 00:11:05,280 Speaker 1: colors also in the largest type that was on the 183 00:11:05,280 --> 00:11:08,160 Speaker 1: package or the bottle of the product was in There 184 00:11:08,240 --> 00:11:12,080 Speaker 1: wasn't really any data being kept on household poisonings at 185 00:11:12,080 --> 00:11:16,760 Speaker 1: this point, but anecdotally, justice labeling requirements significantly reduced the 186 00:11:16,840 --> 00:11:20,600 Speaker 1: number of poisoning deaths that were happening. Household poisoning was 187 00:11:20,640 --> 00:11:23,120 Speaker 1: still a problem, though, and it was not long after 188 00:11:23,160 --> 00:11:25,760 Speaker 1: this that the first steps were made towards the poison 189 00:11:25,800 --> 00:11:29,040 Speaker 1: control system that exists today. We'll talk about that more 190 00:11:29,120 --> 00:11:40,800 Speaker 1: after we pause for a sponsor break. Overall, manufacturers supported 191 00:11:40,840 --> 00:11:43,280 Speaker 1: the Caustic Poison Act when it was signed into law. 192 00:11:43,320 --> 00:11:49,120 Speaker 1: In it replaced a previous and sometimes really contradictory hodgepodge 193 00:11:49,160 --> 00:11:52,400 Speaker 1: of state regulations on labeling, so it kind of made 194 00:11:52,400 --> 00:11:58,480 Speaker 1: things easier from the manufacturer's perspective. But they resisted broader regulations, 195 00:11:58,559 --> 00:12:02,040 Speaker 1: including a federal Little Poisons Act that was proposed in 196 00:12:02,040 --> 00:12:06,560 Speaker 1: the nineteen thirties. This would have introduced more specific labeling standards, 197 00:12:06,600 --> 00:12:10,680 Speaker 1: including marking poisonous products with a skull and cross bones, 198 00:12:11,000 --> 00:12:15,160 Speaker 1: something that had also been proposed earlier. On Again, manufacturers 199 00:12:15,280 --> 00:12:18,079 Speaker 1: argued that this labeling would just keep people from buying 200 00:12:18,080 --> 00:12:21,640 Speaker 1: the products. This was happening during the Great Depression, and 201 00:12:21,679 --> 00:12:24,800 Speaker 1: the chemical manufacturing industry was one of a very few 202 00:12:25,120 --> 00:12:29,480 Speaker 1: that have actually increased production, so legislators were worried that 203 00:12:29,520 --> 00:12:32,679 Speaker 1: if customers did become reluctant to buy these products, as 204 00:12:32,720 --> 00:12:35,720 Speaker 1: manufacturers feared they would, it would harm one of the 205 00:12:35,800 --> 00:12:40,000 Speaker 1: few industries it was not seriously struggling. Meanwhile, in the 206 00:12:40,040 --> 00:12:44,240 Speaker 1: late nineteen twenties and early nineteen thirties, multiple doctors published 207 00:12:44,240 --> 00:12:46,920 Speaker 1: papers on the patterns of poisoning that they were seeing 208 00:12:46,960 --> 00:12:51,280 Speaker 1: in their practice. In n p. P. Vincent reported that 209 00:12:51,400 --> 00:12:55,000 Speaker 1: well over half the esophageal strictures that he had seen 210 00:12:55,080 --> 00:12:58,439 Speaker 1: at the Mayo Clinic had been caused because someone had 211 00:12:58,480 --> 00:13:03,840 Speaker 1: swallowed lie. Dr J. Arena of Duke University published similar 212 00:13:03,880 --> 00:13:07,679 Speaker 1: findings in nineteen thirty nine. In some cases the concentration 213 00:13:07,800 --> 00:13:10,320 Speaker 1: of LIE in the product had not been high enough 214 00:13:10,360 --> 00:13:13,720 Speaker 1: for the labeling that was required under the Caustic Poison Act. 215 00:13:14,120 --> 00:13:17,160 Speaker 1: Also in the nineteen thirties, Louis Goodallman, who was a 216 00:13:17,160 --> 00:13:20,760 Speaker 1: pharmacist in Chicago who also had a chemistry degree, was 217 00:13:20,840 --> 00:13:24,720 Speaker 1: also collecting information on poisonings and the products and substances 218 00:13:24,760 --> 00:13:28,199 Speaker 1: that had caused them. He started documenting products and their 219 00:13:28,320 --> 00:13:31,680 Speaker 1: ingredients on index cards, including what to do in cases 220 00:13:31,720 --> 00:13:35,240 Speaker 1: of exposure to those ingredients, creating records for at least 221 00:13:35,360 --> 00:13:40,800 Speaker 1: nine thousand products. Eventually, he also started collecting stomach contents 222 00:13:40,880 --> 00:13:45,360 Speaker 1: and other samples from poisoning victims for analysis. Through this work, 223 00:13:45,440 --> 00:13:49,400 Speaker 1: Goodalman became the go to person for poisoning cases in Chicago. 224 00:13:50,080 --> 00:13:52,840 Speaker 1: The pharmacy at St. Luke's Hospital where he worked was 225 00:13:52,920 --> 00:13:55,720 Speaker 1: directly across from the emergency room, so it made it 226 00:13:55,800 --> 00:13:58,240 Speaker 1: really easy for E R doctors to just come ask 227 00:13:58,320 --> 00:14:01,520 Speaker 1: him questions, but he all they took calls at home 228 00:14:01,679 --> 00:14:05,280 Speaker 1: and elsewhere twenty four hours a day. As words spread 229 00:14:05,320 --> 00:14:08,000 Speaker 1: beyond St. Luke's Hospital of what he was doing, doctors 230 00:14:08,080 --> 00:14:11,240 Speaker 1: from other Chicago facilities started to call him for advice 231 00:14:11,280 --> 00:14:14,360 Speaker 1: and information as well. It eventually got to the point 232 00:14:14,360 --> 00:14:17,600 Speaker 1: that people from other states would call around in Chicago 233 00:14:17,679 --> 00:14:20,360 Speaker 1: trying to find this pharmacist that they'd heard about who 234 00:14:20,440 --> 00:14:23,680 Speaker 1: knew so much about poisoning. As a Goodloman was