Skip to main content

National Poisons Information Service urgent alerting system for chemicals: data from the first year

Author/s Crawford CL, Jackson G, Thomas SHL, Thompson JP, Vale JA, Eddleston M
Year 2014
Type of publication Conference proceeding

Objective: The UK National Poisons Information Service (NPIS) has established a real-time reporting system with healthcare professionals in the UK, whereby accesses to 143 entries of interest on TOXBASE®, the UK's primary poisons database, generate an urgent e-mail alert to NPIS units within 10 min. The alert gives user details, location, time, and whether a specific patient is involved. NPIS contacts the user, and enters details of follow-ups into the UK poisons information database (UKPID), with a tag. We now report the first full year of data generated by this system.

Methods: All tagged call records for one year from 1 April 2012 to 31 March 2013 were extracted from UKPID for analysis.

Results: During the study year, 127 of the 143 selected chemical pages were accessed 10,892 times by 962 different users. Of these, 2636 alerts (24.2%) were marked as involving a patient and user contact details entered for 424 (16.1%). Excluding overseas accesses, multiple accesses and cases already known to the NPIS, 289 alerts were followed up, and further details collected from 252 cases. An additional 13 follow-ups were made where there had been multiple accesses but no user details were entered. Of the 265 cases, 202 (76.2%) related to 1 patient and 40 (15.1%) related to a population (median 3 patients, range 2–22). Exposures were most frequently accidental (n = 198, 74.7%), by inhalation (153, 57.7%), and occurred at home (112, 42.3%), and were managed in hospital (248, 93.6%). The most common agents involved were carbon monoxide (93, 35.1%), chlorine (33, 12.5%), and ammonia (13, 4.9%). An NPIS consultant was involved in 26 (9.8%) follow-ups. The maximum WHO/IPCS/EC/EAPCCT Poisoning Severity Score (PSS) was recorded in 205 cases: this was 0 in 46 (22.4%), 1 in 129 (62.9%), 2 in 20 (9.8%), and 3 in 10 cases (4.9%). There were 15 calls alerted to Public Health England Chemicals and Poisons Division.

Conclusion: This mechanism allows detection and rapid response by NPIS to cases of poisoning involving highly toxic agents across the UK, facilitating rapid provision of information including consultant advice, and prompt alerting of public health bodies to potentially serious chemical incidents.


  • Persson H, Sjöberg G, Haines JA, et al. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol 1998; 36:205–213. 
Follow AWTTC: