Japan Poison Information Center


[English]

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Contents



Foreword

Despite rapid progress in modern medicine, the development of extremely sophisticated medical technology and the huge amount of consumption of various drugs in recent years, countermeasures to cope with poisoning have lagged far behind in Japan. Household chemicals, agricultural chemicals, and other chemicals came into our daily lives, but the ingredients of these new chemical substances were not made clear because of the protection of industrial secrets. Therefore, it was not easy even for physicians to get the most up-to-date appropriate informations about various poisonous substances.

Through daily practice, emergency physicians first noticed the necessity to establish well organized poison information/control centers in our country about 15 years ago. Since then, zealous and earnest discussions were presented at every opportunity in the Japanese Association for Acute Medicine (JAAM).

On the 9th of Sept. 1986, the official Japan Poison Information Center (JPIC) was founded as a result of cooperation between the Ministry of Health and Welfare and voluntary physicians with the full support of JAAM.

Every year, JPIC receives about 30,000 inquiries from medical personnel and citizens and helps them by providing most appropriate and up-to-date informations on poisoning.

Hereafter, JPIC is planning to expand its research and laboratory services. I hope this booklet will help to show our past and present activities and future commitment to you.

Japan Poison Information Center
Chairman, Board of Directors,
Tsuyoshi Sugimoto, M.D.


History


1977The Committee for Preparation of National Poison Information Center was organized in the Japanese Association for Acute Medicine.
1980The Study Mission headed by Prof. M. Horioka was sent to poison centers in Europe and the United States.
1981 The Ministry of Health and Welfare approved the claim of the committee that the official poison information centers(PIC) should be organized in Japan.
1981~1983 Investigation on the incidence of poisoning in Japan . (Osaka University Hospital)
Experimental trial of poison information service (Osaka. and Tsukuba University Hospital)
1984Committee's recommendation on the organization and the management of PIC was submitted to the Ministry of Health and Welfare.
　　　
1986 		July: JPIC was established as a juridical foundation.
September: Poison information telephone service was started.
December: Poison information database development was started with grant-aid of Ministry of Health and Welfare.


Organization
Chairman of a Board of Directors
The Board of Directors
Tsuyoshi Sugimoto, M.D.
Head Office in Tokyo
Secretariat
(Secretary General, Minoru Takano)
Osaka Office

Information Service
(24 hrs. all through the year)
    １．An Emergency Line for the Public and Medical Personnel
    ２．An Toll Line for Medical Personnel Only
    ３．An Exclusive Line for Supporting Members
Development of Poison Information Database
        With the grants from the Ministry of Health and Welfare
(The Chef of Osaka Office
General Manager
Mitsuo Numata, PhD.)
　　
　　
　　

Tsukuba Office

An Emergency Line for the Public and Medical Personnel
(a.m. 9:00- p.m. 5:00)
    (The Chief of Tsukuba Office Noriyoshi Ohhashi,M.D.)




Board of Directors
Chairman
　Tsuyoshi Sugimoto, M.D.

Director of Operations
　Minoru Takano

Members
　Yoshiaki Yoneda
　　Executive Director Japan Soap and Detergent Association
　Masayoshi Horioka
　　Professor College of Pharmacy Nihon University
　Shigeo Morioka
　　Chairman
　　The Federation of Pharmaceutical Manufacturer's Associations of Japan
　Shuichi Tokushima
　　President
　　Society of Agricultural Chemical Industry (Japan)

　Fuminae Kubo
　　Director General
　　Japan Pharmaceutical Information Center
　Noboru Yamaguchi
　　Vice Chairman
　　The Life Insurance Association of Japan
　Shouzo Matsuta
　　Executive Director
　　The Marine and Fire Insurance Association of Japan Inc
　Hiroshi Naitoh,M.D.
　　Professor
　　Institute of Clinical Medicine, University of Tsukuba
　Yoshitaka Nakata.M.D.
　　Director
　　Tsukuba Medical Center
　Yoshihiko Ohkawa
　　Senior Vice President
　　Japan Tabacco Inc
　Tadayuki Arai
　　Executive Vice President
　　Senior Executive Manager Integrated Communications Systems Sector
　　Nippon Telegraph and Telephone corporation
　Ichiro Ohsawa
　　Executive Director
　　The Medical Information System Development Center
　Makoto Nishimura
　　Standing Director
　　Japan Dental Association
　Eikichi Itoi
　　Executive Member Board of Trustees
　　The Japan Medical Association
　Eisuke Ueyama
　　Chairman
　　Japan Insecticides Industrial Association
　Takashi Ukai.M . D.
　　President
　　Osaka Municipal General Medicai Center
　Eiji Wada
　　General Manager
　　Fertilizer and Pesticide Dept
　　ZEN-NOH
　Toshiharu Yoshioka, M.D.
　　Associate Professor
　　Dept. of Traumatology, Osaka University School of Medicine

Auditor
Tomoaki Tanaka
　　General Manager
　　Daiichi Kangin Bank


Current Activities


(1)Information Service (Limited to acute toxic exposure)

*Emergency telephone services

Osaka Information Service operates 24 all through the year, enabling the public to acquire poison information at any time. Tsukuba Information Service operates from 9:00 a.m. to 5:00 p.m. The staffs are all pharmacists. trained as poison information specialists. Osaka Office is situated next to Osaka University Hospital and Tsukuba Office is located in Tsukuba Medical Center. Each office is closely associated with each hospital, so the staffs of JPIC can get back-up from doctors at any time if necessary.

