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