2009 Service Summary
Mississippi Poison Control Center
Robert D. Cox, M.D.,
This report contains a summary of the activities for the Mississippi Poison Control Center
(MPCC) for the year 2009. Since 2005, the MPCC has had a steady increase in the year
recall volume up to 2008. In 2009, a call volume decreased 6% from the previous years
high. In 2009, the MPCC handled 37,447 calls. This is the second highest call volume
that the MPCC has experienced in its history.
Nationally, poisonings remain a major source of morbidity and mortality. According to
the Centers for Disease Control and Prevention, poisoning was second only to motor-
vehicle crashes as a cause of death from unintentional injury in the United States.
Among people 35 to 54 years old, unintentional poisoning caused more deaths than motor
vehicle crashes. In 2006, poisonings resulted in 924,626 emergency department visits and
over 325,000 hospitalizations, at a cost over $26 billion (2).
Poison Control Centers provide the first line of defense against poisoning in the United
States. They provide free information concerning the dangers of exposure, initial
treatment, and whether or not to seek emergency medical care. Poison Control Centers
also give advice to hospitals and health care providers on the treatment of poisonings.
All states and territories in the United States are served by a Poison Control Center. All
of the state and regional Poison Control Centers upload their data several times a day to a
national database that is used by the Centers for Disease Control and Prevention and the
Department of Homeland Security for toxicosurveillance. This is currently the only
national system that is monitoring for potential disease outbreaks that might be related to
terrorist activity in the United States.
The Mississippi Poison Control Center fields calls from private citizens, health care
facilities, schools, law enforcement agencies and other entities concerning exposures to
poisons and other toxic substances and envenomations and provides advice on risks and
medical management. All of these calls are entered into a computer database that is
uploaded into the national database and used for toxicosurveillance. The Mississippi
Poison Control Center has served this state since 1978. This document summarizes the
call volume and types of calls received and managed by the Mississippi Poison Control
Center in 2009.
The Mississippi Poison Control Center managed 37,447 calls in 2009. This included
37,362 calls from Mississippi and 85 calls from out of state. The volume of calls
managed by the Mississippi Poison Control Center over the past eight years is shown in
Figure 1. In 2009, the overall call volume decreased by 6% from the previous year.
Exposure calls increased by 4% and information calls decreased by 15%. The decrease in
information calls is primarily due to a change in the way that pill identification calls were
handled by the MPCC. This change was prompted by local and national concerns of
prescription drug abuse that was facilitated by free poison center identification of pills.
The call volume in 2009 was the second highest in the history of the MPCC.
Mississippi Poison Control Center
Yearly Call Volume
Exposures Information calls
2002 2003 2004 2005 2006 2007 2008 2009
Figure 1. Yearly call volume managed by the Mississippi Poison Control Center
The number of calls managed by the Mississippi Poison Control Center each month is
shown in Figure 2. In the average month, 3125 calls were managed by the Mississippi
Poison Control Center. This figure demonstrates the decrease that occurred when the new
policy on handling pill identification calls went into effect during the month of April.
Figure 2. Monthly calls managed by the Mississippi Poison Control Center in 2009
3500 2008 Monthly Average
Ja n Fe b Ma r Apr Ma y Jun Jul Aug Se p O ct No v Dec 3
The calls in 2009 included 19,022 cases of human exposures to potentially toxic
substances, 562 cases of animal exposures and 17,859 information calls. Free information
was provided to law enforcement agencies, health care providers, emergency response
teams, schools and private citizens. The toxic exposures that the MPCC assisted in
medical management included the following:
Table 1. Severity of Poisonings Managed by the Mississippi Poison Control Center
Severity Human Exposures Animal Exposures
Mild Toxicity 3322 36
Moderate Toxicity 757 14
Severe Toxicity 114 0
Death 14 0
The location of callers when initial contact was made is shown in Figure 3. Data are
presented for the past two years for comparison. In 2009, 79% of all calls came from
private residences. This is a slight increase over the previous year. Health-care facilities
including hospitals, pharmacies, doctor’s offices and clinics accounted for 14% of calls in
2009. The remainder of the calls came from workplaces - 3.9%, and public locations
including automobiles, schools and day-care centers.
