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Bronstein Alvin

NPDS is a national database of detailed information collected from each call, uploaded in near real-time, from the 57 participating regional poison centers (PCs) located across the US. NPDS is owned and operated by the American Association of Poison Control Centers (AAPCC). Since 2001, scientists from the Centers for Disease Control and Prevention collaborated with AAPCC to use NPDS for surveillance of chemical, poison and radiological exposures. In March of 2011, a 9.0 magnitude earthquake and tsunami damaged the reactors at the Fukushima Daiichi nuclear power plant in Japan, causing a radiological incident classified as a "major accident" according to the International Nuclear Event Scale. The incident resulted in the release of radioactive iodine (I-131) into the global environment, which was detected in precipitation in parts of the United States. While no adverse health effects were expected, concerned citizens contacted public health officials at the local, state and federal levels. Many started to acquire and use potassium iodide (KI) and other iodide-containing products intended for thyroid protection from I-131, even though this was not a public health recommendation by state and federal public health agencies. Shortly after international media coverage began, regional PCs began receiving calls regarding the Japan radiological incident. State and federal health officials were interested in identifying health communication needs and targeting risk communication messages to address radiation concerns and KI usage recommendations as part of the public health response. This was done in part through NPDS-based surveillance.

Objective

To describe how the National Poison Data System (NPDS) was used for surveillance of individuals with potential incident-related exposures in the United States resulting from the Japan earthquake radiological incident of 2011. Our secondary objective is to briefly describe the process used to confirm exposures identified through NPDS-based surveillance.

Referenced File
Submitted by elamb on

The National Poison Data System (NPDS) is maintained and operated by the American Association of Poison Control Centers (AAPCC) for the analysis, visualization, and reporting of call data from all 61 regional poison centers (PCs) in cooperation with CDC's National Center for Environmental Health (NCEH). NCEH collaborates with AAPCC toxicologists using NPDS to facilitate early recognition and monitoring of illness due to intentional or unintentional chemical or toxin exposures. NPDS algorithms identify statistically significant increases in callers' reported signs and symptoms - 131 clinical effects (CEs) such as rash and diarrhea - for detection of national poison exposure anomalies. Each day AAPCC toxicologists make decisions about NPDS anomalies' public health importance. Regional PCs are contacted as required for additional information about potentially important anomalies. NPDS also allows for individual case tracking through user-defined 'case-based definitions.' This additional method is especially useful during an outbreak when the agent and/or symptoms of affected persons are known.

Referenced File
Submitted by elamb on

For radiological incidents, collecting surveillance data can identify radiation-related public health significant incidents quickly and enable public health officials to describe the characteristics of the affected population and the magnitude of the health impact which in turn can inform public health decision-making. A survey administered by the Council of State and Territorial Epidemiologists (CSTE) to state health departments in 2010 assessed the extent of state-level planning for surveillance of radiation-related exposures and incidents: 70%–84% of states reported minimal or no planning completed. One data source for surveillance of radiological exposures and illnesses is regional poison centers (PCs), who receive information requests and reported exposures from healthcare providers and the public. Since 2010, the Centers for Disease Control and Prevention (CDC) and the American Association of Poison Control Centers (AAPCC) have conducted ongoing surveillance for exposures to radiation and radioactive materials reported from all 57 United States (US) PCs to NPDS, a web-based, national PC reporting database and surveillance system.

 

Objective

To describe radiation-related exposures of potential public health significance reported to the National Poison Data System (NPDS).

Submitted by hparton on

NPDS is a near real-time surveillance system and national database operated by the American Association of Poison Control Centers. NPDS receives records of all calls made to the 55 regional US poison centers (PCs). The Centers for Disease Control and Prevention (CDC) use NPDS to 1) provide public health surveillance for chemical, radiological and biological exposures and illnesses, 2) identify early markers of chemical, radiological, and biological incidents, and 3) find potential cases and enhance situational awareness during a known incident. Anomalies are reviewed daily by a distributed team of PC medical and clinical toxicologists for potential incidents of public health significance (IPHS). Information on anomalies elevated to IPHS is promptly relayed to state epidemiologists or other designated officials for situational awareness and public health response.

Current NPDS surveillance algorithms utilize the Historical Limits Method, which identifies a data anomaly when call volumes exceed a statistical threshold derived from multiple years of historical data. Alternative analysis tools such as those employed by ESSENCE and other computerized data surveillance systems have been sought to enhance NPDS signal analysis capability. Technical improvements have been implemented in 2013 to expand NPDS surveillance capabilities but have not been thoroughly tested. Moreover, other data aberration detection algorithms, such as temporal scan statistics, have not yet been tested on real-time poison center data.

Objective

To compare the effectiveness of current surveillance algorithms used in the National Poison Data System (NPDS) to identify incidents of potential public health significance with 1) new algorithms using expanded NPDS surveillance capabilities and 2) methods beyond the NPDS’ generalized historical limits model.

Submitted by teresa.hamby@d… on
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