SYMHC Class: Poison Control

This 2020 episode examines how the U. S. got to the point of having one resource, specifically for poisoning, that’s so reliable and available that it gets printed on the labels of consumer products. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Holly Frey?

  This is an iHeart Podcast. Guaranteed Human. A rare disease diagnosis can change your life, but it doesn't have to define your future. In season seven of Untold Stories: Life with a Severe Autoimmune Condition, host Martine Hackett continues the conversation with people living with MG, CIDP, and the broader rare disease community, exploring what comes after diagnosis through stories of hope, progress, and connection. Produced by Ruby Studio in partnership with Argentix. Listen on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.

• 0:35Tracy V. Wilson?

  Whether you're calling the wise women in your life, video calling your girlfriends across the country, or checking in on someone who always knows how to make you smile, staying connected matters. Those small conversations, shared laughs, and quick hellos are what keep relationships strong even when life gets busy. Some of the most life-giving conversations start with just a phone call. That's why AT&T guarantees the network you can rely on, so you can focus on the moments and people that matter most. That's the AT&T Guarantee. AT&T: Connecting Changes Everything. Terms and conditions apply. Visit att.com/guarantee for details. The Old Gays are back with Silver Linings, their lovable podcast from iHeart's Ruby

• 1:15Tracy V. Wilson?

  Studio in partnership with ViiV Healthcare. Robert, Mick, Bill, and Jessa strut back down memory lane for season two, sharing lessons on life, love, and loss. These are the kind of insights that only come from experience. So tune in to Silver Linings with The Old Gays on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Workplace chaos. We've all been there. Deadlines are slipping, projects are piling up, and suddenly you realize the missing piece is the right person. That's when you say, "This is a job for Sponsored Jobs." With Indeed Sponsored Jobs, your job post gets a boost, so you can connect with quality candidates faster. In fact, Sponsored Jobs posted directly

• 1:56Tracy V. Wilson?

  on Indeed are 95% more likely to report a hire than non-sponsored jobs. Spend less time searching and more time interviewing candidates who check all your boxes. Get a $75 Sponsored Job credit at indeed.com/podcast. Need a hiring hero? This is a job for Indeed Sponsored Jobs.

• 2:17Tracy V. Wilson?

  Happy Saturday. In our behind the scenes episode yesterday, we mentioned our prior episode on poison control. So we're bringing that out as today's Saturday classic.

• 2:28Holly Frey?

  This episode originally came out on March 25, 2020. Enjoy.

• 2:35Holly Frey?

  Welcome to Stuff You Missed in History Class, a production of iHeartRadio.

• 2:46Tracy V. Wilson?

  Hello and welcome to the podcast. I'm Tracy V. Wilson.

• 2:49Holly Frey?

  And I'm Holly Frey.

• 2:52Tracy V. Wilson?

  In case you've never heard our show before, this is episode two of us recording the show with everyone involved in the process in their own homes because of the current pandemic and resulting quarantine slash shelter in place slash self isolation slash social distancing instructions we have all been under.

• 3:15Holly Frey?

  Yeah.

• 3:16Tracy V. Wilson?

  So if you're a longtime listener and you're like, why doesn't this sound quite the same? That's why. If you're brand new, that's just a heads up. That's where we are right now. And we coincidentally have a medical history week that we did not plan that just happens to be falling in line with all of this. So the other day, it was time to give our kittens their flea and tick prevention. And then afterward, I was idly reading the back of the box while I was washing my hands. And I noticed that it said to contact poison control if swallowed. And at first, I thought, why not just print what to do on the box instead of directing people to call poison control? But then I was like, where did poison control even come from? How did we get to the point of having this one resource specifically for poisoning that's

• 4:01Tracy V. Wilson?

  so reliable and available that companies can print it on the labels of consumer products? And especially here in the US where Holly and I are, this is a healthcare service that is staffed 24/7 and accessible to everyone for free, which is not a thing that exists in many other contexts. I mean, there are some other 24 hour hotlines, but like, it's not often that anybody, literally anyone, can call a medical professional 24 hours a day and get an answer for free. The first service like this was established in the Netherlands in 1949. And today, they exist in a lot of countries around the world, particularly in the Americas, Western Europe, and parts of the Middle East.

• 4:42Tracy V. Wilson?

  According to the World Health Organization, 47% of member states have a poison center of some sort. But because the development of poison control centers in the US closely parallels some other shifts in American history, that's really where we're focusing on with this story today.

• 4:59Holly Frey?

  So you can really define the word poisoning in a lot of different ways, but in general, it is any toxin-related injury. The toxin can come from all kinds of sources: cleaning products, medications, mushrooms out in the yard, and things that we actually think of poisons, like insecticides and rat poisons. Sometimes people describe being envenomed from something like a snake bite or insect sting also as being poisoned.

• 5:26Tracy V. Wilson?