becoming 235 00:14:23,760 --> 00:14:28,120 Speaker 1: a one man poison hotline. The legal and regulatory landscape 236 00:14:28,120 --> 00:14:31,720 Speaker 1: in the United States was continuing to evolve. The Food, 237 00:14:31,800 --> 00:14:35,360 Speaker 1: Drug and Cosmetic Act was passed in ninety eight, which 238 00:14:35,360 --> 00:14:38,200 Speaker 1: required drugs to be evaluated for safety by the Food 239 00:14:38,200 --> 00:14:43,720 Speaker 1: and Drug Administration. In seven, the Federal Insecticide, Fungicide and 240 00:14:43,800 --> 00:14:47,480 Speaker 1: Rodenticide Act required these products to be registered with the 241 00:14:47,560 --> 00:14:51,240 Speaker 1: f d A. This law updated an earlier version that 242 00:14:51,320 --> 00:14:54,360 Speaker 1: was passed in nineteen ten, and among other things, it 243 00:14:54,480 --> 00:14:58,400 Speaker 1: required these products to be in child resistant packaging and 244 00:14:58,560 --> 00:15:01,960 Speaker 1: clearly labeled with an a appropriate warning. Even with these 245 00:15:02,040 --> 00:15:04,720 Speaker 1: kinds of steps, though by the nineteen fifties, as many 246 00:15:04,760 --> 00:15:08,560 Speaker 1: as four hundred children a year were dying from poisoning, 247 00:15:09,160 --> 00:15:12,640 Speaker 1: there were also adult poisoning victims as well, of course, 248 00:15:12,760 --> 00:15:17,360 Speaker 1: including incidents that had multiple victims. For example, on November, 249 00:15:19,120 --> 00:15:22,080 Speaker 1: a patient at Oregon State Hospital was helping out in 250 00:15:22,120 --> 00:15:26,800 Speaker 1: the kitchen. He accidentally brought the cooks cockroach poison instead 251 00:15:26,840 --> 00:15:29,560 Speaker 1: of the powdered milk that they had asked for. These 252 00:15:29,600 --> 00:15:33,040 Speaker 1: two substances looked visually very similar and had been stored 253 00:15:33,160 --> 00:15:37,080 Speaker 1: near each other. Forty seven patients died, and this is 254 00:15:37,120 --> 00:15:41,000 Speaker 1: something where the chemical manufacturing industry had resisted calls for 255 00:15:41,080 --> 00:15:44,800 Speaker 1: these kinds of products to be tinted rather than white 256 00:15:44,960 --> 00:15:48,240 Speaker 1: and easily mistaken for something like salt or sugar powdered milk. 257 00:15:48,720 --> 00:15:51,800 Speaker 1: By this point, medical experts just could not keep up 258 00:15:51,800 --> 00:15:55,120 Speaker 1: with the massive increase in the number of potentially dangerous 259 00:15:55,160 --> 00:15:59,040 Speaker 1: products and what to do if someone was exposed to them. 260 00:15:59,120 --> 00:16:02,760 Speaker 1: About two hundred fifty thousand drugs and household products had 261 00:16:02,800 --> 00:16:06,000 Speaker 1: been introduced since World War Two, and there wasn't any 262 00:16:06,080 --> 00:16:08,880 Speaker 1: kind of centralized system for keeping up with all of 263 00:16:08,920 --> 00:16:14,360 Speaker 1: these products, their ingredients, and their antidotes. Accidents replaced disease 264 00:16:14,440 --> 00:16:17,440 Speaker 1: as the leading cause of death in children, and according 265 00:16:17,440 --> 00:16:20,880 Speaker 1: to a survey of members of the American Academy of Pediatrics, 266 00:16:20,920 --> 00:16:25,080 Speaker 1: about half of the accidents that pediatricians were treating were poisonings. 267 00:16:25,560 --> 00:16:29,440 Speaker 1: In nineteen fifty three, Dr Edward Press and Louis Godalman 268 00:16:29,680 --> 00:16:34,280 Speaker 1: established the first formal poison control center. This was in Chicago, Illinois. 269 00:16:34,800 --> 00:16:38,240 Speaker 1: The Illinois Chapter of the American Academy of Pediatrics, the 270 00:16:38,360 --> 00:16:42,160 Speaker 1: Illinois Department of Public Health, and seven Chicago area hospitals 271 00:16:42,160 --> 00:16:45,720 Speaker 1: were also part of this project. They provided information on 272 00:16:45,800 --> 00:16:49,920 Speaker 1: poisonings and their antidotes to doctors who were treating affected patients. 273 00:16:50,520 --> 00:16:54,240 Speaker 1: Illinois State Toxicology Laboratory was also part of this project. 274 00:16:54,520 --> 00:16:57,040 Speaker 1: Toxicology was still a pretty new field at this point, 275 00:16:57,080 --> 00:17:00,440 Speaker 1: and that lab analyzed any specimens that were called elected. 276 00:17:00,840 --> 00:17:03,720 Speaker 1: A number of sources also credits some of this work 277 00:17:03,800 --> 00:17:07,760 Speaker 1: to an unnamed secretary who would call the area emergency 278 00:17:07,840 --> 00:17:11,000 Speaker 1: rooms every morning and ask what the children who had 279 00:17:11,000 --> 00:17:15,000 Speaker 1: been admitted for poisoning had eaten. She would then contact 280 00:17:15,000 --> 00:17:18,480 Speaker 1: the manufacturers of those substances to try to get them 281 00:17:18,480 --> 00:17:21,159 Speaker 1: to disclose the ingredients, and she would document all this 282 00:17:21,280 --> 00:17:24,520 Speaker 1: information on an index card. I wish I could find 283 00:17:24,520 --> 00:17:27,560 Speaker 1: out more about this person. I found several references to 284 00:17:27,640 --> 00:17:32,119 Speaker 1: this unnamed secretary and no other details. The Chicago Poison 285 00:17:32,160 --> 00:17:35,000 Speaker 1: Control Center started with a pilot program that ran from 286 00:17:35,040 --> 00:17:38,800 Speaker 1: November fift nineteen fifty three to March tenth, nineteen fifty four, 287 00:17:39,160 --> 00:17:42,439 Speaker 1: and it was so successful that other hospitals