10% 3.9% 3.0% 1.7%
1.5% 0.4% 0.8% 0.4% 0.4%
Residence Health care Workplace Other/Unkn Public School
Figure 3. Location of caller when the Mississippi Poison Control Center was contact
Service by County
The number of calls the Mississippi Poison Control Center managed for each county in
Mississippi in 2009 is listed in Table 2. This data is shown pictorially along with the
population for each county on the front cover. In general, the call volume for each
county reflected the county’s population
Table 2. Calls Managed by the MPCC by County in 2009
County # Calls County # Calls
Adams 493 Leflore 288
Alcorn 777 Lincoln 912
Amite 44 Lowndes 521
Attala 304 Madison 555
Benton 37 Marion 568
Bolivar 346 Marshall 222
Calhoun 101 Monroe 509
Carroll 13 Montgomery 83
Chickasaw 102 Neshoba 459
Choctaw 35 Newton 92
Claiborne 47 Noxubee 47
Clarke 51 Oktibbeha 345
Clay 184 Panola 579
Coahoma 188 Pearl River 950
Copiah 186 Perry 139
Covington 223 Pike 525
De Soto 622 Pontotoc 293
Forrest 2377 Prentiss 534
Franklin 87 Quitman 54
George 436 Rankin 919
Greene 84 Scott 262
Grenada 358 Sharkey 26
Hancock 853 Simpson 321
Harrison 3804 Smith 66
Hinds 4747 Stone 226
Holmes 60 Sunflower 132
Humphreys 50 Tallahatchie 58
Issaquena 0 Tate 194
Itawamba 105 Tippah 236
Jackson 2309 Tishomingo 276
Jasper 71 Tunica 49
Jefferson 31 Union 389
Jefferson Davis 56 Walthall 119
Jones 1080 Warren 756
Kemper 15 Washington 485
Lafayette 383 Wayne 209
Lamar 207 Webster 115
Lauderdale 1223 Wilkinson 47
Lawrence 176 Winston 142
Leake 120 Yalobusha 49
Lee 1758 Yazoo 468
The Mississippi Poison Control Center assisted in the management of 19,584 cases of
exposure to potentially toxic substances in 2009. The main substances involved in these
toxic exposures are shown in Figure 4. Fifty-five percent of exposures involved
pharmaceutical products. Broken down, 31% of potentially toxic exposures involved
prescription drugs and 24% involved over-the-counter drug products like cough and cold
medications. The next largest category, 26%, involved home products such as hair
products, cosmetics, drain cleaners and cleaning agents. Chemicals accounted for 9.4% of
exposures and pesticides 5.7%. Bites from snakes and spiders and insect stings
accounted for 2.3% of exposure cases.
442 255 248
OTC Meds &
Figure 4. Types of substances associated with exposures reported to the Mississippi
Poison Control Center in 2009.
The age ranges of exposure victims for the past two years are shown in Figure 5. The age
distribution has been very constant compared to previous years. Sixty percent of all
exposures occurred in children less than 6 years old and 71% occurred in children and
adolescents less than 19. Adults accounted for 29 percent of exposures and those over 65
accounted for 3 percent.
30% 26% 26%
10% 6% 5% 6%
3% 5% 3%
<6 6-12 13-18 19-64 >65
Figure 5. Age distribution of human exposures reported to the Mississippi Poison Control
The estimated reasons for poison exposures are shown in Figure 6. Accidental exposures
were the most common reason for toxic exposures followed by exposures due to
inappropriate access to toxic substances. Therapeutic errors resulted in 7.8% of
exposures and suicide resulted in 8.5%.
1655 1520 1462
380 222 209 185 126 12
Figure 6. Reasons for human and animal exposures to toxic substances reported to the
Mississippi Poison Control Center in 2009.
