Poison control centers in the United States report nearly 2.2 million poison exposures each year. It is estimated that there is one poison exposure every 15 seconds, with 90 percent occurring in the home and 51 percent in children 5 years old and younger.

A "poison exposure" is defined as "the ingestion of or contact with a substance that can produce toxic effects" and a "poisoning" as "a poison exposure that results in bodily harm." Exposures are categorized by intent. Unintentional poisonings are exposures that occur by accident, such as a child ingesting a cleaning solution. Intentional poisonings are those exposures that result from a conscious decision to cause harm, such as a suicide.

Children, particularly those 6 years old and younger, are at greater risk of unintentional poisoning exposures. For these children, elevated blood levels as low as 10ug/dL are associated with negative effects on cognitive development, behavior and physical growth. Adolescents are at risk for both unintentional and intentional poisoning exposures.

The most common poisoning exposures for adults are pain relievers, antidepressants, sedatives and cleaning substances. Among children, the most common exposures are pain relievers, cleaning substances, personal care products, cosmetics, foreign bodies, plants, carbon monoxide and lead.

Doctors' Role in Poison Control
Physicians can help reduce the numbers of poisonings by knowing, sharing and distributing prevention tips with patients, including parents, grandparents and caregivers. Doctors can also make adults aware that poison control centers are not only for childhood poisoning, but for adults as well.

Physicians can order free packages of California Poison Action Line telephone stickers by calling 800/582-3387 or by visiting www.calpoison.org. The stickers come in display boxes of 100.

The following tips are provided by the American Association of Poison Control Centers and the Centers for Disease Control and Prevention.

Make Your Home Safer
1) Post the California Poison Action Line number 800/222-1222 on or near every home telephone.

2) Store all medicines, household products and personal care products in locked cabinets out of reach of small children.

3) Know the names of the plants in your house and yard. Identify poisonous plants and place them out of reach of children.

4) Be aware of any medicines that visitors may bring into your home. Make sure visitors do not leave their medicines where children can find them, for example, in an unattended purse or suitcase.

5) Monitor the air quality in your house. Use carbon monoxide monitors.

6) Check your house for lead-based paints. Contact the National Lead Information Center at 800/424-LEAD to receive more detailed information.

Use Poisonous Products Safely
1) Always store household products in their original containers. Do not use food containers to store chemicals, such as cleaning solutions or cosmetic products.

2) Always read the labels before using a potentially poisonous product. Never leave the product unattended while using it and return the product to the locked cabinet when you are finished.

3) When giving or taking medication, make sure there is ample, available light.

4) Avoid taking medicine in front of children because they tend to imitate adults.

5) Do not call medicine "candy."

6) Follow label directions when taking medicines. Be aware of potential interactions with other medicines or alcohol.

7) Turn on a fan and open windows when using chemical products.

8) Wear protective clothing (gloves, long pants, long sleeves, socks and shoes) when spraying pesticides.

9) Never mix household chemical products together. A poisonous gas may form.

10) Do not burn fuels or charcoal or use gasoline-powered engines in confined spaces such as garages or tents.

Respond Quickly
1) Act fast in getting help, but try to remain calm.

2) If you have a poison emergency and the victim has collapsed or is not breathing, call 911. If you have a poison exposure and the victim is alert, call the California Poison Action Line at 800/222-1222. Try to have the following information: the person's age and estimated weight; the container or bottle of the poisonous product; and the time that the poison exposure occurred.

3) Follow the instructions from the emergency operator or poison center.

Physicians are on the frontline in treating poison exposures, so it only makes sense that they work toward increasing awareness about preventing such injuries and illness.

James M. DeCarli, MPH, MPA, CHES, is a research analyst in the Injury and Violence Prevention Program of the Los Angeles County Department of Health Services. He can be reached at 213/351-7888 or jdecarli@ladhs.org.