Speaker 1: So my name is Susanoyon and I'm the medical director
Speaker 1: of the Connecticut Poison Control Center. We're going to start
Speaker 1: the podcast today with little story, very common story that
Speaker 1: every poison center really in the country encounters at some
Speaker 1: point in time, you know, in the course of their work.
Speaker 1: We're going to talk about the little laundry pods. You've
Speaker 1: seen them in your grocy stores. The little laundry pods
Speaker 1: are on the shelves right there with the other laundry detergents,
Speaker 1: and they are used to clean your laundry. They hit
Speaker 1: the market in the United States probably fifteen, maybe even
Speaker 1: twenty years ago, and we moved at that point from
Speaker 1: kind of powder based detergents to there were a lot
Speaker 1: of liquid laundry detergents to these little pods. And these
Speaker 1: little pods and I'm sure you've seen them, but they're
Speaker 1: wrapped in plastic and they're usually very colorful. But there's
Speaker 1: a component of laundry detergent. This is a component in
Speaker 1: there of usually water softener, other components in there as well,
Speaker 1: and again all wrapped up in a nice a little
Speaker 1: plastic pouch. In their single use, we call them laundry pods,
Speaker 1: but really the technical name is single use laundry detergent.
Speaker 1: And even before they hit the market in the United States,
Speaker 1: they had been quite popular in Europe and they had
Speaker 1: adopted this quite quite quite avidly in Europe. So the
Speaker 1: manufacturers of these detergents and these single use pods were
Speaker 1: quite confident that this was going to take off in
Speaker 1: the United States.
Speaker 2: And it did.
Speaker 1: And I want to take you back again fifteen twenty
Speaker 1: years ago when they just hit the market, and we
Speaker 1: had this interesting email from North Carolina going, what is
Speaker 1: up with these laundry pods? I had a child or
Speaker 1: a child in North Carolina bit into it and got
Speaker 1: quite quite sick. And I don't call you know, the
Speaker 1: medical director said, I don't quite understand what's going on.
Speaker 1: And then we had other people in upstate New York,
Speaker 1: and then a few months later in Florida going, we
Speaker 1: have had the same issues. We have little children who
Speaker 1: bite into these laundry pods and they get quite quite ill.
Speaker 1: And we looked at the illnesses and all that stuff.
Speaker 1: But let's just take a step back here. We are
Speaker 1: in the United States used to liquid laundry deturches. We've
Speaker 1: had that product on the market for decades. Children have
Speaker 1: ingested that product for decades, and never did it result
Speaker 1: in any really serious injury, certainly never resulted in ICU admissions,
Speaker 1: never resulted in death. It was just not our expectation.
Speaker 1: So here this new product enters the market, or at
Speaker 1: least a new packaging of the product enters the market,
Speaker 1: and we're starting to see a lot more ED visits.
Speaker 1: Children are having problems with it, and we're seeing a
Speaker 1: lot more admissions to the hospital. We're seeing admissions to
Speaker 1: the intensive carrion things we had never ever seen before
Speaker 1: with laundry dechurches.
Speaker 2: So something's going on, basically.
Speaker 1: And so we sit down, We sit down with each other,
Speaker 1: We sit down with you know, kind of the pods themselves,
Speaker 1: start looking at them, start looking at them differently. We
Speaker 1: even sit down with the manufacturers of these laundry pods.
Speaker 1: So we sit down with Pocter and Gamble, we'ing, what
Speaker 1: did you put in those laundry pots? What are the ingredients?
Speaker 2: What's going on?
Speaker 1: And they came back they said, no, no, no, it's
Speaker 1: laundry detergent. It is just plain laundry detergent. We're going,
Speaker 1: what's the pH did you change the pH. Did you
Speaker 1: do something? And they laughed a little bit when we
Speaker 1: mentioned the pH, they go, yeah, the pH of that
Speaker 1: product is lower, meaning it's closer to a pH of
Speaker 1: seven than our typical laundry product. Because if we had
Speaker 1: its pH at nine, which is what it usually is,
Speaker 1: it would destroy the plastic as it's sitting on the shelf,
Speaker 1: so we had to lower the pH. Well, if the
Speaker 1: pH is lower than nine and somewhere between nine and seven,
Speaker 1: that should be perfectly fine for the child.
Speaker 2: So just hitting.
Speaker 1: Against a lot of kind of like none of this
Speaker 1: makes sense. And then I think, after thinking about this
Speaker 1: and thinking about this and just realizing what it was
Speaker 1: that we were seeing at the bedside, we came up
Speaker 1: with likely what the answer was.
Speaker 2: So what were we seeing at the bedside?
Speaker 1: So these children would bite into these laundry pods sometimes,
Speaker 1: you know, think about.
Speaker 2: These laundry pods. They're under a little bit of pressure.
Speaker 1: So when the children the child bites and bites again,
Speaker 1: often the contents start to squirt out and they could
Speaker 1: squirt out vertically up, they could squirt out horizontally out
Speaker 1: of their mouth, or they could squirt out horizontally to
Speaker 1: the back of their mouth if it squirted up and
Speaker 1: ended up in their eyes, and we did have a
Speaker 1: number of ocular exposures. We had a bit of corneal issues.
Speaker 1: The cornea of the eye was looked, burned, was injured.
Speaker 1: If it squirted out, you know, that would end up
Speaker 1: on the floor, we don't worry about that. If it
Speaker 1: squirts back, it would hit the back of the throat
Speaker 1: the uvula. Children aren't very small children, not terribly coordinated
Speaker 1: in terms of swallowing, and they would kind of choke, cough,
Speaker 1: and swallow kind of all at the same time because
Speaker 1: they're not very coordinated, and some of it would end
Speaker 1: up in their lungs, and we had kind of an
Speaker 1: aspiration type of issue. Some of them would kind of
Speaker 1: go down into the stomach and kind of sort of
Speaker 1: reside in the stomach as a result, and then we
Speaker 1: were seeing a few, just a few injuries to the stomach,
Speaker 1: burns to the stomach.
Speaker 2: So studying this and looking at.
Speaker 1: This a little bit, it's sort of behave like again,
Speaker 1: something with a very high pH, something with a very
Speaker 1: low pH. But this was not the issue here. It
Speaker 1: behaved a lot like the very concentrated detergents that we
Speaker 1: have out there. We ended up looking at.