started their 288 00:17:42,440 --> 00:17:46,359 Speaker 1: own programs. Within a year, there were eleven poison control 289 00:17:46,400 --> 00:17:50,240 Speaker 1: centers just in Chicago and the surrounding area. In December 290 00:17:50,280 --> 00:17:53,920 Speaker 1: of nineteen fifty four, Edward Press and Dr Robert Mellin's 291 00:17:53,960 --> 00:17:57,679 Speaker 1: published a paper titled a Poisoning Control Program in the 292 00:17:57,680 --> 00:18:01,960 Speaker 1: American Journal of Public Health. This paper described poisoning as 293 00:18:01,960 --> 00:18:05,679 Speaker 1: a major public health concern before describing how the poison 294 00:18:05,720 --> 00:18:09,080 Speaker 1: control centers were operating and what they had found during 295 00:18:09,119 --> 00:18:13,159 Speaker 1: that time. The paper also made recommendations for future poison 296 00:18:13,200 --> 00:18:17,080 Speaker 1: control centers based on that experience. The following year, the 297 00:18:17,119 --> 00:18:21,400 Speaker 1: American Academy of Pediatrics published a reference book called Accidental 298 00:18:21,440 --> 00:18:27,040 Speaker 1: Poisoning in Childhood. Soon, poison control centers were expanding beyond Chicago. 299 00:18:27,520 --> 00:18:30,959 Speaker 1: In nineteen fifty seven, the U. S Surgeon General established 300 00:18:30,960 --> 00:18:34,840 Speaker 1: the National Clearing House for Poison Control Centers. This was 301 00:18:34,880 --> 00:18:37,760 Speaker 1: the federal government's first attempt to try to provide some 302 00:18:37,920 --> 00:18:41,840 Speaker 1: standardized resources for poison control and to collect data on 303 00:18:41,920 --> 00:18:45,280 Speaker 1: poisonings to report back to the government. The clearing House 304 00:18:45,320 --> 00:18:48,560 Speaker 1: produced a set of index cards with information on potentially 305 00:18:48,600 --> 00:18:52,760 Speaker 1: hazardous drugs, chemicals, and household products and plants along with 306 00:18:52,800 --> 00:18:56,040 Speaker 1: their antidotes, and it also published a monthly newsletter as 307 00:18:56,080 --> 00:18:59,439 Speaker 1: well as a statistical report of all that collected data 308 00:18:59,480 --> 00:19:02,640 Speaker 1: from each year. Also in nineteen fifty seven, the first 309 00:19:02,840 --> 00:19:07,080 Speaker 1: edition of the Clinical Toxicology of Commercial Products was published 310 00:19:07,080 --> 00:19:11,040 Speaker 1: and quickly became a standard reference work. It included basic 311 00:19:11,119 --> 00:19:14,840 Speaker 1: first aid and emergency treatment, followed by an ingredient index 312 00:19:14,880 --> 00:19:18,080 Speaker 1: that listed more than one thousand substances ranked on a 313 00:19:18,119 --> 00:19:21,600 Speaker 1: scale from one to six according to their toxicity, with 314 00:19:21,720 --> 00:19:26,159 Speaker 1: one being nearly harmless and six being extremely toxic. It 315 00:19:26,240 --> 00:19:28,920 Speaker 1: had a separate index for the trade names of products 316 00:19:28,920 --> 00:19:32,400 Speaker 1: that used these ingredients, along with the symptoms and treatments 317 00:19:32,440 --> 00:19:36,200 Speaker 1: for exposure to a range of different compounds. The American 318 00:19:36,240 --> 00:19:40,080 Speaker 1: Association of Poison Control Centers was founded in nineteen fifty eight, 319 00:19:40,080 --> 00:19:42,800 Speaker 1: and by that point the number of poison control centers 320 00:19:42,840 --> 00:19:44,879 Speaker 1: in the United States had grown to at least two 321 00:19:45,000 --> 00:19:50,120 Speaker 1: hundred sixty five. On April twenty, nineteen fifty nine, Arthur S. Fleming, 322 00:19:50,160 --> 00:19:53,520 Speaker 1: the Secretary of Health, released a statement about the poisoning 323 00:19:53,600 --> 00:19:56,840 Speaker 1: data that the National clearing House for Poison Control Centers 324 00:19:57,080 --> 00:20:01,440 Speaker 1: had compiled between July nineteen fifty six and April ninety eight. 325 00:20:02,200 --> 00:20:05,720 Speaker 1: The clearing House reported that almost five hundred child deaths 326 00:20:05,720 --> 00:20:11,000 Speaker 1: and six hundred thousand non fatal poisonings were happening per year, 327 00:20:11,359 --> 00:20:16,000 Speaker 1: which overwhelmingly occurred at home. More than of the people 328 00:20:16,040 --> 00:20:19,200 Speaker 1: affected were children under the age of five, and most 329 00:20:19,280 --> 00:20:21,520 Speaker 1: of those were between the ages of one and two. 330 00:20:22,280 --> 00:20:25,719 Speaker 1: Although many types of household products were involved, a major 331 00:20:25,800 --> 00:20:29,360 Speaker 1: source of poisoning was candied asprin, which was a chewable 332 00:20:29,400 --> 00:20:32,760 Speaker 1: formula developed to be palatable to children and was introduced 333 00:20:32,800 --> 00:20:36,679 Speaker 1: in nineteen forty seven. Fleming statement gave some examples of 334 00:20:36,720 --> 00:20:39,720 Speaker 1: the types of poison exposure that led calls to a 335 00:20:39,760 --> 00:20:42,359 Speaker 1: poison control center, and most of the time it was 336 00:20:42,400 --> 00:20:45,480 Speaker 1: something that had taken just a moment when a parent 337 00:20:45,600 --> 00:20:48,760 Speaker 1: or other caregiver's back was turned. He also noted the 338 00:20:48,800 --> 00:20:51,920 Speaker 1: need for the public to be better educated about poisons 339 00:20:52,000 --> 00:20:55,439 Speaker 1: and poison safety. Many of the cases that the clearing 340 00:20:55,440 --> 00:20:58,600 Speaker 1: House