Case management recommendations for poisoning exposure cases reported to the
Mississippi Poison Control Center for the past two years are shown in Figure 7. The
proportion of cases managed at home by the MPCC was very constant over the past two
years. In 2009, the Mississippi Poison Control Center managed 67% of potential
poisoning exposures at home (13,076 total cases, 12,648 human cases). The majority of
these cases were children who potentially ingested a medication or a household product.
Home management saves considerable money instead of referring all cases to a health-
care facility. Hospitals, medical clinics and doctor’s offices directly contacted the
Mississippi Poison Control Center on 4,209 exposure cases. Of the remaining cases,
1,857 cases were referred to hospitals by the Mississippi Poison Control Center.
14000 12749 13076
Managed at home In Health-care Facility Referred to Health-care Other
Figure 7. Management of exposure cases by the Mississippi Poison Control Center from
Research performed by personnel from the Mississippi Poison Control Center
on the types of poison exposures seen in Mississippi following Hurricane Katrina was
published in the journal Clinical Toxicology. Also several book chapters on management
of Hazardous Chemical Incidents and Chemical Burns were published in a popular on-
line medical reference. Also, a joint project between the Mississippi State Department of
Health and the Mississippi Poison Control Center was undertaken to study the percentage
of children in Mississippi with elevated blood lead levels. This project has been
completed and the results were presented to the CDC. It should be published in 2010.
Cox RD, Amundson, T, Brackin B. Evaluation of the patterns of potentially toxic
exposures in Mississippi following Hurricane Katrina. Clin Toxicol 2009;46:722-
Cox RD. HAZMAT. in Emergency Medicine On-Line. Boston Medical
Publishing Group, Boston, MA, 2009.
Cox RD. Chemical Burns. in Emergency Medicine On-Line. Boston Medical
Publishing Group, Boston, MA, 2009
In addition to intervening in exposure cases and answering questions for those who call,
the Mississippi Poison Control Center also conducts ongoing poison-prevention
educational programs in an attempt to decrease the exposure of children and adults to
toxic substances. These programs include providing educational materials to hospitals,
county health departments, schools and day-care centers on how to decrease toxic
exposures in the home, information on how to contact the Mississippi Poison Control
Center if an exposure has occurred and direct classroom instruction in schools, hospitals
and day-care centers. In 2009, the Mississippi Poison Control Center provided more than
16,500 stickers and pamphlets to organizations in Mississippi. Presentations were made
by Mississippi Poison Control Center at 3 different health fairs and school functions.
The Mississippi Poison Control Center has maintained its web site, available for public
viewing at http://poisoncontrol.umc.edu/. This contains a variety of educational
information including emergency first aid information for poisoning exposures, the types
of poisonings seen in Mississippi and educational brochures on venomous animals and
poisonous plants in Mississippi, baby-sitting and home safety for children.
Several studies have demonstrated that Poison Control Centers save money by reducing
unnecessary visits to emergency departments (3-5) and reduce hospital stays in
hospitalized patients (6-7). It has been estimated that every dollar spent on poison
control centers saves $7-13 in health care costs. In 2009, there were 19,022 cases of
human exposures to potentially toxic substances in Mississippi and 12,648 of these were
managed at home by the Mississippi Poison Control Center. Of these, 10,165 were
children and adolescents under 19 years of age and 2483 were adults. Using factors of
51% of children and 17% of adults in Mississippi that are covered by Medicaid, this
results in 5,608 cases of individuals likely covered by Medicaid that were managed at
home by the Mississippi Poison Control Center in 2009. The costs of treating these
patients in an emergency setting are outlined below using Mississippi Medicaid
Table 3. Mississippi Medicaid Savings for Emergency Medical Services by the
Mississippi Poison Control Center
Emergency Service Medicaid Patients Savings
Ambulance 50% use $215 5608 x 0.5 $602,860
Emergency Department, $101 5608 $566,408
Physician, Level 3 $53 5608 $297,224
Several studies have demonstrated that when poison centers are consulted on hospitalized
patients the length of stay is reduced by 1.2 to 3 days (6, 7). In 2009, the MPCC was
consulted on 792 patients requiring critical care admission and another 706 patients who
required inpatient hospitalization. Of the total 1498 hospitalized patients the MPCC
assisted on, 469 were children and 1029 were adults. Using Mississippi Medicaid
percentages, it was calculated that there 414 of these patients would be covered by
Medicaid. The savings to Medicaid for reduced hospital stays is calculated below,
assuming that the average admission was reduced by 1.5 hospital days.