  In a lot of cases, exposure to a small amount of one of these substances isn't really dangerous. And when it's something like medicine, that can be helpful rather than harmful. But in large enough amounts, otherwise harmless or even beneficial substances can become lethal.

• 5:42Holly Frey?

  To be clear, we also use terms like sun poisoning and food poisoning, but that's not really what we're talking about here. Sun poisoning is actually a severe type of sunburn. And in most cases, food poisoning is an illness that's caused by a pathogen like Salmonella or Shigella bacteria. There are foodborne illnesses that involve pathogens that can produce toxins, and foods can be contaminated with toxic substances. But most of the time, when we say food poisoning, we're actually talking about an illness, not a poison that someone put in your food.

• 6:16Tracy V. Wilson?

  People have been exposed to poisons, of course, throughout human history. There are toxic plants and fungi and metals all over the world. Most places have at least some species of venomous animals. People have also done things like making their drinking vessels or makeup out of toxic metals like lead. But household toxins really started to proliferate with industrialization.

• 6:41Tracy V. Wilson?

  Over time, people's most likely sources of poisoning shifted from things like berries that they had gathered to eat to things like cleaning products and pharmaceuticals.

• 6:50Holly Frey?

  In some parts of the world, governments passed laws to try to protect people from the most potentially dangerous products, starting in the 19th century. For example, in the UK, the 1868 Pharmacy Act restricted the sale of a specific set of poisons. Only licensed pharmacists could sell them, and they had to keep a careful record of every sale.

• 7:13Tracy V. Wilson?

  There was not a similar federal law in the US, but between 1870 and 1890, 33 states adopted some kind of regulation on the sale of poisons. At the federal level, the first bills were introduced into Congress in 1879, but broad legislation didn't come along until much later.

• 7:32Holly Frey?

  Manufacturers also recognized the potential dangers involved with the products that they were making. Starting in the late 18th and early 19th centuries, manufacturers of things like rat poisons packaged their products in distinctively shaped bottles marked with things like skulls and crossbones and the word poison to try to prevent accidents. Manufacturers also used textured glass bottles so that people could tell what they were holding just by touch, and they also developed safety caps.

• 8:01Tracy V. Wilson?

  Most of these innovations weren't being used on products that were being sold directly to consumers, though. They were being used on products that would be repackaged at a pharmacy or another store. So the idea was to keep the druggist from selling somebody something dangerous by accident, not to prevent the consumer at home from accidentally hurting themselves or someone else.

• 8:24Holly Frey?

  By the middle of the 19th century, the American Pharmaceutical Association and American Medical Association had each passed resolutions recommending clearer labeling on dangerous household products, including medicines that could be harmful at high doses. But in general, manufacturers resisted laws that required this kind of packaging and labeling on consumer products. They argued that people might not buy a product that was in a scary-looking bottle with a skull and crossbones on it. Another argument was that consumers might put their products in a different container or reuse that skull-and-crossbone bottle to hold some other harmless substance, and that could just create all kinds of confusion.

• 9:04Tracy V. Wilson?

  By the turn of the 20th century, a couple of simultaneous developments dramatically increased the number of poisons that most people had in their homes. The germ theory of disease had become more widely accepted and generally known, so people became kind of hyper-aware of the idea of germs infesting their homes and infecting their families. Progressive reformers were also advocating ideas like good hygiene and cleanliness. There was just messaging about this kind of thing all over the place in news articles and women's magazines and that type of thing.

• 9:35Holly Frey?

  As a result, manufacturers introduced a ton of cleaning and disinfecting products, many of which were toxic. They marketed these products primarily to women as household time savers and as a vital part of keeping a clean home. Women's magazines also caught up to the trend and published household cleaning and sanitation tips, along with consumer education about safety, like keeping these products out of the reach of children, clearly labeling their packaging, and sticking a pin through the stopper of toxic products, so it would be obvious which bottle you were about to open.

• 10:11Tracy V. Wilson?

  At about the same time, drug makers were also introducing all kinds of new medications. This is something that we've talked about in previous episodes, including our two-parter on thalidomide. These new medications also became a potential source of poisoning.

• 10:27Holly Frey?

  With so many new sources of potential poisoning in people's homes, the number of accidental exposures skyrocketed.

• 10:35Holly Frey?

  Doctors and other members of the medical community reported huge increases in the number of patients they saw who had been harmed by a poisonous product. And because these products were brand new, doctors often didn't know what to do to treat these exposures. During the progressive era, muckraking journalists also tried to expose the dangers of these products, especially if they were poorly labeled or incorrectly handled.

• 11:00Tracy V. Wilson?

  Running in parallel with this focus on household poisons was a similar focus on food safety. This included the safety and quality of the foods themselves, the cleanliness and safety of facilities like slaughterhouses and packing houses, and the safety of food additives. As part of all this, Dr. Harvey "Washington" Wiley studied the effects of food additives by feeding things to a team of volunteers who came to be known as the Poison Squad. There's an episode in our archive about this. It's called "A Pure Food Father and His Poison Squad", and it came out in May of 2011. It's shorter than our episodes typically are today, and I haven't found a good companion to kind of pair it with, so we haven't lined it up as a Saturday classic as of yet.