had compiled involved parents who had waited hours or 341 00:20:58,720 --> 00:21:01,520 Speaker 1: days after a child was exposed to a poison to 342 00:21:01,560 --> 00:21:05,480 Speaker 1: seek help instead of doing it right away. Other major 343 00:21:05,520 --> 00:21:09,400 Speaker 1: contributors to accidental poisonings were products that had been transferred 344 00:21:09,440 --> 00:21:12,760 Speaker 1: to food cans or other containers rather than being kept 345 00:21:12,760 --> 00:21:16,040 Speaker 1: in their original packaging, as well as hazardous products that 346 00:21:16,080 --> 00:21:19,040 Speaker 1: have been kept in easy reach of children. It was 347 00:21:19,080 --> 00:21:22,639 Speaker 1: about this time that poison control centers started working directly 348 00:21:22,720 --> 00:21:26,360 Speaker 1: with the public rather than mostly providing information to doctors, 349 00:21:26,760 --> 00:21:35,320 Speaker 1: and we'll get to that after another quick sponsor break. 350 00:21:36,480 --> 00:21:39,879 Speaker 1: The rapid expansion of poison control centers in the nineteen 351 00:21:39,920 --> 00:21:43,800 Speaker 1: fifties and sixties was kind of a tangle. They were 352 00:21:43,840 --> 00:21:47,160 Speaker 1: definitely giving medical staff and the general public an on 353 00:21:47,200 --> 00:21:50,800 Speaker 1: call resource to use in cases of potential poisoning. That 354 00:21:50,920 --> 00:21:53,960 Speaker 1: was good in many places where they operated. They were 355 00:21:54,000 --> 00:21:58,560 Speaker 1: also educating consumers about household safety, things like keeping toxic 356 00:21:58,600 --> 00:22:02,000 Speaker 1: products in their original packaging and keeping them locked out 357 00:22:02,000 --> 00:22:05,240 Speaker 1: of the reach of children also useful. But at the 358 00:22:05,280 --> 00:22:09,600 Speaker 1: same time, most of these centers were being established at hospitals, 359 00:22:09,880 --> 00:22:12,640 Speaker 1: with the hospitals trying to staff them from their existing 360 00:22:12,680 --> 00:22:16,040 Speaker 1: emergency rooms. The idea was that this would be an 361 00:22:16,080 --> 00:22:18,879 Speaker 1: easy addition to a department that was already staffed twenty 362 00:22:19,160 --> 00:22:21,960 Speaker 1: seven with people who were used to the high stress 363 00:22:22,040 --> 00:22:25,760 Speaker 1: world of emergency medicine. From the hospital's point of view, 364 00:22:25,840 --> 00:22:28,960 Speaker 1: adding a poison control center might even bring in more 365 00:22:29,000 --> 00:22:32,440 Speaker 1: patients as the center referred emergencies to the hospital's own 366 00:22:32,560 --> 00:22:36,680 Speaker 1: e r. As poison control centers started marketing their services 367 00:22:36,720 --> 00:22:39,800 Speaker 1: directly to the public, they also became a positive source 368 00:22:39,840 --> 00:22:42,960 Speaker 1: of pr for the hospitals where they were operating. As 369 00:22:43,040 --> 00:22:45,679 Speaker 1: more and more people became aware of the dangers of 370 00:22:45,720 --> 00:22:49,359 Speaker 1: poisoning and the existence of poison control centers, more and 371 00:22:49,480 --> 00:22:53,280 Speaker 1: more hospitals opened them, in part motivated by the idea 372 00:22:53,320 --> 00:22:57,080 Speaker 1: of good publicity in practice, though this did not always 373 00:22:57,119 --> 00:22:59,680 Speaker 1: work out. There were some centers that didn't get a 374 00:22:59,720 --> 00:23:03,000 Speaker 1: lot of calls. Either they weren't well publicized, or they 375 00:23:03,040 --> 00:23:06,200 Speaker 1: were in a city that had multiple other poison control centers, 376 00:23:06,600 --> 00:23:08,880 Speaker 1: or they were in a location with a small population. 377 00:23:09,720 --> 00:23:12,639 Speaker 1: But many poison control centers found that they had to 378 00:23:12,640 --> 00:23:16,240 Speaker 1: have a dedicated twenty four hour staff just for the 379 00:23:16,280 --> 00:23:19,520 Speaker 1: calls about poisonings. There were just too many calls to 380 00:23:19,560 --> 00:23:23,040 Speaker 1: add it into the existing emergency department's work. This is 381 00:23:23,359 --> 00:23:26,680 Speaker 1: how it goes for so many projects that someone says, 382 00:23:26,840 --> 00:23:29,520 Speaker 1: you can just add the center where it won't take long. 383 00:23:30,840 --> 00:23:33,560 Speaker 1: This also meant that there was no real pattern to 384 00:23:33,640 --> 00:23:37,760 Speaker 1: where these poison control centers were being established. Some cities 385 00:23:37,800 --> 00:23:40,960 Speaker 1: had more than a hundred centers scattered across all their 386 00:23:41,000 --> 00:23:45,560 Speaker 1: hospitals and pharmacies and other medical practices. Others had not 387 00:23:45,840 --> 00:23:48,720 Speaker 1: enough to really serve their whole community, or they had 388 00:23:48,760 --> 00:23:51,760 Speaker 1: no poison control center at all. Even though the nineteen 389 00:23:51,800 --> 00:23:54,720 Speaker 1: fifties had seen the establishment of the National Clearinghouse for 390 00:23:54,760 --> 00:23:58,520 Speaker 1: Poison Control Centers and the publication of the clinical toxicology 391 00:23:58,520 --> 00:24:02,359 Speaker 1: of commercial products, there also wasn't a lot of standardization 392 00:24:02,440 --> 00:24:05,439 Speaker 1: among all these centers. The quality of care could be 393 00:24:05,560 --> 00:24:08,760 Speaker 1: vastly different depending on which center you called and who 394 00:24:08,800 --> 00:24:12,120 Speaker 1: answered the