Speaker 2: The surf factants.
Speaker 1: The surfact it is a component of detergents that stabilize bubbles.
Speaker 1: We like things to bubble up, right if we if
Speaker 1: we put a detergent, we wanted to bubble in our
Speaker 1: you know, in our washing machine. And so because they're
Speaker 1: packaging such small quantities of detergents, they had to increase
Speaker 1: the amount of surfactants. And it turns out that the
Speaker 1: surffactants were the issue. They are concentrated surfactants, and the
Speaker 1: concentrated surfactants kind of destroy a little bit the inner
Speaker 1: lining of the trachea, the lungs, the bronchi and the lungs,
Speaker 1: and can to some degree wash away a lot of
Speaker 1: that nice mucus that coats the stomach, causing a bit
Speaker 1: of gestrointestinal kind of burns. Many many poison centers after
Speaker 1: a few months were kind of declaring themselves, going, this
Speaker 1: is an issue.
Speaker 2: This is an issue. This is an issue.
Speaker 1: So who do you sit with kind of regulate this
Speaker 1: a little bit. And this is not a food, It
Speaker 1: doesn't our drug, it doesn't fall under the Food and
Speaker 1: Drug administration. This falls into the consumer product safety Commissions CPS,
Speaker 1: and so you sit down with CPS, or at least
Speaker 1: you alert this to CPS. They have discussions with the manufacturer.
Speaker 1: They tried to negotiate and kind of arrive at some
Speaker 1: kind of understanding about what's going on and now.
Speaker 2: And since you will.
Speaker 1: See the products often often packaged child resistant, bigger packages,
Speaker 1: it's the double zip pouch. It's a container with a
Speaker 1: child resistant cap, so there was a child resistant component
Speaker 1: to it.
Speaker 2: So that was part of the regulation. The other part
Speaker 2: is education needed to occur.
Speaker 1: There needed to be a public health education campaign and
Speaker 1: if you watch your TV you will occasionally see really
Speaker 1: nicely they really nicely made commercials paid for by the manufacturer,
Speaker 1: or alerting parents of young children to not let them
Speaker 1: get a hold of these laundry pods, that they could
Speaker 1: be dangerous, or them away from children, and so on
Speaker 1: and so forth. This all took years, but it was
Speaker 1: through the work of poison centers that well, first of all,
Speaker 1: recognize it was a problem, dug in and kind of
Speaker 1: found sort of what we think likely the problem is,
Speaker 1: and sort of alerting the federal regulatory entities and having
Speaker 1: them kind of way in on this.
Speaker 2: So it was a terrific, terrific effort. Right there.
Speaker 1: We were a little bit puzzled since these products had
Speaker 1: been in use in Europe for years before they were
Speaker 1: introduced in the United States.
Speaker 2: Don't you have children in Europe? Isn't this occurring? You're like,
Speaker 2: don't you have this problem in Europe?
Speaker 1: And in turns out that yes, they yes, they have
Speaker 1: children in Europe. But more importantly, they don't have a
Speaker 1: very cohesive poison center system, so if they were encountering
Speaker 1: the issues, they really didn't have a great way of
Speaker 1: communicating that to each other, certainly across countries. And so
Speaker 1: because of that, they told us, yeah, we did have
Speaker 1: a problem, but we didn't know the extent of the problem.
Speaker 1: So now twenty years later, I wouldn't say we never
Speaker 1: get a laundry pod exposure. We do, but they're they're
Speaker 1: they're much fewer and far between. I think parents know
Speaker 1: now to keep it away from children. I think that's
Speaker 1: one of the big reasons why we see lag. I
Speaker 1: think physicians are also much better prepared to take care
Speaker 1: of these problems. They are and when they arrived to
Speaker 1: the emergency department, we have a much better understanding of
Speaker 1: what to do. So we rarely have the ICU admissions
Speaker 1: the deaths that we recorded years ago, decades ago with
Speaker 1: the introduction of the single use of laundry detergents. So
Speaker 1: I think that's a great success story to share with everybody.
Speaker 3: I loved that story so much, erin so much. Yeah,
Speaker 3: I feel like I remember when tide pods and like
Speaker 3: Tidepod Challenge was a thing on TikTok or something a
Speaker 3: few years ago, and then I never really thought, like,
Speaker 3: why are tiepods so bad? I just assumed all detergents
Speaker 3: were sabably not good for you.
Speaker 4: And that like more people just were eating these because
Speaker 4: they're cute and like good looking.
Speaker 3: For your right and also to just learn how the
Speaker 3: whole process worked, to be like we see this, what
Speaker 3: is happening, Let's get to the bottom of it, how
Speaker 3: do we stop it? Beautiful?
Speaker 4: And also like the working across industry and like government
Speaker 4: and like other bodies like that was so it's so interesting,
Speaker 4: Like wow, I'm and to.
Speaker 3: Hear from an expert. Thank you so much, doctor Doyon
Speaker 3: for sharing that story with us, and you are going
Speaker 3: to be hearing so much more from her in next
Speaker 3: week's episode. To be continued, But first, Hi, I'm.
Speaker 4: Erin Welsh and I'm Erin Allman Updike.
Speaker 3: And this is this podcast will kill you.
Speaker 4: And today, if you haven't guessed it, we're talking about
Speaker 4: poison control. Yes, we are so excited. We say this
Speaker 4: every single time, but we are so excited for this
Speaker 4: episode or should we say these two episodes?
Speaker 3: I mean, there is so much more to poison control
Speaker 3: and it is all so fascinating.
Speaker 2: Erin.
Speaker 3: You have been talking about your intellectual crush on toxicologists
Speaker 3: and toxicology for ages, and so I really feel like
Speaker 3: we're we're digging deep, but not even as deep as
Speaker 3: we could, Like we're covering so much ground because there's
Speaker 3: so much ground to cover when it comes to poison control,
Speaker 3: we're not even digging that deeply, know I When.