• 11:45Holly Frey?

  All of this together led to the passage of the Pure Food and Drugs Act of 1906, which is also known as the Wiley Act. Most of its provisions were focused on food and food additives, but it also included labeling requirements for drugs, and it forbade patent medicines in interstate commerce. The Wiley Act was one of the first consumer protection laws of its kind. And while it did introduce some requirements for drugs and drug labeling, it didn't really address the many toxic household products that were being introduced into the market.

• 12:18Tracy V. Wilson?

  Then in 1926, bills were introduced in the House and the Senate that required labeling for a list of caustic substances. This included several acids, ammonia, silver nitrate, and sodium hydroxide, also known as lye. As part of this, Chevalier Jackson of Jefferson Medical College in Philadelphia testified before the Senate about injuries that he had witnessed from these types of substances in his practice. One case was a child who swallowed a product called Cleanol, and that had caused terrible damage to his esophagus. When the mother was asked why she had given this product to her child, she said she had not known it was poison.

• 13:00Holly Frey?

  In his testimony, Jackson said, "I got her to bring me a can. And here you can see on this can that I have here, which was bought in the stores, that there is not only no poison label whatever on it, but it says, 'Does not injure the finest fabric or the most delicate skin.'" Now, how could you expect any mother to think that this thing was dangerous?

• 13:23Tracy V. Wilson?

  After this and other testimony in 1927, President Calvin Coolidge signed the Caustic Poison Act into law. This act required a list of caustic poisons to be clearly labeled with the warnings in contrasting colors, also in the largest type that was on the package or the bottle the product was in. There wasn't really any data being kept on household poisonings at this point, but anecdotally, just this labeling requirement significantly reduced the number of poisoning deaths that were happening.

• 13:53Holly Frey?

  Household poisoning was still a problem, though, and it was not long after this that the first steps were made toward the poison control system that exists today. We'll talk about that more after we pause for a sponsor break.

• 14:08Speaker 02

  First thought is like, wow, how are we going to do all this?

• 14:11Tracy V. Wilson?

  Hey, everybody, it's Tracy from Stuff You Missed in History Class. That's Alan Goya, a planning engineer at AT&T. He's talking about Intuit Dome, home of the Los Angeles Clippers, where every seat, screen, phone, and transaction is connected with AT&T fiber and 5G, defining the fan's experience. And Alan's master plan made it all possible.

• 14:31Speaker 02

  It was going to rival anything that was already built, and that takes quite a bit of people. Different teams to all be on the same page.

• 14:39Tracy V. Wilson?

  That includes field services manager Drexel Jones. His team made sure it all came together and held up on game day.

• 14:46Speaker 03

  Through what Alan's whole crew designed, we connected the event visitors to the world.

• 14:51Tracy V. Wilson?

  And after years of hard work and collaboration, it was opening night.

• 14:55Speaker 03

  To actually see the whole stadium light up and data is flowing is a beautiful thing.

• 14:59Speaker 02

  What the fans experience is incredible. It gave me a lot of pride.

• 15:03Tracy V. Wilson?

  AT&T, connecting fans to what they love. Connecting changes everything. AT&T. So you're considering getting a home security system, but you want something that fits your space. Well, with ADT Blue, it's easy to customize a system that's right for you and set it up yourself. Just pick the kit and monitoring plan that makes sense for your home. Let's say you're worried about package theft. The ADT Plus app can walk you through setting up a new doorbell camera kit. Once it's installed, ADT Pros can help you keep tabs on it 24/7, or you can manage it yourself from the ADT Plus app. There are no long-term contracts, so you can change your monitoring plan whenever you want. The flexibility doesn't end there. You can add to your system as you need to with things like extra cameras or motion sensors.

• 15:48Tracy V. Wilson?

  Some life decisions are hard, but thanks to ADT Blue, you can DIY trusted ADT home security in a snap. Head to ADT.com/BLU to build your system today. And to hear more about home protection and other grown-up topics, check out new episodes of Grown Up Stuff on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

• 16:15Speaker 04

  Okay, chicken nugget fans, I've got huge news. The new Burger King Chicken Nuggets just dropped, and they are the crispiest, the juiciest, and the tastiest chicken nuggets ever at Burger King. Burger King heard that a lot of you didn't like the old chicken nuggets, so they got to work and reinvented them. To go along with the new chicken nuggets, a lot of the sauces were reinvented too, because better chicken nuggets deserve better sauces. We're talking new buffalo sauce, honey mustard, sweet and sour, and even a whole new option, too, the new special savory sauce, which is only available for a limited time at participating U.S. restaurants. I mean, you need to taste it all for yourself.