phone, and in places where there were multiple 395 00:24:12,160 --> 00:24:15,639 Speaker 1: centers operating within the same city, those centers were often 396 00:24:15,680 --> 00:24:19,280 Speaker 1: competing with each other, each with their own phone number, logos, 397 00:24:19,320 --> 00:24:24,760 Speaker 1: warning stickers, and educational materials, which could often cause confusion. Also, 398 00:24:25,320 --> 00:24:28,200 Speaker 1: while one of the reasons that hospitals had started establishing 399 00:24:28,280 --> 00:24:30,800 Speaker 1: poison control centers was to try to bring in new 400 00:24:30,800 --> 00:24:33,919 Speaker 1: patients to the e R, when people called the poison 401 00:24:33,920 --> 00:24:36,439 Speaker 1: control center for advice and we're told to go to 402 00:24:36,440 --> 00:24:40,520 Speaker 1: the R, the opposite happened when poison control centers started 403 00:24:40,560 --> 00:24:43,439 Speaker 1: working directly with the public. Rather than being primarily a 404 00:24:43,480 --> 00:24:47,359 Speaker 1: resource for doctors, they were essentially acting as triage. The 405 00:24:47,440 --> 00:24:50,640 Speaker 1: person answering the phone would find out what products someone 406 00:24:50,680 --> 00:24:53,360 Speaker 1: had been exposed to, along with their age and wait. 407 00:24:54,119 --> 00:24:57,160 Speaker 1: In a lot of cases, after doing the math with that, 408 00:24:57,280 --> 00:25:00,480 Speaker 1: it turned out that the dose was not dangerous or 409 00:25:00,480 --> 00:25:03,520 Speaker 1: that treating it could be managed at home. Visits to 410 00:25:03,560 --> 00:25:06,919 Speaker 1: the e er for poisoning went down, not up. This 411 00:25:06,960 --> 00:25:10,639 Speaker 1: could be a really challenging job as well. The poison 412 00:25:10,720 --> 00:25:14,120 Speaker 1: control staff were often talking to panicked parents who were 413 00:25:14,160 --> 00:25:17,960 Speaker 1: holding or in the same room with crying children. Calls 414 00:25:18,000 --> 00:25:20,520 Speaker 1: often involved a lay person who needed to be talked 415 00:25:20,520 --> 00:25:23,679 Speaker 1: through a specific set of first aid steps, which in 416 00:25:23,720 --> 00:25:26,239 Speaker 1: the early days of these centers could involve trying to 417 00:25:26,280 --> 00:25:29,760 Speaker 1: induce vomiting. Some of the calls that came in also 418 00:25:29,800 --> 00:25:32,960 Speaker 1: involved people who were either considering harming themselves with the 419 00:25:32,960 --> 00:25:36,840 Speaker 1: poison or had already tried to do so. Meanwhile, the 420 00:25:36,880 --> 00:25:42,000 Speaker 1: federal government continued to add new regulations regarding toxic products. 421 00:25:42,040 --> 00:25:45,399 Speaker 1: The Hazardous Substances Labeling Act was passed in July of 422 00:25:45,480 --> 00:25:51,440 Speaker 1: nineteen sixty and that required specific labeling of toxic, corrosive, irritant, flammable, 423 00:25:51,560 --> 00:25:56,120 Speaker 1: strong sensitizers, or pressure generating substances, as well as language 424 00:25:56,160 --> 00:26:00,439 Speaker 1: like danger, warning, caution, and keep out of reach of children. 425 00:26:00,960 --> 00:26:04,960 Speaker 1: In nineteen sixty one, those eleven poison control centers that 426 00:26:05,040 --> 00:26:08,880 Speaker 1: have been established in the Chicago area were consolidated down 427 00:26:08,920 --> 00:26:12,919 Speaker 1: into one facility at Presbyterian St. Luke's Hospital, which got 428 00:26:12,960 --> 00:26:17,520 Speaker 1: about fifty five thousand calls annually. That same year, President 429 00:26:17,560 --> 00:26:20,840 Speaker 1: John F. Kennedy named the third full week of March 430 00:26:20,960 --> 00:26:24,480 Speaker 1: as National Poison Prevention Week, which is something I learned 431 00:26:24,520 --> 00:26:27,680 Speaker 1: while researching this podcast. So it is a weird coincidence 432 00:26:27,720 --> 00:26:30,639 Speaker 1: that this episode is coming out immediately after it ended. 433 00:26:31,480 --> 00:26:34,400 Speaker 1: This started with Homer A. George, who was a pharmacist 434 00:26:34,400 --> 00:26:37,959 Speaker 1: from Missouri. George had convinced his town and then the 435 00:26:38,000 --> 00:26:41,880 Speaker 1: state of Missouri to establish a poison prevention week before 436 00:26:42,240 --> 00:26:44,840 Speaker 1: advocating for one to be established at the federal level. 437 00:26:45,440 --> 00:26:51,199 Speaker 1: National Poison Prevention Week was first observed March two. In 438 00:26:51,320 --> 00:26:54,840 Speaker 1: nineteen sixty six, Dr James Goddard, Commissioner of the FDA, 439 00:26:55,119 --> 00:26:59,320 Speaker 1: convened a meeting of aspirin producers who voluntarily agreed to 440 00:26:59,400 --> 00:27:03,800 Speaker 1: restrict baby aspirint packaging to a non lethal dose. Each 441 00:27:03,840 --> 00:27:06,840 Speaker 1: package would contain no more than thirty six tablets of 442 00:27:06,920 --> 00:27:10,000 Speaker 1: eighty one milligrams apiece, so that if a child did 443 00:27:10,040 --> 00:27:13,360 Speaker 1: consume a whole bottle, it was not likely to be fatal. 444 00:27:14,119 --> 00:27:17,520 Speaker 1: Formal legislation along these lines followed with the Poison Prevention 445 00:27:17,600 --> 00:27:22,119 Speaker 1: Packaging Act in nineteen seventy, which required child resistant packaging. 