The Canadian
Association for Poison Centres and Clinical Toxicology

Established in 1982, the Canadian Association of Poison Centres and Clinical Toxicology (formerly called the Canadian Association of Poison Control Centres) provides a centralized, volunteer forum for communication, information and idea exchange among Canada’s five poison centres.

While its members are primarily professionals working in the poison centres, other members have included:

Pharmacists
Pharmaceutical Companies
Forensic Toxicologists
Public
Health Staff
Emergency Physicians

Canada’s Poison Centres

Today’s five centres, established in the 1980s and 1990s to respond to public inquiries about poison exposure, took over from local emergency-department-based poison response telephone lines.

While initially calls to the centres came from the public, over the years, healthcare providers have come to rely on the toxicological expertise of poison centre staff to assist with management of poisoned patients who present to healthcare facilities across the country.

Half the received calls are about a child and half are about adult exposure to poison.

Each centre strives to follow the criteria as set by the American Association of Poison Control Centers (AAPCC) for certification. Registered nurses and pharmacists answering the information lines in each of these Canadian centres are eligible for certification as a Specialist in Poison Information.

Eligibility for certification includes:

handling 2,000
human exposure calls
a written examination
as set by the AAPCC
at least two years of
full-time employment
at a poison centre

Poisoning statistics

As poison centres are funded provincially, each province has different reporting requirements and formats. Currently, no federal government department keeps of reports national poisoning statistics, except for those resulting in death.

In 2020, Parachute, Canada’s national charity dedicated to injury prevention, and the Injury Prevention Centre at the University of Alberta coauthored the Evidence Summary for the Prevention of Poisoning in Canada. The poison centres worked closely with the report authors and it provides the best – though not complete – current picture of poisoning information for Canada.

The centres provide the following online contacts to request statistical information:

Our Mandate

The Association provides a centralized forum for communication, information and idea exchange among Canadian Poison Centres. In 1998, a member newsletter “The Bulletin” was started and is produced quarterly. Association members have agreed to a national Poison Prevention Week date, to coincide with the American Association of Poison Control Centers date in March, and are developing a process of sharing resources to realize this collaborative educational promotion venture.

To find ways to reduce the morbidity and mortality from poisonings.
To represent Poison Centres as a group in interactions with public health and governmental agencies.
To set standards for poison control centre operations.
To promote scientific research in the area of toxicology.
To provide a forum for poison control centres and individuals or institutions interested in toxicology to discuss matters of mutual concern.
To establish educational programs for health professionals with an interest or involvement in poison control.
To set up, or to evaluate existing injury prevention programs and materials for the public.
To partner with the American Association of Poison Control Centres, to hold a joint Annual Scientific Meeting which attracts participants from North America as well as from other countries.
To represent Canadian Centres at the World Federation of Associations of Poison Centres and Clinical Toxicology Centres.

History of poison response in Canada

1957

Health and Welfare Canada (now Health Canada) establishes the Poison Control Program, within the Product-Related Diseases Division. Product formulation cards served as the database for information requests regarding poison exposures. These cards were distributed to all active treatment hospitals throughout Canada. Manufacturers would voluntarily submit this information to Health and Welfare Canada. Missing information would be solicited by Health and Welfare Canada staff when an exposure occurred to a product about which no information was available. In exchange for these information cards, centres kept statistics and reported these back to the program.

1960s

Although the database and statistical reports came from the Federal Poison Control Program, funding for the centres is provincial and varied from province to province. In the ’60s and ’70s, most centres were in the emergency departments of active treatment hospitals. Emergency Department nurses usually answered the “Poison Telephone”.

1975

BC Drug and Poison Information Centre is formally established at St. Paul’s Hospital, building on an earlier research project at the Faculty of Pharmaceutical Sciences at the University of British Columbia (UBC). The project involved development and distribution of Poison Information Cards designed to assist practitioners in the diagnosis and treatment of poisoning incidents. The centre’s mandate: to develop centralized services to assist health professionals throughout B.C. in providing optimal levels of drug therapy and poison management.