Speaker 4: You first Aaron brought up the idea of covering poison
Speaker 4: controls like as a topic on this podcast, I was like, okay,
Speaker 4: Like I love toxicologists, all of them, and I love
Speaker 4: the field of toxicology, but I was like, I have
Speaker 4: no idea, like how to do an episode the way
Speaker 4: that we usually do things. And turns out can we
Speaker 4: do it?
Speaker 3: Sure?
Speaker 4: Can can we do it? Over and over again. I'd
Speaker 4: love to oh yeah, yeah.
Speaker 3: So just to give you a little bit of a
Speaker 3: rough idea of how the structure of these episodes are
Speaker 3: going to go, what we're going to do in this
Speaker 3: first episode is kind of share the story of how
Speaker 3: Poison Control came to be from its humble beginnings in Chicago,
Speaker 3: Illinois spoilers all the way to this like beautiful nationwide
Speaker 3: system that we have today. How did that process begin?
Speaker 3: Who who looked at this need and said, oh, yeah,
Speaker 3: we should do something about this. Yeah, So that's going
Speaker 3: to be this first episode.
Speaker 4: It's going to be thrilling. You might not think that,
Speaker 4: like you would ever have wondered like how did Poison
Speaker 4: Control Center come to exist? But after this episode you're
Speaker 4: going to be like, I'm sorry, I will never not
Speaker 4: think about this, I know, and it will be your
Speaker 4: new Roman empire? Is that they these days? Is that
Speaker 4: still a thing?
Speaker 3: I don't know. Maybe by the time this comes out,
Speaker 3: probably not. And then next week we're going to get
Speaker 3: the chance to interview the provider of our first hand account,
Speaker 3: doctor Suzanne Douyon, who is not just the provider of
Speaker 3: our first hand account, she is the medical director of
Speaker 3: the Connecticut Poison Control Center. Oh my gosh, she's also
Speaker 3: an associate professor at the University of Connecticut School of Medicine.
Speaker 3: I am so thrilled we're going to get to ask
Speaker 3: her all kinds of behind the scenes questions about like
Speaker 3: how what goes on at poison control centers? Who do
Speaker 3: you have to be to work at a poison control center?
Speaker 3: Or what kind of calls do you get? What? Like,
Speaker 3: what what happens?
Speaker 4: What do you what does one do in poison centers.
Speaker 4: It's gonna be such a great episode. It was such
Speaker 4: a fun conversation. We got super nerdy.
Speaker 3: Oh yeah we did.
Speaker 4: But before we can get into any of that, it's
Speaker 4: quarantin any time.
Speaker 3: It certainly is what are we drinking this week?
Speaker 4: This week we're drinking Name your Poison?
Speaker 3: Yeah?
Speaker 2: You know.
Speaker 3: I have these sweet sweet glasses that say name your
Speaker 3: Poison on them, and they have a bunch of different
Speaker 3: poison names on them. And I think I've used one
Speaker 3: once for arsenic maybe I did Paris green or something
Speaker 3: that sounds right. But I have more, so now I
Speaker 3: have to pick which one I want to use. I
Speaker 3: love them. I'm so excited to get to use these.
Speaker 4: I mean, we should have any time, but yeah, we
Speaker 4: should have split into however, many episodes you have of
Speaker 4: these glasses like that many poison episodes.
Speaker 3: Honestly, what I need to do is go back in
Speaker 3: there and be like, Okay, what can we do? What
Speaker 3: can we cover for future sos? Add it to our
Speaker 3: long list of ideas that never is never ending. But
Speaker 3: in this, name your poison it is. It's delicious. It's whiskey.
Speaker 3: Name your whiskey. Really, I think a lot of whiskeys
Speaker 3: will work with this, probably not like a heavily peated scotch,
Speaker 3: but a lot of them will work. And then peaches
Speaker 3: and a little bit of lemon juice, some simple syrup.
Speaker 3: It's simple, it's delicious, it's amazing, it really is.
Speaker 4: Check it out. We'll post full recipe for that quarantini
Speaker 4: as well as our non alcoholic plusy Brita on our
Speaker 4: website This podcast will Kill You dot com and all
Speaker 4: of our social media channels.
Speaker 3: Are you following us on social media?
Speaker 4: Are you?
Speaker 3: You should be? You've got some pretty stellar content coming out.
Speaker 3: If I do say so, do you.
Speaker 4: Toot our own horn like.
Speaker 3: We've got reels, We've got you know, other posts. That's
Speaker 3: all we've got. We've also got a website though, which
Speaker 3: is pretty sweet. Website has all kinds of cool things,
Speaker 3: you know. We've got transcripts. We've got a submit your
Speaker 3: first hand account form, which is amazing thanks to everyone
Speaker 3: who has ever submitted their first hand account. We've got
Speaker 3: links to merch We've got music by Bloodmobile. We've got
Speaker 3: links to our bookshop dot org affiliate account, our Goodreads list, sources, things,
Speaker 3: the list goes on. Yeah, all right, can we get
Speaker 3: to like the episode already?
Speaker 4: Yes, Aaron, please start us off with how the heck
Speaker 4: we got to hear? Aaron?
Speaker 3: I will. Let's take a quick break, and then that
Speaker 3: is exactly what I'll get into. It's midnight. In six hours,
Speaker 3: you're supposed to be heading to the airport for a
Speaker 3: two week trip to I don't know, say, Scotland. And
Speaker 3: even though you promised yourself that you'd be fully packed
Speaker 3: well before now, with enough time to get a full,
Speaker 3: glorious eight hours of sleep, that promise has long since
Speaker 3: been shattered. Tossing in that extra pair of just in
Speaker 3: case socks, you zip your bag and you sit back,
Speaker 3: breathing a long sigh of relief. It's finally over, but
Speaker 3: your mind is still restless, and it starts to run
Speaker 3: through the list of non packing things you're supposed to
Speaker 3: have done. Water the plants, check, clean out the fridge, check,
Speaker 3: leave instructions for the dog sitter check. Oh God, realized
Speaker 3: you haven't given the dog his flea and tick medication.