*Exclusive lines for supporting members (Osaka Office)

Inquiries from medical personnel are on more serious emergency situations than from the public . and more accurate and urgent information is necessary. However. JPIC could not afford to respond to the every telephone calls from medical personnel because of the limited budget.

To solve this problem . JPIC made a new supporting membership system and started the information service on an exclusive line for supporting members from June I 990. About 200 personal and hospital members. and 30 industries have been registered to this system.


(2)Information Collection and Preparation

Two types of information are necessary to answer the inquiries, one is toxicity data and the other is product ingredient data. Toxicity data include range of toxicity, clinical effects, treatment pathology and laboratory. These data are carefully extracted from published literature, inspected by medical doctors, and arranged in the "Original File". In preparation for the "Original File", about 60 Japanese and foreign reference books, and 20 journals were referenced.

Product ingredient data contains trade names, formulations, outlook, pH or other chemical features, use, manufacturers, and so on. They are arranged in alphabetical order of trade names, and also grouped in use of the products.

In order to make the product ingredient data file reliable, it is essential to get accurate data from manufacturers. However, manufacturers often hesitate to offer up-to-date information of all products voluntarily, which sometimes make it difficult for JPIC to prepare the most up-to-date product ingredient data files.


(3)Use of computers in JPIC

*Poison information database

JPIC has been building two databases to respond to telephone inquiries. One is a personal computer-aided poison data file called "Database for Citizens", and the other is a mini-computer system called "Poison Information Database for Medical Personnel" (CD-ROM).

In the Database for Citizens, about 2,500 poison data of household products and OTC drugs are compiled, which are the leading cause of accidental poisonings at home in Japan. JPIC is planning to distribute this database to 31 Prefectural Emergency Medical Information Centers or other medical facilities in Japan to be used for answering telephone inquiries from citizens.

The Poison Information Database for Medical Personnel is made up of four parts, Index, Clinical Toxicology, Principles of Treatment, and Case Reports. Index database includes brand names, chemical ingredients, and other Japanese common names of chemical products. Index, Clinical toxicology and Principles of treatment can be searched on-line to retrieve data using telephone.

*Records of all inquiries

JPIC also put the results of the telephone inquiries into its computer, in order to compile statistics.

Analysis of inquiries is published as an annual report every year.


(4)Educational Activities

*Post-graduate education for pharmacists

JPIC published a textbook of clinical toxicology for post-graduate pharmacists working In drug-stores and health nurses to help them understand the basis of clinical toxicology and know how to apply to the poisoned or suspected patients. At the same time, in cooperation with Japan Pharmaceutical Association and active emergency physicians of JAAM, JPIC established a radio Poison information course to answer inquiries from the public . The latter is expected to reduce unnecessary consultations at emergency medical facilities.

*Education for other emergency service personnel

There are 31 Emergency Medical Information Centers in Japan and are providing information on the vacant emergency beds in hospitals, specialists of doctors on night duties, etc. Some of the centers are going to extend their services to poison information services.

In response to the request of Kanagawa Prefectural Emergency Medical Information Center, JPIC started the training of its personnel on clinical toxicology and information science. Each prefectural emergency medical information center will start poison information service gradually.



Future Plans


*Public education for prevention of chemical poisoning

It is needless to say that the ultimate purpose of the activities on poison information is to prevent the occurance of acute chemical poisonings by public education . JPIC find a key point that may become the first target for education is the unique character of the circumstances concerning acute chemical poisoning in Japan. A lot of accidental exposure cases by ingestion of household products, especially tobacco products and household insecticides occurs in children aged 6-11 months.

*Development of clinical toxicology in Japan

JPIC hopes to play a leading role in the development of clinical toxicology, such as the introduction of new methods of toxicological screening tests, evaluation on the effects of newly applied treatment measures to intoxication, etc.

*Toxicological laboratory service network

To treat poisoned patients appropriately, it is obvious that the blood/urine/gastric content samples from poisoned patients should be analyzed immediately. Though most of the pharmacies of university hospitals in Japan have therapeutic drug monitoring systems for anticonvulsants, digoxin, and anti-asthmatic drugs, toxicological screening system has not established yet. In collaboration with pharmacies of big hospitals, JPIC is planning to establish a toxicology laboratory service network.

*International Cooperation

JPIC cordially hopes to exchange the knowledge and experiences of poison with other information control centers of the world. since our planet "earth" is getting smaller and smaller.



The Poison Information Service Guideline
Secretariat
　Call: 0298-56-3566
　Facsimile: 0298-56-3533
　Address: C/O Tsukuba Medical Center,
　　　　　　　1-3-1 Amakubo, Tsukuba-Clty, Ibaraki-Pref.

Osaka office
　Emergency call: 0990-50-2499 (24 hrs.)
　　　　　　　　　　　06-6878-1232 (for medical personnel toll line)
　Exclusive calls: not open to the public
　Business call and Facsimile
　Address: C/O Ichou-Kaikan, Osaka University Medical Hospital
　　　　　　　2-2 Yamada-Oka, Suita, Osaka

Tsukuba Office
　Emergency call: 0990-52-9899 (9:00 a.m. - 5:00 p.m.)
　　　　　　　　　　　0298-51-9999 (9:00 a.m. - 5:00 p.m. for medical personnel)
　Business call and Facsimile Address
　Address: C/O Tsukuba Medical Center,
　　　　　　　1-3-1 Amakubo, Tsukuba-Clty, Ibaraki-Pref.


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