Table 4. Mississippi Medicaid Savings for Hospitalizations by the Mississippi Poison
Hospital days saved Medicaid Admissions Savings
1.5 days/admission $1637/day 414 $1,016,577
The total savings to Medicaid by the MPCC is estimated to be $2,483,069 in 2009.
These estimates do not include any laboratory or radiographic studies that might have
been done in hospitals. Adding these in could drive the Medicaid cost savings even
higher. If poisoning exposure occurs at an increased rate for low-income families, then
this number would also be greater.
The cost savings were also calculated for non-Medicaid patients who suffered poison
exposures. Shown below are the calculations for outpatient cases managed at home in
Table 5 and inpatient savings using the estimate of decreasing inpatient stays by 1.5 days
when the MPCC was involved in patient care in Table 6.
Table 5. Mississippi non-Medicaid Savings for Emergency Medical Services by the
Mississippi Poison Control Center
Emergency Service Typical Cost Patients Savings
Ambulance 25% use $1000 7040 x 0.25 $1,760,000
Emergency Department, $350 7040 $2,464,000
Physician, Level 3 $132 7040 $929,280
Table 6. Mississippi non-Medicaid Savings for Hospitalizations by the Mississippi
Poison Control Center
Hospital days saved Typical Admissions Savings
1.5 days/admission $3500/day 1084 $5,691,000
The total cost savings for non-Medicaid patients is $10,844,280. Even if only one-half of
the minor poisonings sought emergency care, the total savings would still be over eight
million dollars. For insured patients, this amounts to a savings to insurance companies
and to the patients for co-pays. For uninsured patients, this results in a significant
savings to hospitals and to the debt incurred by the patients and their families. For all
Mississippians, this results in a decrease in emergency department over-crowding.
Combining all of these factors, Medicaid and non-Medicaid cases managed at home,
costs savings to hospitals, cost savings to individuals hospitalized, it is estimated that the
Mississippi Poison Control Center saves the state of Mississippi approximately 10.5 - 13
million dollars a year. Given the operating budget of the MPCC, this works out to a
savings of 7 - 9 dollars saved for every dollar spent. These numbers are on the
conservative side of other national estimates (3-5).
1. CDC. Unintentional Poisoning Deaths – United States, 1999-2004. MMWR 2007;56:93-
2. CDC. Poisoning in the United States: Fact sheet. Available at
3. Miller T, Lestina D. Costs of poisoning in the United States and savings from poison
control centers: A benefit-cost analysis. Ann Emerg Med 1997:29;239–245.
4. Kelly N, Ellis M, Kirkland R, Holmes S, and Kozinetz C. Effectiveness of a poison
center: Impact on medical facility visits. Vet. Human Toxicol. 1997:39;44–48.
5. Chafee-Bahamon C, and Lovejoy F. Effectiveness of regional poison center in reducing
excess emergency room visits for children’s poisonings. Pediatrics 1983:72;164–169.
6. Vassilev Z, Marcus SM. The impact of poison control center on the length of stay for
patients with poisoning. J Toxicol Environ Health 2007:70;107-110.
7. Bunn, TL, Slavova S, Spiller HA, et al. The Effect of Poison Control Center Consultation
on Accidental Poisoning Inpatient Hospitalizations with Preexisting Medical Conditions.
J Toxicol Environ Health Part A 2008:71;283-288.