Speaker 3: What if the dogs that are takes into the park
Speaker 3: and he gets tons and tons of ticks. You scrounged
Speaker 3: around for the front line and kneel down next to
Speaker 3: your peacefully sleeping dog. Because it's late and because you're
Speaker 3: desperate to crawl into bed. Your brain doesn't register the
Speaker 3: bold lettering on the frontline package stating to open away
Speaker 3: from your face in all caps, complete with illustrations, and
Speaker 3: you twist open the applicator inches from your face. A
Speaker 3: burning sensation in your eye alerts you to the fact
Speaker 3: that something has gone horribly wrong, that a drop of
Speaker 3: who knows what chemicals has found its way into your eye.
Speaker 3: Panic coursing through your body. You run to the sink
Speaker 3: to flush out your eye, but the burning doesn't cease.
Speaker 3: What do I do now, you think, Should I go
Speaker 3: to the er? Have I permanently damaged my eye, who
Speaker 3: could possibly have the answers. I don't even want to
Speaker 3: go on the internet. Then it hits you poison control
Speaker 3: with one phone call. The reassuring voice on the other
Speaker 3: end tells you that you don't need to go to
Speaker 3: the er, that you should keep flushing your eye, and
Speaker 3: that you're gonna be okay. As someone who personally witnessed
Speaker 3: this entire incident, my favorite thing.
Speaker 4: Erin is that from the first line, I was like, Oh,
Speaker 4: I know this, I owe the story. This is a real.
Speaker 3: Life scenario, a real life scenario. But yes, as a
Speaker 3: witness to this, it was really amazing to see this
Speaker 3: resource that I had seen mentioned, I had read on
Speaker 3: so many medication packages and other packages for my whole life,
Speaker 3: had never used myself, and then to finally see it
Speaker 3: be used, and I was just like, this is an
Speaker 3: absolute gold mine of information that anyone could use at
Speaker 3: any time to get potentially life saving instructions. But even
Speaker 3: though it may seem like it's always been around, that's
Speaker 3: how it seems to me, it most definitely has not.
Speaker 3: And so that's the story that I want to tell today.
Speaker 3: The need for poison control centers is clear to all
Speaker 3: of us, whether we've used them or not. But who
Speaker 3: first recognized this need and decided to do something about it.
Speaker 3: I'll get to the who in a bit, but first
Speaker 3: let's get into the need, the why that motivated the
Speaker 3: who to create poison centers. That sentence was very confusing.
Speaker 4: But I loved it.
Speaker 3: We'll get there. Poisons, as in substances that have the
Speaker 3: capacity to cause harm or death to humans, have been
Speaker 3: around since the dawn of humanity, whether accidental like eating
Speaker 3: a poisonous mushroom or intentional like lacing someone's dinner with
Speaker 3: arsenic poisoning has been something humans have contended with forever,
Speaker 3: and if you haven't listened to our book club episode
Speaker 3: with doctor Noah Whiteman about his book Most Dangerous Poison
Speaker 3: from a couple weeks ago, here's your cue to check
Speaker 3: it out. For millennia, the concept of poison primarily included
Speaker 3: substances found in nature, whether from a plant, an animal,
Speaker 3: or a mineral slash metal and accidentally encountered, slash ingested,
Speaker 3: or administered with the explicit goal of causing harm. The
Speaker 3: Industrial Revolution shook things up a bit, as the number
Speaker 3: of people working with or using toxic substances, both natural
Speaker 3: and artificial in manufacturing rapidly increased, and poison grew to
Speaker 3: encompass those occupationally encountered substances as well, But largely going
Speaker 3: into the twentieth century, poisons were seen as specific instances
Speaker 3: poisonings tied to certain substances rather than ambient toxins, unless
Speaker 3: you were talking about workplaces where the threat could be environmental,
Speaker 3: and with the exception of certain medications where paraphrasing Paracelsus
Speaker 3: from the sixteenth century, the dose makes the poison. Poisons
Speaker 3: weren't really seen as a super common household item, which
Speaker 3: I think is a really interesting thing to think about,
Speaker 3: because if you asked me to think about the poisons
Speaker 3: that I would encounter on a daily basis, I'm like, oh, well,
Speaker 3: you know, there's a lot of chemicals in underneath my
Speaker 3: sink in my laundry room, like in my garage, there
Speaker 3: are things that are absolutely toxic.
Speaker 4: Right anti freeze, the stuff I used to clean my
Speaker 4: toilet lea.
Speaker 3: Yeah, Like there's a lot. And that has not really
Speaker 3: that's been a more recent development over the course of humanity,
Speaker 3: or at least like for most people encountering on a
Speaker 3: day to day basis.
Speaker 2: I don't know.
Speaker 3: I just thought that was a really interesting shift.
Speaker 4: Is interesting because you don't you don't think about it,
Speaker 4: and I think too probably like we probably don't often
Speaker 4: think of those things as poisons, right, but we would
Speaker 4: think of them as poison us or hazardous to our health.
Speaker 4: And so it's also that like distinction of like is
Speaker 4: it a poison or is it poisonous? And like, oh
Speaker 4: what does it mean?
Speaker 3: Yeah, and there's there's a really interesting paper that all
Speaker 3: put on the website, but there's a lot of fascinating
Speaker 3: links to the environmentalism movement in the twentieth century as
Speaker 3: it became recognized that like, oh, these aren't just like
Speaker 3: specific things that cause one person harm, but these are
Speaker 3: things that can leach into our entire world, the environment basically. Yeah,
Speaker 3: and I'm not getting into that here, but I just
Speaker 3: I thought that was a really interesting perspective on that.
Speaker 4: It really is.
Speaker 3: But yeah, going into the twentieth century, things were beginning
Speaker 3: to change as the continued growth of industrial chemistry and
Speaker 3: food and drug manufacturing brought new products to the market
Speaker 3: and into the home. I read that between eighteen seventy
Speaker 3: nine and nineteen twenty, sales of quote unquote, drug, toilet
Speaker 3: and household preparations for the home increased from forty million
Speaker 3: dollars in eighteen seventy nine to seven hundred and sixty
Speaker 3: five million dollars in nineteen twenty.
Speaker 4: Just by nineteen twenty.
