Assessment of Clinical Toxicological Resources in Countries Belonging to the World Health Organization's Regional Office of the Eastern Mediterranean.

Abstract

Introduction: Poison Centers are vital to prevent and manage exposures to chemicals, toxins, and ionizing radiation. However, many countries still lack sufficient poison information center services. Within the World Health Organization's Eastern Mediterranean Regional Office (EMRO) region, we were not able to identify a formal assessment of its toxicological resources. We sought to assess the clinical toxicological resources in the EMRO region and the attitudes, needs, and perspective of the workforce in that region.  METHODS: This was a two part survey study. First, we developed a poison center questionnaire and scoring system based on the World Health Organization's Guidelines for Establishing a Poison Center; this instrument was administered by phone to poison center directors and faculty in the EMRO region. Questions assessed for the presence or absence of important poison center capabilities listed in the WHO guidelines, and points were assigned based on response. Secondly, we administered an electronic workforce survey to clinical toxicology professionals in the region; participant eligibility for the workforce survey was based on the membership roster of MENATOX.

Results: Out of 22 EMRO countries, 16 countries have an established poison center, and 14 of 16 participated in the poison center survey.  The results reflected a wide variability in capabilities among countries. Areas such as call centers, clinical toxicology units, laboratory services, and data management were relatively lacking while some other areas including toxicovigilance, chemical incidents and emergencies, antidotes/antivenoms, poisoning information sources, and the availability of free services were relatively stronger. Twenty-seven out of 32 workforce respondents were physicians. Results from that survey highlighted a desire for more support from government and better compensation.

Conclusions: Our study identified areas of need for the EMRO region. The poison center survey results reflect large disparities among countries with some areas being stronger than others. The workforce survey highlighted issues such as compensation and government recognition. Overall, a formal assessment of individual poison centers can provide benchmarks to drive improvement of services, but further research is needed to identify and characterize country-specific needs.