Some countries have “poison centers” as part of their healthcare service

Poison centres are specialist services offering expert medical advice when you’re poisoned. They’re common in countries like the US, but barely visible to the public in the UK.

I bought new laundry pods today, and the packaging has a stern warning:

If swallowed immediately contact a POISON CENTER/doctor.

I’ve never come across a poison centre in the UK, and it doesn’t seem to be a common thing here. If I search the phrase on Google Maps, the nearest results are a hardware store and a beauty salon. I was tempted to post something snarky “haha, what’s a poison centre”, but then I looked up the term and I got sucked into a rabbit hole.

What is a poison centre?

Poison centres are more of a thing in other countries, especially the USA, which has 53 poison control centres. (The spelling of “center” on the label might have been a clue.) There’s a telephone number you can call 24/7 from anywhere in the country, and also an online help portal.

The purpose of a poison centre is fairly obvious: you can get expert medical advice quickly, potentially allowing you to start treatment at home, and not wait to travel to hospital.

I imagine there are poison treatments that you can administer at home, but which aren’t well-known – and conversely, popular treatments which are actually counterproductive.

For example, my laundry pods are keen to stress that I shouldn’t induce vomiting if I swallow them. As the New Zealand poison centre explains, it’s not an effective treatment and it risks doing more damage. It pushes the poison back through your throat, and might cause you to absorb the poison faster.

History of poison centres in the USA

I found an interesting book chapter from the National Academy of Sciences, which explains the history of US poison control centers. They started in the 1930s when individual physicians began to systematically collect information about children poisoned by household products, including a 24-hour telephone service:

In the 1930s, childhood poisoning was recognized as a significant component of pediatric practice and patient morbidity. Unfortunately, little information existed regarding the toxicity of household products and management recommendations.

Jay Arena, M.D., a pediatrician at Duke University, began to systematically collect information regarding toxic hazards in the early 1930s and provided advice to physicians on poisoning cases in the surrounding area. He provided one of the first reports on the hazards of household products to children (Martin and Arena, 1939).

Louis Gdalman, R.Ph., a pharmacist in Chicago, collected information during World War II. He developed a toxicological information system using index cards and eventually converted to microfiche. This system eventually covered more than 9,000 commercial and consumer products. Moreover, Gdalman established the precursor to the modern poison control center by personally taking telephone calls 24 hours per day (Botticelli and Pierpaoli, 1992; Burda and Burda, 1997).

These early centers started as a strictly professional service – physicians could call for advice on treating children who’d been poisoned, but you couldn’t call as a member of the public. This changed in the 1960s, and over time these systems were gradually formalised.

Adult treatment became a bigger part of the process – especially as other changes reduced the rate of child poisoning (like childproof medicine bottles).

The number of American poison control centers has varied quite a lot:

Designations of poison control centers were made by each state health department, peaking in 1978 with 649 sites in the 50 states and 12 more in U.S. territories and the Virgin Islands (Scherz and Robertson, 1978) (Table 4-1). However, there were few large poison control centers and the number receiving more than 1,000 calls per year never exceeded 80. In 1970, less than 6 percent of poison control centers received more than 9 to 10 calls per day, or 3,285 to 3,650 per year (Manoguerra, 1976).

Today there are 53 such centers, presumably consolidating a lot of the less-frequently called centers into larger institutions that each handle more calls. Given that the advice service is provided entirely remotely, it makes sense that you could consolidate the service and not run centers in every state.

Identifying poisons in the EU

I was reading the Wikipedia article about poison control centres, and I was intrigued by this paragraph about the EU:

In the EEA, since 2020–2025, hazardous product manufacturers are required to send the formulation of their products to the European Chemicals Agency (ECHA) and to print a unique formula identifier (UFI) code on their products. This code lets poison centers know the exact formulation of a product, while the formulation is only shared to the ECHA and attached poison control centers.

I found the date range in the paragraph a bit confusing – the requirement still stands, but the regulation was phased in over multiple years. In particular, the scope was gradually increased to include more and more products.

This UFI code has to be printed prominently on hazardous products. If you’ve swallowed something nasty, you can read the code to the poison control center, and they know exactly how you’ve been poisoned – and so they can advise appropriate treatments.

There are more details in a document from the European Chemicals Agency: The UFI and what it means for your product labels.

My laundry pods don’t have a UFI, because the UK isn’t in the EEA.

The National Poisons Information Service (NPIS) in the UK

The UK’s version of a poison control centre is the National Poisons Information Service (NPIS). This is a service solely for professional use – providing advice to physicians, not the general public.

The Health & Safety Executive website explicitly says as such, and advises the public to contact 111 or 999 instead:

The NPIS do not take calls from the general public. In case of a medical emergency following exposure to a chemical, you should contact the NHS.

That would explain why I’ve never heard of poison centres, or the NPIS – they’re not something I’d ever interact with directly, and it’s unlikely I know anybody who’s interacted with them either.