Speaker 3: Wow, I know, and these industries initially faced very light,
Speaker 3: if any regulation. We've touched on this a bit in
Speaker 3: our Supplements episode and in our book Club episode featuring
Speaker 3: Deborah Blum chatting about her book The Poison Squad. But
Speaker 3: it was a real uphill battle to get manufacturers to
Speaker 3: accurately label the contents of their products. The Food and
Speaker 3: Drug Act of nineteen oh six helped to increase transparency,
Speaker 3: but just for food and drugs, primarily not household cleaners
Speaker 3: or other chemicals, which were becoming increasingly popular as marketing
Speaker 3: campaigns targeted housewives and told them that they needed these
Speaker 3: products to maintain a sparkling, clean, germ free home. You know,
Speaker 3: I'm gonna put germ theory in here. It was only
Speaker 3: because of germ theory. No, and even if labels on
Speaker 3: these household these new household products contained information about what
Speaker 3: was in this cleaner or that cleaner. Who knew what
Speaker 3: some of those confusing sounding names. Chemical names meant like
Speaker 3: what's for instance, I pulled a bottle of a window
Speaker 3: cleaner from my sink. What is isopropanolamine? I probably mispronounced that?
Speaker 3: Or sodium c tens dash sixteen alkyl benzene sulfonate.
Speaker 4: You know things you don't have all of your okem
Speaker 4: things memorized.
Speaker 3: I have tried to block that part of my undergrad
Speaker 3: from my memory. So that was like thirty years about yeah,
Speaker 3: or what if you were a child and you couldn't
Speaker 3: even read those labels. Some magazines like Good Housekeeping published
Speaker 3: safety information about common household products, but there wasn't a
Speaker 3: central database where someone could find this information, information which
Speaker 3: was growing exponentially by the year. Manufacturers initially placed the
Speaker 3: responsibility on mothers to know whether or not a product
Speaker 3: or medication was safe or not and in what amounts
Speaker 3: it would be a danger, and it didn't provide that
Speaker 3: information directly, or if it did, it was in like
Speaker 3: the tiniest fonts possible, where it would say like danger
Speaker 3: if ingested and you have to get out of magnifying glass.
Speaker 3: And to illustrate This is testimony from a nineteen twenty
Speaker 3: six Senate committee meeting about a bill to appropriately label
Speaker 3: certain products as poisons. Quote, here is the picture of
Speaker 3: a child of a citizen of Pennsylvania which swallowed a
Speaker 3: preparation no as clean all up in the state of Massachusetts.
Speaker 3: The child's passage to the stomach was totally obliterated. A
Speaker 3: person saved her life by putting a tube in the stomach.
Speaker 3: When I asked the mother, why did you let the
Speaker 3: child have that? She said why, I did not know
Speaker 3: that it was poison. And I got her to bring
Speaker 3: me a can. And here you can see on this
Speaker 3: can that I have here, which was bought in the stores,
Speaker 3: that there is not only no poison label whatever on it,
Speaker 3: but it says quote does not injure the finest fabric
Speaker 3: or the most delicate skin. Now, how could you expect
Speaker 3: any mother to think that thing was dangerous?
Speaker 2: End? Quote?
Speaker 3: Wow?
Speaker 4: Right, that's really interesting.
Speaker 3: I mean, and that's a whole separate episode, like the
Speaker 3: labeling of products as poisonous or toxic or whatever. And
Speaker 3: even still today, I was kind of going through some
Speaker 3: of the cleaning products and there's not a whole lot
Speaker 3: of like blatant Holy cow, you know this is really bad, right, Yeah,
Speaker 3: it's like.
Speaker 4: If contact with eyes rints and call poison control if
Speaker 4: ingested cal poison control, Like that's all they say.
Speaker 3: Uh huh huh. And it's like, we're not going to
Speaker 3: freak you out here, We're gonna let somebody else tell
Speaker 3: you just how back.
Speaker 4: How freaked out to be. So hopefully you read enough
Speaker 4: English to be able to see this on the label
Speaker 4: and know how to call.
Speaker 3: Yep, yeah, yeah, yeah. And some of it didn't even
Speaker 3: call poison control, just said like seek help or oh
Speaker 3: interesting or and then some doesn't have some don't have
Speaker 3: the poison control number. Anyway, I think that's really labeling.
Speaker 3: Who knew there's so much to a label, but there is?
Speaker 4: Is that gonna be our new knitch, Sharon.
Speaker 3: I'm into it.
Speaker 4: I'm there.
Speaker 3: As a reaction to this, these these issues surrounding labeling,
Speaker 3: and as part of a larger trend in consumer protection,
Speaker 3: regulation was passed in the US to help oversee the
Speaker 3: labeling of these products and in some cases the packaging,
Speaker 3: such as childproof lids, which varied in their child proofness.
Speaker 3: You know, some reports of like a kid had to
Speaker 3: instruct the mom how to open the baby aspirin, which
Speaker 3: tasted like candy, and then it's like that's a whole
Speaker 3: thing too, where it's like, uh, it tastes like candy,
Speaker 3: it must be candy anyway. But this didn't really seem
Speaker 3: to make a huge dent in the frequency of accidental
Speaker 3: poisonings in the home, especially for children. And part of
Speaker 3: this rise in the frequency of accidental poisonings in children
Speaker 3: was certainly due to the wider availability of potentially dangerous
Speaker 3: household products with or without labels, But another big part
Speaker 3: was that these accidental poisonings were becoming much more visible
Speaker 3: thanks to what was happening in the background in terms
Speaker 3: of medicine, essentially the drastic reduction in infectious diseases as
Speaker 3: a leading cause of mortality in children.
Speaker 4: I never thought about that. So it's like we've fixed
Speaker 4: we're fixing this problem, and so now we have like
Speaker 4: more bandwidth to be concerned about this other problem.
Speaker 3: Right, So it's like how much I mean in epidemiological
Speaker 3: studies of even accidental poisonings were rare in the nineteen forties,
Speaker 3: but before then, like who even knew?
Speaker 4: Right, how interesting?
Speaker 3: It's Yeah, vaccines and antibiotics and other medical advancements had
Speaker 3: slashed the rates of infectious disease cases and deaths by
Speaker 3: I think, a rate that is unfathomable to many of
Speaker 3: us today, upwards of ninety percent, especially for children. You know,
Speaker 3: morte due to infectious disease was absolutely slashed. Incredible vaccines, man, vaccines.
Speaker 4: They can't say it enough, I know.