• 16:57Speaker 04

  This new chicken nugget, reinvented based on real feedback, is made with 100% white meat chicken and is now better than ever. You gotta try the new Burger King chicken nuggets and sauces today.

• 17:09Tracy V. Wilson?

  For any small business owner, there's a moment when you realize the next hire could be the difference between staying busy and actually growing. The challenge is finding the right person without wasting time sorting through candidates who aren't the right fit. That's where Indeed Sponsored Jobs comes in. When workplace chaos hits and you need someone who can step in and make a difference, this is a job for sponsored jobs. It helps put your job in front of candidates who match the criteria that matter most to you, whether that's skills, experience, certifications, or location. And you're certainly not alone in using Indeed. Join the 3.3 million employers worldwide that use Indeed to connect with quality talent that fits their needs. That's millions of businesses turning to Indeed

• 17:53Tracy V. Wilson?

  to help solve hiring challenges and find people who can help drive results. Spend less time searching and more time actually interviewing candidates who check all your boxes. Less stress, less time, more results. Get your $75 sponsored job credit today at indeed.com/podcast. Terms and conditions apply. Hiring now, then this is a job for Indeed Sponsored Jobs.

• 18:27Tracy V. Wilson?

  Overall, manufacturers supported the Caustic Poison Act when it was signed into law in 1927. It replaced a previous and sometimes really contradictory hodgepodge of state regulations on labeling, so it kind of made things easier from the manufacturer's perspective. But they resisted broader regulations, including a federal volatile poisons act that was proposed in the 1930s. This would have introduced more specific labeling standards, including marking poisonous products with a skull and crossbones, something that had also been proposed earlier on.

• 19:02Holly Frey?

  Again, manufacturers argued that this labeling would just keep people from buying the products. This was happening during the Great Depression, and the chemical manufacturing industry was one of a very few that had actually increased production. So legislators were worried that if customers did become reluctant to buy these products, as manufacturers feared they would, it would harm one of the few industries that was not seriously struggling.

• 19:27Tracy V. Wilson?

  Meanwhile, in the late 1920s and early 1930s, multiple doctors published papers on the patterns of poisoning that they were seeing in their practice. In 1927, P. P. Vinson reported that well over half the esophageal strictures that he had seen at the Mayo Clinic had been caused because someone had swallowed lye. Dr. Jay Arena of Duke University published similar findings in 1939. In some cases, the concentration of lye in the product had not been high enough for the labeling that was required under the Caustic Poison Act.

• 20:02Holly Frey?

  Also in the 1930s, Louis Godalman, who was a pharmacist in Chicago who also had a chemistry degree, was also collecting information on poisonings and the products and substances that had caused them. He started documenting products and their ingredients on index cards, including what to do in cases of exposure to those ingredients, creating records for at least 9,000 products. Eventually, he also started collecting stomach contents and other samples from poisoning victims for analysis.

• 20:33Tracy V. Wilson?

  Through this work, Godalman became the go-to person for poisoning cases in Chicago. The pharmacy at St. Luke's Hospital where he worked was directly across from the emergency room, so it made it really easy for ER doctors to just come ask him questions. But he also took calls at home and elsewhere 24 hours a day. As word spread beyond St. Luke's Hospital of what he was doing, doctors from other Chicago facilities started to call him for advice and information as well. It eventually got to the point that people from other states would call around in Chicago trying to find this pharmacist that they'd heard about who knew so much about poisoning.

• 21:11Holly Frey?

  As Gdolman was becoming a one-man poison hotline, the legal and regulatory landscape in the United States was continuing to evolve. The Food, Drug and Cosmetic Act was passed in 1938, which required drugs to be evaluated for safety by the Food and Drug Administration. In 1947, the Federal Insecticide, Fungicide and Rodenticide Act required these products to be registered with the FDA. This law updated an earlier version that was passed in 1910. And among other things, it required these products to be in child-resistant packaging and clearly labeled with an appropriate warning.

• 21:50Tracy V. Wilson?

  Even with these kinds of steps, though, by the 1950s, as many as 400 children a year were dying from poisoning. There were also adult poisoning victims as well, of course, including incidents that had multiple victims. For example, on November 18, 1942, a patient at Oregon State Hospital was helping out in the kitchen. He accidentally brought the cook's cockroach poison instead of the powdered milk that they had asked for. These two substances looked visually very similar and had been stored near each other. Forty-seven patients died, and this is something where the chemical manufacturing industry had resisted calls for these kinds of products to be tinted rather than white and easily

• 22:34Tracy V. Wilson?

  mistaken for something like salt or sugar or powdered milk.

• 22:37Holly Frey?

  By this point, medical experts just could not keep up with the massive increase in the number of potentially dangerous products and what to do if someone was exposed to them. About 250,000 drugs and household products had been introduced since World War II, and there wasn't any kind of centralized system for keeping up with all of these products, their ingredients, and their antidotes. Accidents replaced disease as the leading cause of death in children. And according to a survey of members of the American Academy of Pediatrics, about half of the accidents that pediatricians were treating were poisonings.