1980s

Most local centres are replaced by regional or provincial centres with dedicated, trained staff. The centres hired physicians with specific training in toxicology to give medical direction and continuing education. As many reported exposures were in children, four of the new dedicated centres were located within pediatric hospitals.

1981

Ontario poison centres in Ottawa (Civic Hospital) and Toronto (Hospital for Sick Children) expand to include 24/7 staffing and a full-time medical director at each.

1981

BC Drug and Poison Information Centre expands to receive inquiries from the public in the Vancouver area; the public service expands to Victoria area in 1985.

1986

Three remaining regional poison centres in Quebec amalgamate as one provincial centre at le Centre Hospitalier de l’Université Laval in Québec City. Toxicologists throughout the province remained on staff.

1986

Alberta establishes the toll-free provincial Poison and Drug and Information Service (P.A.D.I.S.) in 1986 at the Calgary Foothills Hospital to replace five regional centres and to link the provision of poison information services with that of drug information services already established and operating out of the Pharmacy Department at Foothills. Both registered nurses and pharmacists now answer these information lines.

1986

At the BC Drug and Poison Information Centre, nurses join the existing staff of pharmacists and consulting physicians, toll-free poison information services now available province-wide.

1988

The federal Poison Control Program ends and, along with it, annual reports produced from national data.

1993

A toll-free poison information number for southern Saskatchewan is established in Regina and another in Saskatoon for northern Saskatchewan but with no dedicated staffing.

1993

IWK Regional Poison Centre is established at the IWK Hospital in Halifax, Nova Scotia. Specialist trained nurses and pharmacists answer the poison information lines. A physician toxicologist joined the centre in 2005 and a complement of emergency physicians offer medical backup.

2001

Saskatchewan contracts with Poison and Drug and Information Service (P.A.D.I.S.) in Alberta to provide comprehensive poison service to Saskatchewan through a dedicated toll-free number.

2003

The Quebec centre moves and comes under the jurisdiction of the CLSC-CHSLD Haute-Ville-Des-Rivières.

2005

The centre at the Hospital for Sick Children becomes the Ontario Poison Centre after a poison centre at the Children’s Hospital of Eastern Ontario in Ottawa closes.

2007

The Ontario Poison Centre enters a partnership with Montfort Hospital in Ottawa and opens a satellite site to ensure provision of services in both English and French.

2016

Partnership between the Federal Government, Chemical Emergency Management & Toxicovigilance Division, Environmental Health Science & Research Bureau, Health Canada and Canadian Poison Centre establishing CSSPI (Canadian Surveillance System for Poison Information).

2021

Membership votes to change the name of the Canadian Association of Poison Control Centres to the Canadian Association of Poison Centres and Clinical Toxicology.

Accessing product information: a key challenge

When the Canadian Poison Control Program started in 1957, patent and proprietary medicine formulas were registered in the then federal Food and Drugs Directorate. Because of confidentiality, only selected information was given to a physician on direct request or in an emergency. In 1965, there was no regulation that allowed for product information to be given to poison centres.

To address this problem, Health and Welfare Canada collaborated with industry and manufacturers to establish a voluntary mechanism to collect and distribute product formulations to the poison centres. The federal government product database was maintained and distributed until 1986 when the program was cut.

In 1988, this responsibility was handed over the Canadian Paediatric Society (CPS), which agreed to receive Canadian product formulations from industry and manufacturers. The CAPCC decided that the needs of its members would be best served by incorporating the Canadian data into the existing U.S.-based POISINDEX database that was presently being used by all members.

The Canadian federal data files were downloaded into the POISINDEX system and updates provided. Late in 2005, the Ottawa Regional Poison Centre based at Children’s Hospital of Eastern Ontario, which up to then had maintained POISINDEX entries, closed. After this, only a limited amount of Canadian information has been sent to be included in POISINDEX.

Some Canadian companies, primarily industrial, submit their product information to the centre for Occupational Health, based in Hamilton ON, which maintains a database on potentially poisonous products used in workplaces.

The Canadian Association for Poison Centres and Clinical Toxicology

Canada’s Poison Centres

Eligibility for certification includes:

Poisoning statistics

Our Mandate

Accessing product information: a key challenge

The Canadian
Association for Poison Centres and Clinical Toxicology