446 00:27:22,920 --> 00:27:27,280 Speaker 1: Other laws about child resistant packaging, especially drug packaging, followed 447 00:27:27,320 --> 00:27:31,280 Speaker 1: from Mayor. All of these things are, of course, imperfect solutions, 448 00:27:31,400 --> 00:27:34,000 Speaker 1: right because of packaging that is harder for a child 449 00:27:34,040 --> 00:27:38,080 Speaker 1: to get into is also harder for many disabled and 450 00:27:38,119 --> 00:27:40,880 Speaker 1: elderly people to get into. But it's one of those 451 00:27:40,880 --> 00:27:44,919 Speaker 1: things where you have to evaluate the risks involved with 452 00:27:44,960 --> 00:27:50,120 Speaker 1: the packaging. Medical specialties involved with studying and treating poisoning 453 00:27:50,119 --> 00:27:53,720 Speaker 1: were also evolving during all this time. The American Academy 454 00:27:53,760 --> 00:27:58,040 Speaker 1: of Clinical Toxicology and the American College of Emergency Physicians 455 00:27:58,080 --> 00:28:01,040 Speaker 1: were both founded in nineteen sixty eight. By that point, 456 00:28:01,080 --> 00:28:04,000 Speaker 1: there were hundreds of poison control centers all over the 457 00:28:04,040 --> 00:28:09,560 Speaker 1: country and multiple competing mascots, including my favorite Mr Yuck, Officer, 458 00:28:09,720 --> 00:28:13,480 Speaker 1: Ug Pinky, the Elephant, Uncle Barf, and No psi Op 459 00:28:13,560 --> 00:28:18,199 Speaker 1: the snake with no Siop being poisoned spelled backwards. The 460 00:28:18,240 --> 00:28:21,520 Speaker 1: most widely known of these is probably Holly's favorite Mr Yuck, 461 00:28:21,960 --> 00:28:27,520 Speaker 1: whose development started in. Dr Richard Moriarty of Pittsburgh Children's 462 00:28:27,560 --> 00:28:31,480 Speaker 1: Hospital wanted some kind of child friendly warning or mascot 463 00:28:31,560 --> 00:28:35,080 Speaker 1: for toxic products. One reason for this was that the 464 00:28:35,119 --> 00:28:39,120 Speaker 1: Pittsburgh Pirates had adopted the skull and crossbones as their logo, 465 00:28:39,320 --> 00:28:43,720 Speaker 1: which understandably might cause some confusion for children who can 466 00:28:43,720 --> 00:28:46,160 Speaker 1: see the logo but not necessarily read or get the 467 00:28:46,200 --> 00:28:51,840 Speaker 1: context of what's involved, like ya sports um. Moriarty started 468 00:28:51,840 --> 00:28:54,400 Speaker 1: by asking children what would happen to them if they 469 00:28:54,440 --> 00:28:57,840 Speaker 1: got into poison, and their responses were that their parents 470 00:28:57,880 --> 00:29:00,520 Speaker 1: would yell at them, they would get sick, or they die, 471 00:29:01,160 --> 00:29:03,320 Speaker 1: and he wanted to find an image that seemed to 472 00:29:03,360 --> 00:29:07,000 Speaker 1: suggest these ideas, which led to a design contest sponsored 473 00:29:07,000 --> 00:29:10,160 Speaker 1: by the Pittsburgh Poison Center, and that was one by 474 00:29:10,200 --> 00:29:14,080 Speaker 1: fourth grader Wendy Brown. A commercial was released in nineteen 475 00:29:14,080 --> 00:29:16,960 Speaker 1: seventy one with a Mr. Yuck is Mean, Mr Yuck 476 00:29:17,040 --> 00:29:20,880 Speaker 1: is Green theme song. Pittsburgh Children's Hospital made Mr Yuck 477 00:29:21,000 --> 00:29:24,840 Speaker 1: stickers available to other poison control centers and to parents 478 00:29:24,920 --> 00:29:29,520 Speaker 1: through the National Poison Center Network established in nineteen seventy three. Yeah, 479 00:29:29,520 --> 00:29:32,240 Speaker 1: I did not grow up anywhere near Pittsburgh. I grew 480 00:29:32,280 --> 00:29:35,520 Speaker 1: up in North Carolina. I could still sing you the 481 00:29:35,720 --> 00:29:39,480 Speaker 1: entire Mr. Yuck theme song, I won't because I do 482 00:29:39,560 --> 00:29:44,600 Speaker 1: not sing well. Uh. More developments followed after this. Of course, 483 00:29:44,600 --> 00:29:48,880 Speaker 1: the Consumer Product Safety Commission was established in nineteen seventy two, 484 00:29:48,920 --> 00:29:52,840 Speaker 1: so that was a year before that poison control center 485 00:29:52,880 --> 00:29:57,080 Speaker 1: network was established. The Emergency Medical Systems Act was enacted 486 00:29:57,080 --> 00:30:00,800 Speaker 1: in nineteen seventy three, and that authorized grants to establish 487 00:30:00,800 --> 00:30:06,239 Speaker 1: a more robust nationwide emergency services system. In ninety eight, 488 00:30:06,440 --> 00:30:09,560 Speaker 1: the National Animal Poison Control Center was established at the 489 00:30:09,640 --> 00:30:14,440 Speaker 1: University of Illinois Champagne Urbana College of Veterinary Medicine. It 490 00:30:14,520 --> 00:30:19,000 Speaker 1: started fielding calls about animal exposure to toxic and caustic chemicals, 491 00:30:19,040 --> 00:30:22,320 Speaker 1: as well as substances that are safe for most humans 492 00:30:22,360 --> 00:30:26,520 Speaker 1: but toxic to many animals, such as chocolate, grapes, and lilies. 493 00:30:27,560 --> 00:30:30,480 Speaker 1: I have a friend whose cat wound up in the 494 00:30:30,600 --> 00:30:34,920 Speaker 1: veterinary hospital not long ago at all after eating some lilies. 495 00:30:36,160 --> 00:30:38,960 Speaker 1: That same year, the number of poison control centers for 496 00:30:39,080 --> 00:30:42,360 Speaker 1: humans reached its peak, with more than six hundred sixty 497 00:30:42,480 --> 00:30:45,479 Speaker 1: in the US and its territories. Many of them, as 498 00:30:45,520 --> 00:30:49,120 Speaker 1: we talked about earlier, overlapped in their coverage area, some 499 00:30:49,240 --> 00:30:52,720 Speaker 1: got very few calls. There were also concerns about training 500 00:30:52,840 --> 00:30:55,840 Speaker 1: and consistency at some of the smallest centers that had 501 00:30:55,840 --> 00:30:58,960 Speaker 1: the least funding and training, and a lot of centers 502 00:30:59,040 --> 00:31:02,560 Speaker 1: overall had really struggled to get adequate funding throughout their 503 00:31:02,560 --> 00:31:07,880 Speaker 1: whole history. Hospitals also became concerned about liability, especially after 504 00:31:07,920 --> 00:31:11,840 Speaker 1: an Arizona jury ordered a state funded poison control center 505 00:31:12,160 --> 00:31:14,960 Speaker 1: to pay out a more than three million dollars settlement. 