• 23:14Tracy V. Wilson?

  In 1953, Dr. Edward Press and Louis Gudalman established the first formal poison control center. This was in Chicago, Illinois. The Illinois Chapter of the American Academy of Pediatrics, the Illinois Department of Public Health, and seven Chicago-area hospitals were also part of this project. They provided information on poisonings and their antidotes to doctors who were treating affected patients. Illinois's State Toxicology Laboratory was also part of this project. Toxicology was still a pretty new field at this point, and that lab analyzed any specimens that were collected.

• 23:49Holly Frey?

  A number of sources also credit some of this work to an unnamed secretary, who would call the area emergency rooms every morning and ask what the children who had been admitted for poisoning had eaten. She would then contact the manufacturers of those substances to try to get them to disclose the ingredients, and she would document all this information on an index card.

• 24:12Tracy V. Wilson?

  I wish I could find out more about this person. I found several references to this unnamed secretary and no other details. The Chicago Poison Control Center started with a pilot program that ran from November 15, 1953, to March 10, 1954. And it was so successful that other hospitals started their own programs. Within a year, there were 11 poison control centers just in Chicago and the surrounding area.

• 24:38Holly Frey?

  In December of 1954, Edward Press and Dr. Robert Melons published a paper titled "A Poisoning Control Program" in the American Journal of Public Health. This paper described poisoning as a major public health concern, before describing how the poison control centers were operating and what they had found during that time. The paper also made recommendations for future poison control centers based on that experience. The following year, the American Academy of Pediatrics published a reference book called "Accidental Poisoning in Childhood."

• 25:12Tracy V. Wilson?

  Soon, poison control centers were expanding beyond Chicago. In 1957, the U.S. Surgeon General established the National Clearing House for Poison Control Centers. This was the federal government's first attempt to try to provide some standardized resources for poison control and to collect data on poisonings to report back to the government. The Clearing House produced a set of index cards with information on potentially hazardous drugs, chemicals, and household products and plants, along with their antidotes. And it also published a monthly newsletter, as well as a statistical report of all that collected data from each year.

• 25:49Holly Frey?

  Also in 1957, the first edition of the Clinical Toxicology of Commercial Products was published and quickly became a standard reference work. It included basic first aid and emergency treatment, followed by an ingredient index that listed more than 1,000 substances, ranked on a scale from 1 to 6 according to their toxicity, with 1 being nearly harmless and 6 being extremely toxic. It had a separate index for the trade names of products that used these ingredients, along with the symptoms and treatments for exposure to a range of different compounds.

• 26:24Tracy V. Wilson?

  The American Association of Poison Control Centers was founded in 1958, and by that point, the number of poison control centers in the United States had grown to at least 265.

• 26:35Holly Frey?

  On April 20, 1959, Arthur S. Fleming, the Secretary of Health, released a statement about the poisoning data that the National Clearing House for Poison Control Centers had compiled between July 1956 and April 1958. The Clearing House reported that almost 500 child deaths and 600,000 non-fatal poisonings were happening per year, which overwhelmingly occurred at home. More than 85% of the people affected were children under the age of 5, and most of those were between the ages of 1 and 2. Although many types of household products were involved, a major source of poisoning was candied aspirin, which was

• 27:17Holly Frey?

  a chewable formula developed to be palatable to children and was introduced in 1947.

• 27:23Tracy V. Wilson?

  Fleming's statement gave some examples of the types of poison exposure that led calls to a poison control center, and most of the time, it was something that had taken just a moment when a parent or other caregiver's back was turned.

• 27:36Holly Frey?

  He also noted the need for the public to be better educated about poisons and poison safety. Many of the cases that the Clearing House had compiled involved parents who had waited hours or days after a child was exposed to a poison to seek help, instead of doing it right away. Other major contributors to accidental poisonings were products that had been transferred to food cans or other containers rather than being kept in their original packaging, as well as hazardous products that had been kept in easy reach of children.

• 28:07Tracy V. Wilson?

  It was about this time that poison control centers started working directly with the public rather than mostly providing information to doctors. And we'll get to that after another quick sponsor break.

• 28:18Speaker 04

  Okay, chicken nugget fans, I've got huge news. The new Burger King Chicken Nuggets just dropped, and they are the crispiest, the juiciest, and the tastiest chicken nuggets ever at Burger King. Burger King heard that a lot of you didn't like the old chicken nuggets, so they got to work and reinvented them. To go along with the new chicken nuggets, a lot of the sauces were reinvented too, because better chicken nuggets deserve better sauces. We're talking new buffalo sauce, honey mustard, sweet and sour, and even a whole new option too, the new special savory sauce, which is only available for a limited

• 28:58Speaker 04

  time at participating US restaurants. I mean, you need to taste it all for yourself. This new chicken nugget, reinvented based on real feedback, is made with 100% white meat chicken and is now better than ever. You gotta try the new Burger King Chicken Nuggets and sauces today.

