Poisonings from lamp oil ingestion continue to occur worldwide among the pediatric population despite preventive measures such as restricted sale of colored and scented lamp oils. This suggests that optimal prevention practices for unintentional pediatric exposures to lamp oil have yet to be identified and/or properly implemented. Objective To characterize demographic, health data, and potential risk factors associated with reported exposures to lamp oil by callers to poison centers (PCs) in the US and discuss their public health implications. Study design . This was a two part study in which the first part included characterizing all exposures to a lamp oil product reported to the National Poison Data System (NPDS) with regard to demographics, exposure, health, and outcome data from 1/1/2000 to 12/31/2010. Regional penetrance was calculated using NPDS data by grouping states into four regions and dividing the number of exposure calls by pediatric population per region (from the 2000 US census). Temporal analyses were performed on NPDS data by comparing number of exposures by season and around the July 4th holiday. Poisson regression was used to model the count of exposures for these analyses. In the second part of this project, in order to identify risk factors we conducted a telephone-based survey to the parents of children from five PCs in five different states. The 10 most recent lamp oil product exposure calls for each poison center were systematically selected for inclusion. Calls in which a parent or guardian witnessed a pediatric lamp oil product ingestion were eligible for inclusion. Data on demographics, exposure information, behavioral traits, and health were collected. A descriptive analysis was performed and Fisher’s exact test was used to evaluate associations between variables. All analyses were conducted using SAS v9.3. Results Among NPDS data, 2 years was the most common patient age reported and states in the Midwestern region had the highest numbers of exposure calls compared to other regions. Exposure calls differed by season (p<0.0001) and were higher around the July 4th holiday compared to the rest of the days in July (2.09 vs. 1.89 calls/day, p<0.002). Most exposures occurred inside a house, were managed on-site and also had a “no effect” medical outcome. Of the 50 PC-administered surveys to parents or guardians, 39 (78%) met inclusion criteria for analysis. The majority of ingestions occurred in children that were 2 years of age, that were not alone, involved tiki torch fuel products located on a table or shelf, and occurred inside the home. The amount of lamp oil ingested did not appear to be associated with either the smell (p = 0.19) or the color of the oil (p = 1.00) in this small sample. Approximately half were asymptomatic (n = 18; 46%), and of those that reported symptoms, cough was the most common (n = 20, 95%) complaint. Conclusions Lamp oil product exposures are most common among young children (around 2 years of age) while at home, not alone and likely as a result of th...

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The overall ability of the SPIs to predict exposure severity is excellent but less accurate with less frequently encountered, more severe cases. A better understanding of SPI's decision-making processes, including the relationship between perceived severity and decision-making strategies, is necessary for the development of educational strategies and decision support technologies.

Context The communication demands faced by specialists in poison information (SPI) are challenging in the health care context. Objectives 1: Describe SPI communication patterns for the highest risk poison exposure calls using cluster analysis, and 2: describe variation in communication patterns or clusters. Methods A sample of 1 year of poison exposure calls to a regional PCC with SPIs’ perceived severity rating of major/moderate perceived was collected. Digital voice recordings were linked with medical records and were coded using the Roter Interaction Analysis System (RIAS). Descriptive analyses were applied and cluster-analytic techniques were used to assess variation in call communication and factors associated with that variation. Results Cases were described and 4 communication styles were identified. The Informational cluster represents 24% of calls and represent a pattern of relatively high levels of SPI clinical information and caller questions. The Facilitative cluster represents 35% of calls with a pattern of relatively high SPI questions and caller information provision. The Planning cluster represents 33.5% of calls representing a pattern of relatively high levels of SPI relationship talk. The Emotional cluster represents 7.5% of calls representing a pattern of relatively high caller and SPI emotion. Multinomial logistic regression using call/case characteristics as stepwise predictors of cluster membership revealed relationships between cluster membership and number of substances, type of exposure (intentional vs. unintentional), caller relationship to patient, length of call (χ2s > 21.59, df =3, ps < .01)and SPI identity (χ2 = 88.34, df =33, p < .01). Conclusion This study provides a beginning step to understanding SPI communication behaviors. Our results suggest that SPIs are able to use a range of communication strategies that often involve not only information but also emotional responsiveness and rapport building. Findings also point to the opportunity for future communication training for SPIs to meet the needs of the heterogeneous caller population.

Historical processes and procedures for matching patient identities require adaptation or added functionality to adequately support the PCC use case.