506 00:31:15,680 --> 00:31:19,040 Speaker 1: This happened after a nurse at a medical practice accidentally 507 00:31:19,080 --> 00:31:22,480 Speaker 1: gave a patient liquid cocaine rather than liquid a seat 508 00:31:22,520 --> 00:31:25,240 Speaker 1: a menifin which had been stored on a shelf next 509 00:31:25,280 --> 00:31:28,360 Speaker 1: to each other. The poison control center and the doctor 510 00:31:28,680 --> 00:31:33,080 Speaker 1: both had outdated information about just how toxic liquid cocaine 511 00:31:33,120 --> 00:31:36,000 Speaker 1: could be, but the poison control center was ordered to 512 00:31:36,000 --> 00:31:39,320 Speaker 1: pay a larger settlement because it had not specifically told 513 00:31:39,360 --> 00:31:41,920 Speaker 1: the doctor that the patient should be taken to the hospital. 514 00:31:42,560 --> 00:31:45,280 Speaker 1: All of this, combined with the challenges we talked about 515 00:31:45,320 --> 00:31:49,480 Speaker 1: earlier to prompt hospitals to start closing down and consolidating 516 00:31:49,480 --> 00:31:53,280 Speaker 1: their poison control centers and the nineties. Over the next 517 00:31:53,360 --> 00:31:56,640 Speaker 1: decade or so, the poison control center shifted from this 518 00:31:56,800 --> 00:32:00,760 Speaker 1: overlapping assortment of centers at multiple hospital sometimes in the 519 00:32:00,800 --> 00:32:05,080 Speaker 1: same region, to a more government funded regional model. The 520 00:32:05,200 --> 00:32:09,880 Speaker 1: national Clearinghouse for poison control centers stopped collecting poisoning data, 521 00:32:10,320 --> 00:32:14,600 Speaker 1: and that responsibility moved to the Toxic Exposure Surveillance System 522 00:32:14,800 --> 00:32:19,040 Speaker 1: or tests in three. At that point, childhood deaths from 523 00:32:19,080 --> 00:32:22,440 Speaker 1: accidental poisoning had dropped to a quarter of what they 524 00:32:22,440 --> 00:32:26,320 Speaker 1: had been twenty years before. In February of two thousand, 525 00:32:26,480 --> 00:32:30,160 Speaker 1: President Bill Clinton signed the Poison Control Center Enhancement and 526 00:32:30,200 --> 00:32:34,560 Speaker 1: Awareness Act. This act provided federal funding for poison control 527 00:32:34,600 --> 00:32:38,080 Speaker 1: centers and made provisions for the establishment of a national 528 00:32:38,160 --> 00:32:42,680 Speaker 1: toll free number. The nationwide number of one eight hundred 529 00:32:42,680 --> 00:32:46,200 Speaker 1: two two two one two two two was launched in 530 00:32:46,320 --> 00:32:49,920 Speaker 1: January of two thousand two. In two thousand three, the 531 00:32:49,960 --> 00:32:54,440 Speaker 1: federal government reauthorized the Poison Control Center Enhancement and Awareness Act, 532 00:32:54,680 --> 00:32:58,040 Speaker 1: citing the need for emergency preparedness following the nine eleven 533 00:32:58,120 --> 00:33:01,440 Speaker 1: terrorist attacks and the ant wrax attack that followed in 534 00:33:01,480 --> 00:33:04,880 Speaker 1: October of two thousand one. Today, in the United States, 535 00:33:04,880 --> 00:33:08,480 Speaker 1: there are about fifty five regional poison control centers that 536 00:33:08,560 --> 00:33:12,520 Speaker 1: serve the entire country. Through that number When people call 537 00:33:12,600 --> 00:33:15,480 Speaker 1: the number, it routes them to their regional center. There 538 00:33:15,560 --> 00:33:19,280 Speaker 1: is also now an online triage tool at web poison 539 00:33:19,320 --> 00:33:24,720 Speaker 1: control dot org. The regional center's staff generally includes pharmacists, 540 00:33:24,800 --> 00:33:29,600 Speaker 1: board certified toxicologists and certified specialists, and poison Information or 541 00:33:29,680 --> 00:33:33,680 Speaker 1: csp I, and these centers take about four million calls 542 00:33:33,720 --> 00:33:37,040 Speaker 1: a year. At this point, the Poison Control Network is 543 00:33:37,080 --> 00:33:40,400 Speaker 1: the only real time healthcare database that applies to the 544 00:33:40,400 --> 00:33:44,880 Speaker 1: whole US population. Centers also provide education to the public, 545 00:33:44,960 --> 00:33:48,440 Speaker 1: as well as monitoring and reporting events that might suggest 546 00:33:48,480 --> 00:33:52,440 Speaker 1: some kind of wide scale exposure or a deliberate chemical attack. 