• 29:16Tracy V. Wilson?

  For any small business owner, there's a moment when you realize the next hire could be the difference between staying busy and actually growing. The challenge is finding the right person without wasting time sorting through candidates who aren't the right fit. That's where Indeed Sponsored Jobs comes in. When workplace chaos hits and you need someone who can step in and make a difference, this is a job for Sponsored Jobs. It helps put your job in front of candidates who match the criteria that matter most to you, whether that's skills, experience, certifications, or location. And you're certainly not alone in using Indeed. Join the 3.3 million employers worldwide that use Indeed to connect with quality talent that fits their needs. That's millions of businesses turning to Indeed

• 29:59Tracy V. Wilson?

  to help solve hiring challenges and find people who can help drive results. Spend less time searching and more time actually interviewing candidates who check all your boxes. Less stress, less time, more results. Get your $75 sponsored job credit today at indeed.com/podcast. Terms and conditions apply. Hiring now? Then this is a job for Indeed Sponsored Jobs.

• 30:27Holly Frey?

  We've all done it. Tumble down an internet rabbit hole trying to self diagnose. And sometimes doing our own research can leave us more anxious than informed. Your feed is packed with wellness trends telling you to cold plunge, protein max, detox, track your sleep. But what's actually real? What's exaggerated? What's just wrong? That's exactly what Health vs. Hype from the American Medical Association and iHeartMedia's Ruby Studio is here to find out. Each episode, Emmy nominated science communicator Trace Dominguez, who's racked up billions of views across PBS Discovery Channel and YouTube, talks to doctors, influencers, and real people trying these trends. Not to cancel them,

• 31:11Holly Frey?

  not to hype them more, but to actually understand them. Because when it comes to your health, who you listen to matters. Start asking better questions and listen to Health vs. Hype on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

• 31:31Tracy V. Wilson?

  Guess who's back in the house? The old gays return for season two of Silver Linings, their hit podcast from iHeart's Ruby Studio in partnership with ViiV Healthcare. Just wait until you hear what hosts Robert McMillan and Jess A. have in store this time around. They strut back down memory lane navigating life, love, loss, and everything that shaped them along the way. And as usual, someone just might break into song. From leather bars to bathhouses, dance floors to drag brunch, nothing stays off limits. These are the kinds of insights that can only come from experience. So listen to your elders, honey, and discover the silver linings you can take with you. All sass, zero filter,

• 32:12Tracy V. Wilson?

  and decades of perspective from four friends proving that queer joy only gets better with age on the podcast that never gets old. Listen to Silver Linings, available on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

• 32:35Tracy V. Wilson?

  The rapid expansion of poison control centers in the 1950s and 60s was kind of a tangle. They were definitely giving medical staff and the general public an on-call resource to use in cases of potential poisoning. That was good. In many places where they operated, they were also educating consumers about household safety, things like keeping toxic products in their original packaging and keeping them locked out of the reach of children. Also useful.

• 33:04Holly Frey?

  But at the same time, most of these centers were being established at hospitals, with the hospitals trying to staff them from their existing emergency rooms. The idea was that this would be an easy addition to a department that was already staffed 24/7 with people who were used to the high-stress world of emergency medicine. From the hospital's point of view, adding a poison control center might even bring in more patients as the center referred emergencies to the hospital's own ER.

• 33:32Tracy V. Wilson?

  As poison control centers started marketing their services directly to the public, they also became a positive source of PR for the hospitals where they were operating. As more and more people became aware of the dangers of poisoning and the existence of poison control centers, more and more hospitals opened them, in part motivated by the idea of good publicity.

• 33:54Holly Frey?

  In practice, though, this did not always work out. There were some centers that didn't get a lot of calls. Either they weren't well-publicized, or they were in a city that had multiple other poison control centers, or they were in a location with a small population. But many poison control centers found that they had to have a dedicated 24-hour staff just for the calls about poisonings. There were just too many calls to add it into the existing emergency department's work.

• 34:22Tracy V. Wilson?

  This is how it goes for so many projects that someone says, "You can just add this into your work. It won't take long." This also meant that there was no real pattern to where these poison control centers were being established. Some cities had more than 100 centers scattered across all their hospitals and pharmacies and other medical practices. Others had not enough to really serve their whole community, or they had no poison control center at all.

• 34:50Holly Frey?

  Even though the 1950s had seen the establishment of the National Clearinghouse for Poison Control Centers and the publication of the Clinical Toxicology of Commercial Products, there also wasn't a lot of standardization among all these centers. The quality of care could be vastly different, depending on which center you called and who answered the phone. And in places where there were multiple centers operating within the same city, those centers were often competing with each other, each with their own phone number, logos, warning stickers, and educational materials, which could often cause confusion.

