National Poison Data System^® Annual Report: under the hood

The 41st National Poison Data System^® Annual Report from America's Poison Centers^® is published in this issue of Clinical Toxicology. This Commentary focuses on comparing the different poisoning-related surveillance systems in the United States while highlighting some of the strengths and weaknesses of the National Poison Data System^®. It also reviews the process underlying the fatality review section of the Annual Report.

In order to place the data reported by the National Poison Data System^® in context, the National Poison Data System^® was compared to other available poisoning surveillance systems in the United States: the American College of Medical Toxicology's Toxicology Investigators Consortium (ToxIC) Registry, the Centers for Disease Control and Prevention Injury Prevention and Control Web-based Injury Statistics Query and Reporting System (WISQARS^™) which partners with the Consumer Products Safety Commission's National Electronic Injury Surveillance System - All Injury Program (NEISS-AIP), and the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database. Differences exist in the scope and focus of these databases, including the underlying population base and sources of reporting, use of statistical sampling, type of medical outcomes reported, type and number of products/substances reportable, granularity of product/substances reported, case volumes, timeliness of reporting and surveillance activities.

The National Poison Data System^® mortality data may vary from data collected by other sources but has some characteristics that render it unique, including the publication of narratives of selected fatalities. Each direct death undergoes a rigorous review by medical and clinical toxicologists at the regional poison center and by America's Poison Centers^® Fatality Review Committee. This review process is outlined in detail and compared to other poisoning mortality reporting systems.

National Poison Data System^® data from poison centers in the United States provide a unique perspective of the epidemiology of poisoning that is distinct but complementary to other poisoning surveillance systems in the United States. The National Poison Data System^® conducts a rigorous fatality review process that incorporates a variety of inputs that provide additional verification of the poisoning fatalities reported to it. The availability of and routine publication of fatality narratives is a unique feature of the National Poison Data System^®.