547 00:33:53,080 --> 00:33:55,800 Speaker 1: Most of the people who call into poison control centers 548 00:33:55,800 --> 00:34:00,480 Speaker 1: today are lay people. About fift are medical personnel. More 549 00:34:00,520 --> 00:34:03,440 Speaker 1: than seventy of the people who call poison control do 550 00:34:03,480 --> 00:34:06,360 Speaker 1: not wind up meeting to go to the hospital. Numbers 551 00:34:06,400 --> 00:34:09,360 Speaker 1: are really all over the place about how much money 552 00:34:09,440 --> 00:34:12,960 Speaker 1: this saves per dollar of money that is invested into 553 00:34:13,000 --> 00:34:15,640 Speaker 1: the system, but it should be noted that this is 554 00:34:15,680 --> 00:34:19,000 Speaker 1: not just savings on the patient's part, Like people who 555 00:34:19,080 --> 00:34:22,319 Speaker 1: are able to treat the potential poisoning at home save 556 00:34:22,360 --> 00:34:23,799 Speaker 1: a lot of money by not having to go to 557 00:34:23,840 --> 00:34:26,319 Speaker 1: the emergency room. But a lot of people who need 558 00:34:26,360 --> 00:34:29,200 Speaker 1: to call into the poison control system for whatever reason 559 00:34:29,239 --> 00:34:33,640 Speaker 1: are covered by Medicare, Medicaid, or Estate Children's Health Insurance program, 560 00:34:33,960 --> 00:34:37,160 Speaker 1: so there are savings for these programs also, and for 561 00:34:37,239 --> 00:34:39,360 Speaker 1: the people who do need to go to the hospital, 562 00:34:39,680 --> 00:34:42,319 Speaker 1: there is some data that suggests that their stays tend 563 00:34:42,360 --> 00:34:45,040 Speaker 1: to be shorter because of the immediate first aid and 564 00:34:45,120 --> 00:34:48,719 Speaker 1: recommendations from poison control. Also, I just want to note 565 00:34:48,719 --> 00:34:51,120 Speaker 1: that I am not the only person who has had 566 00:34:51,160 --> 00:34:54,400 Speaker 1: this whole experience of kind of going where did poison 567 00:34:54,480 --> 00:35:00,920 Speaker 1: control come from? Nearly that exact UH scenario inspired a 568 00:35:01,120 --> 00:35:04,360 Speaker 1: radio lab episode on poison control that came out in 569 00:35:05,680 --> 00:35:08,640 Speaker 1: UM That was after the reporter involved had to call 570 00:35:08,719 --> 00:35:15,560 Speaker 1: poison control for their child. UH controlled the poison UM Tracy, Yeah, 571 00:35:15,680 --> 00:35:21,279 Speaker 1: do you have non poisonous, non toxic email from I do? UH? 572 00:35:21,320 --> 00:35:24,360 Speaker 1: This is from Doug. Doug says Dear Holly and Tracy. 573 00:35:24,400 --> 00:35:26,760 Speaker 1: I just listened to your two part episode on insulin. 574 00:35:27,239 --> 00:35:30,160 Speaker 1: Early in the first episode, you mentioned that a diabetics 575 00:35:30,320 --> 00:35:34,400 Speaker 1: urine was sweet and wondered who verified that. When I 576 00:35:34,440 --> 00:35:36,600 Speaker 1: was young, my dad a doctor told us about a 577 00:35:36,640 --> 00:35:39,600 Speaker 1: standard practice in medical school where the instructor would dip 578 00:35:39,600 --> 00:35:43,080 Speaker 1: his finger into a beaker of diabetic urine demonstrate tasting it. 579 00:35:43,440 --> 00:35:45,480 Speaker 1: The beaker was then passed around the room for each 580 00:35:45,480 --> 00:35:48,759 Speaker 1: student to taste. Afterwards, the instructor would tell them they 581 00:35:48,760 --> 00:35:51,840 Speaker 1: had learned two things. One, the urine of a diabetic 582 00:35:51,920 --> 00:35:55,640 Speaker 1: is sweet too the power of observation, because the instructor 583 00:35:55,719 --> 00:35:58,160 Speaker 1: dipped his middle finger into the urine and tasted his 584 00:35:58,239 --> 00:36:03,239 Speaker 1: index finger. This scenario was used in the movie Young 585 00:36:03,320 --> 00:36:05,799 Speaker 1: Doctors in Love roughly twenty years after I heard about 586 00:36:05,800 --> 00:36:08,200 Speaker 1: it from my dad. Plays out a little differently in 587 00:36:08,239 --> 00:36:10,360 Speaker 1: the movie, but the concept is the same. Thank you 588 00:36:10,400 --> 00:36:13,279 Speaker 1: for your always interesting podcast. I like the addition of 589 00:36:13,320 --> 00:36:15,319 Speaker 1: your behind the scenes many as I really enjoy the 590 00:36:15,360 --> 00:36:18,399 Speaker 1: more casual discussion of the week's topics. Doug. Thank you, Doug. 591 00:36:18,440 --> 00:36:21,480 Speaker 1: I wanted to read this email number one because it 592 00:36:21,560 --> 00:36:24,560 Speaker 1: was funny to me. Uh number two. We've gotten a 593 00:36:24,600 --> 00:36:28,120 Speaker 1: couple of notes from people who remember this same urine 594 00:36:28,160 --> 00:36:33,239 Speaker 1: tasting scene in the TV show Outlander Um, which yes, 595 00:36:33,560 --> 00:36:38,320 Speaker 1: I also remember being a person who watches Outlander Um, 596 00:36:38,400 --> 00:36:40,400 Speaker 1: and they just to make it into the episode for 597 00:36:40,480 --> 00:36:43,279 Speaker 1: whatever reason. So anyway, if you'd like to write to 598 00:36:43,360 --> 00:36:46,640 Speaker 1: us about this or any other podcast that's currently the 599 00:36:46,680 --> 00:36:49,759 Speaker 1: best way to reach us rather than physical mail, as 600 00:36:49,800 --> 00:36:53,560 Speaker 1: we are all working from home for the time being. 601 00:36:54,080 --> 00:36:56,560 Speaker 1: Um So we're at history podcast at my heart radio 602 00:36:56,600 --> 00:36:58,720 Speaker 1: dot com, and then we're also all over social media 603 00:36:58,800 --> 00:37:02,000 Speaker 1: at missed in History Me. That's where we'll fund our Facebook, Pinterest, Twitter, 604 00:37:02,120 --> 00:37:05,200 Speaker 1: and Instagram, and you can subscribe to our show on 605 00:37:05,239 --> 00:37:07,879 Speaker 1: Apple podcast, the I heart radio app, and anywhere else 606 00:37:07,960 --> 00:37:15,480 Speaker 1: you get your podcast. Stuff you Missed in History Class 607 00:37:15,520 --> 00:37:18,600 Speaker 1: is a production of I heart Radio. For more podcasts 608 00:37:18,600 --> 00:37:21,000 Speaker 1: from I heart Radio, visit the i heart Radio app, 609 00:37:21,080 --> 00:37:24,280 Speaker 1: Apple Podcasts, or wherever you listen to your favorite shows.