• 35:23Tracy V. Wilson?

  Also, while one of the reasons that hospitals had started establishing poison control centers was to try to bring in new patients to the ER, when people called the poison control center for advice and were told to go to the ER, the opposite happened. When poison control centers started working directly with the public, rather than being primarily a resource for doctors, they were essentially acting as triage. The person answering the phone would find out what product someone had been exposed to, along with their age and weight. In a lot of cases, after doing the math with that, it turned out that the dose was not dangerous, or that treating it could be managed at home. Visits to the ER for poisoning went down, not up.

• 36:06Holly Frey?

  This could be a really challenging job as well. The poison control staff were often talking to panicked parents who were holding or in the same room with crying children. Calls often involved a layperson who needed to be talked through a specific set of first aid steps, which, in the early days of these centers, could involve trying to induce vomiting. Some of the calls that came in also involved people who were either considering harming themselves with the poison or had already tried to do so.

• 36:35Tracy V. Wilson?

  Meanwhile, the federal government continued to add new regulations regarding toxic products. The Hazardous Substances Labeling Act was passed in July of 1960, and that required specific labeling of toxic, corrosive, irritant, flammable, strong sensitizers, or pressure generating substances, as well as language like "danger," "warning," "caution," and "keep out of reach of children."

• 37:00Holly Frey?

  In 1961, those 11 poison control centers that had been established in the Chicago area were consolidated down into one facility at Presbyterian St. Luke's Hospital, which got about 55,000 calls annually.

• 37:15Tracy V. Wilson?

  That same year, President John F. Kennedy named the third full week of March as National Poison Prevention Week, which is something I learned while researching this podcast. So it is a weird coincidence that this episode is coming out immediately after it ended. This started with Homer A. George, who was a pharmacist from Missouri. George had convinced his town and then the state of Missouri to establish a Poison Prevention Week before advocating for one to be established at the federal level. National Poison Prevention Week was first observed March 18 through 24, 1962.

• 37:50Holly Frey?

  In 1966, Dr. James Goddard, Commissioner of the FDA, convened a meeting of aspirin producers, who voluntarily agreed to restrict baby aspirin packaging to a non-lethal dose. Each package would contain no more than 36 tablets of 81mg apiece, so that if a child did consume a whole bottle, it was not likely to be fatal. Formal legislation along these lines followed with the Poison Prevention Packaging Act in 1970, which required child-resistant packaging.

• 38:22Holly Frey?

  Other laws about child-resistant packaging, especially drug packaging, followed from there.

• 38:27Tracy V. Wilson?

  All of these things are, of course, imperfect solutions, right? Because a packaging that is harder for a child to get into is also harder for many disabled and elderly people to get into. But it's one of those things where you have to evaluate the risks involved with the packaging. Medical specialties involved with studying and treating poisoning were also evolving during all this time. The American Academy of Clinical Toxicology and the American College of Emergency Physicians were both founded in 1968.

• 38:59Holly Frey?

  By that point, there were hundreds of poison control centers all over the country and multiple competing mascots, including my favorite, Mr. Yuck, Officer Ugg, Pinky the Elephant, Uncle Barf, and No Sciop the Snake, with No Sciop being poison spelled backwards.

• 39:17Tracy V. Wilson?

  The most widely known of these is probably Holly's favorite, Mr. Yuck, whose development started in 1970. Dr. Richard Moriarty of Pittsburgh Children's Hospital wanted some kind of child-friendly warning or mascot for toxic products. One reason for this was that the Pittsburgh Pirates had adopted the skull and crossbones as their logo, which understandably might cause some confusion for children who can see the logo but not necessarily read or get the context of what's involved.

• 39:46Holly Frey?

  Like, yay, sports!

• 39:50Holly Frey?

  Moriarty started by asking children what would happen to them if they got into poison. And their responses were that their parents would yell at them, they would get sick, or they'd die. And he wanted to find an image that seemed to suggest these ideas, which led to a design contest sponsored by the Pittsburgh Poison Center. And that was won by 4th grader Wendy Brown. A commercial was released in 1971 with a "Mr. Yuck is Mean, Mr. Yuck is Green" theme song. Pittsburgh Children's Hospital made Mr. Yuck stickers available to other poison control centers and to parents through the National Poison Center Network, established in 1973.

• 40:28Tracy V. Wilson?

  Yeah, I did not grow up anywhere near Pittsburgh. I grew up in North Carolina. I could still sing you the entire Mr. Yuck theme song. I won't, because I do not sing well.

• 40:41Tracy V. Wilson?

  More developments followed after this, of course. The Consumer Product Safety Commission was established in 1972. So that was a year before that Poison Control Center network was established. The Emergency Medical Systems Act was enacted in 1973, and that authorized grants to establish a more robust nationwide emergency services system.

