Three out of four of the Centre's long-serving staff members, from left, Lucy Shieffelbien, Yvette Millard, and Robin Slaughter. They, along with AJ Barnes, have a combined 88 years worth of experience working at the Centre.
The National Poisons Centre celebrated its 60th anniversary in December. Housed in the University’s Wellcome Building, the Centre provides over-the-phone advice to people who may have encountered something toxic, while maintaining an online database containing knowledge on more than 125,000 different substances. Internal communications adviser Koren Allpress spoke with Service Delivery Manager Lucy Shieffelbien about what the centre does and some of its history.
In 1963, Dr Jack Dacre, of the University’s Chemistry Department, took a sabbatical in America where he noticed poison centres being set up in many towns and cities.
Realising the value of such clinics, he broached the idea of a Dunedin-based national centre with the then director of toxicology research Professor Garth McQueen, who thought it was a “brilliant idea”.
The Centre – a phone-in help and advice service – started in December 1964 as a one-person operation, run from the Dunedin Hospital Emergency Department, dealing only with emergency poisonings. It took 105 calls in the first six months.
Sixty years later, the Centre is housed in its first purpose-built office, has 15 staff, including two full-time doctors, it runs 24/7 and receives about 25,000 calls a year – from health professionals and members of the public - often parents who “didn’t know their kids could climb that high”.
Service Delivery Manager Lucy Shieffelbien says the Centre proves it’s worth every day.
“The Centre provides acute medical advice in situations of poisonings, overdose and exposure. Members of the public can phone up because they’ve swallowed something, or their child has gotten into something,” Lucy says.
“We also take calls from health professionals, so doctors who are perhaps treating patients in the hospital and they need some further advice.
“This sort of sets us apart from other helplines because we deal with public and clinicians, so it’s quite a high level of expertise.”
To begin with, the service was called the ‘New Zealand Poison Information Centre’. In 1973 it became the ‘NZ Poisons and Hazardous Chemicals Information Centre’, and then in the late 1990s it became the ‘NZ National Poisons Centre’.
From the get-go, the centre started a file to hold information about different substances – their ingredients and effect on a person.
“It started off as a Windmill file, and it was kept up to date by the Department of Pharmacology’s administration team.”
The original Windmill file which the Centre relied on to keep track of its data sheets.
The database, now digitised, has information on about 125,000 different compounds and is still updated and added to. The information comes from case studies, published articles, published research, medicine and chemical data sheets
The database, called TOXINZ™, was also commercialised in 2008 and is now used in over 33 countries.
Lucy says it’s “pretty awesome” to think that TOXINZ™ – which started as a tool for the Centre – is now being acknowledged as a “gold standard, worldwide”.
Speed and accuracy are both vital for the Centre and its call-takers. Lucy says 80 percent of calls are answered within 20 seconds, and a risk assessment can usually be completed within five minutes.
“Parents who are thinking the worst when their child is crying and vomiting do not want to be put on hold. They’re wanting reassurance their child is going to be okay,” Lucy says.
“So, within the time it’s going to take you to find your keys, strap your child in their car seat and back down the drive, you could have had all that advice over the phone and know that you don’t need to be rushing off to the hospital.”
There has been a huge increase in the number of toxic products available, during the past 60 years, Lucy says.
“I mean, 60 years ago, pretty much what you had in your house was a cake of sunlight soap, not too dangerous. If you look at the supermarket shelves nowadays, we have such a world of consumer products.
“It’s really helpful for us to know about new consumer products.”
When new products are made available for sale in Aotearoa, they legally must have instructions on the label as to what to do if the product is ingested. The producer can offer this information, or supply the Poisons Centre with a list of its ingredients and then list the Poisons Centre as the place to call.
The Centre maintains ‘toxicovigilance’, looking at trends and keeping an eye on statistics so that if there is a spike in calls regarding a product, it can flag it with the appropriate authorities.
An example of this was about 25 years ago when the Centre was fielding a lot of calls about children ingesting dishwasher powder.
“You know, when you’re unloading the dishwasher, the door’s open and there’s still sludge in the dispenser, children can sometimes scoop it out,” Lucy says.
“This was causing a lot of corrosive burn injuries; we were seeing children with quite significant oesophageal burns and injuries.”
The Centre raised the issue as a concern, but unfortunately it took a tragic incident in 2006 until their warnings were heeded she says. An 18-month-old climbed up onto a kitchen counter and got hold of a bottle of dishwasher powder that did not have the lid screwed on properly. He picked the bottle up and tilted it towards himself, pouring the powder down his throat.
“He suffered some horrific injuries.”
The boy survived but to this day is still receiving treatment, Lucy says.
A law change not long after that incident prohibited the sale of dishwash powders with a pH of greater than 12.5.
“As a result of that law change, we no longer see the same types of horrific injuries associated with dishwash powders.”
It is another product found in many New Zealand homes that makes up 10 per cent of all calls to the Centre – paracetomol.
“That’s the biggest cause of exposures in New Zealand. If you think about it, any household with a child, you’re going to have paracetamol,” Lucy says.
Issues arise when children help themselves to the medicine - even with child resistant closures on it - or when parents accidentally double dose the child not realising the other parent has already given them a dose.
“Luckily paracetamol is actually, when used normally, a very safe drug, and luckily it has a very, very effective antidote.”
Which leads Lucy to her first piece of advice from lessons learned during her 23 years with the Centre - never underestimate a child’s physical abilities.
“You might think today that they’re not capable of climbing that high, but tomorrow they might surprise you. If we had a dollar for every parent that said, ‘I didn’t know they could do that’, we would be self-funded.”
Secondly, she suggests people learn the names of plants in their garden, identify any which are poisonous and teach their children not to touch those plants.
“The most common plant we get phoned about is the one that’s got green leaves and red berries.”
It’s not always easy for our Poisons Information Officers to access information on a plant using this description, because many plants have green leaves and red berries, Lucy says.
“We’re not botanists, so we can’t identify plants over the phone. If we get it wrong, it could be a bit of an issue because different plants have different effects on different body systems.”
Further reading: TOXINZ™ success
-Kōrero by Koren Allpress, Internal Communications Adviser