Speaker 3: And as many deadly infectious diseases became preventable, another leading
Speaker 3: cause of death, also viewed as preventable in children, took
Speaker 3: their place accidents, especially accidental poisonings. By the nineteen forties
Speaker 3: in the US, studies found that seven out of ten
Speaker 3: accidents resulting in death for children under the age of
Speaker 3: five took place in the home, and the numbers were rising.
Speaker 3: In nineteen thirty and estimated eleven percent of all deaths
Speaker 3: among those aged one to four were caused by accidents,
Speaker 3: but in nineteen fifty that had risen to seventeen percent.
Speaker 3: There was one group, though, that didn't need to see
Speaker 3: these numbers to know that there was a concerning rise
Speaker 3: in the incidence of accidental poisonings among their patients, and
Speaker 3: that was the pediatricians. When a child ingested or got
Speaker 3: into something that they should not have, which that's what
Speaker 3: they do. Parents often turned first to pediatricians for answers.
Speaker 3: My kid just ate this or drank that? Are they
Speaker 3: going to be okay? What should I do?
Speaker 1: Like?
Speaker 3: How do I proceed? Pediatricians and other healthcare professionals did
Speaker 3: their best to answer these questions, but as the number
Speaker 3: of household products grew, it became more difficult to keep
Speaker 3: a grasp on what was in this cleaning product or
Speaker 3: that furniture polish. You know, this disinfectant, that insecticide, and
Speaker 3: so on, like more and more and more and more,
Speaker 3: and not only like what is in these different products,
Speaker 3: but like what do you do afterwards? How much is
Speaker 3: an okay amount to ingest? Is there an okaymout to ingest?
Speaker 2: You know?
Speaker 3: Like all of these different decision trees, How is one
Speaker 3: person or even one doctor's office supposed to hold all
Speaker 3: that information at once, especially as things are growing? And
Speaker 3: this is need I say, pre Internet.
Speaker 4: So right, they couldn't google it, They couldn't google it.
Speaker 3: And to say this was frustrating for the pediatricians I
Speaker 3: think would be a huge understatement, because pediatricians saw accidental
Speaker 3: poisonings as a largely preventable cause of death. With so
Speaker 3: many opportunities at many different stages or layers to reduce
Speaker 3: their incidence.
Speaker 1: Right.
Speaker 3: There could be better design, like with childproof lids or
Speaker 3: childproof containers or cabinets that where you could store these
Speaker 3: things under lock and key. There could be better labeling
Speaker 3: transparency saying whether or not a substance was toxic and
Speaker 3: needed a childproof lid or needed to be locked away
Speaker 3: in that cabinet. There could be less toxic formulas, like
Speaker 3: maybe we don't need industrial strength pesticide in our garage, right,
Speaker 3: Maybe there are other ways. There could be lots of
Speaker 3: different stages in terms of like design at the front
Speaker 3: end of things. Right, But even with all of these
Speaker 3: extra safety measures in place, kids still get into things.
Speaker 3: Kids are still going to get past that lock and key.
Speaker 3: They're still going to get into that child proof past
Speaker 3: a childproof lid.
Speaker 1: You know.
Speaker 4: It's just very they're very good at it experts.
Speaker 3: Yeah, it's how it is. And so a crucial layer
Speaker 3: of protection against accidental poisonings was access to information about
Speaker 3: what was in these products and the best course of
Speaker 3: treatment for an exposure. With hundreds of thousands of trade
Speaker 3: name substances on the market and rising that information was
Speaker 3: impossible for any one person or one doctor's office to
Speaker 3: keep track of, but some people still tried. One of
Speaker 3: these people was Chicago pharmacist Lewis Godalman, who began working
Speaker 3: as the director of the two person pharmacy department of
Speaker 3: Saint Luke's Hospital in show Cago in nineteen thirty. The
Speaker 3: other person was the delivery boy. Isn't that cute?
Speaker 2: I don't know why.
Speaker 4: I love that.
Speaker 3: I love that that detail was in this paper I read.
Speaker 4: I read really good.
Speaker 3: It just so happened that at Saint Luke's the pharmacy
Speaker 3: department was located right across the hall from the emergency room,
Speaker 3: and Godalman, with his pharmacy and chemistry background, would get
Speaker 3: requests for information from er docs and other hospital staff,
Speaker 3: wanting to know whether a patient that had just eaten
Speaker 3: some type of poison or toxin was in danger or
Speaker 3: what kind of danger they were in. Over time, news
Speaker 3: of Godalman's expertise spread beyond the hospital and spilled over
Speaker 3: into other hospitals around Chicago, then around Illinois, then around
Speaker 3: the country, and even into the general public. And his
Speaker 3: phone number was published in all emergency references, and so
Speaker 3: Godalman would get phone calls at all hours of the day,
Speaker 3: like twenty four hours a day at work at home,
Speaker 3: and he never refused to call. He knew as much
Speaker 3: as any one person could about this. Realizing that speediness
Speaker 3: and efficiency was key, he began writing out information on
Speaker 3: little note cards like index cards, where he could quickly
Speaker 3: access the most relevant info, like maybe the most commonly
Speaker 3: purchased products, or the ones that were like, oh, we
Speaker 3: need this second smatter here, let's get this information first,
Speaker 3: And by nineteen fifty he had amassed quite the stack
Speaker 3: of cards. But still, it's just one person, right, one human,
Speaker 3: one human, one human, and there's only so much that
Speaker 3: one person could do, and given that his phone never
Speaker 3: stopped ringing, essentially there was a clear need for a standard,
Speaker 3: formalized service to provide this life saving information. In nineteen
Speaker 3: fifty two, the American Academy of Pediatrics established it's Accident
Speaker 3: Prevention Committee, and one of the first things they did
Speaker 3: was survey the most common household factors associated with children's accidents,
Speaker 3: and they found that fifty percent of the reported accidents
Speaker 3: involved poisoning, which was much higher than anyone had expected
Speaker 3: to find, except probably for the pediatricians who were seeing
Speaker 3: these patients like every day. These findings, combined with the
Speaker 3: impact of Godalman's informal poison control hotline, led to the
Speaker 3: first official poison control center being established at Godalman's Hospital
Speaker 3: Saint Luke's Hospital, in November of nineteen fifty three.