• 41:04Holly Frey?

  In 1978, the National Animal Poison Control Center was established at the University of Illinois-Champaign-Urbana College of Veterinary Medicine. It started fielding calls about animal exposure to toxic and caustic chemicals, as well as substances that are safe for most humans but toxic to many animals, such as chocolate, grapes, and lilies.

• 41:26Tracy V. Wilson?

  I have a friend whose cat wound up in the veterinary hospital not long ago at all after eating some lilies. That same year, the number of Poison Control Centers for humans reached its peak with more than 660 in the U.S. and its territories. Many of them, as we talked about earlier, overlapped in their coverage area. Some got very few calls. There were also concerns about training and consistency at some of the smallest centers that had the least funding and training. And a lot of centers overall had really struggled to get adequate funding throughout their whole history.

• 42:03Holly Frey?

  Hospitals also became concerned about liability, especially after an Arizona jury ordered a state-funded Poison Control Center to pay out a more than $3 million settlement. This happened after a nurse at a medical practice accidentally gave a patient liquid cocaine rather than liquid acetaminophen, which had been stored on a shelf next to each other. The Poison Control Center and the doctor both had outdated information about just how toxic liquid cocaine could be. But the Poison Control Center was ordered to pay a larger settlement because it had not specifically told the doctor that the patient should be taken to the hospital.

• 42:41Tracy V. Wilson?

  All of this, combined with the challenges we talked about earlier, to prompt hospitals to start closing down and consolidating their Poison Control Centers in the 1980s.

• 42:52Tracy V. Wilson?

  Over the next decade or so, the Poison Control Center shifted from this overlapping assortment of centers at multiple hospitals, sometimes in the same region, to a more government-funded regional model. The National Clearing House for Poison Control Centers stopped collecting poisoning data, and that responsibility moved to the Toxic Exposure Surveillance System, or TESS, in 1983. At that point, childhood deaths from accidental poisoning had dropped to a quarter of what they had been 20 years before.

• 43:23Holly Frey?

  In February of 2000, President Bill Clinton signed the Poison Control Center Enhancement and Awareness Act. This act provided federal funding for poison control centers and made provisions for the establishment of a national toll-free number. The nationwide number of 1-800-222-1222 was launched in January of 2002. In 2003, the federal government reauthorized the Poison Control Center Enhancement and Awareness Act, citing the need for emergency preparedness following the 9/11 terrorist attacks and the anthrax attack that followed in October of 2001.

• 44:02Tracy V. Wilson?

  Today in the United States, there are about 55 regional poison control centers that serve the entire country through that 1-800 number. When people call the number, it routes them to their regional center. There is also now an online triage tool at webpoisoncontrol.org. The regional center's staff generally includes pharmacists, board-certified toxicologists, and Certified Specialists in Poison Information, or CSPI, and these centers take about 4 million calls a year.

• 44:33Holly Frey?

  At this point, the Poison Control Network is the only real-time healthcare database that applies to the whole U.S. population. Centers also provide education to the public, as well as monitoring and reporting events that might suggest some kind of wide-scale exposure or a deliberate chemical attack.

• 44:51Tracy V. Wilson?

  Most of the people who call into poison control centers today are laypeople. About 15% are medical personnel. More than 70% of the people who call poison control do not wind up needing to go to the hospital. Numbers are really all over the place about how much money this saves, per dollar of money that is invested into the system. But it should be noted that this is not just savings on the patient's part, like people who are able to treat the potential poisoning at home, save a lot of money by not having to go to the emergency room. But a lot of people who need to call into the poison control system, for whatever reason, are covered by Medicare, Medicaid, or a state children's health insurance program. So there are savings for these programs also.

• 45:36Holly Frey?

  And for the people who do need to go to the hospital, there is some data that suggests that their stays tend to be shorter because of the immediate first aid and recommendations from poison control.

• 45:46Tracy V. Wilson?

  Also, I just want to note that I am not the only person who has had this whole experience of kind of going, where did poison control come from? Nearly that exact scenario inspired a Radiolab episode on poison control that came out in 2018. That was after the reporter involved had to call poison control for their child.

• 46:10Holly Frey?

  Ah, control the poison.

• 46:18Tracy V. Wilson?

  Thanks so much for joining us on this Saturday. If you'd like to send us a note, our email address is [email protected]. And you can subscribe to the show on the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.

• 46:33Holly Frey?

  A rare disease diagnosis can change your life, but it doesn't have to define your future. In season seven of Untold Stories: Life with a Severe Autoimmune Condition, host Martine Hackett continues the conversation with people living with MG, CIDP, and the broader rare disease community, exploring what comes after diagnosis through stories of hope, progress, and connection. Produced by Ruby Studio in partnership with Argenx, listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

• 47:10Tracy V. Wilson?

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• 47:52Tracy V. Wilson?

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• 48:18Speaker 05

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• 48:45Tracy V. Wilson?

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