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Occupational poison exposures reported to a poison center helpline, Colorado, 2000-2010

Occupational poison exposures reported to a poison center helpline, Colorado, 2000-2010. Amanda Tran, MPH, Colorado School of Public Health Occupational Health and Safety Surveillance Program, Colorado Department of Public Health and Environment. Poisoning, what is it?. Poisoning :

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Occupational poison exposures reported to a poison center helpline, Colorado, 2000-2010

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  1. Occupational poison exposures reported to a poison center helpline, Colorado, 2000-2010 Amanda Tran, MPH, Colorado School of Public Health Occupational Health and Safety Surveillance Program, Colorado Department of Public Health and Environment

  2. Poisoning, what is it? Poisoning: unintended exposure to extrinsic substances that results in at least one related adverse clinical effect SSA, ISW7 Poisoning Surveillance, 2011

  3. Occupational poisoning surveillance sources, 2010 Survey of occupational injuries and illnesses (SOII) National poison data system (NPDS) • Occupational poisonings = 4.4% of all occupational injuries and illnesses nationwide (BLS SOII, 2010) • For every 1 poisoning exposure: • Median 4 days away from work (BLS SOII, 2010) • ~ 578 cumulative person-years lost in workplace productivity • No Colorado Data • Occupational poisonings = 1.6% of all national poison center exposure calls (AAPCC 2010 annual report) • Rocky Mountain Poison and Drug Center (RMPDC) • Occupational poisoning = 1.9% of Colorado exposure calls (NPDS 2010 data)

  4. Significance • True burden of occupational injuries in the U.S. is estimated to be 3-5x higher than reported (Blanc, et al., Annals of Internal Medicine) • Healthcare costs • Lack of access to care • Reluctance to seek care or report an injury or illness as being work-related • Long latency periods between exposure and symptoms • Low specificity of symptoms

  5. Significance No estimations on the burden of occupational poison exposures in Colorado No estimations on the burden of occupational exposures to alltoxic substances

  6. Specific Aims Describe the magnitude and distribution of occupational poison exposures from all substances among Colorado’s employed from 2000-2010 Understand characteristics and risk factors associated with these exposures Inform occupational health surveillance efforts

  7. Methods Data Sources • Colorado 2000-2010 data • RMPDC data reported through the NPDS • Demographic & location variables • Exposure descriptions • Exposure substance • Health effects • BLS Geographic Profile of Employment and Unemployment

  8. Methods Case definition National Institute for Occupational Safety and Health (NIOSH) & Council of State and Territorial Epidemiologist (CSTE) guidelines for occupational health indicator (OHI) surveillance of work-related pesticide poisonings (NIOSH & CSTE)

  9. Study inclusions Source: Rocky Mountain Poison and Drug Center (RMPDC) data from the National Poison Data System (NPDS)

  10. Methods Analyses • Descriptive statistics • Rates and frequency by demographic and exposure variables • Chi-square • Student’s t-test • Geospatial mapping

  11. Decrease in annual numbers & crude rates of work-related exposure, Age 16 years or older, Colorado, 2000-2010 Numerator : Rocky Mountain Poison and Drug Center (RMPDC) data from the National Poison Data System (NPDS) Denominator: Employed persons age 16 years and older as reported by the Bureau of Labor Statistics (BLS) Geographic Profile of Employment and Unemployment

  12. Occupational poison exposure calls by gender

  13. Occupational calls by gender and age group (N=8367) The 25-34 age group had the greatest exposure Source: Rocky Mountain Poison and Drug Center (RMPDC) data from the National Poison Data System (NPDS)

  14. Younger age groups had higher crude rates of occupational poison exposure Numerator : Rocky Mountain Poison and Drug Center (RMPDC) data from the National Poison Data System (NPDS) Denominator: Employed persons age 16 years and older as reported by the Bureau of Labor Statistics (BLS) Geographic Profile of Employment and Unemployment

  15. Health outcomes by gender Males Females

  16. Health management site and medical outcome of work-related poisoning exposures (N=8,367) Source: Rocky Mountain Poison and Drug Center (RMPDC) data from the National Poison Data System (NPDS)

  17. Work-associated exposure route & health effects Top 10 clinical effects Pathway { 88%

  18. Top 10 exposure substances

  19. Summary • Decreasing trend in occupational poison exposures from 2000-2010 • Annual average rate of 32/100,000 employed • Males had higher rates and reported more severe health outcomes than females (p<.0001) • 25-34 age group had the highest incidence (p<.001), but the 16-19 age group had the highest rate (p<.0001)

  20. Summary • ~80% of occupational exposures had minor or moderate health outcomes • 40% of exposures were treated at the workplace • Most common substance exposures • Chemicals • Fumes/gases/vapors • Household cleaning substances • Hydrocarbons

  21. Strengths & Limitations • NPDS is a near real-time database • Passive approach relying on self-reports • Underreporting • Caller may not be the exposed worker • Possibility of duplicate cases • Reporting bias based on demographic groups

  22. Conclusions • NPDS may identify less severe poisonings that are not reported to established surveillance programs • Males and young workers appear to be at higher risk • Requires further analyses of industries and occupations associated with exposures in these groups • Additional or more focused steps need to be pursued to prevent exposure to common substances

  23. Next Steps • Report publication http://www.cdphe.state.co.us/dc/OH/ • Data linkage analysis between RMPDC’s center-level reports and established surveillance systems for lead and mercury toxicity • Explore underlying causes and circumstances of workplace exposures reported to RMPDC • Evaluate and compare cases captured by the two surveillance systems

  24. Acknowledgments • Colorado Department of Public Health and Environment: • Meredith Towle, MPH • Amy Warner, MPH • Kirk Bol, MSPH • Rocky Mountain Poison and Drug Center • Alvin Bronstein, MD, FACMT

  25. Questions? Contact: amanda.tran@ucdenver.edu meredith.towle@state.co.us Phone: (303) 691-4938

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