Speaker 4: I love it.
Speaker 3: I do too.
Speaker 4: I want you to keep going, Okay.
Speaker 3: Just a few months later, the second poison control center
Speaker 3: was named in Durham, North Carolina, and over the next
Speaker 3: few years, hundreds more followed. Hundreds hundreds. I mean, has
Speaker 3: there been anything that has caught on so quickly in medicine?
Speaker 3: I mean probably, but like still it's impressive.
Speaker 4: And so did goodolmans like stash of cards like get
Speaker 4: grandfathered to all of these places? Like did the information
Speaker 4: make it to all of these new centers that were
Speaker 4: opening up?
Speaker 3: Yeah, So I don't know about the logistics of that,
Speaker 3: but that was something like I don't know whether that
Speaker 3: precise stack of cards or the info that he had there,
Speaker 3: or whether they just adopted his technique. But that is
Speaker 3: something that I'll talk about in a second. In terms
Speaker 3: of like organization, yes, orgnation, et cetera.
Speaker 4: Yeah, I love.
Speaker 3: It, but I want to read you a bit from
Speaker 3: a nineteen fifty four paper where the rationale for this
Speaker 3: poison control program like generally was proposed. It's kind of
Speaker 3: a long quote quote. There is a toxin that maybe
Speaker 3: more deadly than that generated by the germs causing typhoid fever, tuberculosis, diphtheria,
Speaker 3: or leprosy, and this toxin has already spread to almost
Speaker 3: every household in the United States. Although there are a
Speaker 3: variety of strains of this toxin and many type specific groups,
Speaker 3: sublethal attacks usually confer no immunity. We are speaking of
Speaker 3: the ready made and often highly virulent test tube toxins
Speaker 3: synthesized by modern industry and used in millions of households
Speaker 3: to clean clothes, kill flies or rats, provide heat, and
Speaker 3: accomplish many other everyday tasks. The same machine age responsible,
Speaker 3: through its advances in sanitation, immunization, chemotherapy, and antibiotics, for
Speaker 3: controlling the damage done by the toxic products generated by
Speaker 3: germs that caused epidemics, has, by similar advances, posed new
Speaker 3: threats to life and health.
Speaker 2: End quote.
Speaker 3: Test tube toxin, test tube toxin.
Speaker 4: You want that on a T shirt? I love it,
Speaker 4: but I love.
Speaker 3: That I think it kind of it wraps it up
Speaker 3: so nicely where it's like put all into perspective, like,
Speaker 3: here's this world. We can see how far technology has
Speaker 3: allowed us to come in terms of medicine, in terms
Speaker 3: of technology, in terms of other things. And yet and
Speaker 3: yet yeah, and we need to do something about that.
Speaker 3: And yet right, and we can do something about and
Speaker 3: we can and we are and we will. Yeah. Over
Speaker 3: the rest of the nineteen fifties, poison control centers grew
Speaker 3: in leaps and bounds, and there were certainly some growing
Speaker 3: pains to work out. There was still some inefficiency or
Speaker 3: inconsistency in how information was gathered and transmitted, and so
Speaker 3: in nineteen fifty seven, the FDA established the National Clearinghouse
Speaker 3: for Poison Control Centers, which essentially acted as a place
Speaker 3: where information about poisons and toxicology was gathered and then
Speaker 3: distributed in the forms of bulletins, index cards, and so on.
Speaker 3: The following year, nineteen fifty eight, the first meeting of
Speaker 3: the American Association of Poison Control Centers was held in Chicago,
Speaker 3: and the majority of attendees and members were pediatricians. Throughout
Speaker 3: the nineteen seventies and into the nineteen eighties, poison control
Speaker 3: centers continued to grow in number, shooting up to six
Speaker 3: hundred at one point nationwide in the US at one
Speaker 3: point in the nineteen seventies, and then eventually it began
Speaker 3: to grow in coordination, which led to fewer centers overall,
Speaker 3: because it was like, we don't need a poison control
Speaker 3: center at each hospital or at each doctor's office, like
Speaker 3: we can have one consolidator, the area consolidation yep efficiency.
Speaker 3: In nineteen eighty, the creation of a national database for
Speaker 3: all poisoning cases in the US really helped to centralize
Speaker 3: information and also helped to demonstrate the impacts of these
Speaker 3: poison control centers. For instance, in nineteen seventy two, at
Speaker 3: least two hundred and sixteen children died as a result
Speaker 3: of poisoning. In two thousand and seven, that number would
Speaker 3: dropped to thirty nine. And remember, during that time, the
Speaker 3: US population grew a lot. But besides the obvious and
Speaker 3: incredible effect that poison control centers have had on providing
Speaker 3: life saving information to get people the help they need,
Speaker 3: they have also dramatically helped to reduce healthcare costs, especially
Speaker 3: when it comes to emergency healthcare utilization, which I know
Speaker 3: you'll talk a bit more about later.
Speaker 4: On so much.
Speaker 3: It's thrilling, it's amazing. But another core, and I think
Speaker 3: sometimes underappreciated aspect of poison control centers, is that they
Speaker 3: represent something that seems harder and harder to come by
Speaker 3: these days, a reliable source of factual information that provides answers, guidance,
Speaker 3: and often peace of mind for nothing, for nothing, in minutes,
Speaker 3: in minutes, instantaneously.
Speaker 4: It's true phenomenal to call poison control. Yeah, like the
Speaker 4: amount of information, how detailed the information, how factual the information,
Speaker 4: and when you're in a panic, how reassuring that information is.
Speaker 4: You cannot overstate it.
Speaker 2: Yep.
Speaker 3: Absolutely, And I feel like nowadays so many of us
Speaker 3: go straight to the Internet to seek answers to our questions,
Speaker 3: whether that's like what headphones should I buy? Or what's
Speaker 3: this mole on my arm? And where we're met with
Speaker 3: an absolutely overwhelming tsunami of information, good and bad, and
Speaker 3: opinions also good and bad, and we can sift through
Speaker 3: results and forums for hours and emerge on the other
Speaker 3: side with no more clarity than we had at the start.
Speaker 3: But when you don't have the luxury of time, and
Speaker 3: you need accurate information immediately from a trusted source. That
Speaker 3: Reddit thread from five years ago about somebody accidentally squirting
Speaker 3: frontline in their eye, it's not where you're gonna want
Speaker 3: to turn right. Instead, you're going to want to call
Speaker 3: poison control, where the voice on the other end has
Speaker 3: the answers that you so desperately need.
Speaker 4: And I think that also can't be understated because if
Speaker 4: you go online and search for anything like, you will
Speaker 4: never come to an actual answer. You will see every possibility,
Speaker 4: which inevitably ends with well it could be colon cancer,
Speaker 4: because that's how all Internet searches about anything medical end. Huh, Like,
Speaker 4: you can't get an actual answer. But when you call
Speaker 4: poison control at the end of it, there will be
Speaker 4: an answer. It will be either you don't need to panic,
Speaker 4: don't worry about it, you need to go to the
Speaker 4: emergency room, in which case they will continue to follow
Speaker 4: by the way as you go to the emergency room.
Speaker 4: Or it will be something else. But it will be
Speaker 4: like a concrete answer, like do X, Y and Z
Speaker 4: steps and if that doesn't work, then do abn C
Speaker 4: steps Like it's it is so.
Speaker 3: Concrete in that way, yes, that is concrete.
Speaker 2: Is great.
Speaker 3: It is like no waffling, there isn't Oh well, let
Speaker 3: me just keep you know it is. This is the
Speaker 3: sequence of events. This is how we're going to make
Speaker 3: our decisions.
Speaker 4: Yeah, decisions will be made.
Speaker 3: I love it so much.
Speaker 4: I've loved every conversation I've ever had with poison Control.
Speaker 4: I have had several. It's so I love it.
Speaker 3: We're big fans.
Speaker 4: Big fans if you can't tell.
Speaker 3: But that's that's poison Control. That's the story of how
Speaker 3: we got to where we are today, more or less,
Speaker 3: more or.
Speaker 4: Less, I really love. Like I I wish that I
Speaker 4: could talk to good Almond. I know he has passed,
Speaker 4: but I just wish that like imagining the series and
Speaker 4: like the conversations that happened between him and like people
Speaker 4: at AAP and like you know, other people that were
Speaker 4: like in these medical organizations and then talking to people
Speaker 4: in state governments and federal governments to get this funding
Speaker 4: and to get started and at the hospitals, like and
Speaker 4: to have it now exist the way that it does today,
Speaker 4: Like that is just it's so cool.
Speaker 3: As a household name, like hopefully everyone knows about poison
Speaker 3: Control or they do after this episode. Yeah, and it's
Speaker 3: on package like it is, just it makes so much sense.
Speaker 4: It does.
Speaker 3: Yeah, and it's of course it exists, Yeah, of course
Speaker 3: it exists.
Speaker 4: Yeah.
Speaker 3: But also Aaron, we have, like I have more questions,
Speaker 3: and those questions are mostly like but it exists, yes,
Speaker 3: but awesome? What does that mean? How does it work?
Speaker 4: Happens when you what happens? Who are we talking to?
Speaker 3: Yeah? How do they know what they know and what
Speaker 3: to tell us and in what order? And everything?
Speaker 4: Everything?
Speaker 3: And they know so much?
Speaker 4: How this so much when you talk to them on
Speaker 4: the phone. How do they know all of the things.
Speaker 3: I'm sure that all of you all out there also
Speaker 3: have these burning questions, and you're in a lot of
Speaker 3: luck because next week that is exactly what we'll be
Speaker 3: getting into with our amazing provider of our first hand
Speaker 3: account and also the medical director of the Connecticut Poison
Speaker 3: Control Center, doctor Suzanne Doyon. A big thank you again
Speaker 3: to doctor Doyon.
Speaker 4: Make sure that you smash that subscribe button so that
Speaker 4: you don't miss that episode when it drops next week.
Speaker 4: It's going to be great.
Speaker 3: It's going to be great. And to tide you over
Speaker 3: until then, if you're like, oh, my gosh, but wait,
Speaker 3: poison control guess what, there are sources that you can release.
Speaker 3: So I have a long list of sources. Actually for
Speaker 3: this episode, I'm going to shout out just a few
Speaker 3: of them, and then you can check out our website
Speaker 3: where you can find lots more So, the one that
Speaker 3: I mentioned earlier in the episode where I was talking
Speaker 3: about sort of the rise of environmentalism, that is by
Speaker 3: Burnham from nineteen ninety five and it's called how the
Speaker 3: discovery of accidental childhood poisoning contributed to the development of
Speaker 3: environmentalism in the United States. Another source that I used
Speaker 3: is by Burda and Birda from two thousand called Taking
Speaker 3: a Stand against Accidental Childhood Poisoning The Founding of the
Speaker 3: Nation's first Poison Control Center in Chicago. And then there
Speaker 3: was a paper that I liked from nineteen seventy eight
Speaker 3: because it was a little bit older, so it had
Speaker 3: a different perspective on like the history of poison control centers.
Speaker 3: This was by Shares and Robertson and it was titled
Speaker 3: the History of Poison Control Centers in the United States,
Speaker 3: so from nineteen seventy eight, so it was like very
Speaker 3: new at that point. But I liked that anyway. You
Speaker 3: can find a full list of all of our sources
Speaker 3: on our website. This podcast will kill you dot com,
Speaker 3: so go check it out.
Speaker 4: Thank you to Bloodmobile for providing the music for this
Speaker 4: episode and every single one of ours.
Speaker 3: Thank you to Leanna Squalacci and Tom bry Foegel for
Speaker 3: the amazing audio mixing.
Speaker 4: Thank you to everyone exactly Right Network.
Speaker 3: And thank you to you listeners. We hope that you
Speaker 3: are as jazzed about poison control centers as we are.
Speaker 4: Jazz is a good word, super jazz like jazz fingers
Speaker 4: over here. Yes, and especially thank you to our patrons.
Speaker 4: We appreciate your support so so, so so much. We
Speaker 4: can't say it enough.
Speaker 3: Yes, thank you, thank you, thank you. Until next time,
Speaker 3: wash your hands.
Speaker 4: You filthy animals. Five